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California, parts of Washington state and New York-areas
with large Asian-American and Pacific Islander populations-have
been on the forefront of caring for Asian Americans.
The Asian Counseling and Referral Service is one example
in the Seattle area. The service operates from an office
in the heart of the primarily Asian International District,
and offers a continuum of services, including an emergency
feeding program stocked with Asian diet staples, a substance
abuse treatment program and programs for children, youth
and families. The center began small but has grown dramatically,
from 100 clients in 1973 to 15,800 clients in 2001.
Jeannie-Trang Nguyen, RN, and Hanh Lai, RN, are two
of the six nurses working for the service. Nguyen has
worked as a nurse consultant for the service for the
past six years. Lai has worked in the same position
for three years. Most of their patients do not speak
English.
Both women are Vietnamese American and bilingual. That
helps dramatically with Vietnamese-American patients,
they said. But together, the nurses serve about 1,000
people who speak a total of 10 different languages.
In their home visits with clients, the nurses know
that they will be asking very personal questions, and
it's important that their patients trust them.
"Every time we go to see a patient when we don't
speak the language, we ask the case manager to write
down some basic questions [in the language], like 'How
are you?' and 'Are you in pain?' and ways to address
them appropriately," Lai said. "By doing that,
we break the ice."
Because they deal with various ethnicities, Nguyen
and Lai know the special problems related to some. Respiratory
problems, including tuberculosis, are significant problems
for some Asian subgroups. For people coming from highland
Laos, opium addiction can be an issue, they said.
The nurses may not speak all the languages of their
patients, but they do have one thing in common with
many of them-a shared understanding of war. Both nurses
lived in Vietnam during the war, and Lai, for one, still
has nightmares.
"Sometimes, I still have very bad dreams, so I
can really understand where our patients come from,
and why they [have] so much suffering and depression
and other illnesses," she said.
Both nurses feel their experiences help them relate
to people from Asian countries that underwent horrible
strife and war.
"For every Cambodian family, we acknowledge they
are survivors," Nguyen said. "We know that
and we feel that for them."
Barbara Masterson, RN, a wellness nurse at Yu-Ai Kai,
an organization in San Jose, Calif., that offers social
services and assistance to elderly Asian Americans,
primarily Japanese Americans who speak English, has
had the opposite experience. She has found that not
being Asian herself sometimes has been to her advantage.
Masterson said that because she isn't Asian, sometimes
her patients are more comfortable talking about their
health problems.
"It's a very small community, it's like a small
town where everyone knows everyone," she said.
"They know that I won't go and blab something accidentally,
because I'm not a cousin of someone else."
Masterson also has helped Yu-Ai Kai bring attention
to an increasing health problem among its patients:
breast cancer.
Although breast cancer rates for Asian-American women
of different ethnicities are lower than for other racial
groups, they are increasing with every generation. A
five-year study of women in Los Angeles published in
a 2002 issue of the International Journal of Cancer
found that breast cancer rates for Asian women older
than 50 were increasing by 6.3 percent each year. Caucasian
women were the only other group to show an increase,
but it was just 1.5 percent annually, according to the
study.
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