Breaching Barriers of Culture and Understanding

Holy Cross Links Immigrants With Health Professionals Who Speak Their Language

Several years ago, shortly after arriving in the United States, Lyubov Belyayeva suffered a massive heart attack. She had left Russia to be with her daughter in Silver Spring, and she spoke no English.

In her mid-60s at the time, she'd had high blood pressure but no inkling of a heart attack. "There is no history of heart disease in my family," she said in Russian. "I think stress brought on the heart attack."

The American health-care system was a mystery to Belyayeva. She was used to no-cost, centralized health care, where seeking second opinions for simple ailments was acceptable, even expected. What's more, she had no insurance and needed her daughter to translate the complex information her U.S. doctors conveyed.

But many of the potential pitfalls in Belyayeva's experience were mitigated by a program in which health educators, including foreign-educated doctors, help recent immigrants.

A few weeks before her heart attack, Belyayeva had sat through a Holy Cross Hospital seminar in Russian, in which she had learned how to access health care and even received information about heart health. She had enrolled in the Silver Spring hospital's financial assistance program and ended up paying virtually nothing for her care.

The health education program, she said, may have saved her life.

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Immigrants are the new face of Montgomery County. In a 2003 United States Census update from the Montgomery County Planning Department, 30 percent of county homes had a foreign-born head of household or a foreign-born spouse.

This change in the population calls for adjustments in delivering care, said internist Irene Dankwa-Mullan, program director of public health services in the county health department. The concept of going to a doctor for checkups is novel to many minorities and immigrants, she said.

Dankwa-Mullan's department, along with local hospitals, have therefore created education programs that focus on minority and immigrant populations. Their goal? To save costly emergency room admissions.

The program in which Belyayeva participated, the Holy Cross Hospital Ethnic Health Promotion Program, uses community leaders and laymen to teach prevention in the immigrants' languages and in the context of their various cultures. Sometimes the topic is prenatal care or breast health; other times, it's quitting smoking and heart health. The program started in 2001 and is run by the hospital's director of community health, Wendy Friar.

Friar is enthusiastic about developing one particular source of help: foreign-trained doctors who cannot practice medicine in the United States. Who better to overcome the many challenges immigrants face, Friar thought, than a doctor who not only speaks the language but understands the system his participants come from?