Local medical students help Spokane’s Afghan refugees navigate health records: ‘Language access is a big problem, especially in medical settings’

As a child, Mary Kim took on the role of translator for her parents’ medical appointments. A couple of years before she was born, they had immigrated to the U.S. from South Korea.

Now a Spokane medical student, Kim wants to help the approximately 400 Afghan refugees here receive translated medical records, from Dari to English. So in March, she and a group of medical school students worked with 18 Afghan adults through translators to fill out health records. The students plan a larger session this fall.

Kim and Jessica Giang are leaders of a University of Washington School of Medicine-Spokane student group called Refugee Clinical Navigators. Years ago, Kim said it was difficult for her parents to understand without her help how to even take medications and when the next doctor’s appointment was scheduled.

“I’ve seen how difficult it is to access health care when you don’t speak the language,” Kim said.

“I’m trying to see as a medical student how I can help to break down barriers. I’m originally from Seattle, so I wasn’t really aware that the refugee population was so big here in Spokane.”

In the fall, the group began a new project with Refugee Connections Spokane, which has had a health pamphlet program. The partnership between students and the organization will support Afghanistan families so they can have the health records for medical appointments or emergencies in both their Dari language and English.

At the spring event held at Gonzaga University, the students and interpreters helped adults fill out those booklets, while some volunteers supported an activity table for children. The numbers were small under COVID protocols.

Refugee Connections Spokane provided the refugees with transportation and brought in three interpreters for the event. More than a dozen medical students helped, including a few from Washington State University’s Elson S. Floyd College of Medicine, said Kim and Giang. They just finished their first year of medical school in Spokane.

Giang experienced the same dynamics growing up.

“I grew up in Olympia, and my parents are from Vietnam,” Giang said. “I attended all my parents’ medical events. I was the eldest, so I also attended my siblings’ medical appointments to interpret, and the same for student-parent conferences. We didn’t have a computer interpreter like some do now.”

She said a few hospitals, and sometimes clinics, use a relatively new system of having a tablet to interact in languages that require translations.

Refugee Connections Spokane has had a patient passport program to document health records, now in about a dozen languages. The Afghan refugees in the Spokane area are close to numbering 400, said Kathryn Garras, Refugee Connections Spokane executive director.

The organization supports refugee and immigrant communities by providing services, fostering community bonds and advocating for refugee and immigrant rights.

“Afghan refugees continue to arrive,” Garras said. “Spokane is proportionally a pretty good-sized city for resettlement, so we ended up just getting folks coming through World Relief to resettle. A few ended up coming through the International Rescue Committee, which is new in our city, and a couple of others from outside of the two organizations.

“One reason, too, is that many of the Afghan families are pretty large with several kids, so the 400 number represents that. I don’t know exactly how many families, but we work with families who have up to 12 in the family.”

She said the medical students approached the organization this past fall to ask about support for refugees.

“I shared information about the patient passport program, and they were pretty excited about that idea,” Garras said.

“We got a grant through the University of Washington School of Medicine. A couple of the students worked on that grant, and it supported translating the passports into Dari, then printing 300 copies. That was a new language for the patient passport program.”

In March, the family groups were spread out to protect patient privacy, she said. “The medical students sat at each of the pods with the interpreters and with the families, and they helped facilitate the process, while our interpreters were filling it out in English based on the responses.”

A patient passport includes allergies, medications, medical conditions and past procedures. Such records can be crucial, especially in an emergency, Garras added.

“Language access is a big problem, especially in medical settings,” she said. “If a medical provider can’t immediately find a translator for an urgent need, then at least that provider would have some background health information for the patient.

“It also helps facilitate the check-in process when someone goes to the doctor’s office if they don’t have an interpreter available, then they can just hand the front-desk employees the booklet and that person can help them fill out their paperwork.”

Kim said the first event was small because of COVID, but the next one should be much larger. The group had a physician on site in case of medical questions or concerns.

“Among the families, some were able to speak English and some weren’t, and that’s where the interpreters helped,” Kim said.

Garras said the next session might have a general health fair, with providers and organizations that can offer resources to refugees, while also offering the patient passports.

She said that for the region’s new Ukrainian refugees, “there are definitely more language resources especially for Russian speakers (here). It’s not to say at all that language access isn’t an issue, but for a less common language in our city like Dari, it’s definitely a different situation.

“If down the road we hear there’s a need for our newly arrived Ukrainian folks, I’d be interested in learning more about that need and possibly doing something similar.”