Reflections of a Bilingual Labor Coach

||STORY||

On Saturday morning at 6:50AM I was jolted from my dreamless slumber by a loud phone call from my co-labor coach. Our patient had called her at 4AM and said she was going into labor.

I am a volunteer labor coach through Asian Health Services in Oakland, CA. Most patients are new immigrants from China who only speak Cantonese, so I help them through the labor process by interpreting what the doctors say to her, teaching her breathing and pushing techniques, and act as her emotional and physical support during the labor.

YES. MY FIRST LIVE DELIVERY. EVER. It was truly epic. EPIC! I picked up my co-coach from the bart and we rushed to Highland Hospital in Oakland, where the patient was already having contractions every eight minutes.

I proceeded to introduce myself, and told her that I was the interpreter from Asian Health. I tried to make small talk with her so she could focus her pain on something else, and chatted lightly about what the baby’s name was going to be, about the color of the baby’s room, of the chicken-ginger soup her mother-in-law was cooking for her. The doctors rushed in and out of the room, anxious to see how dilated her cervix was. The nurse who stood by me asked me to translate for her and asked for me to reposition her body and to console her through the wrenching contractions. Her husband stood by nervously, eager to understand what was going on in the blur of English sentences and half a dozen of medical staff coming in and out of the room.

I stayed by her hour after hour, wiped the sweat off her forehead. When the contractions became more frequent, grabbed her hand, and told her to concentrate. I told her in Cantonese that she was doing great—that if she could conserve all her energy and push as hard as she could, the baby would be out.

And to make a long story short........ Yes, I saw a real live vaginal delivery. The patient was in labor for four long hours. Yes, there was a boatload of blood, gore, pus, vaginal fluid, pee (they deflated her bladder using a catheter!), poop (the baby pooped), hair, amniotic fluid (water broke), genitalia, umbilical cord, a gigantic and fleshy placenta..... and more. She didn't use an epidural or any other pain medication.. she just ... toughed it out.

To anyone who doubts the pain and agony that a woman goes through labor and delivery.. ask any mother or have one of your own. I offered my hand for her to squeeze quite a few times during her contractions. I could barely feel my fingers afterwards.

What blows my mind is how strong and persevering the mother was. She just overcame the pain and worked so incredibly hard to push out her beautiful baby boy, and really, when I saw the head of the baby come out, I nearly cried from joy and relief and just pride for what she had done. It was beautiful….Absolutely surreal.

The baby boy's name is Eric. He came out healthy but what delayed his delivery was he had trouble getting out since his hand was reaching upwards and the umbilical cord was dangerously wrapped around his neck. After the delivery, the mom was getting stitched up (the doctor said that her vagina was "really torn up") and she asked me if I wanted to hold her newborn. I hesitated at first (I doubted my own child-rearing / child-holding abilities) but she insisted and there I was, holding this little life in my arms that was less than an hour old. I was at a total loss of words..................

||REFLECTION||
Despite the long hours and the sporadic nature of being a labor coach, I continue to volunteer because I know that these people really need me and our services. There really is no one else there for them. I can’t imagine being pregnant and checking into a hospital but not knowing the language or being able to communicate with the medical staff. Thus, to participate in such an intimate situation with a total stranger, where I see a breathing, crying baby emerge as a result of coaching makes me proud that I could help, and grateful that the delivery was a success. Through a common language and culture, I am happy that I was able to impact someone’s life.

||COMMUNITY||

If you are interested in becoming a volunteer labor coach, check out asianhealthservices.org and contact Thuy for more information. There are training sessions every several months, and AHS is always looking for interpreters who speak Cantonese, Vietnamese, Mandarin, Tagalog, Khmer, Mongolian, Lao, Korean, and other languages.

Do young adults care about health care?

I remember growing up having my parents take me to the dentist every 6 months and seeing the doctor every two years. I'm 24 now and haven't had that privilege since I graduated from UCLA 2.5 years ago.

I would think that a degree from UCLA and having a traditional upbringing in a Filipino household would teach me how to be more responsible in the real world. But this is a reality that many recent graduates face; not understanding health care.

Check out this article from The Sacramento Bee about what college grads face once they lose insurance...

http://bit.ly/GradsandHealthInsurance

This issue also brings another issue at hand. How much do people, educated or not, understand or care about in our current health care system?

