Pandemic Precautions Come at a Cost for Yazidis Seeking Healthcare
Published for Nebraska Public Media
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Yazidi refugees in Nebraska face language barriers, social stigma, and economic hardships, but the COVID-19 pandemic has exacerbated the issues. Local groups and researchers are trying to help alleviate the barriers.
At the Yazidi Cultural Center in Lincoln, Ahmed Mastto spends his days helping out members of his community with small tasks -- such as helping another figure out how to download his pay stubs from Walmart or translating someone's mail.
Earlier this year, Khero Ibrahim entered this same office. He was coughing and spoke to Mastto in Kurmanji – a Kurdish dialect.
“And he said, ‘Please, I want to do a test. And I don't know where to go, what to do. And I don't know anything.’ I said, ‘Okay, give me your ID,” Mastto said.
Mastto booked a COVID-19 test appointment and wrote down the time, address, phone number, and verification number on a small piece of paper. He said Ibrahim was nervous to go to his appointment.
“He’s really not good in English. Even I put in his phone, like the address 1234 A Street, so I write down on GPS. I said ‘Okay, like tomorrow at two o'clock, just go over there,” he said. “So it was a little bit hard for him to get an appointment.”
Mastto likes helping his community, but he wishes he had more resources to explain how the American healthcare system works. He’d like more COVID-19 testing websites in Arabic, or interpreters to explain how the health care system works. He said Yazidis are used to going directly to clinics, like they have in their home country, so in America they end up going to the emergency room.
“But they don't need to if they know how to use the clinic like Express Care, so they can go over there,” he said. “And they should go over there but they don't know.”
The pandemic increased social stigma and discrimination against close-knit refugee communities like Yazidis, according to the CDC. Mastto estimates more than 25% of Yazidis contracted COVID-19, but hid their illness to avoid more discrimination.
“They feel a little bit of shame, and they don't tell people that [they] have it.,” Mastto said.
Falah Rashoka is a Yazidi PhD student pursuing a second master’s degree in public health at the University of Nebraska Medical Center. Last year, he volunteered as an interpreter for Nebraska’s health departments and published papers about his observations and work with a research focus group of immigrants.
He said marginalized communities faced economic, social, and language barriers that worsened during the COVID-19 pandemic.
“Before it was possible that [an] in-person interpreter [could] visit with somebody who's not speaking English, to visit with him or her to the health institute,” Rashoka said. “When COVID hit, to protect the staff and doctors and nurses, they put in new rules saying that we're gonna stop in-person interpretation.”
Rashoka said at the time, interpretation services were offered on the phone, but it was hard to find the right interpreter to speak specific dialects like Kurmanji.
“Not having the correct interpretations led to getting misdiagnosis,” he said.
“And that led many, many refugees and immigrants to visit [the] ER (emergency room), and even in the ER, they didn't get the correct service.”
Another community member, Hasan Khalil, said his father was frustrated by not being able to tell doctors that he was struggling to breathe. He had been to the hospital three times since being diagnosed with COVID-19 last year, and decided to call Khalil to help with translation. Khalil said he was at home and sick too.
“He's like ‘This [is the] third time. What are they trying to do to me? Like, what are they trying to do?’ And I wasn't sure,” Khalil said. “I had to call him back then call my sister, my sister's a nurse. So, my sister ended up translating for him and then told him that ‘They're going to give you medicine that's going to make you breathe better.”
Khalil said the whole ordeal made his father uncomfortable, especially because there was no one there with him. He’s now recovered.
PhD student Falah Rashoka is also working with a team at University of Nebraska Medical Center to understand why some immigrants haven’t been vaccinated.
“The problem why they are not getting [the] vaccine [is] because they have [a] problem with language,” he said.
But misinformation is another reason, which Rashoka said may be harder to overcome. Bsaam Alali is a Yazidi barber in Lincoln and agrees.
“Some people from our community, I hear them say, ‘it's not safe,” Alali said.
Hasan Khalil said his whole family contracted the virus and got vaccinated, but Khalil hasn’t.
“I'm confused myself, “ he said. “Like my mind tells me ‘Take the shot, it's good.’ Then I tell myself, ‘Oh my god, I don't need it.’ So I'm still kind of undecided.”
As a Yazidi refugee himself, Rashoka hopes to alleviate some of the barriers minorities face. He sent a report to the state health department with recommendations, including mobile clinics in cultural centers and hard to reach communities, and cultural awareness videos for healthcare providers.
“They have many problems when it comes to healthcare, and I believe it's time to help them to be able to navigate the healthcare system in the US and Nebraska,” he said.
Rashoka is also developing a booklet and online videos in Arabic, Kurmanji dialects, and English to explain how COVID-19 vaccines and the healthcare system work.