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Spanish-English dictionary page showing translation for Latino
Spanish dictionary, by Abigail Luke on Flickr, shared under Creative Commons Attribution 2.0 license

In honor of National Hispanic Heritage Month, let’s spend some time focusing on SALUD!

SALUD is a student-run organization at GW which was founded about five years ago, and is dedicated to teaching and learning Medical Spanish. During the academic year, SALUD runs regular Spanish classes for medical students at three different levels: Beginner, Intermediate, and Advanced. The content of these sessions, which occur during the lunch hour, is keyed to vocabulary related to body systems students are covering in the Practice of Medicine course.

In class one day in early Fall, MS2 student instructors Emily and Giuliana ask the eight students attending the Advanced level class where they have learned their Spanish. Some speak it at home, while others have studied the language. There is a review of the vocabulary for the musculoskeletal system, after which the students partner up to practice patient interview skills. “¿Que le molesta?” (“Can you tell me what hurts?”) is one opening, whereas others might start with, “¿Necesita un intérprete?” (“Do you need an interpreter?”) Some students form groups of three, with one student acting as the interpreter. A student is curious about interpreting opportunities. While certification is required to be a medical interpreter, GW students are able to volunteer and use their language skills as patient navigators at the GW Healing Clinic, where about 80% of the clientele are Spanish-speaking.

Screenshot of slide on translating a 1-10 pain scale into Spanish
Screenshot of Advanced level Medical Spanish lesson on how to translate a 1-10 pain scale

Over in the Intermediate level classroom, students are reviewing musculoskeletal vocabulary, translating it from Spanish to English. The lesson follows the structure of a history of present illness, teaching students to seek information from patients on the location, quality, and severity of their pain, along with its duration, timing and context. The instructor points out synonyms, such as débil and tenue for weak, as well as words that have more than one meaning, like sordo, which can mean deaf, but also dull, which might describe a patient’s pain. In the Beginner classroom, a dozen students begin their exploration of the same vocabulary at a slower pace.

In addition to teaching Medical Spanish, classes aim to teach students the correct use of interpreters. SALUD also serves the Latinx community in DC through Bridge to Care, an initiative of the GW Healing Clinic. Because up to 80% of patients seeking care at the Healing Clinic are Spanish-speaking, the support of students with Spanish-speaking skills from across the MD Program, PA Program, and MPH candidates from the Milken Institute of Public Health is essential.

A few days after the first lesson of the year, I met with two of SALUD’s board members, Tammy Moscovich (MS2) and Alisha Pershad (MS2). While Tammy was raised in a Spanish-speaking family, Alisha’s interest in learning Spanish developed through school. Alisha sought to put her Spanish skills to use, and pursued official interpreter training to earn a certification. Through her SALUD teaching, Alisha hopes “to empower others” to combine their Spanish-speaking skills with patient care.

The curriculum used by SALUD comes from a Medical Spanish course from Boston University, which was adapted with permission by medical student Cecilia Velarde De La Via (MS3). The curriculum correlates to the system blocks students learn about in the Practice of Medicine course, and includes both vocabulary, sample patient interviews, and flash card decks. The Intermediate level class is “more conversational than technical,” according to Tammy, whereas the Advanced class focuses more on review.

Screenshot of phrases in Spanish and English suggested for patient interactions
Screenshot of a suggested script for interacting with Spanish-speaking patients

Are there SALUD success stories? Tammy and Alisha shared one: a current MS3 student who began Medical Spanish last year eager to practice her skills gained confidence through the classes. Now, in rotations, she feels more confident with her Spanish skills in working with patients. For Tammy, her time serving at Bridge to Care serves as a good refresher for vocabulary lessons. Then there are the finer points to learn when working with patients coming from different parts of the Spanish-speaking world, like the difference in terminology from one country to another, or learning the informal terms used by patients in a medical context, versus the clinical terms. Tammy commented that, “This is the word I use” is a valuable contribution to the Spanish lessons, helping to communicate the variations across borders. Alisha agrees, adding that classes are enriched by people bringing their individual experiences and sharing it.

