A Fresno family got coronavirus. Advocates say language accessibility could’ve prevented it
Government agencies and interpreters have rushed to make sure information about COVID-19 is available in various languages — but some hospital patients are falling through the cracks, according to at least one Fresno-area advocacy group.
Naindeep Singh, the executive director of the Jakara Movement, says he’s heard several accounts in which medical providers rely too heavily on bilingual staff rather than provide interpretation and translation services.
Just like with other health issues, language access and literacy could affect health outcomes related to COVID-19, research shows.
One person spoke to The Fresno Bee about her family’s experience at Clovis Community Medical Center. The Bee agreed to only use her first name, Simran, and not identify the family since they fear being stigmatized for having coronavirus.
”I think it’s really important to have these procedures in place now. If you’re not informing people, especially people from different backgrounds who speak different languages,” Simran said. “I think the hospitals should do their due diligence and do that. They can’t just brush it off to nurses and doctors who speak another language.”
Community Medical Centers says it offers interpretation services 24/7, and employees who are bilingual wear special badges.
California and federal laws require hospitals to provide language assistance services.
Fresno family’s experience
When Simran’s mother was discharged from Clovis Community Medical Center in late March, she assumed she just had a bad cold and would quickly recover.
Simran said hospital staff didn’t clarify with her mother that the results of her COVID-19 test were pending and she should continue to isolate herself. She went home and continued to care for her family, cooking meals for them and sharing common areas.
“The assumption was that since she got the coronavirus test and they let her go home, nothing was wrong,” Simran said. “She walked out thinking she was absolutely fine.”
Eventually, Simran’s mother, father, brother and sister all tested positive for COVID-19. Her brother was hospitalized and feared he wouldn’t survive. Since then, the family has recovered.
When Simran’s mother got the call confirming she tested positive, the test result wasn’t why she panicked.
“She had mixed emotions, being a mother and wife and thinking she put everyone’s lives at stake,” Simran said.
Because Simran’s mom showed symptoms of COVID-19, she went to the emergency room alone. The hospital didn’t follow up with the family, Simran said.
She said her mother told hospital staff she understands English, but she wasn’t informed interpretation services were available and did not seek them out. Hospital staff did not offer them, either, Simran said. She’s lived in the U.S. for more than 30 years and understands English, but she is more comfortable and confident in Punjabi, her native language.
Simran and her family wish hospital staff would’ve taken steps to ensure her mother understood the care she received and instructions upon returning home, whether in English or Punjabi. Sending her home with pamphlets of information was not enough, Simran said.
‘Our entire community suffers’
Singh, the executive director of the Jakara Movement, wrote what Simran’s family says happened to her mother in a letter to the Clovis hospital.
“The family is suffering due to a lapse in communication, but in their suffering, our entire community suffers,” he says in the letter. “We feel that it is critical that we take immediate steps to mitigate such lapses and reduce the number of potential safety hazards arising therefrom in the future.”
Singh says in the letter that family members often served as reliable aides for patients who need translation. But with new coronavirus policies in place at hospitals, family members can’t accompany patients.
In Fresno County, nearly 19% of residents ages 5 or older do not speak English well, according to 2017 estimates from the Census Bureau’s American Community Survey. Spanish, Hmong and Punjabi are the top languages spoken at home, outside of English.
Tania Pacheco-Werner, a research scientist with Fresno State’s Central Valley Health Policy Institute, said language access and literacy with coronavirus information affect health outcomes, just like it does for other diseases, such as diabetes.
“The same access issues people were having before COVID, they’re still going to have them and they’re going to be augmented because we’re in crisis mode,” she said. “If we didn’t have infrastructure to really communicate with folks about this before, it’s going to be hard to catch up and do that now.
“This is why we need such a broader infrastructure of community health workers that are culturally and linguistically competent,” she said.
Hospital services
Community Medical Centers officials could not comment specifically on the case of Simran’s mother due to privacy laws. Hospital officials say in a statement to The Bee that collaboration from community groups is welcomed.
Community Medical Centers, which operates four hospitals, provides certified interpreters 24/7 for patients whose preferred language is not English, according to the statement from Mary Lisa Russell, a public relations specialist. The hospitals serve a population that speaks 100 different languages and comes from a variety of cultural backgrounds.
“We ensure with every patient that we communicate in their preferred language,” the hospital’s statement says. “Using certified in-house interpreters, we are able to serve patients and families in their language of comfort.”
Interpreter services include the Health Care Interpreter Network, American Sign Language services and a language line to access 3,000 interpreters, 170 languages and bilingual employees. Employees wear special badges showing the additional language they speak, such as Spanish, Hindi, Hmong, Punjabi, Farsi, Vietnamese and Laotian.
“Diversity and inclusion is a cornerstone of our patient care. We welcome any assistance from local community groups that represent our region’s rich and diverse populations to help us provide outstanding service to all of the patients we serve,” the statement says.