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West African Patients Lost in Translation

Less than two weeks into his first visit to the United States in August this year, Kamissoko Cheickno began having unusual chest pains. The 55-year-old initially dismissed it as jet lag from his 13-hour flight from Mali to visit his daughter and nephew in the Morris Heights section of the Bronx. But persistent night coughs left his body weak. A private doctor in the Bronx decided Cheickno was medically fit after a brief examination, but the Mali native was not so sure. The doctor spoke only English, which Cheickno’s nephew translated for him into his native Mandingo. It was his first time he had spoken to a doctor through a translator. “It was like a wall, I could not talk with him directly,” Cheikno said later said through a translator. Two weeks later, Cheickno’s health had deteriorated. He was rushed to an emergency room and hospitalized for one week. “My blood pressure had gone high and the doctors found out that I had a kidney problem,” Cheickno said. The doctors who finally got the diagnosis right were part of the recently opened Diaspora Clinic, a new idea in health care designed to break down the cultural and language barriers between doctors and immigrant patients. The health facility associated with the Martin Luther King Jr. Health Center opened in June specifically for the growing West African immigrant population in the Bronx. It is staffed with West African volunteers who speak the various dialects of the region. Known as cultural brokers, the volunteers assist patients with registration and help translate for the doctors. “There is a limit to what the cultural brokers can do. They help patients feel at home, but patients must agree to having a third party in the doctor’s office before we use them,” said Sohaib Majeed, a medical doctor who works at the clinic. So far, the Diaspora clinic has registered 1,100 visits since it opened four months ago.

Kamissoko Cheickno (seated), with a blood pressure meter fastened to his arm, waits for a medical laboratory result on one of his followup visits at the Diaspora Clinic. (SELASE KOVE-SEYRAM/The Bronx Ink).

In 2008, the U.S. Department of Health and Human Services estimated that over 23 million people in America needed the services of specially trained in-person translators or telephone translation to communicate with doctors. Without translation, the consequences could be dire. President Bill Clinton passed a regulation in 2000 mandating that federally funded agencies must provide translators for speakers of minority languages. As a result, many hospitals created telephone translation services. These services allow doctors to call toll free numbers, where a specially trained translator brokers the conversation between doctor and patient. In spite of new telephone technology, the lack of direct human connection still often stands in the way. “From my experience, many West African immigrants I have worked with speak their local languages,” said Dr. Aboyemi Salako, head of primary care at the Lebanon Hospital. “Doctors who do not speak those languages cannot communicate.” Dr. Salako, a Nigerian immigrant, has realized the need for hospitals to communicate with this population for more than 30 years. Since 1985, more than 36,000 Africans have moved to the Bronx, most of whom are from the West African countries of Ghana, Guinea, Mali, Nigeria and Sierra Leone. Few speak international languages. More commonly they speak West African languages such as Hausa, Mandingo, Twi and Ewe. Before the Diaspora Clinic opened, health workers at the Martin Luther King Hospital found that many patients who speak minority languages ended up in emergency rooms. They tend to avoid early treatment due to language, cultural or economic difficulties.  “We reach out to West Africans because we want to emphasize the need for primary health care,” said Lionel Stewart, executive director of the hospital. Many patients now visit the clinic regularly for appointments with four specialist doctors who operate on Tuesdays, Thursdays and Saturdays. The clinic has a social worker, who helps those without medical insurance to sign on to what they require. For the unemployed, undocumented or temporary residents like Cheickno, the hospital provides charity care – at little or no cost. This goes beyond the language and cultural differences. A study published in a 2008 issue of Journal of the National Medical Association found most parents of pediatric patients were satisfied communicating with doctors by telephone translation services. It differs from other studies, which reported low satisfaction. Dr. Dodi Meyer, an Associate Clinical Professor in Pediatrics with the Columbia University Medical Center, said using human interpreters in a medical environment is ideal, but that is costly. Telephone translators are better than nothing.

Dr. Dodi Meyer argues that cultural brokers are very important as long as they don't violate patient rights. (SELASE KOVE-SEYRAM/The Bronx Ink).

