The state of Rhode Island has long been regarded as an immigrant hub, with immigrants making up one in eight Rhode Island residents.
But, despite this diversity, cultural and linguistic barriers for immigrant residents of Providence — such as access to personnel in medical spaces that speak their native language — minimize access to equitable and culturally competent healthcare. Providence’s undocumented residents, many of whom are Hispanic, face even greater obstacles to securing health insurance, making financially accessible healthcare all the more vital.
Stepping away from their homes on College Hill, many Brown students have sought to rectify some of these inequalities, volunteering and working with local organizations to support these communities by working as interpreters in medical spaces.
For Brown students who are Spanish heritage speakers, the ability to support the city’s Spanish-speaking community and immigrant populations has proven to be an impactful way to make change. In recognition of National Hispanic Heritage Month, The Herald spoke with members of the student body who are using their linguistic and cultural backgrounds to support the Providence community, bringing pieces of home with them as they venture past College Hill.
Searching for spaces to leave an impact
Melanie Morales Aquino ’23 MPH ’24, an interpreter for Clínica Esperanza and Rhode Island Free Clinic, knew she wanted to do Spanish language translation work in the Providence community before arriving on campus.
Clínica Esperanza “provides linguistically-appropriate, culturally-attuned medical care to uninsured adults living in Rhode Island,” serving more than 10,000 patients since 2010, 80 percent of whom are Spanish speaking, according to the clinic’s website. Similarly, Rhode Island Free Clinic provides “comprehensive healthcare to low-income uninsured adults” across the state, supporting those “who are below 200 percent of the federal poverty level,” according to the clinic’s website.
As the child of immigrants from Guatemala whose first language is Spanish, Morales Aquino’s parents often had difficulty understanding English-speaking doctors.
For Morales Aquino, acting as an interpreter for her parents when they went to the hospital from an early age taught her the importance of providing Spanish-language information to patients who struggle to understand medical advice in English.
Though Zephelline Villalobos ’23 grew up in a Mexican-American household, she did not know Spanish as a child. Instead, Villalobos picked up bits and pieces of the language from her family members while her parents sought to ensure that, first and foremost, their daughter would be able to communicate in English. It wasn’t until middle school that Villalobos began to learn Spanish and become comfortable with her heritage language.
As Villalobos grew toward fluency in high school and her early college years, she began to seek out opportunities to use her skills to support Spanish speakers in Providence, serving “undocumented, uninsured, primarily Hispanic individuals” at Clínica Esperanza by helping with patient intake and interpreting for doctors, she noted.
With the onset of the pandemic, Villalobos began to look for other ways to support the community, too, taking on a virtual COVID-19 screening and information providing position at Contra COVID, a nationwide organization that works to ensure “Latino and immigrant individuals have the information they need to protect themselves and their families,” according to the organization’s website.
Coming to Brown from her home in Puerto Rico, Adriana Báez Berríos ’22 also knew that she wanted to support local Spanish-speaking communities by applying the linguistic knowledge she had garnered over a lifetime of speaking Spanish at home to help city populations.
“I searched for places where I could perhaps put my language skills to use” upon arriving at College Hill, she said. Báez Berríos ultimately found the same two clinics as Morales Aquino — Clínica Esperanza and Rhode Island Free Clinic. She noted that, upon reaching out, the organizations emphasized their need for Spanish speakers, “because there’s not a lot of Spanish interpreters” available to them.
“We are always looking for interpreters,” Morgan Leonard, Director of Clinic Operations for Clínica Esperanza, said, noting that they are most in need of Spanish language volunteers during the summer and winter breaks.
Student interpreters provide the “link between provider and the patient” at Clínica Esperanza, where many of the providers do not speak Spanish, Leonard said. Interpretation services are “imperative” in offering “culturally competent, linguistically appropriate care” that allows Clinica Esperanza’s patients to feel comfortable at the clinic, she added.
“The U.S. is made up of immigrants, and there’s a lot of diversity,” Báez Berríos said. “I’ve seen how, as a U.S. citizen, even though I’m Latina, I’m really privileged, and I know how important it is to offer these services because the majority of patients that come to us are uninsured because of their immigration status.”
“We have to understand that we owe this to our community, so we have to use our education and privilege to provide for them,” she added. “That’s why I volunteer at these clinics.”
