​One of the challenges that many healthcare providers face today is learning to adequately provide care to a diverse set of patients. This is a problem that the hospital Health Bridges has partnered with, Pomona Valley Hospital Medical Center (PVHMC), also faces. One of the largest demographics that PVHMC serves is immigrants. Many of these immigrants are limited English proficient (LEP) patients, setting them up for confusion and frustration in a healthcare system dominated by the English language. To address this issue, Health Bridges has placed Health Advocates, such as myself, in PVHMC's ER to help uninsured LEP patients learn more about their health insurance options in their native languages.
 
Being a Health Advocate has been a rewarding experience. I have the opportunity to work directly with the LEP patients who speak Spanish. In particular, I help patients who are uninsured enroll for HPE, an emergency medical insurance that gives qualifying patients enough time to enroll in full coverage programs. Many of these patients do not know what options they have for health insurance. Patients are concerned about the costs of their ER visit, which adds to the stress of the medical emergency they are already facing. The service that Health Advocates provide offers a sense of relief to patients who qualify for HPE because they can focus on convalescing rather than on the financial burden they would otherwise have to confront. Thus, Health Advocates have the potential to make an already stressful experience at the hospital more bearable for patients and their family members. 
 
In addition to helping uninsured LEP patients, as a Health Advocate we also help nurses with other small tasks around the ER such as changing beds or helping visitors find their family member's room. This has been an eye-opening experience because as Health Advocates, we are directly immersed in the ER's fast-paced environment. Health care providers have many responsibilities in the ER, but they also want to make the patients feel comfortable. With their already packed schedules, nurses and doctors cannot always afford to give each patient the attention that they would like to. That is where volunteers come in. They can provide the smaller touches to ER visits that makes patients feel welcomed at the hospital. For instance, as a Health Advocate I have been asked to show visitors to their friend's or family member's room, get water and coffee for visitors, change beds, and help patients to the bathroom. These seemingly insignificant tasks help create a friendly and encouraging environment for patients and their families alike.
 
So, whether Health Advocates are helping LEP patients learn about their health insurance options or bringing a cup of coffee to a father who has spent the night in vigil at the bedside of his son, Health Bridges is making a difference at PVHMC.

​Last weekend, Hong, Sophia, and I drove to the home of the Wu family. For our fundraising campaign video, we spent the past week interviewing and filming nurses, hospital administrators, and Health Bridges coordinators to highlight the importance of what we do at Health Bridges. What we (and our intended audience) needed the most, however, was testimony from the patients themselves, so that’s why we were going to interview the Wu’s.
 
When we entered the house, we were greeted by a chorus of screams. The Wu’s had four little boys with boundless energy. They ran around, jumped on the piano, and climbed onto anything that was climbable. Since they couldn’t sit still by themselves while we interviewed the mother and father, I babysat the boys and made sure they didn’t injure themselves. As I watched them run, I was hit by a wave a nostalgia. The entire atmosphere reminded me of my childhood, from the rapid fire Chinese being spoken, to the aroma of Chinese spices in the kitchen, to the boys who looked and acted as I did.
 
During our interview with the Wu’s, we learned more about their situation. As recent immigrants from China, they spoke limited English. They met Hong in the emergency room in the midst of a family emergency. From their emotional accounts, it was clear that the anxiety from their emergency was exacerbated by the difficulty of navigating the American healthcare system. It was, simply put, frightening when you have trouble understanding what the doctor is saying and not knowing how much you will be charged. Thankfully, Hong was able to alleviate some of that burden and the Wu’s were grateful for our help.
 
My experience with the Wu’s reminded me why I was a part of Health Bridges. As students, we are so caught up in our schoolwork and our own problems that we sometimes can’t fathom the frustrations that arise from inadequate access to healthcare. But that is their reality. I hope that as Health Bridges expands, we are able to help more families like the Wu’s. 

Working as a Health Advocate for Health Bridges has really made me realize how much of a barrier language is to access to quality healthcare. To illustrate this point, I want to tell you about an experience I had at the end of one of my shifts.
 
It was 11:30 am on a Tuesday morning and my shift was winding down. My usual shift partner, the Spanish-speaker for our shift time, was getting ready to leave early in order to make it back to campus on time for another obligation. After she had left, a family came to the registration window with a small child. It soon became evident that neither parent felt comfortable speaking in English and that Spanish was their primary language of communication.

After struggling to communicate with the admitting staff, the family expressed that the child who needed care did not have health insurance. Panic began to set in as I realized that I would have to handle the HPE sign-up with my limited Spanish-speaking ability. (HPE, or Hospital Presumptive Eligibility, is a program offered through Medi-Cal that allows health care providers to sign patients up for a temporary Medi-Cal service that not only covers the cost of their visit but also covers them for an additional month. )

Now granted, I have been taking Spanish ever since 7th grade and grew up in Miami—a city where you hear just as much Spanish being spoken as English. But unfortunately, my Spanish abilities are limited strictly to academic functions—reading literature and writing essays, which are useful in school but not in a practical setting like a hospital.

Quickly, I began to run through phrases in my head in Spanish. Soy voluntario, puedo ayudarse. ¿Tienes seguro medico? As I approached the family I could feel my heart beating in my chest. To my relief, as I explained the HPE sign-up process in my broken Spanish, the family seemed to understand me. While filling out the sign-up form online, I paused as I thought about how to pose my next question.

Although I am quite sure I messed up many times, the family was patient and understanding while I struggled to communicate to them. Because she was so stressed about her son’s illness, the mother cried as I went through the HPE process and I tried my best to console her with my limited Spanish vocabulary. After the child had been approved for HPE, the mother thanked me profusely and said she was so grateful someone could communicate the process to her in Spanish.

Interacting with this family taught me an important lesson about how a language barrier can make seeking quality healthcare so difficult. When I could not communicate to the family exactly what I intended to say, I felt greatly frustrated. And I felt equally frustrated when they said something to me I could not fully understand.

​I imagined what it would be like if this was my only interaction with a healthcare provider and I could barely speak enough English to get all my questions answered and understand the doctor’s instructions. I think this experience really drove home to me the importance of the work Health Bridges is doing.