Map of life expectancy at birth from Global Education Project.

Thursday, December 09, 2004

enough wonkery

I'm sorry for all the boring, discursive posts. Here's a true story.

Rosa and Carlos fled El Salvador in 1989, leaving their infant son in the care of Rosa's mother. For those of you who don't remember, there was a civil war going on in that country then, and people would disappear in the middle of the night. They found an apartment in East Boston with the help of an agency that assists Central American refugees. Carlos began to work three jobs in restaurant kitchens and cafeterias, and Rosa took a job as a housekeeper in a nursing home. They were just able to pay the rent and send a few dollars each month to Rosa's mother to support their child.

After a few years, Rosa had a bout with chicken pox. Shortly after she recovered, her hair started to fall out. Then one morning she awoke to find her face bloody. When she went to wash herself, blood streamed from her eyes, nose and mouth. She sat in her apartment for two weeks, terrified to go to a hospital for fear that they would demand money she didn't have, or turn her over to be deported. Finally, friends insisted that she go to a hospital, and practically dragged her into their car.

At the hospital, she discovered that they did not ask for a green card or concern themselves with her residency status. But there was bad news: she had lupus, and would soon need a kidney transplant. Realizing that Rosa could not get the medical care she needed in El Salvador, and that, although the civil war had ended, they could not return after all, Rosa and Carlos sent for their son Amado, now seven years old. Rosa went to enroll him in school, where she was happy to find people who spoke Spanish. They told her Amado needed to have his immunizations, and referred her to a hospital-based clinic where, they said, she could walk in and have it done easily, and for free.

Carlos took time off for work to accompany his ailing wife and child on the trip into town to get the shots. When they got to the clinic, they were again happy to discover that the receptionist spoke Spanish. "We used to just give the vaccinations," the receptionist told them, "but now we have a new policy. You have to talk to a doctor. You'll have to wait until we can get an interpreter."

Rosa and Carlos waited for five hours. All that time, Carlos was losing money – he doesn't get paid time off for sick days or doctor visits. Finally, just before closing time, the doctor came with an interpreter. This is what happened:

INTERPRETER: He says . . . mom says he grew up with his grandmother.

DOCTOR: Aha.

INTERPRETER: He was with his grandmother in El Salvador for six years . . .

DOCTOR: Okay, aha.

INTERPRETER: So he's only been here with her for one month.

DOCTOR: Okay.

INTERPRETER: ¿Un mes, nada mas, hace que lo tienes aquí?

ROSA: Sí.

INTERPRETER: He's only been here for one month.

DOCTOR: How long has his mom been here?

INTERPRETER: Y usted, ¿cuánto tiempo hace que está aquí?

ROSA: Siete años.

INTERPRETER: Seven years.

DOCTOR: Then you speak English. No?

INTERPRETER: No, ¿nada de inglés? ¿Nada? ¿Poquito?

DOCTOR: After seven years?

ROSA: Es que a veces si entiendo, pero el problema es que me vaya a confundir con una palabra, y entonces vaya a cometer algún error . . .

INTERPRETER: She says she understands some, but she's afraid she's confused when she, medical terminology. . .

DOCTOR: But you need to try.

INTERPRETER: She might give you the wrong information.

DOCTOR: Just keep trying. The more you try. . .

INTERPRETER: Que siga tratando, que entre más trate más rápido aprende.

DOCTOR: The more you try to talk, the quicker you'll learn, right? Don't run away yet. Don't run away.

INTERPRETER: Está haciéndote una prueba de si tú entiendes lo que ella te está diciendo. (Se ríe). [She's giving you a test to see if you understand what she's saying. (laughs)]

DOCTOR: But you need to practice. You understand me, don't you?
So today is the shot . . . and a shot, and a test for tuberculosis, and medicine in his mouth.

INTERPRETER: ¿Lo entendiste? [Did you understand it?]

ROSA: Sí.

And that was the extent of the doctoring they got that day, after five hours of waiting.

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