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by Sister Joanna Bruno
It has been an interesting and challenging two months working as a certified medical interpreter of Spanish at the Avera Downtown Clinic for the uninsured. It is the only free clinic for the uninsured in the state.
But let me go back in time a little. In 2015, Aberdeen Presentation Sister Liz and I returned from our mission in Guatemala. On reaching South Dakota, we found an empty apartment adjourning the apartment of Presentation Sisters Janet Horstman and Sheila Schnell, who started Caminando Juntos (Walking Together), a free legal service for the undocumented along with English classes. It is a sponsored ministry of the Aberdeen Presentation Sisters, as is the Avera free clinic.
Sister Joanna Bruno takes up new ministry as interpreter to Guatemalans and others in South Dakota.
Liz officially retired at 88 years of age and, as she says, “It takes me all day doing that.” I was given a year sabbatical by my San Francisco community. I volunteered as an interpreter at the downtown Avera free clinic as well as the Avera Behavioral Health Hospital. Word got around that I was a volunteer Spanish interpreter and I found myself interpreting for two immigration lawyers for two families seeking asylum from El Salvador.
When it was time to start investigating a ministry, it didn’t take long for me to realize that medical interpretation in South Dakota was really a growing need. When a medical interpreter is not present, then the “blue phones” Cyracom system is used. A marvelous nationwide system to fill a great need, it never-the-less has its limitations. In health care nothing replaces a human interpreter for clarity of language and culture.
The growing population of Latinos coming to the heartland is mindboggling. What are they coming for? Jobs! South Dakota has the lowest unemployment rate in the nation and too many jobs for the population! What are these jobs? Meat-packing, dairy farms, poultry farms, roofing, construction, carpet laying, road building, landscaping, housekeeping and cleaning offices and hotels to mention a few.
Fast forward to the present, through a grant from the Conrad Hilton Fund for Sisters and in collaboration with Caminando Juntos and Avera McKennan Hospital, I was hired. I am finishing my second month on staff at the clinic. From the outside it looks like any other downtown clinic. On the inside it is a mini United Nations. While I only interpret for the Latino population, there are many ethnic groups represented. Families from Somalia, Ethiopia, Eritrea and other African nations. The African immigrant population in South Dakota is 34.5%. It is a common sight to see a tall thin elderly African woman walking the clinic hall wearing her chaningay, her tribal dress and using a well-used walking stick.
The Latino population represents the countries of Puerto Rico, El Salvador, Honduras, Mexico and Guatemala. By far El Salvador and Guatemala represent the largest number represented at the clinic. The 2011 census showed the Latino immigrant population in South Dakota is 26.7% and growing. Other immigrants coming to South Dakota are from Asia, 34.5%, Europe, 16.3 %, and Oceania, 0.6%. Also seen at the clinic are our own Lakota Sioux Native Americans and of course the Homeless.
Another phenomenon is that many of the medical residents that work at the clinic are from India, Egypt and other Middle Eastern and Eastern countries. The supervising doctors are native born. Along with the doctors, nurses, secretarial and cleaning staff, there is a social worker with whom I share an office. Robyn works miracles getting funds from various state and county agencies to pay for the diagnostic procedures, special lab tests and surgery that are done at the main hospital campus and that run in the tens of thousands of dollars. The Avera Foundation absorbs much of this cost. Much of the social worker’s job is to get people onto Medicare/Medicaid if they meet the requirements or get them onto food stamps. Since most of the applications are in English, I help the patient fill out the forms.
My average day starts at the reception office calling the Spanish speaking patient, reminding them of their coming appointment. Then, I help the secretaries register a patient, many of whom the secretaries know by name. Then, they go through the doors, where the nurse takes the weight and height of the adult or child. In the exam room the nurse takes the vitals and interviews the patient as to medications, safety issues, travel history, allergies and more. The resident enters and does the interview and examines the patient and then reports to the attending physician. All pretty standard stuff that all of us have probably experienced. During the waiting times after the nurse and before the doctor arrives, I chat with the patient and gently approach the issue of immigration status. By this time we have established a relationship and they are willing to tell me. If they don’t have papers I refer them to Caminando Juntos and give them a flier of the services.
This one day, I was having a difficult time understanding one of our male patients from Guatemala. I apologized to Dr. Jean for taking so long, “Doctor, this gentleman is speaking a second language also. His native language isn’t Spanish, it is Quiche, an Indian dialect from the highlands of Guatemala.” She was so surprised that there were other Indians coming into the clinic. I told her that the majority of the Latino patients coming to the clinic were speaking Spanish as a second language.
In another consult with a Latino man, we were both struggling in Spanish trying to find the right word. I told the doctor that the man spoke Tzutujil, another Indian dialect from the highlands of Guatemala. The patient asked me where the doctor was from, I interpreted to the doctor who smiled and said, “China!”
Out in the reception area I spotted an elderly woman wearing a typical Indian skirt from the highlands of Guatemala called a corte. I asked her what part of Guatemala she was from. She said the
capital. When I told her I had lived in Guatemala for 14 years, she smiled and as if to test me and said, “Where?” I told her Solola and San Marcos. She said, “I grew up in Quetzaltenengo near Solola.” I asked, “Do you speak Quiche?” She responded, “No, Cachikel!” Small world!
Every day I am amazed at how people are able to leave their homeland for various reasons, for the opportunity to raise their families in a safe secure environment. The first generation has the hardest and most difficult time, oftentimes being exploited, making $7.00/hour if they don’t have all their papers. Many hotels would be closed if these service workers were no longer available.
As the sisters of Caminando Juntos send us their clients for free health care, I send them our patients for free immigration advice. It is a nice collaboration of efforts and the living out of the lesson of Jesus to welcome the stranger.