Vietnamese Mass & some thoughts

I went to a Vietnamese Mass today at Resurrection of Our Lord Church to hand out my surveys. I got 10 surveys back, which isn't very much compared to how many people were there, but I'm happy to get as many as I can. Father Dominic had me come there 15 minutes before the Mass ended, and he had a table out for me near the exit to make sure people would see me. But, it's hard to get people to participate when most want to go home and/or don't have time. I did have a couple of people seek me out, which was nice, but also adds a sampling bias.


I'm trying to concentrate more on getting surveys from the middle-aged to younger age group. Working with Catholic Charities, I've gotten a lot of participation from the elderly population, but I expect each age group to have different needs when it comes to healthcare. Even though some of the elders have been in the U.S. for at least 20-30 years, they still don't know very much English. On the other hand, with the middle-aged group, for those who have been here for 20-30 years, they know English very well, since they most likely came here when they were young and went to school here. So barriers such as not understanding the doctor, or not having a physician speak Vietnamese, may not apply to them. 


Another kind of issue I'm running into, is that for couples, usually the husband will do one survey for the both of them, even though I gave each person a survey. I'm not sure if this has to do with Vietnamese traditional roles, or they don't see the necessity in getting as many responses as possible. I've also noticed that the men are more willing to do the survey, and also have less trouble completing it. There's just a lot more things that I want to get done with this project, but I don't think the summer is enough time to get everything that I want to done. I see this continuing over the year, but hopefully I'll get a better idea once I start doing data analysis.

Catholic Charities

As part of my blogging, I also wanted to give some more information about the different organizations I'm working with. I briefly mentioned in my last post that I'm working with Catholic Charities. They have been so wonderful and helpful with my project, especially Sister Cecilia. So many hugs to her. 

Catholic Charities provides various services in St. Louis to help people in need. For the Vietnamese community in particular, there is the Vietnamese Health Clinic, and an Elders program. The Vietnamese Health Clinic mainly serves the elderly population, but they also provide services for children, and those related to women's health. The clinic always has the same people working there-a nurse practitioner, Sam, Tuesday afternoons, and Dr. Campbell Wednesday mornings. Sister Cecilia is always there to help with interpretation, and there are sometimes undergrad students to help her as well. Many of the patients like the familiarity. They know exactly who is going to be there, and also don't have to worry about the doctor not being able to understand them. This also helps ease the nervousness in having to see a doctor. Everything they need, whether it is making appointments with a specialist, to calling in for refills, can be done at the clinic. Sam, Dr. Campbell or Sister Cecilia will do it for them. I just think it's really neat to have this resource. Navigating the healthcare system can be very confusing, and much more so for those who don't know how to read or speak English. 

I've really enjoyed being at the clinic, and sitting in on the patient visits. My favorite patient was probably from yesterday. The patient was an elderly, super hyper man, who apparently comes in every time with a ridiculous hat. He was such a hoot. He noticed that I was new there, and literally, the first thing he said to me was, "Watch me speak English." He turned to Sam, and just started telling her why he was there. It was awesome. It's definitely interesting to compare the patients here with those who come to the HRC. Many of the patients consider the Vietnamese Health Clinic as their source of primary care, so they come for follow-up and things like that-it's nice to see their patient history. I haven't seen that many physicals, so for me, it's been a little bit more interesting. 

The other resource that Catholic Charities provides, is the Elder's program. The elderly Vietnamese get together about twice a month, kind of on a social basis. They have tea and snacks, and there is a speaker who comes in to talk to them about various subjects. I went to one of the meetings on Tuesday to administer my surveys (I got almost 50!!). That day, they had a lady come and talk to them about the new changes/updates to Medicare/Medicaid for 2012. I did not know there was so much to Medicare/Medicaid. There's like different types, and if you are at a certain poverty level, you can have extra assistance in paying the deductible, etc. etc. They've also had doctors come in and explain to them when they should go to the emergency room vs. urgent care vs. waiting to see a doctor. It's pretty awesome to see things like this, and really shows that there is a lot that you can do in your own city to help (not that there is anything wrong with going abroad either!).

Anyway, that's all for now. After two weeks, I've gotten 65 surveys done (woo!). My goal is to get 150 total, so I'm hoping that I'll meet that goal, or get close to it. I've gotten a lot of responses from the elderly population because of working with Catholic Charities, so now I'm looking for places to get a younger patient base. I'm looking into going to restaurants and also clients of the Multicultural Counseling and Research Center (more on them in a later post). I'm also meeting with Dr. Slavin, my mentor, tomorrow, to go over data analysis and stuff, so I'm sure there will be plenty to talk about in my next post.

