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Mayans Find Guiding Light into Western Medicine

Vista Magazine, News Feature, Andrea Alegra Posted: Jul 13, 2008

From her small office at Clnica Oscar Romero, a community clinic serving one of Los Angeles most overcrowded and impoverished neighborhoods, Idalia Xuncax helps Mayan women receive medical services. She helps patients overcome a language and cultural barrier that has kept many in the dark, as Xuncax herself was when she arrived from Guatemala over two decades ago.

mayan Idalia XuncaxHere, [in the United States] if your child is sick you take him to the hospital. But there its more about making a herbal tea, about taking him to a curandero [herbal healer], says Xuncax, 38, whose official badge reads Mesoamerican Clinic Coordinator.

For eight years, she has gained the trust of Mayan women by acting as an interpreter for their patient-doctor dialogues and a guide through the process. Some of these women, she says, will come to her office first before a doctors appointment, and if they dont find her there, they will leave.

Some 20,000 Mayans settled in Pico Union and other Los Angeles neighborhoods during the 1980s. Like Xuncax and her family, many are among the 250,000 Guatemalans who fled torture, rape, and murder during a civil war that lasted over 30 years. The massive killings during those years are often referred to as the "Silent Holocaust", when hundreds of Mayan villages were wiped off the map.

New generations of Mayans have kept coming to the area in constant waves, and many arrive with no knowledge of English or Spanish, and cant read or write. The majority of Maya who show up at the clinic speak Kanjobal, but there are also patients who speak Quiche and Mam, among other Maya dialects.

Xuncax, with her straight black hair, copper colored skin and short stature, speaks English, Spanish and Kanjobal fluently. She is among a handful of the clinics staff members who speak Mayan, a group that includes her sister, Rosa, who works at the front desk.

For many patients, access to an interpreter has meant the difference between getting the right help from a doctor, or not. For timid 22-year-old Juana Juan, who arrived in Los Angeles from Huehuetenango Guatemala only five months ago, it meant being able to tell a doctor about those chest pains shes been having, and understanding that she should have an electrocardiogram performed.

Its comforting to know that the doctor will know everything that I am feeling, she says in her native tongue. Her husband, 25-year-old Tomas Juan Pedro, who speaks a little Spanish, says they came to Clnica Romero only when they heard from a Mayan neighbor that people spoke Kanjobal there.

Through Xuncaxs efforts to reach out to this particular population, the clinic has seen the numbers of Mayan patients go up from just a handful 8 years ago to upwards of 700 today. Despite the increase, getting Maya patients to come to the clinic remains a challenge.

These patients come with some reluctance, or apprehension I should say, in many cases not fully understanding or knowing exactly what it is we do, says Dr. Eduardo Gonzlez, Clnica Romeros Executive Director, and one of its founders back in 1983. Many of them have never gone to see a physician before in their entire lives, not in their homeland or in the United States.

Back in Guatemala, going to see a doctor would usually mean a significant economic expense for Mayan families, and many dont know about the free services that Clnica Romero offers. Their culture, where they have no regular access to health care, has come with them, and they tend to be more resourceful, caring for their own with herbal remedies and things of that nature, Gonzlez says.

Like all immigrant populations throughout Los Angeles County, Gonzlez says the Maya community is experiencing an increase in the number of people with chronic diseases, mainly obesity and diabetes, in part as a result of changes in their personal habits and exercise patterns. In their homelands, for example, Mayan people tend to walk more, he says. Of the 15,000 patients the clinic saw in 2007, about 2,400 had diabetes.

Our mission is to provide quality health care to the uninsured and underserved and I truly cant think of a population that is less served and less insured than the Mesoamerican population, says Gonzlez.

One of the greatest challenges for Xuncax and the clinic has been educating Mayan women about the importance of pre-natal care. How do you explain to a pregnant mother who has already had nine healthy children in her native land without the use of doctors, that prenatal care is important for the health of her baby? Its difficult, she says. They just dont understand.

Her own mother didnt understand after migrating to Los Angeles.

Far from the bustle of Alvarado Street, where the clinic is located, Xuncax and eight of her siblings were born in the rural town of San Miguel Acatan, a municipality in the Guatemalan department of Huehuetenango. Gynecologists, exam rooms, sonograms and the concept of pre-natal care were unheard of, and her mother gave birth to all of them in the house where they lived, aided not by a doctor, but by a partera or midwife. But there was one exception.

I had one brother who was born here [in the United States] and my mother said she would never like to have that experience again, Xuncax says. With nine children, her mother had never been examined by a physician, and the experience of going to a doctor, getting regular examinations, and giving birth at a hospital was traumatic for her, Xuncax explains.

Still today, she adds, I have patients who refuse to have a Pap smear done. They just dont like being examined.

Not seeing the benefit in prenatal care can have devastating consequences. Its sad, she says. I explain to them that there are silent diseases, that its important for their babys health that they go to the checkups, but most of the times they dont believe in pre-natal care.

Xuncax has to be patient. Her job at the clinic is an opportunity to help the members of this community who have to adjust to a radically different lifestyle in Los Angeles. It is her responsibility to guide them. Its about really having that sensibility to want to understand and help, she says.

From her own experience she can understand the struggles and the hurdles the Maya immigrants face as they adapt to life in the United States.

Our culture is very rich. Its free. Its full of rivers and trees and all kinds of crops, fruits and vegetables. Its about walking to the market in the middle of town, walking to church, walking everywhere, Xuncax explains. Here, its very different, its about feeling enclosed, about strict routines and eight-hour workdays, about being in cars and buses and living in tiny apartments.
After arriving in Los Angeles, Xuncax and her family worked in downtown garment shops to make ends meet. Her family was able to legalize their immigration status through political asylum, and Xuncax is now a U.S. citizen. However, many of the Maya women she helps are stuck in the shadows, making their fears of seeking medical help, at times, even greater.

My people have been able to survive but there is a great demand for Maya interpreters at hospitals, clinics and pharmacies, says Xuncax. There is a great need for people with the sensibility to want to help, especially those who dont speak English or Spanish and those who cant read or write.

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