The increased arrival of migrants to the DC area is something the GW Healing Clinic is experiencing via some of the patients coming through its doors. Alisha reported that there have been more patients arriving with acute conditions, adding that “it’s gratifying to facilitate the encounter, and help them recover.”

From the classroom to the exam room, SALUD is helping students increase their confidence in both bilingual encounters and collaborating with interpreters, while helping patients in the community access medical care that speaks their language.

Dr. Antonia Novello is a healthcare professional who for many decades focused on improving the health of women, children and those most vulnerable in modern society. 

She was born in Puerto Rico on August 23, 1944 and is the oldest of three children. During her childhood, Dr. Novello suffered from congenital megacolon which impacted her large intestine. Treatment options were available, but due to her family’s financial situation, Dr. Novella was unable to receive surgery to cure the condition until she was eighteen years old. This experience had a lasting impact on her and was one factor that inspired her to pursue a career in health sciences. Dr. Novello earned a multitude of degrees and certificates including a Bachelor of Science and a Doctor of Medicine from the University of Puerto Rico in 1965 and 1970 respectively and a master degree in Public Health from John Hopkins University in 1982.  

After marrying Joseph R. Novello and moving to Michigan, Dr. Antonia Novello completed an internship and residency in pediatrics and a fellowship in pediatrics nephrology. She took an interest in nephrology after a beloved family member died due to complications with their kidneys. Dr. Novello practiced medicine in a private office for two years, but eventually transitioned to work for the National Institutes of Health (NIH) in 1978. Novello focused on health issues related to women, children and marginalized communities during her time at NIH. She was instrumental in the legislation that led to the creation of the national organ transplant registry and she also played a significant role in requiring all cigarette containers be labeled with a health warning. In 1989, President George H.W. Bush selected her as the new United States Surgeon General making her both the first woman and the first Hispanic American to fill the role. 

Novello served as the U.S. Surgeon General from 1990 until 1994 when the Clinton Administration began. During her tenure, Novello continued to advocate for women and children. “In March 1992, she and James S. Todd, executive vice-president of the American Medical Association (AMA), held a news conference at which they denounced the R.J. Reynolds Tobacco Company’s advertisements featuring the cartoon character Joe Camel, because research showed that it appealed to young children.” (Meier et al., 1997, p. 272) Novello was also vocal about the alcohol industry’s marketing practices, particularly the industry’s use of advertisements which showed people skiing, surfing or mountain climbing with alcoholic beverages close by as it suggested people could perform these activities while consuming alcohol. Novello also raised awareness on domestic violence and its impact on women. (Meier et al. 1997)

After 1994, when a new Surgeon General was appointed, Novello continued to work within the healthcare industry until her retirement in the 2010s. Novello currently spends her time between Puerto Rico and Florida and is still an active advocate for the health needs of others. Most recently during the COVID-19 vaccine rollout, Novello spoke with parents and other community members of the importance of vaccination and even participated in local vaccination clinics and programs. And in August of 2021, she and other living former surgeon generals participated in a White House event where they discussed “getting information and access to vaccines to communities of color, who have been the hardest hit during the pandemic.” (Sesin, 2021)

Novello has received recognition for her work as a healthcare provider and public health advocate. Some of the awards she has received over the course of her career include “the Public Health Service Commendation Medal (1983); Congressional Hispanic Caucus Medal (1991); Order of Military Medical Merit Award (1992); and the James Smithson Bicentennial Medal (2002).” (Brandman, 2021) Dr. Antonia Novello’s lengthy career is inspirational for people committed to serving their communities and her legacy of speaking up for women and children will have profound effects for years to come. 

