This is the second piece in a series about my experience working with 3-year old Bana and her family as mentor through AHOPE (Americans Helping Others ProspEr), a volunteer-based organization that assists Syrian and other refugee families coming to Rhode Island. My role is to aid Bana’s family as they navigate the healthcare system in Rhode Island, and serve as an advocate for Bana as her “patient partner.” I first met Bana and her family in August at their community mentor’s home, where Bana’s mother and grandmother hosted a cooking class on Middle-Eastern food. Read more here: http://alpertmurmur.org/2017/10/02/providence-eats-ahope-by-pranati-panuganti/
At the cooking class in August, I had learned so much about Bana’s family, but I was still curious to hear more about their experience resettling in Providence. What is the process to obtain refugee status? What challenges did they face during their resettlement in Providence? Who helped them? What are their dreams for their life in America?
So over the next couple of months, as I became closer with Bana and her family, through casual settings (which often came along with delicious food prepared by her mother), I began to learn more about their lives and their resettling process. The family graciously welcomed me into their lives; Although Bana was initially shy, before I knew it, we were watching Thomas the Train and playing dress-up. Adnan, Bana’s brother, taught me to play backgammon, as Bana helped count the checker pieces and pointed out colors. We had picnics and went to the beach, playing soccer and hide-and-go-seek.
How did they so easily place trust in me?, I wondered. Is it because I am a medical student? As they began to share their stories with me, I felt more integrated into their family, even though most of our communication was through Adnan– the only family member who speaks English. I communicated with the rest of the family through mostly emotional gestures, alongside some Google Translate and a few English words.
As Bana felt more comfortable around me, I suggested accompanying Bana and her mother to her healthcare appointments. They were excited, especially because I could drive them to the hospital, instead of them having to take the bus or walk. After working with a professional translator during one of her appointments, I reflected on what the first year medical students had been taught about translation services during our doctoring session a couple of weeks prior. This session with the Arabic translator, Grace, carried out very differently– I felt there was a disconnect between Bana’s mother and the coordinators of the program, as it seemed that Grace was in a conversation with each party but did not integrate the conversation between Bana’s mother and the physician.
Indeed, throughout my time with Bana’s family, I have noticed that most of the challenges they face in accessing health care are due to lapses in communication. Last month, I drove Bana and her mother to an appointment at Hasbro. We navigated the parking deck, driving in circles before finally finding a spot and heading into the outpatient building. Bana’s mother, who clearly knows her way around Hasbro, led us the entire way to the busy waiting room. We walked up to the front desk to check in, where the person informed us that the appointment was the next Monday.
There was no further conversation and no emotion expressed on the part of the check in assistant. I asked if there were any open spots today, and all I got was a head shake “no.” Bana’s mother opened her pocketbook and pointed to today’s date, where she carefully noted the details of her appointment. I explained that the appointment was actually scheduled for next Monday, so we head back home.
I was frustrated that the check in personnel didn’t seem to care, appeared to feel as thought their time was being wasted, and didn’t offer any other options to Bana and her mother. What if they had walked a mile in the snow, just for this appointment? Does Hasbro treat all patients this way? Will Bana and her mother actually go to the appointment next Monday?
I felt guilty that I didn’t do more to advocate for Bana and her mother at Hasbro. I felt helpless that these struggles are likely common among other refugees, both young and old, and angry at the root cause of their struggle. Why is it, that the people who have endured the most struggle in their home countries, seeking refuge in the United States, continue to face hardships? Haven’t they already been through enough?
I entered the patient partnership program this semester, without many expectations about what my experience would encompass. From early on, I viewed communication as a major barrier towards my relationship with Bana and her family, and, in many ways, further limited myself in my interactions: In the beginning, I only participated in activities when Adnan was around and stayed away from Google Translate and other options to help with communication. I had to push myself to be comfortable attempting to communicate with people that don’t speak the same language as me. After all, they experience communication barriers on a day-to-day basis.
The key, I realized, was patience.
This patience comes in different forms: It includes the patience to ring doorbells on a couple of different houses because I was given the wrong house number; the patience to sit in my car for half an hour, waiting for Adnan to translate between Bana’s mother and myself that I’m waiting outside their house; the patience to laugh at silly translations on Google Translate; the patience to wait for the translator to mediate communication; the patience to write down the actual date of Bana’s appointment in her mother’s pocketbook.
I think we could all use a little bit more patience in our lives, especially as future doctors. It is important for everyone– the elderly, who may not process information as quickly as their younger counterparts, children, who may be resistant to talking with doctors, and parents, who may distrust the medical system and refuse vaccines for their children. I’ve learned so much from Bana and her family already, and they are truly my mentors, rather than vice versa. Although they may not know it, they have inspired me in many ways: teaching me patience, resilience, and most importantly, to slow down, and to appreciate life (and the food that comes along with it).
I’m excited to continue being a part of this family, to continue to share a part of my life with them, and to continue to learn from them.
Pranati is an MD’21 from Charlotte, NC. She graduated from UNC-Chapel Hill in 2016.