Salud conference focuses on health care

Last Saturday, the first Salud Conference for Student Leadership in Cultural Competence was held in the Mattin Center.

Students from many area universities, from as far as George Washington University, attended the three-hour conference, which was sponsored by the Johns Hopkins Alumni Association, the Office of Community Relations and Volunteer Services and the Office of the Dean of Student Life.

The event featured an introduction by MarA?a del Pilar Ortega, Coordinator for Programa Salud, and speeches from keynote speakers Angelo Solera, the Hispanic Community Liaison and health educator for Baltimore HealthCare Access, and Miryam Granthon of Disease Prevention and Health Promotion at Health and Human Services in Washington, DC.

Solera, who has served as a mentor for Programa Salud since its inception in Spring of 2001, spoke on the idea of "incorporating the language, cultural values and health beliefs of Latinos" into the health care system. Solera presented statistics which showed insufficient numbers of bilingual health providers, as well as inadequate cultural competency training for hospital and clinic staff.

He also cited the fact that 43 percent of the total U.S. Latino population is without health insurance, and that because Latinos are considered an ethnic group rather than a race, most organizations exclude them from health-related statistical studies.

Solera promoted what he termed "the four principle factors for a cultural and linguistically competent system," namely, personnel, agencies, access and public policy. According to Solera, these are the areas of the health care system which have proven deficient and which need to be focused on and changed.

"We have a responsibility to advocate and require adequate health care," said Solera. "Health care is not a privilege - it should be a right."

Granthon followed Solera's speech with an in-depth look at cultural and linguistic barriers and the ways in which awareness about these issues can be raised.

She defined "cultural and linguistic competence" as "the ability of health care providers and organizations to understand and respond effectively to the cultural and linguistic needs brought by patients to the health care encounter."

She spoke of the efficacy of such mediums as Spanish Language television, and the values of working directly with the Spanish-speaking community.

The general session was followed by three workshop sessions, which were designed to address more specific issues and allow questions from the audience.

"How to Start a Campus Health Initiative" was led by Rumana Rahman, student at the Johns Hopkins School of Public Health; she is a founding member of Programa Salud and a current executive officer. The talk focused on the history, management and logistics of Programa Salud, and the funding issues, challenges and goals of any such organization. Rahman spoke of the need "to create partnerships with local universities" and to "pool resources and learn from each other." She also discussed the goals and duties of the group in improving the "structural barriers" faced by Hispanics in health care, which are manifested in financial, immigration and insurance issues.

"A lot are personal issues which medicine can't handle," said Rahman. "It is up to us to read between the lines."

Rahman also expressed satisfaction with the progress of Programa Salud.

"I am really impressed by the maturity and dedication of the Salud members," said Rahman. "It's my hope that Salud will one day be an exemplary model nationwide for student organizations of its kind."

A talk entitled "The Hispanic/Latino community in Baltimore: Who? What? Where? When?" was led by Ana Suero-Lopez, Baltimore City Health Department Hispanic Community Liaison in the Office of Hispanic Affairs, and Carmen Nieves, Executive Director and Chief Operating Officer of Centro de la Comunidad, Inc., the leading family support services center for the Hispanic/Latino communities of Baltimore City and its surrounding counties.

The discussion concerned the rights of the patient under Title VI of the Civil Rights Act of 1964, which prohibits discrimination on the basis of race, color and national origin. Since language falls under the category of national origin, federally-funded agencies are required to ensure equal access to benefits and services by providing adequate translation services. Suero-Lopez also discussed the need to recognize and respect the cultural differences of patients.

"It is human nature to be ethnocentric," said Suero-Lopez. "We need to step back and realize that cultures have their own ways of doing things."

Citing the fact that Spanish and Korean are the top two non-English languages spoken in Maryland, Suero-Lopez emphasized the need for quality translation services, and warned against the all-too-common practice of using family members as translators, which violates privacy rights and often leads to "children being placed in positions that they shouldn't be."

Susan Atlas, RN, IBCLC, Lactation Consultant and staff nurse in the Obstetrics Department at Union Memorial Hospital, and Pamela Bohrer Brown, Prenatal Coordinator for Planned Parenthood of Maryland, led "Barriers to Health Care: What are they and how can we break them down?"

Both women discussed the obstacles that they have encountered in dealing with patients who lack medical insurance, are discriminated against due to immigration status and lack their traditional support systems of family and community.

"It should not matter what your immigration status is," said Brown. "Acts are illegal; people are not."

Brown went on to discuss her personal experiences with cultural and linguistic incompetence, citing many incidences in which patients were put at serious risk because a nurse or doctor failed to accurately communicate vital information.

In her opening speech, Ortega had outlined the main goals of the conference; namely, "to spread the message of cultural competence to the general student body, to show what students are capable of doing in the field, and to form a network of campus and community initiatives that work together toward the common goal of alleviating the cultural and linguistic barriers to health care that many Hispanics/Latinos experience in Baltimore."

According to Ortega, one of the most immediate effects of the conference was the involvement and initiation of other campus programs.

"Little by little, Salud becomes a huge network of volunteers that is not only aware of the problem, but is working together to change the problems in the health care system," said Ortega.

As for future plans, Ortega is confident that the conference will become a yearly event.

"I expect that each year, as the program changes and improves, new issues will be addressed at the conference," said Ortega.