UCLA School of Public Health Field Studies Program


Community Health Sciences

Field Placement: Kokua Kalihi Valley Comprehensive Family Center
Location:
Honolulu Hawaii
Preceptor:
Zavi Brees-Saunders, MPH
Student Name: Wingshan Lo
Year: 2005

I interned for 10 ½ weeks during the summer of 2005 at Kokua Kalihi Valley (KKV) Comprehensive Family Center in Honolulu Hawaii. KKV offers medical, dental, and psychological services, WIC, family planning and perinatal counseling and health promotion programs, like exercising classes for the elderly. KKV is located in Kalihi Valley, known by most locals as the second worst neighborhood on the island of Oahu. The community around KKV is very ethnically diverse, with 30.0% Filipino, 23.0% Samoan, 11.4% Other Pacific Islander, 8.9% Unknown, 8.1% Hawaiian, 5.7% Micronesian and 3.8% Laotian. Most of the residents are low income or immigrants who have Limited English Proficiency (LEP). Because of its rich cultural diversity, KKV is on the forefront in providing quality of care that is culturally and linguistically sensitive. KKV have bilingual staff that speak 21 different languages, create programs that are appropriate for the diverse community to be receptive of and established long term relationships with the people in the community since the early 70s.

My main project I worked on this summer was the Cross-Cultural Bridges (CCB) program, which is a 3 year grant from the Office of Minority Health that was created to alleviate the linguistic and cultural gap between the growing number of immigrant, LEP population in Hawaii and Hawaii’s health care providers. So far, untrained interpreters have been used to bridge this gap, but they do not have the skills to be an effective communicator for the providers and patients. Untrained interpreters do not know how to be the cultural broker. For example some cultures consider it rude if they are told directly that they have a serious illness or are going to die. Some physicians may tell patients that their traditional alternative ways of medicine is not valid and they should only use Western type medicine. Also, some untrained interpreters fail to convey everything that is said. When physicians use untrained interpreters as a way to break the barrier, they often may get different messages of what the patient may convey and vice a versa. This can lead to frustration, noncompliance and in the worse case scenario, death for the patient.

As an intern, I worked closely with the CCB program director Merina Sapolu and CCB program coordinator Emmy Davison, to meet the program’s first year objectives to; 1) increase the number of health care paraprofessionals to be trained medical interpreters, 2) increase the number of University of Hawaii medical residents to complete a minimum 1-hr Cultural Competency and Working with Interpreter training workshop that increases their knowledge on health disparities and provides culturally and linguistically competent health care services and 3) design a culturally appropriate prenatal care program.

Because the CCB program is the first structured medical interpreter training program in Hawaii, other hospitals and health clinics are allowed to send their staff to complete the training for free. At the same time, KKV works closely with medical residents to teach them techniques and build their awareness about the cultural and linguistic barriers that they may face and the consequences that can arise when they work with an LEP patient and an untrained medical interpreter. Eventually the ultimate goal of the CCB program is to build enough awareness at the community level to bring system level changes, such that this type of training can be provided not only for the surrounding community of KKV, but for all of Hawaii.

 

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