MONTAGNARD WOMEN CAN CONNECT HEALTH SERVICES AND COMMUNITY
•Project •Who Benefits? •Urgent Need •History •Selecting health team members •Community cooperation and legitimization
Community to Campus Collaboration. Khin H, a Montagnard woman and public health worker in her village for ten years, speaks to grad students in Dr Sharon Morrison’s public health class. Some in the class had attended Dega Day in Asheboro in order to improve their knowledge of the refugee community. During the class students conducted health interviews with Khin and other visiting Montagnards about diabetes and got first hand experience working with diverse populations.
Project
The importance of creating a Community Health Team became apparent as discussion about scholarly research into Montagnard health problems among a core group of interested parties turned from plans into action. Through a collaborative process built on mutual interests, we’ve worked in stages, developing research instruments, obtaining community and university support, and identifying and training health team members. Research topics on family health and food security suggested older women and mothers who could be trained as acceptable interviewers and translators within a short time frame and whose capacity-building costs could be offset by the value of the survey data they gathered. Possibly, this approach might model similar efforts undertaken with other refugee groups in the region.
Who Benefits?
Without objective data it's difficult to analyze or understand longstanding problems of the Montagnard community or target solutions for funding. Specific health information is valuable to many stakeholders such as city and county service agencies, state-contracted refugee agencies, faith-based organizations, area health providers, academic teaching departments, researchers seeking future grants, etc. Other stakeholders can immediately benefit by working with the Community Health Team. For example, the women will be available to work with nurses in the Congregational Nurse Program, part of the Moses Cone Health System, to help deliver better health information to Montagnard individuals and families.
Kwol Ksa, who arrived in the US in 1992, is a member of the Koho tribe. She is interviewed by UNCG public health grads. Touger Vang (face partially hidden), is a Hmong refugee also from Southeast Asia. Since the Montagnard population represents many languages (7+) and at least as many dialects, it is nearly impossible to find an individual who could reliably gather data from everyone. Kwol and Khin will pool their skills and work together.
Urgent Need
Who Benefits?
Without objective data it's difficult to analyze or understand longstanding problems of the Montagnard community or target solutions for funding. Specific health information is valuable to many stakeholders such as city and county service agencies, state-contracted refugee agencies, faith-based organizations, area health providers, academic teaching departments, researchers seeking future grants, etc. Other stakeholders can immediately benefit by working with the Community Health Team. For example, the women will be available to work with nurses in the Congregational Nurse Program, part of the Moses Cone Health System, to help deliver better health information to Montagnard individuals and families.
Urgent Need
It seems that few health studies exist on this unique population although the Montagnard community has been here for decades. While there have been plenty of anecdotes suggesting the breadth and seriousness of their health problems, it appears no concerted effort has been made to gather and analyze data. For example, the size of the population has not been known and census information had not been collected until this year (2010) through a project I worked on conducted by Montagnard Dega Association using modest grants from the Asian American Justice Center and Southern Coalition for Social Justice.
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| Sodium examples in the Asian diet. |
Concerned about the urgent health needs of the Montagnard community, Teresa Sullivan, a Reading Connections volunteer, Eugene Pierce, a member of United Montagnard Christian Church (UMCC), and I, then working with Montagnard Dega Association (MDA), met with Carolyn O'Brien, the Moses Cone Hospital Congregational Nurse Program's RN working at UMCC in late December, 2009. Together we coordinated a blood pressure clinic at Montagnard Central Highlands church. On January 10, we held the first ot two blood pressure clinics with over 100 participants attending. Contributing organizations included Reading Connections, whose volunteer teachers Teresa and Adele Filip spearheaded the effort to bring in volunteer nurses, and MDA which provided translators and taught lifestyle education. In March, we held a follow-up session during which time participants reported improved results based on lifestyle changes.
The results and community interest and cooperation were encouraging. Our follow discussion recognized that similar clinics had been held in the past, to be revived as Montagnard and American resources and interests came together. What was missing that prevented better health in the Montagnad community?
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| Community blood pressure clinic |
We had built a lot of collective experience working with the community at the blood pressure clinics and gained technical expertise overcoming difficult translation problems through the 2010 Census, we had demonstrated our need for health data from the community, identified tentative funding, we had supportive training and health literacy resources, and in a pinch, we had space in the form of our living room now converted into a meeting center.
