HLC: Growing the ranks of language-skilled healthcare workers

HAWAI‘I LANGUAGE CHAMPION : MARY SANTA MARIA

by Shiwani Johnson, Hawai’i Language Roadmap Initiative Intern
Mary Santa Maria is a Public Health Educator with the Maui District Health Office.

Mary Santa Maria is a Public Health Educator with the Maui District Health Office.

The work that Mary Santa Maria does in the Department of Health is, on the surface, what you might think it would be: working with all kinds of people, and with all types of health related issues. That being said, when I speak with her, I get the feeling that her work is much more than that for her: It is a portrayal of her vision. She does not treat the subject of language access as something that exists outside of life and work but as part of it. Mary’s calm voice and smile are earnest; her words say she wants to tell you about her work, but, more than that, she wants you to listen.

Mary is a Public Health Educator with the Maui District Health Office. She also works for the Chronic Disease Prevention Branch of the Hawai‘i State Department of Health (DOH) and has worked for the DOH on Hawai‘i, O‘ahu and Maui. Although originally from Texas, she calls Hawai‘i, specifically Maui, her home.

She has worked in many different capacities over the years, including being a P.E. teacher, working in health promotion and prevention. While on O‘ahu she coordinated and trained counselors and testers for the HIV counseling and testing program for the State of Hawai‘i. It was in this last role that Mary was able to travel to the mainland, where she had an eye-opening and inspirational experience that eventually led her to where she is today.

“My job was to train people to be HIV counselors and testers. I had been through my own training with the Center for Disease Control as part of the grant the STD/AIDS Branch received from them. I also had the opportunity, within that time frame, to do the Red Cross HIV prevention education training in Spanish for our Spanish speaking communities. I was really fortunate…I was the only person in there whose first language was not Spanish. All of this together made me really realize that we had puka, here in Hawai‘i, regarding being able to address HIV and do outreach with people that didn’t speak English or had limited English proficiency.”

When she came back to Hawai‘i she learned of Kokua Kalihi Valley and the Bridging the Gap training for interpreting in healthcare settings that they offered. She took part in that training, and KKV invited her to become a trainer for their program at the same time she moved back to Maui. Mary passed on the information she learned about working with interpreters through Bridging the Gap to the counselors she worked with at the STD/AIDS Branch. Eventually, it became a formal part of the training she conducted. She even had the opportunity, she said, to train a native Spanish speaker in Spanish and English, and he passed his training using both languages.

Now Mary works with language access issues with anyone who asks her, training them as she was trained. It can be small companies or the District Health Office, with sessions lasting only an hour or even all day. Recently, she worked with a local non-profit on Maui; in her session with them she discussed language access laws, helped them to understand when a situation calls for an interpreter and gave them tips for working with interpreters.

Mary is known for her work with language access, but her jurisdiction actually falls under Chronic Disease Prevention at the Department of Health. Language falls under this umbrella because decreasing health disparities and increasing access to equal services contribute in important ways to prevention. Simply put, patients need to understand what is being said to them in order for the health care providers to do their jobs correctly, and for the patient to continue to progress.

Currently, Mary is working with Maui Memorial Hospital and Maui Community College (MCC) to create an interpreter training program at MCC. The program prepares participants to assist with language access in healthcare settings. Students completing the program will enhance not only their workplace skills, but also their opportunities for career development. Importantly, they will also join the growing ranks of language-skilled workers positioned to contribute to Hawaii’s fulfilling its legal and ethical obligations, mandated by both State and federal laws, for equitable access to healthcare services. Ideally, those who complete the program will be able to use their skills as interpreters and health care workers at the hospital immediately after graduating. One cycle of the program has been completed thus far and Mary hopes to start a second soon.

[The disaster preparedness outreach program on Maui supports effective communication with communities in a number of languages.]

The disaster preparedness outreach program on Maui developed effective resources in a number of community languages.

Another project that she has contributed to is a multilingual outreach program that focused on disaster preparedness training. Rachel Hecksher, a fellow Public Health Educator at the Department of Health Maui District Health office, recruited Mary to help her train the non-English speaking members of the community as well as those with limited English Proficiency (LEP) on disaster preparedness. After finding funding, searching for lead community members with bilingual skills, and conducting rounds of interviews, a group was hired to translate the materials that were already in place, and use them to promote disaster preparedness in different language communities. In the two rounds of outreach training conducted to date ASL, Hawaiian, Mandarin, Cantonese, Ilokano, Tagalog, Spanish, Korean, Chuukese, Marshallese, and Pohnpeian speakers have all been able to go out into the community and teach about the importance of disaster preparedness.

The outreach program is the perfect example of how people can think constructively about language. This group of people was able to look at language as a tool and use it to increase the reach of their training efforts. Mary tells me that the way people think about language has a lot to do with their actions, and reactions, when the subject of language access comes up. Meaningful action is a direct consequence of a thought or a mindset that views language as a tool; it reflects the acceptance of another’s language or the importance of the availability of access. This way of thinking is visible in the interaction between workers who have an understanding of language access and the less proficient or non-English speaking community members seeking a service. It is seen in their application and understanding of laws that deal with the subject. However, according to Mary, just because laws are in place does not mean that all people understand or even accept them.

“We have the Office of Language Access embedded in the Department of Health.” Yet, Mary says, she feels that the Department of Health is not the model of language access it should be. It has the structure, but the implementation is lacking. According to Mary, language in America is sometimes looked at as a barrier or divider, and Hawai‘i is no different. Encountering a language they don’t understand can cause people to close themselves off from others’ perspectives, or to become more attached to their own ways of thinking. In order to progress, everyone needs to look at themselves, and beyond themselves.

“I look at my own father and I think ‘Whoa, he literally had his Italian beaten out of him in school’ and so many people have had that experience,” said Mary. It is strange to me that this is an actuality. Mary tells me that, when you think about, we have never really had a native language in the USA; there has always been a multitude of languages at work here. Still, the perspective that language is something that divides has persisted. This is not the case. Mary believes a simple change of perspective is needed.

“We, ultimately, are all individuals that deserve each other’s respect. The way that I respect you is to find out who you are and how you approach the world, and vice versa. Then we find some way that we can communicate. That’s how the world goes around; when it doesn’t happen, that’s how barriers get thrown up and miscommunication happens… I don’t even have to speak your language but, I do have to let you be yourself and be open to seeing what that is.”

Being willing to accept someone’s differences is just the beginning Mary tells me. First is acceptance, then communication and finally cooperation. She hopes that one day more people will feel the same excitement she feels at meeting someone who speaks a different language than she does or has been someplace she hasn’t. For Mary, there is much to be learned from everyone around us and simply knowing that is not enough.

Author: Shiwani Blessing Mahealani Johnson lives on O‘ahu with her cat and her younger sister. She is currently attending the University of Hawai‘i at Mānoa, pursuing a major in Spanish. She works and spends her free time eating, studying, reading, writing, doodling, hiking, and doing yoga. She enjoys sci-fi and romance movies, her fixed-gear bicycle and skateboards, fantasy novels and poetry. Shiwani has been known to be emotionally confused about a number of things simultaneously. Her sister and mother often tell her to get over herself.

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