Southwest Georgia Multicultural Health Initiative

In southwest Georgia, agriculture is the predominant, driving force of the rural economy. Some Spanish-speaking individuals who moved into the region during the 1990s became permanent residents, while others found work as migrant or seasonal farmworkers. But language proved to be a major obstacle that separated many Spanish-speaking individuals from receiving the health care they needed, including basic screenings for blood pressure and glucose levels. As a result, many Spanish-speaking residents received care only at the local hospital’s emergency room—when their health had reached a crisis situation.

• To ensure that translation and interpretation assistance was available to individuals with limited English proficiency seeking care at local hospitals and health departments
• To improve providers’ understanding of cultural diversity issues related to the people they serve
• To ensure that people with limited English proficiency have access to routine health education and screening services.

At first, the project’s target service area consisted of Brooks, Early, Grady, and Mitchell Counties; however, during the grant cycle, the service expanded to include Thomas County. The original project network was comprised of John D. Archbold Memorial Hospital, Brooks County Hospital, Early Memorial Hospital, Grady General Hospital, Southwest Georgia Technical College, and Public Health Districts 8-1 and 8-2. However, as the project developed, the network became less formal. Other community organizations supported the project’s efforts, including the region’s Area Health Education Center, local farmworker health clinics, family and community organizations, and two county school systems. While these community partners were not formal members of the network, they made a valuable contribution to developing and implementing project activities.

Some of these activities included offering health screenings for migrant summer school students, providing screenings on Saturday evenings at a Catholic church before Spanish mass and in local trailer parks known to have a large Spanish-speaking population, and engaging nursing school students to conduct screenings.

Project planners recognized that it would not be financially feasible to hire a staff interpreter at each facility participating in the network. Instead, the project created a telephone interpretation system that allows health care providers throughout the service area to contact an interpreter as needed. The system offered interpretation services for up to 150 languages, 24 hours per day. However, it required that each facility use the same telephone equipment, and staff members needed training to know how to use the equipment properly.

Another innovative feature of the project was the occupational Spanish language classes for health care providers. Both the Project Coordinator and the Regional Coordinator were certified as instructors in the Command Spanish, Inc.® curricula. This company offers several courses including “Spanish for Nurses,” “Spanish for the Physician’s Office,” and “Spanish for Paramedics and EMTs.” These courses teach participants words and phrases directly related to their jobs, so a nurse who must give a patient a shot can ask him to roll up his sleeve and make a fist without learning the entire Spanish language. More than 250 health care providers participated in the classes.

The project is seeking new funding to sustain its services. The Decatur County Health Department has expanded its services to three of the five counties in the original target area, and it will be able to continue providing care to farmworkers and their families in case new funding is not secured.