Lately I've been following issues in the health care debate. Why isn't it affordable? What will people lose in this new health care reform? What will people benefit from this health care reform? And, most importantly, how can communities better understand what health care means to them?

In an ideal world people will talk about this. They will analyze it and they will advocate for their beliefs. Unfortunately, a good chunk of the uninsured population are in the 18-29 age range. And, a lot don’t know much about health care. If you have read the article I set a link to above, readers have left interesting comments regarding their take on young people not understanding healthcare. Some of the comments amaze me but make sense to a degree...

"Sorry, but, considering the fact that the majority of our society is overweight/obese and/or has some preventable chronic disease (due to smoking, drinking, not exercisizing, poor eating habits), I just have very little sympathy for this situation. Stop thinking that society owes you something; go out and earn for yourself. You'll actually appreciate what you have."

and

"The reason this is a story is that young people don’t use ins. The premium goes to those unhealthy people that do use the system. Sure they have the highest rate visits to the emergency room."

I get it, but who in their 20s know exactly how to take care of themselves? And how many people (of all ages) go out of their way to understand steps to (good) health care, much less health care in our economic and national crises?

As the health care debate heats up around our nation, it makes me wonder who in our nation has the most impact in changing the health care system. People like me I guess.

My thoughts…

1. 
   As a post grad who has a good future ahead for myself, I still grapple with understanding the health care system. (I’m still young and naïve. I learn best through growing pains like this.)


2. 
   If people my age could begin to question their status as far as health care is concerned, maybe it can further develop their understanding of what role they play in the health care system…
   
3. …hence leading up to people actually advocating for a better health care system for themselves and even more, for their communities.

FYI...

Get Involved! Young Advocate Leadership Training (YALT)

I just wanted to inform folks of a great opportunity. The Children's Defense Fund (CDF) is offering a program called the Young Advocate Leadership Training (YALT) to undergraduates, recent grads, and young professionals. The purpose of the program is to help develop and strengthen the leadership and advocacy skills of young people. This year the program will be focusing on healthcare reform. Participants will be taught new tactics and strategies that can be implemented in their communities and on their college campuses.

This would be a great way for Asian American and Native Hawaiian Pacific Islander youth to engage in discussions about health care reform 2009 and health issues affecting them and their communities.

The CDF is accepting application for their fall YALT program Oct.2-4.

If you are interested please check out their website:

http://www.childrensdefense.org/helping-americas-children/youth-development-leadership-training/young-advocate-leadership-training-yalt-program.html

HIV & Feminism in Vietnam

My teacher and I went in a hospital to talk to HIV patients. We talked to one. (On a side note, it was SO ODD to me that no one checked us in and we just freely walked in and picked a bed and random patient to talk to and even weirder that he was willing to answer our questions and share about his personal history. I guess one of the differences between US and Vietnamese culture.) He contracted HIV from "relations" which I assume to mean an extramarital affair or he hooked up with a prostitute.

His wife was with him and she didn't even wanna get checked! I told her she should really get checked. If I were her, I'd definitely be PISSED...one, because she might have HIV now and two, because he cheated on her and in the end, who is taking care of him? her. I guess I'm especially irritated because it seems like such a NORM for Vietnamese men to do...extramarital affairs or prostitutes (variations of...massage, at a bar, at a cafe shop, comes with beer, on the street)...a sign of manhood. And women in Vietnam are expected to take it like their grandmothers, their mothers, their sisters, and their neighbors...they all take it. Vietnamese women are PRAISED for their sacrifices...for the crap they have to put up with. Just in Malaysia, a Vietnamese women who was in Malaysia to work told me about how her husband would beat her several times a day and she still stayed for the kids. Finally it seemed like he was trying to kill her and with advice from her daughter, she finally left.

I asked him how he knew to get checked. He had a fever that wouldn't go away and then he went into the hospital and got several scans that seemed ok and finally they checked his blood. This particular hospital in Saigon (or this particular building) is for HIV patients when they turn bad...like their health is taking a turn for the worse. Otherwise, they should just be taking their medicine regularly outside of the hospital. I was most curious about prevention. Did he know how to protect himself? He said no, and he also said he didn't think enough...I'm not sure what that answer means. I asked him about sex education in school...he didn't go to school. He worked in the rural areas, and a lot of poor children or children in rural areas stop going to school. What I did read about sex education in VN though is that it's very biologically based and hard to understand. I also asked him now that he knows he is infected, has anyone told him what to do to protect others. He said nope, they just give him medicine a couple times a day. That's terrible. That information is CRUCIAL!

