Community health workers tap shared experiences to ease new life transitions
When Peter Munyanganizi and Kabuo Kabira arrived in Alaska from Uganda five years ago, neither spoke English. They knew nothing of the United States, much less Alaska, with its shockingly different climate and long, dark days. Navigating this foreign new place was bewildering.
“But we were desperate to move somewhere safe,” says Kabira from their Mountain View neighborhood home in Anchorage, through a Swahili-speaking translator.
The Munyanganizi family, which includes five children ranging from 6 months to 13 years old, is among families receiving support and finding hope due to their partnership with a community health worker. Providence St. Joseph Health funds this health-equity program that enables community health workers to slowly build trust in vulnerable communities and create bridges to critical health and social services. The CHWs use their education, training, community partnerships, lived experience, and Providence Alaska resources to remove or reduce issues caused by difference in language, culture, negative past experiences, transportation, lack of insurance and health literacy.
Trained through an Alaska Department of Labor apprenticeship program, these liaisons seek out those who may be struggling and help them navigate the oftentimes overwhelming obstacles to accessing the services they need. Zabeeba Mohammed is one of four Community health workers employed by Providence. She came to Alaska from Lebanon in 2008 and said she remembers well the feelings she experienced at that time.
“It was very difficult,” said Mohammed. “There was the language barrier, the weather, the rules and the different culture. It was very difficult to find transportation, and doctor experiences were hard.”
Mohammed said she remembers a time when a doctor’s office barred her from scheduling anymore appointments after she had missed three in a row. She had newly arrived in Alaska and had to ride the bus, which meant she had to understand the bus schedule and get to her appointments on time. Often, she said, the bus was broken or late, compounding her dilemma. This simple barrier kept her from getting the care she needed.
“I promised myself if I learn to understand the rules, and the language, and the transportation, then I would help people like me when I could,” she said.
That is exactly what she is doing today. At the Munyanganizi home, she sets up her computer and works with Peter to get his family signed up for the public assistance for which they qualify. Peter works at a local bakery, his wife cares for the children. He said the biggest challenge for him is providing for his family. He wants to give his wife and children everything they need and is slowly starting to understand and speak English.
“I was the leader of the family (in Africa),” he said. “Here, I need help.”
Due to their own lived experiences, Mohammed and her fellow CHWs have an idea how Peter feels, which also puts them in the unique position to know precisely how they can help. Their shared experiences lend credibility to their advice, too. Not only do they help newly arrived refugees, but they also seek out those who may be experiencing homelessness, lack transportation or have other challenges limiting their ability to experience wellness. They go into homes and offer health education, help fill out paperwork for such services as housing assistance, Medicaid, and food stamps; provide nutrition education; and sometimes simply listen. Each day is different, and every individual’s needs are unique.
“The CHWs we hire have the ability to see and care for the whole person,” said Rebecca Valentine, senior manager of Population Health at Providence Alaska. “They take the time to listen, to provide hope, and remove the common feelings of ‘aloneness’ that vulnerable people often suffer. They understand the challenges faced, so they provide warm handoffs to important resources, walk the individual through learning processes or systems, and provide encouragement until they can move forward independently.”
For Mohammed and the Munyanganizi family, that trust was already there, because she has known the family for years. When their 4-year-old daughter Esta had a medical emergency, the family was catapulted into a medical system that they did not comprehend – a landscape that Mohammed has faced herself.
“Communication with the doctors can be hard,” she said. “I had a bad, bad experience with a knee surgery in 2011. Every time I went to the doctor’s office, I didn’t understand. And every day I cry. Every time, they asked me something I did not understand.”
Mohammed helped the couple fill out paperwork, and she explained the medical instructions that would help their daughter. She also has been working with them to adjust their diets to reduce or prevent the likelihood that Esta will face another medical crisis – another landmine of unfamiliar territory for a family accustomed to a different diet when they were in Uganda.
“Here, the culture is different,” Mohammed said. “There, the food is fresh, and they get it every day. Here, you have to buy frozen, and it is expensive.”
To help Kabira better understand, Mohammed took her to the grocery store to shop for healthy foods that not only would accommodate Esta’s new medical diagnosis, but also be eligible for purchase through food-assistance programs the family depends on.
After nearly five years in Alaska, Peter and Kabuo say they are beginning to adjust. Having support from Zabeeba Mohammed, and the other CHWs in the Providence family, is comforting – “you welcome us and help us,” Kabuo said. The CHWs work, day by day, to unite people from around the world as neighbors.
“I am so happy I have work, the house payment is fair, and the kids are enjoying school,” Peter said. “The kids are learning the language and we are safe now.”