Residentes guatemaltecos de Kansas que hablan idiomas mayas k'iche', akateko, q'anjob'al y aguacateko hablaron con Alce su Voz el sábado sobre lo que sus comunidades necesitan para lograr equidad en salud. La conversación tuvo lugar en nuestra primera reunión con la comunidad maya en Arkansas City, un pueblo en la zona rural del centro-sur de Kansas, cerca de Oklahoma. No fue una sorpresa para nuestro equipo que uno de los temas más destacados en la conversación fuese la necesidad de que el personal y los proveedores de entidades de atención médica entiendan que los miembros de la comunidad maya no necesariamente hablan español. Sus idiomas forman parte de la familia lingüística maya y se hablaron durante miles de años antes de la colonización española y, sin embargo, muchos habitantes de Kansas creen erróneamente que son dialectos del español.
Nuestra coordinación para la comunicación multilingüe en la reunión del sábado reflejó las necesidades lingüísticas de la comunidad: la reunión se facilitó en español y se interpretó en tres idiomas mayas diferentes; los participantes se sentaron de acuerdo a su idioma para que cada grupo pudiera escuchar a los intérpretes en su propio idioma, discutir temas en su idioma y luego permitir que un intérprete informase a todo el grupo en español. En un momento dado, una enfermera que asistió a la reunión compartió información en inglés, uno de nuestros intérpretes interpretó dicha información al español, y los intérpretes de lenguas mayas transmitieron el mensaje a los que estaban sentados en sus mesas correspondientes.
El proceso de interpretar del inglés al español y luego del español a una lengua maya se denomina interpretación por relevos, y a veces es necesario para una comunicación eficaz con los hablantes de ciertas lenguas menos habladas.
Un grupo de mujeres que hablan k'iche' asistieron a la reunión y compartieron que en las citas de atención médica mediadas por un intérprete de español, a menudo asentían con la cabeza por educación, incluso cuando no entendían lo que se les decía. Cuando solo se utiliza interpretación en español con hablantes de lenguas indígenas, los mensajes se pueden perder.
As mentioned here previously, there is a simple technique called the teach-back method that healthcare workers can use to avoid miscommunication between clinicians and patients. Teach-back means that clinicians or clinical staff ask patients to explain what they have understood about their health condition and plan of care, to confirm understanding. Research has shown that the teach-back method improves patients’ health outcomes.
In addition to the language barrier, some meeting attendees shared that they face an additional obstacle in not being able to read. At one table, an Akateko-speaking family said that they had been denied care by a local healthcare institution because they were not able to fill out the intake paperwork since they could not read it. Relatedly, one K’iche’-speaking family shared that they regularly hired a Spanish translator to help them to understand the instructions for their prescription medications.
Pharmacies, like other healthcare entities, are required by Title VI of the Civil Rights Act of 1964 and Section 1557 of the Affordable Care Act to provide language access services to patients who need language assistance. This includes explaining medication instructions in a language that the patients can understand. There is also a movement for dual language prescription labeling in some states, a practice that could benefit minoritized language communities in Kansas.
When we asked about access to vaccine information, the participants shared that local healthcare institutions have not provided them with information about vaccines in Spanish or in their native languages. One person who attended the meeting said that he first learned about the COVID-19 vaccine when he traveled to Wichita to attend Café con Leche, an annual health fair for Spanish-speaking families. Others shared that they were vaccinated because they were required to do so at work. Cost was also a barrier to being up to date on vaccines for many participants, and other participants shared information about payment plans and where to receive support.
In the past year, Alce su Voz has collaborated with Mayan community members and healthcare leaders in Ark City, Dodge City, and Coffeyville to create a series of videos in Spanish and Akateko with information about vaccines and community members’ testimonies about why they chose to get vaccinated. You can view a video of Coffeyville community leader Guillermo Miguel sharing his vaccine testimony in Akateko.
At the end of our meeting, several participants shared that they were grateful that someone was paying attention to their needs and that they hope that soon Ark City will have a community health clinic where they feel welcome and cared for.
The Community Health Center in Cowley County (CHCCC) in Winfield provides Spanish language interpreters and is planning to open a clinic in Ark City in the coming years. CHCCC is also hosting our upcoming interpreter workshop, organized by Erika Vargas of Alce su Voz y Spanish Ad Hoc Translations, which will take place this Saturday, November 11, from 2-4pm at the Integrated Care building at 118 W. 9th Ave., Winfield.
There is much work to be done to improve healthcare access for Mayan communities in south-central Kansas, and Saturday’s workshop was a significant step in laying the groundwork for this process.
The Ark City meeting was organized by Margarita Francisco, a community liaison on our project who works for Head Start in Ark City, and Denise Romero, the Director of Community Engagement and Education for Alce su Voz and the Executive Director of Salud + Bienestar. Ms. Romero facilitated the meeting with help from Raúl Rangel, a graduate research assistant in the MA program in Spanish in Wichita State University’s Departamento de Lenguas y Literatura Modernas y Clásicas (MCLL).
As part of our initiative to improve vaccine access in Mayan communities in rural Kansas, Mr. Rangel is conducting a survey-based study on Mayan language speakers and access to healthcare in Ark City, Coffeyville, Dodge City, and Liberal. Collected under the mentorship of English Professor Dr. Mythili Menon, the coordinator of Wichita State’s Applied Linguistics program, Rangel’s data from across Kansas reflects similar barriers to access as those discussed at Saturday’s meeting. In his research, he has identified seven different Mayan languages spoken in Kansas. With the exception of Q’anjob’al and Akateko, these languages are not considered to be mutually comprehensible with each other.
Alce su Voz is grateful to the Increase the Reach program for funding this initiative and to the Cowley County Local Health Equity Action Team (LHEAT), part of the Communities Organizing to Promote Equity (COPE) program, for providing gift cards for the Cowley County meeting and workshop participants.
In our previous conversations with healthcare leaders in Cowley County, where Ark City is located, we have observed the presence of an emerging coalition dedicated to improving access to healthcare for speakers of minoritized languages in the region, and Alce su Voz anticipates an opportunity to support the coalition’s efforts by providing resources and educational opportunities.
We foresee that future collaboration in this region will include support for professional development and integration of promotoras de salud (community health workers) in the region’s health equity efforts with support from Salud + Bienestar and a continued collaboration with Wichita State University’s initiative Improving Healthcare Language Access for Spanish Speakers in Kansas, which is funded by a grant from the Office of Minority Health of the U.S. Department of Health and Human Services and led by Wichita State University Spanish Professor Dr. Rachel Showstack.
Alce su Voz es una coalición comunitaria cuya misión es mejorar la equidad en la salud para los hispanohablantes y los hablantes de lenguas indígenas en los Estados Unidos, con un enfoque en Kansas y el Medio Oeste. Nuestros programas actuales están financiados por subvenciones federales y por subvenciones obtenidas por Wichita State University y Wichita State University Foundation para proyectos interdisciplinarios dentro del Departamento de Lenguas y Literatura Modernas y Clásicas. Departamento de Lenguas y Literatura Modernas y Clásicas alcesuvoz@gmail.com. También puede unirse a nuestra lista de correo electrónico y seguirnos en Facebook.