Wednesday, July 2, 2014

Are We There Yet? Civil Rights Act, 50 Years Later In Arizona.

Kamana Khadka, MPH

At about 4:30 pm on weekdays, my Mum would yell from just outside the dinning area of our Kathmandu home, “Kamana. Monika. Come eat first.  Did you two change your school uniforms yet?”

Immediately, after returning from school, my sister and I, sat next to each other, on Galaicha (Carpet, handmade in Nepal), leaving sofa behind us, and stared at our 32 inches, Sony, color television set.  We impatiently flipped through several of our favorite American shows on Star World, HBO, Cinemax, MTV, Nickelodeon, Cartoon Network, National Geography, BBC, Channel V, Disney World, and so on.

We painted a picture of the United States of America, as the land of most progressive minded and intelligent people.  We thought, new innovations, exciting discoveries, and strong systems of law that protect the rights and ensure happiness of All its citizen, were part of everyday life in the United States.

“Chori (daughter), do you want to wear thick glasses like your Hajur Buwa (Grandfather)?” my Dad would say, as he literally picked both of us, one at a time, and placed us further away on the Galaicha. 

“I can’t wait to graduate from high school Dad.  I want to go to the United States,” said I.

In 2005, I was in Phoenix, Arizona. 

“Heavily accented teachers removed from Arizona classrooms,” read the headline in The Washington Post, 2010.

“Arizona bill 2281 targets ban on ethnic studies,” read the headline in The Arizona Republic, 2010.

When SB1070, the anti-immigration law was passed in Arizona, President Obama commented that it threatened “to undermine basic notions of fairness that we cherish as Americans, as well as the trust between police and our communities that is so crucial to keeping us safe.”

Almost a decade has passed since I first arrived in the United States. 

50 years has passed since President Lyndon B. Johnson signed The Civil Rights Act of 1964; the law that outlawed discrimination based on race, color, religion, sex or national origin. 

But, are we there yet?

Sure.  There have been prominent movements for equality.  After all, equality is what we, the Americans, are all about. 

But, I ask again, are we there yet?

The rights of LGBT community, women, undocumented immigrants, refugees, and limited English speakers/speakers of non-English languages still remain unaddressed for the most part.

What about in the State of Arizona? 
Are we there yet?

“We must come together as a proactive cross-cultural movement to eliminate racism within our lifetime. It is time to inspire people to believe – and act on the belief – that this can be achieved. As we lift up healing with efforts to transform, inequitable systems and structures will surely crumble as our collective power is applied.”
 - Mr. Lloyd Y. Asato, Executive Director at Asian Pacific Community In Action
 “Personally and as an immigrant, Civil Rights Act of 1964 and similar laws are one of the reasons why we left our original countries. Being a member of a minority always puts you at risk of discrimination in one way or another. It is usually the legal system that should protect citizens of any act of discrimination. This is why people from all around the world aspire to live in the United States of America.”
-       Ms. R. Radhi. Originally from Iraq.  Living in Phoenix since June 10th, 2010.

“Although the Act was passed 50 years ago and despite the fact that many of the injustices it was designed to combat still exist today, many benefit daily from its passage and implementation.  Personally, I benefit from having a professional role that allows me to implement elements of the Civil Rights Act each and every day by ensuring our organization maintains equitable hiring practices, goes beyond ADA standards of accessibility, provides inclusive, quality service to individuals from all backgrounds, and much more.  Unfortunately, the elimination of important equity-focused programs like Affirmative Action seem to revers our national and state progress as they have had significant negative impacts in areas such as admissions to higher education institutions by people of color.”  
- Mr. Essen Otu, MPA, Diversity & Community Affairs Director at Mountain Park Health Center

“My experience has been in the military from around that time until 24 years later. In the military I did not see or experience anything that appeared to be discriminatory; on the contrary, any behavior of that type was not condoned or permitted and there were severe consequences if that were to occur. I spent a major part of those years outside of the United States.  As it is, I have little personal experience but in my current position I see that Title VI of the Civil Rights Act of 1964 has allowed for better access to health care services by prohibiting any discrimination based on race, color or national origin; this principally enhances the opportunity to communicate in a clinical setting in a form and language that the patient understands. Having experienced health care services in a foreign country and seen the difficulty of English speaking patients in attempting to communicate with the health care provider and having to rely on signals and signs compared to here in the US where the patient can rely of a qualified medical Interpreter… the Civil Rights Act of 1964 has made it possible for the patient not to be concerned if they would be someone available that could understand them and focus more on their health issue. I have seen the progress of language and cultural services in a health care setting… from the use of anyone that may be bilingual to the use of qualified bilingual staff. The professionalization of the medical interpreter has been the direct outcome of the civil rights act and has led to the improvement in communication and in the outcomes of the medical interaction. Positive comments made from satisfied patients and family members praising the medical interpreter for their thoroughness and their ability to help them deal with a difficult issue and understand the what is said is a testament of the importance of assisting in the communication process.”
- Mr. Luis Gendreau, BGS, MBA, Community Relations Director at Maricopa Integrated Health Systems 

“A few seniors asked me these questions during a recent visit to a senior center.  Please note that they are on AHCCCS. 

What do I do if the doctor told me to bring my own "translator"? 

A receptionist told me that the doctor would not see me unless I bring someone to "translate" for me.  What should I do? 

I was glad that the community center assigned an interpreter for me but the liver specialist referred by my family doctor told my daughter that they don't provide interpreter service.  What can I do now? 

The phone interpreter seemed so rushed.  I don't think that the doctor really knew what was wrong with me.  What can I do? 

These questions showcase the common language barrier that many individuals with limited English Proficiency have to deal with while accessing health and social services.  They encounter the language barrier while seeking services at clinics where federal  fund was provided.  And yes we are talking about 50 Years after the inauguration of Title VI, Civil Rights Act of 1964.  More workshops on Title VI are needed to educate the public about the right to receive equal service so that they are empowered to ask for language service.  More complaints should be filed by members from people speaking language of lesser diffusion.  More interpreters need to be trained.  Service providers should be educated on Title VI and CLAS standards so that they know to be compliant with the law by using certified/trained/qualified interpreters.  

The reality is that LEP patients are discriminated against everyday because of their "race, color, and national origin."   We have a lot of work to do.  Perhaps someday Arizona will also have state registry for healthcare interpreters and state certification.  Not in the too distant future, I hope.” 
- Ms. Emma Ditsworth, Co-founder/Interpreter Trainer at Hamro America

During my recent travels to Bhutanese Refugee Camps and a couple of countries in Asia, I was reminded that, just like my sister and I, many of the refugees, immigrants, tourists, and international students, still paint a similar picture of the United States of America; land of endless opportunities for all.  Opportunities, regardless of caste, class, education, color, language, sex, religion, and national origin. 

And, just like my sister and I, they too are bound to be disappointed upon their arrivals.  Because soon, very soon, they will access our health care, social and human services and see right through the discrimination we practice in our State, in our country; sometimes openly and often times very subtly.  Our service delivery and hard-to-change systems reflect the practiced discrimination on a daily basis.

Today, as we celebrate the 50 years of accomplished progress, after the signing of perhaps, one of the most important laws in our country, The Civil Rights Act, let us not forget that indeed, we are not there yet.  Much work lies ahead of us; in the State of Arizona and in our country.

On World Suicide Prevention Day: Because Emotional Self-Expression Is Not Part Of Bhutanese Culture

Kamana Khadka, MPH     “Golden Gate Bridge board Oks $76 million for suicide barriers,” read the headline in SFGate. Despite the cont...