Serving Spanish-speaking patients
The presence of a Spanish speaker in the room can make a significant difference for Spanish-speaking patients, according to Morales Aquino. She has observed this phenomenon watching her mother, who “always gets super excited” when the doctor speaks Spanish, and with patients in Providence. “The way the patient’s face lights up makes my day,” Morales Aquino said.
Villalobos agreed that there is a notable shift in her patients’ expressions when they get to speak with a physician or interpreter who is a native speaker of the same language as them, sharing not only language but a cultural background not all physicians can offer.
“That’s also why I like to do a lot of volunteering at the clinic,” Villalobos said. “I walk in and they’re like, ‘Oh my gosh, someone who speaks Spanish,’ and you can just see it in their face.”
Spanish language interpretation is “a huge part of what we do,” Marvin Ronning, director of strategic partnerships for the Rhode Island Free Clinic, said. With over 70 percent of the clinic’s patients who speak Spanish as their first language, having Spanish language interpreters provides the clinic the ability to provide patients access to “vital medical and dental services,” he added.
Villalobos noted that, from her experience interpreting for her own family inside and outside of a medical setting, individuals who do not speak English fluently often feel misunderstood or underrepresented in English-speaking spaces in the United States.
“I know my grandma expresses that, even though she has an interpreter sometimes, she feels that her voice isn’t getting heard because she doesn’t know if what they’re saying is true, and she doesn’t necessarily trust them entirely,” she said.
Within Providence, “a lot of the time that I’ve talked to patients at (Clínica Esperanza), they’re like, ‘I feel like I don’t ever meet any other Hispanics that are younger who speak English and Spanish,’ so I think that’s something that’s a big need in the Providence community — to actually get out and serve these communities,” Villalobos said.
“I feel like it’s important to not only speak a language but also understand people culturally,” Báez Berríos said. “You want to be inclusive for all patients, so I’ve felt that my identity as a Latina has helped patients feel more welcomed in these clinics, and I value that a lot.”
Through her time volunteering as an interpreter in Providence clinics, Báez Berríos has “been able to explore how fractured or imperfect our healthcare system is and how important it is to have culturally competent physicians.”
Shaping the future
Between Morales Aquino, Villalobos and Báez Berríos, all of whom hope to one day pursue careers as doctors, the experience of working in medical settings with Providence’s immigrant community has been eye-opening, illuminating the nature of the United States’ healthcare system.
Morales Aquino has worked at the Rhode Island Free Clinic since her first semester at Brown and started at Clínica Esperanza last year. She plans to continue this work for the rest of her time at Brown, adding that as a pre-medical student, the experience has helped her improve her understanding of medical terminology and patient interactions.
The most meaningful aspect of the work for Morales Aquino is knowing that she is helping patients feel “comfortable” and “safe” when they are interacting with medical professionals.
Báez Berríos hopes to one day bring home her learned experience from Brown and volunteering in Rhode Island to better support the Hispanic community as well as disenfranchised groups such as those from the undocumented community.
“Of course, I can’t really predict where I’ll be in the future, but my goal is to go back home in Puerto Rico,” she said. “We have a scarcity of physicians because we have an economic recession, so most professionals are moving to the mainland.”
“I really want to work for these communities that are marginalized in the medical setting and who are not well-represented,” Báez Berríos said. Providing a safe and culturally inclusive environment is “part of the treatment” as much as providing care, she said.
“The work I do definitely inspired me to become a physician who tries to understand other people that are different,” she added.
Villalobos plans to one day open up a free clinic where her grandparents lived after immigrating from Mexico, she said. Until then, she hopes to continue volunteering with free clinics during medical school
“Knowing Spanish is really going to help me connect with future patients and form a space (where) they feel welcomed and heard,” she added.
“Volunteer experience has taught me that it is always important to embrace your identity, your cultural roots, no matter if you’re in a country that perhaps doesn’t celebrate the diversity it possesses,” Báez Berríos said. “In professional fields, such as medicine, language is so nuanced and oftentimes we take it for granted, so it’s really important to have representation.”
“You don’t want the lack of cultural competence to be detrimental to patients or any other person that comes to you to receive medical care,” she added, “because in the end we’re all deserving of medical care, no matter our identity.”