First Day

I finally started administering the healthcare surveys today, and am so happy to get things going in terms of collecting data and information. I went to the Vietnamese Health Clinic and was able to get all the patients I talked to agree to do the survey. Most of them were pretty open to doing the questionnaire. I made sure to emphasize that their answers were totally anonymous, and that the research would eventually help the Vietnamese community in terms of obtaining healthcare. I had one lady who didn't really want to do it; she said everyone's answers were probably the same anyway, and that it wouldn't make a difference. I didn't really press her to do it after she declined, but one of the other patients there who had done the survey started talking to her, and telling her how important it was etc. etc. After that, she wanted to take a look at the survey and later agreed to do it. (yay!)


I think it's a good thing to let the participants know, and maybe emphasize, that I'm not doing this research just to do it, or whatever, but that I really, personally want to find out what improvements, or things that are needed to help the Vietnamese community. Many of the patients today answered "poor" in terms of their capabilities to read and understand English. They are really only able to get healthcare because of Catholic Charities. They call the Vietnamese hotline, tell the person that they are sick and need to see the doctor, and the appointment and everything is made for them. If they can't drive, or don't have transportation, a van is sent to pick them up. I can't imagine what it's like to not be able to read, write, or understand English; it's just very hard to navigate many things. Patients also have medical/insurance bills to pay, need to know how to take their medications, etc. I can just empathize with what they have to go through.


In terms of the actual survey, I think I have to throw out a couple questions. I have one question that asks how long the patients wait to see a doctor when they are sick, and almost all of them replied with, well it depends on when I can get an appointment. The purpose of that question was to see how long they waited to contact a doctor, but it only caused more confusion. Anyway, the survey also took much longer than the 10 minutes I had expected, but this was probably because most of the patients were elderly patients, and needed help circling answers and/or reading because they didn't bring their glasses. Going back to the clinic tomorrow, so hopefully I'll get more surveys done!

Summer in the Lou

As I'm sitting in my nicely air conditioned apartment in St. Louis, and very afraid to step outside into the 105 degree weather, I wonder if people think I'm crazy to not spend my last summer at home, in San Diego, where it definitely would not be too hot, and I'd be less than half an hour away from the beach. But, back in the spring semester, I knew I wanted to stay in St. Louis for the summer and do some sort of public health project. After all, I was going to spend three more years here. I thought I should get to know the city more, and get involved, especially in terms of healthcare. 

My interest in public health started in undergrad. There, I had two awesome opportunities to travel to Mbarara, Uganda to do pollution research. My research advisor and our team were working with the nursing school in helping to build Holy Innocents Children's Hospital. The third anniversary of its opening was July 4th by the way! Anyway, as chemistry researchers, we wanted to see if opening the hospital would impact the Rwizi River nearby (ie. think hospital waste and its impact). The river serves as a water source for the community. So we looked for things like E. coli and Enterococci, organics, nitrates, etc. and talked to people about the importance of drinking clean water. I just thought it was really cool to be able to collect this data, and use it to educate people about things that can impact their health. Being a premed at the time, I had this idea that helping patients was just about treating whatever illness they came in with, but the experience in Uganda really got me into public health, and education, and learning that being sick isn't simply because a patient has giardia. Did they get it from drinking this water and not boiling it, etc. 

One of the sampling sites at the Rwizi River-you can see how dirty it is...imagine drinking from this water.

But that was how my interest in public health started, and I knew that once I got into medical school, I wanted to continue it in some way. Which, brings me to my summer project. Thanks to a fellowship grant by the Arnold P. Gold Foundation, my research project is on identifying healthcare barriers (ie. insurance, language, transportation, etc.) in the Vietnamese community in St. Louis. Coming to St. Louis, I honestly did not even know that there was a pretty good sized Vietnamese community here, until I volunteered at the Hepatitis B clinic as a translator. Many immigrants from Vietnam settle in California, such as Orange County, or San Jose, or in Houston, Texas. But, as I've learned, St. Louis also has a significant Vietnamese refugee population. It's also unique in that the city hosted two waves of immigrants-one in the late 70s, and other in the early 90s. So, there's a population of Vietnamese who have most likely gone to school here, have jobs with health insurance, and have had much more time to settle here in the U.S. As you can probably imagine, both groups might have different issues or difficulties when it comes to obtaining healthcare, if any.

In order to identify these barriers, I'm going to be administering surveys to Vietnamese volunteers around the city. I haven't been able to start yet, since the first half of summer I had to work on getting IRB approval, but my first day of data collection will be Tuesday, so I'm definitely looking forward to that. There is a free Vietnamese clinic held on Tuesdays and Wednesdays every week in South St. Louis, through Catholic Charities, so I'm going to be able to talk to some of the patients there, and hopefully get this project going!