Kansas residents from Guatemala who speak the Mayan languages K’iche’, Akateko, Q’anjob’al, and Aguacateko spoke with Alce su Voz on Saturday about what their communities need to attain health equity. The conversation occurred at our first Mayan community meeting in Arkansas City, a town in rural south-central Kansas close to Oklahoma. Not surprising to our team, one of the most salient themes in the conversation was the need for staff and providers within healthcare entities to understand that Mayan community members do not necessarily speak Spanish. Their languages, which are part of the Mayan language family, were spoken for thousands of years before the Spanish colonization, and yet many Kansans mistakenly believe that they are dialects of Spanish.
Our arrangement for multilingual communication at Saturday’s meeting reflected the community language needs: The meeting was facilitated in Spanish and interpreted in three different Mayan languages; participants were seated according to language so that each group could hear the interpreters for their own language, discuss topics in their language, and then allow an interpreter to report to the whole group in Spanish. At one point, when a nurse who attended the meeting shared information in English, one of our interpreters rendered the information in Spanish, and the Mayan language interpreters then relayed the message to those seated at their tables.
The process of interpreting from English to Spanish and then from Spanish to a Mayan language is called relay interpreting, and it is sometimes necessary for effective communication with speakers of certain less-commonly spoken languages.
A group of K’iche’-speaking women who attended the meeting shared that at health care appointments mediated by a Spanish language interpreter, they often nodded their heads to be polite even when they did not understand what was being said to them. When only Spanish interpreting is used with indigenous language speakers, messages can be lost.
As mentioned here previously, there is a simple technique called the teach-back method that healthcare workers can use to avoid miscommunication between clinicians and patients. Teach-back means that clinicians or clinical staff ask patients to explain what they have understood about their health condition and plan of care, to confirm understanding. Research has shown that the teach-back method improves patients’ health outcomes.
In addition to the language barrier, some meeting attendees shared that they face an additional obstacle in not being able to read. At one table, an Akateko-speaking family said that they had been denied care by a local healthcare institution because they were not able to fill out the intake paperwork since they could not read it. Relatedly, one K’iche’-speaking family shared that they regularly hired a Spanish translator to help them to understand the instructions for their prescription medications.
Pharmacies, like other healthcare entities, are required by Title VI of the Civil Rights Act of 1964 and Section 1557 of the Affordable Care Act to provide language access services to patients who need language assistance. This includes explaining medication instructions in a language that the patients can understand. There is also a movement for dual language prescription labeling in some states, a practice that could benefit minoritized language communities in Kansas.
When we asked about access to vaccine information, the participants shared that local healthcare institutions have not provided them with information about vaccines in Spanish or in their native languages. One person who attended the meeting said that he first learned about the COVID-19 vaccine when he traveled to Wichita to attend Café con Leche, an annual health fair for Spanish-speaking families. Others shared that they were vaccinated because they were required to do so at work. Cost was also a barrier to being up to date on vaccines for many participants, and other participants shared information about payment plans and where to receive support.
In the past year, Alce su Voz has collaborated with Mayan community members and healthcare leaders in Ark City, Dodge City, and Coffeyville to create a series of videos in Spanish and Akateko with information about vaccines and community members’ testimonies about why they chose to get vaccinated. You can view a video of Coffeyville community leader Guillermo Miguel sharing his vaccine testimony in Akateko here.
At the end of our meeting, several participants shared that they were grateful that someone was paying attention to their needs and that they hope that soon Ark City will have a community health clinic where they feel welcome and cared for.
The Community Health Center in Cowley County (CHCCC) in Winfield provides Spanish language interpreters and is planning to open a clinic in Ark City in the coming years. CHCCC is also hosting our upcoming interpreter workshop, organized by Erika Vargas of Alce su Voz and Spanish Ad Hoc Translations, which will take place this Saturday, November 11, from 2-4pm at the Integrated Care building at 118 W. 9th Ave., Winfield.
There is much work to be done to improve healthcare access for Mayan communities in south-central Kansas, and Saturday’s workshop was a significant step in laying the groundwork for this process.
The Ark City meeting was organized by Margarita Francisco, a community liaison on our project who works for Head Start in Ark City, and Denise Romero, the Director of Community Engagement and Education for Alce su Voz and the Executive Director of Salud + Bienestar. Ms. Romero facilitated the meeting with help from Raúl Rangel, a graduate research assistant in the MA program in Spanish in Wichita State University’s Department of Modern and Classical Languages and Literatures (MCLL).
As part of our initiative to improve vaccine access in Mayan communities in rural Kansas, Mr. Rangel is conducting a survey-based study on Mayan language speakers and access to healthcare in Ark City, Coffeyville, Dodge City, and Liberal. Collected under the mentorship of English Professor Dr. Mythili Menon, the coordinator of Wichita State’s Applied Linguistics program, Rangel’s data from across Kansas reflects similar barriers to access as those discussed at Saturday’s meeting. In his research, he has identified seven different Mayan languages spoken in Kansas. With the exception of Q’anjob’al and Akateko, these languages are not considered to be mutually comprehensible with each other.
Alce su Voz is grateful to the Increase the Reach program for funding this initiative and to the Cowley County Local Health Equity Action Team (LHEAT), part of the Communities Organizing to Promote Equity (COPE) program, for providing gift cards for the Cowley County meeting and workshop participants.
In our previous conversations with healthcare leaders in Cowley County, where Ark City is located, we have observed the presence of an emerging coalition dedicated to improving access to healthcare for speakers of minoritized languages in the region, and Alce su Voz anticipates an opportunity to support the coalition’s efforts by providing resources and educational opportunities.
We foresee that future collaboration in this region will include support for professional development and integration of promotoras de salud (community health workers) in the region’s health equity efforts with support from Salud + Bienestar and a continued collaboration with Wichita State University’s initiative Improving Healthcare Language Access for Spanish Speakers in Kansas, which is funded by a grant from the Office of Minority Health of the U.S. Department of Health and Human Services and led by Wichita State University Spanish Professor Dr. Rachel Showstack.
Alce su Voz is a community-based coalition whose mission is to improve health equity for Spanish speakers and speakers of indigenous languages in the United States, with a focus on Kansas and the Midwest. Our current programs are funded by federal and foundation grants attained by Wichita State University and the Wichita State University Foundation for interdisciplinary projects housed within the Department of Modern and Classical Languages and Literatures. For more information or to get involved, please send an email to alcesuvoz@gmail.com. You can also join our email list and follow us on Facebook.
You can read this post in Spanish here.