I was talking to one of my other teachers...his wife is part of an organization that counsels HIV patients...I am planning to call to see how I can help. Health education is SO SO important and part of this situation breaks my heart because that knowledge is a privilege that I often take for granted as a Public Health major but important knowledge that they didn't have.

Medical system in VN

I've made an active effort to learn more about the medical system here.

My doctor friend took me on a tour of the hospital and answered my questions (when I volunteered to teach English in SF, one of my students turned out to be a doctor in Saigon...crazy where connections can take you).

So I always think the doctors in America don't give each patient enough time. Vietnamese doctors are seeing about 20 patients an hour. I was like....what the???! How is that possible unless they walk in and out the door. Also, each hospital has another floor for people who are willing to pay more...the floor isn't amazing. There's still a bunch of beds in one room and all the patients can see each other..and those are the good rooms. They said that if they had money, they would also have curtains like in America. The emergency room is just a big room with a bunch of beds and sick or injured people laying on it waiting to be seen or pushed into the appropriate department.

Health insurance is given only to the selected few...health care providers automatically have it. Right now health care insurance in Vietnam is all public, but according to the doctor I talked to, only 30% of the population have it...it's really hard to get it, even if you have money. Furthermore, right now they are trying to switch to universal health care insurance.

Abortion is legal here and seems to be done pretty frequently...for younger girls (under 18), they need parental consent...but not really. Money solves all, and it's such a taboo here that the doctor will just do it anyway rather than make the girl deal with family reputation and such being lost. One of my Vietnamese friends (a few years older than me) says a lot of her friends have gotten pregnant and gotten abortions already.

That's pretty much all I know for now.

Dr. Koh Confirmed as HHS Assistant Secretary for Health

Koh confirmed as assistant secretary at HHS
By Jennifer Lubell
Posted: June 22, 2009 - 11:00 am EDT

HHS Secretary Kathleen Sebelius announced the Senate’s confirmation of Howard Koh, 57, as HHS’ assistant secretary for health.

The former Massachusetts public health commissioner “is a world-renowned public health expert and physician who has devoted his career to promoting prevention and wellness policies and reducing health disparities,” Sebelius said in a written statement. “He will be an outstanding assistant secretary for health, and we look forward to his expertise and advice when it comes to making America’s families healthier and our health system stronger.”

Koh, an associate dean for public health practice and director of the division of public health practice at the Harvard School of Public Health, will oversee major health agencies such as the Centers for Disease Control and Prevention, Food and Drug Administration and National Institutes of Health. He will also serve as the leading health adviser to the HHS secretary.

Koh previously served as Massachusetts’ public health commissioner from 1997 to 2003. At the Harvard School of Public Health, Koh has served as a principal investigator of multiple research grants related to community-based participatory research, cancer prevention, health disparities, tobacco control and emergency preparedness.

The Yale School of Medicine alumnus completed his postgraduate training and chief residencies at Boston City Hospital and Massachusetts General Hospital, Boston, and has earned board certification in internal medicine, hematology, medical oncology and dermatology, as well as a master’s degree in public health.

First Asian H1N1 Death

It's on everyone's mind: Swine flu, or H1N1 flu. What we have to understand is that media coverage in other countries is by no means similar to how it is within the United States. During my trip to China, every time I turned on the TV, I'd hear about someone being quarantined, or how many new cases have popped up. So you wonder how much worse things are going to get once this hits:

First Asian Swine Flu Death Reported

The first swine flu death in Asia is being reported in the Philippines. A 49-year-old woman with heart and liver ailments has died after contracting the virus.

The woman died at her home on Friday, June 19, two days after she first showed symptoms of the virus.

Although

post-autopsy results show that the death was caused by congestive heart failure and pneumonia...

and not H1N1 directly, there's no telling how this piece of news will affect government regulation and action regarding this pandemic.

A more personal story about my experiences with the swine flu scare in China coming up later.

