Cultural (IN)competence

I'm cutting and pasting this from my previous blog, because I think it belongs here. originally posted it in December of 2006, but unfortunately still feel just as angry about this experience!

Cultural (IN)competence

I'm still reeling from my experience with the last training in "Delivering Culturally & Linguistically Competent Care" at a NYC hsopital today. These trainings are usually 3 hours long, and we deliver them to staff of hospitals - from security officers to senior doctors - at the request of HR departments that are fraught with lawsuits for previous discriminatory occurences.

I don't even know where to begin. Just about every right-wing, republican, immigrant-hating, uninformed, ignorant, racist, stereotyped belief one can imagine was uttered at some point during this training, which was attended by all those in this hospital that was putting off the Cultural Competence training.

At one point I just felt like breaking down, holding my knees and burying my head between my legs. I couldn't take it. Que horror.

They hurled everything from "well they don't pay taxes - so why do they deserve health care?" to "why isn't there a law that forces people to speak english?" to "well then tell them to get documented" at me. A whole big group of them sitting in the back of the classroom - mostly EMT workers - wonderful to know that when a Mexican calls an ambulance its one of their racist asses that is going to pick them up.

There were a couple "sympathizers" - a doctor in the back of the room that contradicted a doctor in the front of the room that insisted "nobody is ever turned away from this hospital" by reminding the group that things like Emergency Medicaid doesn't cover everything that could go wrong, and if the undocumented patient has diabetes, or cancer, or a mental health issue that's "non-emergency" then they will and THEY HAVE been turned away – in fact, from the very facility that I was training at. Another guy (that, by the way, bore an uncanny resemblance to like Jerry Springer) - with some button that i think had a liberal slogan on it - reminded everyone that: 1) nobody is "illegal", 2) immigrants do pay taxes, 3) undocumented immigrants get taken advantage of BY the system because its easier for their employers to keep them undocumented and keep paying them under the table and 4) people may especially have a hard time wanting to help undocumented immigrants b/c it doesn't help that their skin tone is generally brown.

I wanted to hug him.

I tried all i could, and I was literally at some points having to shout at them to keep all hell from breaking loose, because folks were yelling things, being so rude, not at ALL listening to what i have said nor reading the slides it seemed b/c they would constantly repeat a question i had already covered or ask a question that was already answered by the data i had presented. One can imagine how long it took to get through this slide which talks about how much immigrants contribute via payroll taxes. Oy vey.

I shouldn't take all this personally, but when I read the comments at the end of the session, they said things like "this was just liberal propoganda" or "too much political correctness". Why is it that people aren't willing to at least dialogue? This reminds me of when Al-Jazeera English launched in the US, and folks were calling in to NPR saying that they didn't want a "terrorist" station, a "biased" news source in this country --- isn't all media biased? So a point of view other than yours is being expressed --- listen to it, you don't have to agree, but then DIALOGUE and present your points. They sat there and went on about how the hospital is bankrupt because of immigrants, how the health care system in this country is suffering because of immigrants, without any real numbers to back up their claims. I told them to read the facts --- that that is clearly NOT true. I quoted articles, studies, I showed them stats on sales & income taxes, I spoke to them about how people contribute and how all deserve to be treated, and the SYSTEM is what we need to fix, not those immigrants. they don't want to open their mind - they don't want to know the facts. so then what do we do???

I sat there and heard all their discriminatory rantings and their frustrations --- now, I KNOW its difficult to do what they do, to be out there every day on the ambulance or in the hospital and answer to the needs of all these patients - many of whom they can't communicate with - many of whom THEY see getting all these "perks" in life, and they insist that despite their frustrations, they treat all the patients the same - like family.

But don't the poor, the undocumented, the non-white members of our family have to suffer their attitude on some level? Can't they feel the frustration, the envy, the scorn, on some level? Especially when it comes to voting - and when the poor, undocumented brown voices are not heard and what IS heard (because its all that CAN be heard since many that we are fighting for don't have voices) is the voice of the privileged, middle & upper-class, white, English-speaking, frustrated-with-immigrants (when they should be frustrated at the SYSTEM) workers like these???

So then i ask, those of you that have read this far and are also sympathetic: what can we do? there must be a way. There has to be some way, besides 3-hour long sessions where people are unwilling to hear what we have to say anyways, that we can inform people of the contributions immigrants make, of how much they pay in taxes, of how little of the health care system they actually ever get to see, how high their uninsurance rates are, how much they want to learn english but can't because they can't get past the 200,000 people ahead of them in line for ESL.

Do we have to write more "the health-of-immigrants" articles in the local papers, indicating immigrants' contributions along with their barriers? Pass around pamphlets? Speak to politicians? I mean, yes, of course we can do all this -- but is this enough? And if not, then what is the answer??

Help, friends – I know together we can find more answers...