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In the lobby of a South Philadelphia medical clinic, the phrase “Welcome” is written on a wall in 30 languages.
The word is not widely spoken in Chinese, Hindi and Thai and other languages. In America.
Philadelphia has nearly 80,000 residents who were born in South, Southeast or South Central Asia, but the Hansjorg Wis Wellness Center is one of the few medical providers in the city who are familiar with the unique needs of this community. Elsewhere, making a doctor’s appointment or getting care in an emergency room can be difficult.
The center includes workers like Gao Vang, who this past summer became fluent in Hmong, a language spoken in parts of Cambodia, Laos, Vietnam and southern China.
“When I come here and see my own language on the board, I’m like, ‘What! I’ve never seen this before,’ she said.
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The center, a partnership between CEMAC, an Asian American advocacy group, and Jefferson Health, combines medical care with services to help people with English language skills, housing insecurity, and Internet and technology literacy.
Of particular concern is hepatitis B, a concern of Asian and African immigrants.
between Asian immigrants are “people who can’t fill out forms, who don’t speak English,” said Esther Heo-Tong Castillo, founder and program director of the Chinese Immigrant Family Welfare Initiative at the Philadelphia Chinatown Development Corporation.
“As refugees, many of them lack the confidence to go to places where they don’t know they are safe,” she said.
Even hospitals with translation services can struggle to understand cultural differences. Hepatitis B, a liver disease that can lead to cirrhosis and liver cancer, highlights the ways in which a lack of cultural understanding and ignorance in the medical community can have significant health consequences in immigrant communities.
There are about 2.2 million cases The virus in the United States, and more than half of them are reported by Asian Americans. This is because the virus has spread in some Asian countries, say experts. While the vaccine is recommended for infants in the United States, it is less common in other countries, making screening and vaccination of foreign-born Asian Americans critical.
Hep B United Philadelphia, a local coalition to raise awareness of the virus Less than 10% The city’s Asian, Pacific Islander and African residents were screened or vaccinated against the disease.
Philadelphia’s best estimate is 22,000 people in the city are living with hepatitis B, said Danica Cuncio, manager of the Philadelphia Department of Public Health’s viral hepatitis program. Between 35% and 45% of the city’s newly reported cases are Asian or Pacific Islander.
“It’s a silent killer,” said associate dean of health disparities at Temple University’s Lewis Katz School of Medicine.
In 2020, the virus killed 1,700 Americans.
Ma is studying how sociohistorical trauma, cultural stereotypes, anti-Asian bias, and mistrust of health care systems hinder hepatitis B screening among Southeast Asian Americans, particularly those from China, Korea, and Vietnam.
“When we look at disparities, we really have to look at structural factors, racism and implicit bias,” she said.
The virus is not well known For most primary care physicians, Catherine Freeland, associate director of public health research at the Hepatitis B Foundation, said.
“Providers frequently misinterpret test results,” she said. “If you talk to someone in medical school, they don’t spend a lot of time on Hep B.”
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2020 survey Additionally, 40% of Philadelphians at high risk of contracting the virus were uninsured and 70% of those infected did not have a regular health care provider. Tests for this virus, as well as others Conditions like high cholesterol, diabetes and tuberculosis can be very expensive for some.
The virus can be transmitted sexually or through drugs, although the most common mode of transmission among immigrants is mother-to-child transmission.
Carrying the virus can lead to discrimination and migration to other countries, Freeland says, making people wary of testing. Stigmatization of an infection means that some are not diagnosed or require vaccination or treatment.
“Giving people this test should be done very carefully,” said Dr. Jessica Deffler of Jefferson, who works at the Wiss Center. “A lot of people are shocked or worried when they get that diagnosis.”
The Wiss Center opened in the Bock Building in March 2021 near South Philadelphia’s large Asian community to serve diverse cultures and ethnicities.
Ming Tio, 75, an immigrant from Indonesia, doesn’t speak enough English to wrangle $800 in medical bills. He learned through a friend who could help him. Retired worker Theo described the treatment. In the year Debt related to a car accident in 2021 is “worrisome”.
“He knows it’s the bill, but he doesn’t know what to do with it,” said Evelyn Kourniadi, a Wis outreach worker, as she passed out the bills.
Slowly, over a phone call where Kurniadi helped Tio and a Jefferson employee communicate, she made her way to understanding the bills.
Kurnyadi says she is often approached by five people a day to make sure they are being heard by health care and social assistance agencies.
In addition to the languages spoken by the center’s staff, the clinic uses iPads with the CyraCom app to connect doctors with translators who speak hundreds of languages.
The app was a vital tool for 67-year-old Tong Trinh, who came to the Wis Center with knee and leg pain.
“Seven months ago, my left leg was weak, but my right leg was completely fine,” the Vietnamese immigrant, who came to the U.S. in 2006, said through an interpreter. “In the last seven months, I started having pain and weakness in my right leg.”
Trin’s hearing loss, as well as misunderstandings between him and the interpreter, made the conversation halting and sometimes frustrating. However, Dr. Deffler of Jefferson, Wis., was able to talk to him about his illness, advise him on how to schedule his medications, and prescribe Tylenol and blood pressure medication.
She points out that cultural competence can be taught.
“It’s about listening and being open,” she said.
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