“Those cultural brokers are very important to bridge the trust between the patients that we serve and the medical system,” she said. “You only have to be careful it does not violate the privacy of the patient.” Once, she remembers, a newborn baby with hip dislocation at birth had to be rushed to an emergency room because the non-English speaking parents could not read the instructions telling them to see a pediatrician regularly. “It almost got out of hand when the parents finally showed up,” she said. “That was a 100 percent case of language barrier.” One Thursday evening in October at the Diaspora Clinic, Cheickno was waiting with more than 12 patients for a follow up visit. Many of them had heard about the clinic in their churches or mosques. They knew either of two cultural brokers who were present. Cheickno was speaking in his native Mandingo with one cultural broker, Bourema Niambele, a Malian immigrant who has lived in the Bronx for 16 years. A former AmeriCorps worker, Niambele now owns a car-rental service in the Highbridge section of the Bronx. He was present on the day Cheickno got rushed to the emergency room. His health has improved since he came here, Niambele said. He gestured to Cheickno, who had a blood pressure meter fastened to his arm. “My blood pressure usually goes high and I’m glad I found this place,” Niambele translated from Mandingo to English.  

Posted in Bronx Life, Featured, Health, Southern Bronx2 Comments

One Dead After Exchange of Gunfire in the Bronx

One person is dead and a police officer is in a stable condition after an exchange of gunfire Wednesday night at the University Heights section of the Bronx. The NY1 reports that an off-duty police officer who witnessed a robbery was shot in the chest after he approached the suspects and identified himself as an officer. The officer pursued the suspects and fired two shots, which killed one of the suspects. Two other suspects are still at large.  

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Obama the Favorite in this Bronx Barbershop

Ghanaian immigrants watching Tuesday's presidential debate in a Bronx barbershop concluded that Obama deserves another term. (SELASE KOVE-SEYRAM/ The Bronx Ink)

Seated between two Hispanic women on the Number 4 train heading to the Bronx, a middle-aged looking African woman talked on her cellphone in a language that was a world away from her immediate surroundings. The woman was speaking Twi, a language that is common in the West African countries of Ghana and Ivory Coast. “As for today, Obama needs to pull up,” she said. After a pause, she continued, “If the other man wins, he’s going to put a tag reading ‘For Sale’ on all of us.” Her reference to the second 2012 presidential debate between President Barack Obama and Republican challenger Mitt Romney was clear. The debate would be live in less than 15 minutes. An estimated 14,769 Ghanaians live in the Bronx, the single largest group from an African country in the borough. A recent report from the American Community survey shows that Africans are the second largest immigrant group in the Bronx out of six continents. And even though they are more than 5,000 miles away from their homeland and many can’t vote here, they are deeply engaged in the current election. Inside a large barbershop on Walton Avenue in the Bronx Tuesday night, over a dozen men watched the live Presidential debate amidst cheers and catcalls. Aged  29 to 48 years old, they all identify themselves as Ghanaian immigrants. They said they were united in the view that health care, immigration and foreign policy are the issues they are most concerned about and they prefer Obama to Romney. Awudu Issu, 36, was one of the men. Looking calm in his green sweatshirt, he seemed removed from the discussion until the debate ended. When he finally spoke, it was with careful deliberation. His views of the two candidates are influenced by his own experiences. “I don’t support Obama because he is black,” he said.  “He is the U.S. President and I’m supporting him objectively.” Issu arrived in this country in June, 2011, on a Diversity Immigrant Visa Program, which gives permanent residence visas to persons who meet eligibility requirements set by the State Department. He now holds a green card and can access free medical care. A graduate of a technical university in Ghana, Issu works as a shop attendant in a Goodwill store in the Bronx. “I came to America because there are opportunities here for immigrants,” he said. “Obama is consistent with his message for people like us, but Romney is not.” He cited Mitt Romney’s response to Arizona gun control laws raised in the debate as an example. Issu worried that a Republican victory might disturb his plans of enrolling in an American university after making enough money from his current job because he said, “Republicans have more foreign policies which do not favor immigrants.” The owner of the barbershop, Kwame Agbo, 38, agreed. “We need somebody who can do the job and Romney does not favor immigrants in his statements,” Agbo said. Though a Ghanaian, he currently holds American citizenship after living here for the past 16 years. A registered Democrat, he said he is familiar with what many new immigrants go through. “It is not good to see people getting deported while trying to work on their immigration documents,” he said. He thinks Romney might do that. “I currently get a single check, and I have five kids,” says Gibrin Mohammed, 42. “Obamacare is something that would also help me, but Romney does not like it. I will go for Obama.” Like Agbo, Mohammed is also a Ghanaian immigrant who has been living in the United States for 16 years. He currently works as an undercover security officer in a Polo Ralph Lauren store. The barbershop punditry is a world away from what is happening in Ghana, where elections will be held in early December. The Ghanaians see a stark contrast with the electoral process in their homeland. In Ghana, a plan by a think tank to engage the presidential candidates in a debate has been postponed many times. The current series of debates is a chance to see American democracy in action. Kofi Addison, 29-year old assistant to Agbo said, “We are here, so this is home. When we go back to Ghana, we would be interested in that too.” Addison has been living in the Bronx for nine years and is now a registered Democrat. As the second debate ends, the mood in the barbershop was one of excitement. Addison turned to the other viewers and communicated in Hausa, a major West African dialect. He later translated: “I like Obama, because he cares for the middle class. In America, that’s how people survive.”