AmbT

Illinois legislation to create colorectal screening and threat

eNews Park Forest, "Riley, Demuzio Team Up to Create Cancer Screening
Program"

June 22, 2009

http://www.enewspf.com/index.php?option=com_content&view=article&id=8369
:riley-demuzio-team-up-to-

create-cancer-screening-program&catid=1:latest
-local-news&Itemid=88889791

Springfield, IL-(ENEWSPF)- State Rep. Al Riley (D-Olympia Fields) and
state Sen. Deanna Demuzio (D-Carlinville) passed legislation out of both
chambers of the General Assembly this session to create the Colorectal
Cancer Screening and Treatment Pilot Program in parts of the state with
the highest number of deaths due to colon cancer.

"People without insurance coverage need to be tested for this too-often
fatal cancer before it is too late," Riley said. "Illinois residents are
dying everyday because of a lack of awareness of colon cancer and
because they are unable to afford potentially life-saving screening and
treatment."

Under Senate Bill 270, the Department of Public Health will provide
grants for the colorectal cancer screening and tests in areas that have
high rates of fatal colorectal cancer. The screening and treatment will
be provided to people without health insurance who are 50 years of age
or have a high risk of colon cancer. Testing will also be available to
those who have exhausted their current health insurance benefits. The
program will spread public information about the importance of screening
and reach out to people eligible for the program in participating
communities.

"Colorectal cancer often has no symptoms, which is why regular screening
is so important," said Demuzio. "I lost my husband to this disease and I
want to do everything I can to help prevent others from dying of colon
cancer."

The bill had support from the American Cancer Society.

According to the American Cancer Society, colorectal cancer is the 3rd
most commonly diagnosed cancer among Illinois residents and causes over
3,000 deaths a year. Screening is essential to catch the cancer in its
early stages and reduces mortality by detecting a higher proportion of
cancers when they are more treatable.

"Screening and early detection will lead to successful treatment for
colon cancer," said Dr. K. Thomas Robbins, Director of the SIU Cancer
Institute at Southern Illinois University School of Medicine. "Senate
Bill 270 is a worthy program that will save lives and cost to the health
care system."

"I am passionate about seeing this bill become law because I have no
doubt it will save lives," said Sheila Strong, American Cancer Society
advocacy volunteer. "I have lost dear friends and loved ones to this
disease. How many more people have to die because they can't afford
life-saving screening? Like the Illinois Breast and Cervical Cancer
program that has saved the lives of so many, I truly hope to see this
measure have that same success."

Senate Bill 270 was sent to the governor's desk for his signature on
June 12.

HEALTH REFORM – ALERT

From: REHDC (Racial and Ethnic Health Disparities Coalition)

healthalliance@comcast.net

A “We the People” NATION-WIDE RESPONSE IS URGENTLY NEEDED NOW

Circulate/Distribute (Use your email list - phone list)

The Health Reform bill is too silent on the elimination of racial and ethnic health disparities! Health Reform will not include you if you don’t speak up and speak out! And, get others to help. Congress is working on one of the most important bills about your health for now and generations to come. You must Get Involved! Stand up now for all of US. Action on health reform is moving quickly.

ACTION: Call your two Senators today at 202-224-3121

[This is the capitol switchboard service – they are very helpful. So, if you don’t know your Senator’s name just tell them the name your state and they will connect you. Do not hang up; do not give up. A phone call is more effective right now because the Congress is moving so quickly; however, if you just to want to email go to senate.gov Whether you call or email, Just do it! You can make that critical difference in health reform]

Tell your two Senators that the health reform bill must:

· Include the elimination of racial and ethnic health disparities in all sections – insurance, prevention, quality, community services, and workforce

· Authorize, strengthen and adequately fund the Office of Minority Health, and Offices of Minority Health at the Department of Health and Human Services including the CDC, FDA, SAMHSA, CMS and other key agencies

· Include a National Strategy to End Racial and Ethnic Health Disparities

· Protect prevention and wellness

The Congress must hear from you NOW!– Now is the time for health reform for all of America’s residents and this will not include all of us if there is not a National will to end racial and ethnic health disparities! YOUR VOICE IS NEEDED NOW!

Watching TV before you go to bed

Watching TV before you go to bed gives you a bad night's sleep and can lead to chronic health problems, scientists have claimed. Read more at http://healtnhappyness.blogspot.com/