Elisabeth Bambara worked as a nurse for 10 years in her native Burkina Faso, but during a pandemic that has stretched hospitals to their limits, she can’t work as one in the United States.
Ten years later, Bambara is working the night shift as a nursing assistant at an assisted-living facility — and wishing she could do more.
“When you know you can bring that help, but you don’t have enough time to get the certification, it doesn’t make you feel good,” she said. “I have to fight for my life. I have to fight for my kids. I don’t have time to study.”
Bambara is one of hundreds of internationally trained health-care providers who have worked with Montgomery County’s Welcome Back Center to try to get the certifications to resume work as a registered nurse, physician or other medical provider in the United States. During the pandemic, many are especially frustrated that they aren’t able to use all of their medical skills to help.
Housed in Montgomery County’s Latino Health Initiative, which addresses disparities affecting Latinos in the county, the Welcome Back Center began its work 15 years ago over concerns about the lack of Spanish-speaking nurses in the county.
Each year, the center helps about 100 medical workers from all over the world obtain their certifications here, said Carmen Sáenz, the program’s director.
When internationally trained medical workers come to the United States, they can’t start working immediately. They must follow a lengthy process involving language and proficiency exams, some of which may be offered only a few times a year and all of which can cost hundreds of dollars. They have to gather transcripts and licenses from their home countries, some of which may have to be professionally translated.
The process can take more than two years for nurses. For physicians and dentists, it can be much more laborious, including completing multiyear residency requirements.
Even after passing the exams, getting a job can be difficult — creating a résumé and acing an interview in a second language takes preparation. As a result, many who are helped by the center initially take low-paying, entry-level jobs for which they are overqualified.
Still, an average of four medical workers a year are able to get certified to work in the United States with the help of the center, Sáenz said. This year, more than five already have succeeded.
“It requires sacrifices,” Sáenz said, adding that the novel coronavirus has forced many participants to put their goals on hold.
Lorraine Ponce Lujan, who trained as a physician in Peru before coming to the region and joining the Welcome Back Center in 2017, is working to become a physician in the United States. In the meantime, she’s working as a medical assistant. She said she also applied to be a contact tracer in May but hasn’t heard back.
“To have the knowledge and the skills to take care of patients and just have to sit back and do nothing about it because you are not certified in this country takes a toll on you,” Ponce Lujan said.
Across the country, 263,000 immigrants with health-related degrees are working in positions that require a lesser degree than they hold — if they are working in health care at all, according to the Migration Policy Institute in D.C.
In a county like Montgomery — where about a third of its residents are foreign-born — these medical workers, with their language skills and varying cultural backgrounds, are especially needed during a pandemic, when demand is heightened, the Welcome Back Center’s administrators and participants said.
“The increased need for health-care workers has nuances. Yes, we need more respiratory therapists, but we need more respiratory therapists that speak the languages and understand the needs of the communities most affected by the pandemic,” said José Ramón Fernández-Peña, who founded the Welcome Back Initiative, a national organization that has helped more than 18,000 internationally trained health-care providers from over 150 countries. “The workforce in the communities has to meet the language and cultural needs of these communities.”
The county’s Welcome Back Center is a chapter of the initiative.
Ponce Lujan said her background has helped her better connect with Latino clients in her work at a Montgomery clinic.
Rather than telling patients to socially distance, for example — which could be nearly impossible for those living in cramped, multigenerational apartments — Ponce Lujan said she’s found it more helpful to tell them how to be safer in those conditions.
Ana Ramirez, who was one of the center’s first participants, has been working as a registered nurse in Maryland since 2007.
Before she came to the United States, Ramirez had worked in emergency care and with the Red Cross in her native Colombia. Without the Welcome Back Center’s help, she said the process of becoming certified would have taken much longer. She didn’t know much English and was just about ready to give up on working as a nurse when she found the center. “We just need someone to open the door and let us prove that we have the skills,” she said. But, she added, “it’s hard to get that door open.”
For Bambara, it has been 10 years of managing little more than touching that door’s handle. But she has faith it will work out eventually, especially with the help of the center and other participants.
“I have that hope that I will get there one day,” she said, adding that allowing more internationally trained medical staff to work during the pandemic is paramount. “It will help foreign nurses. It will help the country. It will help all of us.”