In Rochester’s refugee community, the lack of English language skills becomes even more prevalent when it comes to health issues.
Sarah Miner is a community health nurse who has been doing home care for the last six years.
About four years ago, she connected with Refugees Helping Refugees – an all-volunteer group of refugees and Americans working with refugees from many countries.
Miner began working with the group, offering the medical expertise they couldn’t. She recalls what staffers once told her after a home visit with an elderly woman from Somalia.
“She doesn’t know how to turn on the heat, she doesn’t know how to use the phone,” Miner said, “The other thing that we found is she has this bag with medications in it, but she told us she doesn’t know what they are.”
Miner also worked to try and understand some of the cultural and social issues within the city’s refugee population. But it was the need to teach and reinforce the importance of maintaining good health that occupied most of her time. Chronic illness, such as hypertension and diabetes, were common, though often a new concept for refugees.
“For an acute illness, you take a medication and the illness ends. They understand that,” Miner explained, “But this idea that you can have an illness and you have to take medications, perhaps for the rest of your life, that’s very new to them.”
According to the latest National Healthcare Disparities Report published by the Health Department in 2015, despite improvements, disparities in access to health care persist, especially among people in poor households, Hispanic people, and African Americans.
Community pharmacy helps break health barriers
Sara Laza, 69, moved to Rochester from Puerto Rico 20 years ago. She is not quite fluent in English, but has a good understanding of her prescribed medication. She has been living with diabetes for the last decade, has suffered two heart attacks, and survived a cardiac arrest six years ago.
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As a result of peripheral neuropathy: weakness, numbness, and pain from nerve damage, usually in the hands and feet, Laza now uses a walker.
Every Monday, Laza sits in her kitchen organizing the next week’s set of pills in a package she gets from Saratoga Pharmacy in downtown Rochester. She credits the pharmacy’s easy-to-use packaging system and multilingual staff for helping to preserve her health.
“Sometimes the doctor changes my medicine and I don’t know how to use it. They explain, they call me and they say do like this and like that…in Spanish,” Laza said.
Saratoga Pharmacy has been located at Lyell Ave. and Saratoga Ave since the 1920s. After a takeover in 2015 by its third owner, Usha Ramadugu, the local pharmacy started to become a staple in the community.
“We wanted somebody here who speaks the native language, so I started hiring people,” Ramadugu said, “We have all multicultural employees who speak Nepali, we have Somali, we have Burmese…”
In addition to Spanish-speaking staff helping customers like Laza, pharmacists, technicians, and clerks at Saratoga Pharmacy also speak Korean, Greek and Hindi.
Ramadugu had a dream when she left India with her pharmacy degree for the United States that her skills would one day help one of the country’s underserved communities. After a brief stop in Florida, she landed in Rochester.
The CEO said she immediately saw the city’s health challenges. Language was one, and access to reliable, cost effective transportation was another, which drove Ramadugu to offer free medication delivery with flexible hours, using the six cars on hand.
“The third barrier is compliance, because roughly 58% of the population makes errors when taking medications and then will end up with chronic conditions,” Ramadugu said.
Through the use of medication therapy management, Saratoga Pharmacy acts as the ultimate go-between for doctors and their patients. Pharmacists counsel people about their medications and coordinate with other pharmacies to ease the customer’s burden. The effort, Ramadugu said, also helps reduce hospital re-admissions.
The effects of a sudden hip replacement surgery prompted Dianne Moultrie to call Saratoga Pharmacy a year ago. Having limited ability to walk, Moultrie relies heavily on the pharmacy’s delivery service.
“I live alone and I don’t have any family in Rochester, so there was nobody to go get my medicine for me,” Moultrie said.
Signature customized pill packaging, marking daily and time of day medication dosages, has helped Moultrie manage her health.
“You know, as you get older, it’s like your memory doesn’t work the way it used to. Sometimes I would get my regular pill container out but there were so many bottles I’d forget to put a pill in there.”
At a time when new leadership takes over in Washington, the future of healthcare in America is unknown. Medicare and the Affordable Care Act could undergo major changes or be replaced entirely.
Nurse Sarah Miner said she is frightened by the possibilities, but remains hopeful for the future health of the immigrants in her care.
“I feel passionately about the fact that we have to have an efficient and safe delivery of healthcare for all people in this country,” Miner said.