Posted in Featured, Politics, Southern Bronx0 Comments

Stop-and-Frisk Goes on Trial

Judge Shira Scheindlin of the Manhattan federal court today begins hearing allegations that the NYPD has been unlawfully stopping minorities under its stop-and-frisk program, reports The New York Post. A Columbia professor who has analyzed stop-and-frisk data and a representative of the Bronx District Attorney’s office, which has refused to prosecute some trespassing cases without first interviewing the arresting officers, are expected to testify for the plaintiffs. Click here for the BronxInk's special report on residents views of stop-and-frisk procedures in the Bronx.    

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Fire Destroys Fordham Heights Home

Fire gutted a home on East 184th Street in the Fordham Heights section of The Bronx early Monday morning. A video report by SkyFoxHD shows the house in flames before firefighters arrived on the scene. FDNY officials said the flames broke out at about 6:20 a.m. at 15 E. 184th St. near Walton Avenue. It was brought under control at about 8 a.m., an official tweet by the FDNY reported.

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The Bronx High School of Science and its Nobel Prizes

Since 1972, the Bronx High School of Science has produced eight Nobel Prize laureates. The New York Daily News takes a look at what makes this school unique. Interviews with current students show the school's strong foundation in science education.

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Bronx Science Graduate Wins Nobel Prize in Chemistry

Robert J. Lefkowitz , joint winner of this year's Nobel Prize in Chemistry is a graduate of the Bronx High School of Science, CBS New York reports. A statement issued by Schools Chancellor Dennis Walcott indicates that Lefkowitz is the eighth Bronx Science graduate to win a Nobel Prize.

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The Long Road to Affordable Senior Housing

When Ynocencia Reynoso, 68, applied for an apartment at the University Heights Senior Housing complex in 2009, she was put on a waiting list with more than 200 other applicants. Reynoso, a 68-year resident of University Heights, said that an apartment in the building was all she could afford. That’s the case for many elderly people in the area who end up on the waiting list. Many of them just wait, hoping to get in when a tenant moves out or dies. Reynoso had waited for three years when she finally received a phone call for a tenancy placement interview in July. The University Heights building, classified by the New York City Housing Authority as independent living, provides housing services for people 62 years old or older as well as those with permanent disabilities who cannot afford rent on their own. It is subsidized by the State Department of Housing and Urban Development (HUD) for eligible tenants. For the past 30 years, it has remained the only publicly financed apartment complex for seniors and the disabled in the neighborhood. “We are fully occupied all the time,” says Janette Fortier, senior manager of the building. “We have a waiting list of three to four years. People are living longer and there is no place to go.” When Reynoso applied at the age of 65, she was struggling with a back injury from a car accident, a condition that left her unable to work for seven years. Because of her age and disability, she was qualified to live in the building on two fronts. “I did not want to be a burden to my children,” she said. Although she received federal disability payments, she still needed to take on menial jobs such as babysitting to pay her rent in a single-bedroom apartment she shared with two others. One month after her interview in July, she was offered a one-bedroom studio that had become available a resident senior moved out. She pays $166 a month, approximately 30 percent of her federal disability benefits. “I am very happy now,” she said. “I am going to live here until I die.” A Real Need Her story has a happy ending, but hundreds more Bronx residents are still waiting for help. The University Heights building has only 105 apartments – ranging from one-bedroom studios to three-bedroom units. It currently serves 125 tenants (including couples). Out of this number, about 80 percent come from the University Heights area. According to the 2010 census, the neighborhood has 1,976 seniors more than it had in 2000, representing a 1.5 percent increase. Although the increase remains relatively low, no new low-cost housing has been built for seniors in the area. In the statement of needs submitted to the Bronx Borough President for the year 2013 on behalf of Bronx Community District 5, District Manager Xavier Rodriguez requested funding for senior housing. “It is one of the priority areas for this district,” Rodriguez said. “Though young, the population is getting older.”

The University Heights Senior Housing complex, has over 200 eligible seniors on its waiting list. (SELASE KOVE/ The Bronx Ink)

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