The last challenge was then to consider who could bridge the cultural divide. Who could carry on the day to day work of gathering data? Who had the time, sustained interest and motivation, cultural and language skills? Who would be perceived as the least threatening, least riven by past community differences? Who could approach individuals and families and ask intimate questions?
Selecting Health Team Members
Because of the small number of translators in the community , it became clear that gathering data and conducting interviews would require more workers, preferably those familiar with neighborhoods and community problems, who spoke Montagnard languages, and who could ask personal questions about families and health. I consulted MDA Executive Director Y Siu Hlong, who suggested the names of a female college student and a recently graduated male nurse. The first I believed would be too young and might lack status; the second I believed was over-qualified and committed to building his career. (However, these names and others that came up in the course of discussions suggested that we could work towards a network of Montagnard professionals who could work with and support a community health team.)
Eventually, Khin H was selected because of her past experience as a village health worker, her spoken and written knowledge of Jarai and Vietnamese, her progress in English class and her capacity to learn. She was strongly recommended by Betsy Renfrew, MDA ESOL Director, and Stephanie Cheston, MDA employment specialist.
Kwol Ksa was selected as the second team member based on her spoken knowledge of other Montagnard languages including Koho, Bunong, Bahnar and Sedang, her familiarity with many Montagnard community members and practical experience helping families and especially women adjust to American life. She has also acted as an informal translator in her community and assisted Betsy Renfrew document Montagnard weaving. Both women are mothers with adult and young children. Both women were subsequently interviewed by Mandy Benson of Project Shine and Dr Jigna Dharod, approved, and hired.
Community Cooperation and Legitimization
Community Cooperation and Legitimization
Empowering mothers to take on important community roles could be controversial. In the past, divisions and differences caused numerous breakaway churches, rival organizations and continued self-identification by Montagnards according to tribe and language. With so many competing interests, American legitimization and authorization of the team is important to insure it has time to train, work, and produce results. The women carry bright blue UNCG satchels and will prominently wear ID badges they themselves requested, anticipating doubters and naysayers. They've been trained to introduce themselves as Community Health Team workers, UNCG employees who work for Dr Dharod and Mandy Benson, with day to day supervision, training, and technical support provided by me and additional ESOL and health information support provided by Betsy and Jennifer. Eventually the women will gain acceptance by their own efforts. But building legitimacy and gaining cooperation from the larger Montagnard community will take time.
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Laughable Spin
The below material was written up by ex-LFS workers unfamiliar with the project, Montagnard health workers, or community health problems
Americorps hires Montagnard Women for special project
posted Dec 2, 2010, 8:32 AM by Leilani Roughton
There has been a lot of discussion in
the community about the importance of creating a Community Health Team
that focuses on scholarly research into Montagnard health problems.
Through a collaborative process built on mutual interests, we’ve worked
in stages, developing research instruments, obtaining community and
university support, and identifying and training health team members.
Research topics on family health and food security suggested older women
and mothers who could be trained as acceptable interviewers and
translators within a short time frame and whose capacity-building costs
could be offset by the value of the survey data they gathered. Possibly
this approach might model similar efforts undertaken with other refugee
groups in the region.
Khin H, who arrived in 2009 was
selected for this project because of her past experience as a village
health worker, her spoken and written knowledge of Jarai and Vietnamese,
her progress in English class and her capacity to learn. She was
strongly recommended by Betsy Renfrew, MDA ESOL Director, and Stephanie
Cheston, MDA employment specialist.
Kwol
Ksa was selected as the second team member based on her spoken knowledge
of other Montagnard languages including Koho and Bunong, her
familiarity with many Montagnard community members and practical
experience helping families and especially women adjust to American
life. She has also acted as an informal translator in her community and
assisted Betsy Renfrew document Montagnard weaving. Both women are
mothers with adult and young children. Both women were subsequently interviewed by Mandy Benson of Project Shine and Dr Jigna Dharod, approved, and hired.
Congratulations to Khin and Kwol for this wonderful opportunity to help the entire Montagnard community.