References:

Photo by Tom Fisk via Pexels.com

The Hispanic community is one of the fastest growing populations in the United States. According to census data, people who identified as Hispanic accounted for approximately half of the total population growth in the country between 2010 and 2020 and around 18.7% or 62.1 million Americans self-identify as Hispanic or Latino. (U.S. Census Bureau, 2021) Despite a significant presence in the country, less than 10% of all healthcare workers are Hispanic. Recent statistics and personal anecdotes suggest that having visible representation of Hispanic American healthcare workers will encourage more Hispanic individuals to pursue a career in the health sciences and allow Hispanic American patients to better connect with their healthcare provider.

On June 14, 2022, the Pew Research Center released a report entitled ‘Hispanic Americans’ Trust in and Engagement with Science.’ The report was based on survey data from nearly 15,000 U.S. adults and examined Hispanic Americans’ perceptions of both health sciences and the science, technology, engineering and mathematics (STEM) field. The authors note that overall “Hispanic adults hold largely trusting views of both medical scientists and scientists to act in the public’s interests. Hispanic adults’ encounters with the health and medical care system are varied, reflecting the diverse nature of the U.S. Hispanic population across characteristics such as nativity, language proficiency, gender, age and education.” (Funk & Lopez, 2022) Many Hispanic Americans have poor or no access to the healthcare field and for those able to regularly visit a healthcare provider, there are barriers to care, such as communication problems, that are present during these visits. The Pew Center report noted “Hispanic adults are less likely than other Americans to have health insurance and to receive preventative medical care.” (Funk & Lopez, 2022) Survey respondents shared many different opinions on the cause of health disparities within the Hispanic American population including working jobs with high health risks, language barriers, poverty and preexisting health conditions. When asked about solutions to address these health disparities many people responded that they believed increasing the visible representation of Hispanic healthcare workers would address these disparities. This sentiment is echoed by current Hispanic healthcare professionals:

Professional organizations such as the National Association of Hispanic Nurses and National Hispanic Medical Association connect Hispanic healthcare workers and develop meaningful communities. On the George Washington University campus, there is a local chapter Latino Medical Student Association. This organization will hold its 50th annual conference on January 27-28 in 2023 at John Hopkins University and the theme for the conference is “Un Futuro Para Todos: Highlighting Latino Innovation, Service, and Leadership in Medicine.” Registration for the conference is currently open and early bird prices are available until November 11th. To learn more about GWU’s Latino Medical Student Association, click here to view their website or email the organization at lmsa.gwsmhs@gmail.com.

Wandy D. Hernandez-Gordon writes in their personal narrative for AMA Journal of Ethics “Health professionals with cultural and language proficiency are critical to successful interventions, including health education, preventative medicine, and treatment. But these interventions are only the start in addressing the higher burdens and challenges that Latinos face in accessing quality health care. It is also critical to dissect and understand the systems and structures that both lead to and exacerbate health inequities.” (Hernandez-Gordon, 2022, p. 335) The Hispanic population in the United States continues to grow and it is important that they are able to access the full benefits of the healthcare system. In order to meet the needs of this diverse population, it’s important that more Hispanic healthcare professionals enter the field, share their experiences with their colleagues and collaborate with one another to offer long-lasting solutions.

References: 

Funk, C., & Lopez M.H. “Hispanic Americans’ Trust in and Engagement with Science.” Pew Research Center, Washington D.C. (June 14, 2022) https://www.pewresearch.org/science/2022/06/14/hispanic-americans-trust-in-and-engagement-with-science/

Hernandez-Gordon, W.D. (2022). Why Community Health Workers’ Roles in Latinx Communities Are Essential. AMA Journal of Ethics, 24(2), E333-339. https://doi.org/10.1001/amajethics.2022.333


United States Census Bureau. (2021). 2020 Census Illuminates Racial and Ethnic Composition of the Country. https://www.census.gov/library/stories/2021/08/improved-race-ethnicity-measures-reveal-united-states-population-much-more-multiracial.html