B-N Congolese Patients Face Health Inequity
A growing immigrant group in Bloomington-Normal faces barriers to getting medical attention.
The non-profit Community Health Care Clinic in Normal says Congolese patients face inequities because of the language barrier.
The clinic is used to care for immigrant communities. Five staff members are bilingual in Spanish. Nearly three-quarters of the clinic patient base is Hispanic.
What the clinic didn't have was a French interpreter, said Executive Director Mike Romagnoli.
"It's kind of a chicken-or-the egg situation," Romagnoli said. "We have been caring for some of the patients from Congo for a while, but we have not been meeting their needs very well—and primarily, it's communication."
As the the number of Congolese patients has risen, the issue has become bigger.
Right now, Romagnoli said the clinic has about 25 Congolese patients; a year ago, that number was closer to 10.
He said new patients mostly come through word of mouth.
"We've had a few patients over the years that were African," Romagnoli said. "Now, we've kind of gotten to the point where our African community, you know, we're getting to be better known and kind of building that trust."
The majority of patients don't have insurance, and don't think they can afford to go to the doctor, he said.
They share several health concerns. Romagnoli said high blood pressure and diabetes are common. Congolese women often don't see reproductive health specialists for things like mammograms or pap smears.
If you can't talk to patients to explain a diagnosis and medications, Romagnoli said, there is a safety issue. So, the clinic started looking for French interpreters.
"(We were) grabbing people off the street that look like they speak French, you know, just to get somebody in here," he said. "In the last month and a half, we've gone from zero to eight volunteer translators."
Those volunteers ultimately came from Illinois State and Illinois Wesleyan universities and Heartland Community College—as well as from within the Congolese population itself.
Interpreter Liliane "Lilly" Kiamana is Congolese. She's not a clinic patient. She's just trying to do her part to make sure others get the care they need. Kiamana said people often ignore signs they may be ill—things like constant fatigue or headaches that could be a symptom of hypertension.
Plus, Kiamana said, a lot of Congolese people didn't get routine medical care back home.
"Not everyone knows they need to go to the doctor, because most of the people grow up with a different culture with different families," she said.
Kiamana said her family did get regular check-ups. They also saw eye doctors and went to the dentist. But poorer and rural Congolese families might not have had access or the habit.
Kiamana said she tries to explain to the importance of good health to them.
"You need to take the medication. You need to go get your exams. Going to the doctor is very important—because back home, not many people were doing the check-ups," she said.
There is a side benefit from Congolese translators. The clinic found having "ambassadors" within that community helped let people know about free services like dental care, chronic disease management and lab and diagnostic testing.
They also find some patients don't want their interpreter to be Congolese. Romagnoli said patients are worried about people in their community knowing too much about their gossip.
"Then we're like, 'Oh my God, we need to we need a white person ... that speaks French now' to, you know, get to these people," he said.
That's where Jennifer Howell comes in. She teaches French and Francophone studies at ISU. Francophone refers to French-speaking communities outside of France. Howell specializes in French-speaking Africa.
"The (Democratic Republic of the Congo), actually, is the largest Francophone country on the African continent ... and the Congolese population is actually one of the largest populations to come to the U.S.—for a while for refugee status, and then that immigration has just continued," she said.
Howell said political corruption and armed conflicts made access to resources in the Democratic Republic of the Congo variable, depending on where you live and your socioeconomic status. It can be a learning curve for people to know what's available when they come to the U.S.
Howell said healthy eating also can be an adjustment. She said many staples of the Congolese diet contribute to hypertension, diabetes and other illnesses.
"The one that comes up a lot is cassava. I'm not sure I would really call it a root vegetable, but it's like a tubular vegetable," she said. "They'll grind it up into like a kind of flour. It's interesting because if you're somebody that eats gluten-free, you'll often find cassava flour as an alternative to wheat flour for like tortillas and things like that. But a cup of the cassava flour is like 75 grams of carbohydrates or something. It's actually pretty hefty."
Howell said the Congolese diet also can be high in oil and salt, often hidden in spice mixes. She said many patients didn't realize that was an issue until they started going to the clinic.
Howell said immigrants and refugees tend to land where there are already established communities in the U.S. Bloomington-Normal's Congolese population continues to flourish. There are Congolese churches with services in French, an African grocery store and many take English classes at Heartland.
Romagnoli said if the upward trajectory of new Congolese patients continues, the clinic may need to add a full-time staffer dedicated to that community.
"It's funny, I started here as a volunteer almost 17 years ago, and where we are with the Congolese population is kind of right where we were with the Spanish-speaking community when I started," he said. "The pie in the sky kind of goal, is to basically get to the same spot with the African population as we are with our Hispanics, you know, to be the kind of the trusted authority."
Romagnoli said the clinic is proud of how far it's come to serving Congolese patients in a short amount of time. He said the next step is doing more outreach: Visiting churches, posting information on social media, and continuing to learn about the culture through the patients to meaningfully communicate with them for the first time.
Correction: A previous version of the story stated the Community Health Care Clinic serves around 75 Congolese patients. That number is 25.
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