On Mississippi’s Gulf Coast, a community network steps up to increase Vietnamese language access to healthcare

By Anna Hu | Originally published by Mississippi Today

As a young teen in 1960s Saigon, Vietnam, Coi Nguyen learned English by listening to tape recorders and comparing her speech to the cassette’s. When her friends teased that there was no one to practice with, she responded, “I talk to the machine.”

Now, Nguyen lives on Mississippi’s Gulf Coast, where she volunteers for the local Vietnamese community as a translator and interpreter at doctor’s appointments and legal hearings. Sometimes, Nguyen said, people will give her a tip or take her out to a meal. But for her, the work is not for the money. It’s because of her connection with a community she’s lived in for the past two decades. 

“Everybody knows me as a friend, a family,” she said. 

The Coast is home to half the state’s 9,000 Vietnamese individuals, who represent one of the largest Asian diasporas in Mississippi. Despite the size of the community, local healthcare workers say there are only a handful of Vietnamese-speaking medical providers in the area, creating challenges for those with limited English proficiency. The persistent language barrier has pushed a network of Vietnamese speakers and volunteers to take matters into their own hands, carving out time to help neighbors navigate the healthcare system. 

Nguyen, who is semi-retired, describes herself as an easy-going person with the time to help anyone, especially if they’re a good cook. Working in her apartment kitchen under the guiding eye of a lucky cat figurine, she makes calls and scans documents for her neighbors. She records every appointment in her handmade “little book,” which is filled with names, times and addresses scrawled in both English and Vietnamese. 

Her roster includes those who would otherwise have put off care and some who most potential volunteers didn’t have the patience for. She remembers one woman in particular whose personality neighbors found hard to handle, and who later needed psychiatric care. 

“I feel like, if I don’t drive her, who will? And if I don’t help her, who help?” she said. “It takes me a little more time, but that’s okay.” 

A need for better language access

In the 1970s, large numbers of Vietnamese refugees started arriving in New Orleans, fleeing the fall of Saigon and the conclusion of the Vietnam War. They then gravitated toward Biloxi for work in the seafood industry. 

By the 2000s, roughly 5,000 Vietnamese people lived in Mississippi, one of the largest such communities in the Deep South, according to data from the U.S. Census. 

To’s family lived in public housing surrounded by Vietnamese neighbors. Like many Vietnamese children in the area, she was the bridge between her family and their English-speaking surroundings. 

“When I was growing up, I was the interpreter,” she said. “I interpreted for my parents. If they had surgery or whatever, I skipped school and went to surgery with them.”

It was never a comfortable experience, she said, because relaying medical jargon was difficult as a child. Neither To nor her parents knew specialized medical terms in Vietnamese. 

The barriers in language access to healthcare that To experienced growing up remain present on the Coast today.

The Singing River Health System, a major regional provider, saw over 700 Vietnamese patients in the past year, of whom over 60% likely needed interpretation or translation services, a hospital spokesperson said.

Hospitals that receive federal funding are required by the U.S. Department of Health and Human Services to offer “meaningful access” to language assistance, although there is no government enforcement of the policy. Many have third-party services, such as LanguageLine Solutions, to connect healthcare providers with virtual interpreters. 

However, many Vietnamese-speaking patients prefer to have an in-person interpreter, according to Cynthia Le, a bilingual nurse practitioner at the Singing River Health Medical Clinic in downtown Biloxi. She said she is one of the handful of Vietnamese-speaking healthcare professionals who grew up on the Coast and stayed to serve her community. She uses her Vietnamese daily, and patients are often referred to her because she is fluent in their native tongue. 

“I still have a good bit of Vietnamese patients that don’t have the family support or can’t speak the English language at all,” she said. “It’s just easier for them to speak directly (to me) than go through another person to translate.” 

In her two decades of practice, Le found that speaking to patients in Vietnamese allows them to have more agency in their own care because they understand why their medications are important and are more likely to accept preventive care, such as cancer screenings.

“I have a lot of patients that don’t want to go do their colonoscopy because they don’t have anybody (who speaks Vietnamese) to take them,” she said.  

A network of volunteers and grassroots organizations step up to fill gaps

Many children, young and adult, accompany their parents to medical appointments as interpreters, multiple healthcare providers said. But as younger generations start their careers and have their own families, some, including Le, have seen the number of family interpreters on the Coast drop.

To meet the need for in-person interpretation, volunteers and community health workers step in.

Dat Thanh Phung, Nguyen’s grand-nephew, immigrated to Mississippi from Vietnam seven years ago and followed her into the insurance broker business. In between studying for his accounting degree and taking care of his young family, he volunteers to help his insurance clients with their doctor’s visits. 

“They let me know before, one week, and I will fit my schedule to them,” Phung said.

Phung is still practicing English himself, so he’ll often call clients to go over their symptoms in advance, making sure he knows how to say those symptoms in English.

“I just want to make sure that I understand 100% about the sickness and what medication they need,” he said. 

For Phung, the motivation to help others stems from his own experiences stumbling through language barriers, like when he took 14 visits to the DMV to fill out permit paperwork.

He’s heard his clients talk about not wanting to go to the emergency room because they wouldn’t be able to speak to the workers. Instead, he said, they “absorb the pain.” When he helps interpret, Phung said that he can assuage some of that worry and that clients often invite him to a meal as thanks. 

Nguyen spends much of her free time helping people who can’t go to the doctor on their own. She said one woman only trusts her to accompany her to physical therapy appointments, and another always asks if she can sleep over at “Ms. Coi’s house.” 

Over the years, she’s gotten to know the personalities of her repeat clients, whom she also sees at church, in the restaurants and local supermarkets.  

“I get to the point that I know people inside out,” she said. 

Organizations seek to broaden access

Outside of volunteer efforts, one of the only organizations supporting Vietnamese language access to healthcare in the Gulf Coast area is Boat People SOS. The nonprofit helps community members set up appointments, sends interpreters to doctor’s appointments and connects people with Medicare-covered transportation. 

Nguyen worked part-time at Boat People SOS shortly after she moved to Mississippi from Canada, and got connected to other local efforts to improve healthcare access. One instance is when she was tapped by the Mississippi Department of Health in 2021 for their COVID-19 Vietnamese Task Force to lead vaccination outreach for the community. 

Like many of the people she helps, Nguyen lives alone in Biloxi. Her daughter, Annie, is in nursing school and works in a hospital 90 minutes away. 

Three years ago, Nguyen lost her son Peter, who was living in Canada at the time. His passing is another reason she finds fulfillment in her volunteer work. 

“If I am alone and then have nothing to do, I will miss him and I cry all day, you know? But talking to people and helping them fills up my time,” she said.

There are limits to Nguyen’s efforts. While she has heard of others in the community who will offer rides or help with interpretation, most don’t have the dedicated time that she does or the longstanding knowledge of each person’s history. She said she worries about the people she will one day leave behind, especially those that she drives to appointments because they physically cannot drive or don’t own a vehicle. 

Nguyen added that the number of Vietnamese-speaking providers and volunteers remains limited. She said she wishes for more organized financial support from the city or state to help patients access healthcare through organizations such as Boat People SOS. The low-income Vietnamese community and those who don’t speak English at all are most vulnerable, she said. 

“I’m 65 years old, I cannot stay here forever,” she said. “But if I’m gone, who help them, you know?”

This story was produced as part of the AAJA VOICES fellowship program, a student journalism project of the Asian American Journalists Association (AAJA).  

This story was produced with support from the Sarah Yelena Haselhorst Fund for Health Journalism.

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This article was originally published by Mississippi Today and is republished here under a Creative Commons license.

Source: Original Article