Can You Help Me?
"¿Ustedes están aquí por la vacuna de covid?" (Are you here for the COVID vaccine?)
"Sí, pues claro. ¿Támbien usted?" (Yes, of course. You, too?)
Miguel wore a baseball cap, and had a clipboard and pen in hand. He appeared kind. Walking toward us, he said: "¿Ustedes están aquí por la vacuna de covid?" (Are you here for the COVID vaccine?)
The area between us was separated by a cordon that roped off a few chairs to maintain social distancing. The chairs marked the casual perimeter of the vaccine waiting and observation area, just beyond the pharmacy's main counter and cashier desk.
My Mom and I looked at each other, and she deferred to me. And that was when the conversational Spanish skills I learned during the year I lived in Mexico City (and which I rarely get the chance to use nowadays), kicked in. I coaxed my brain into action. "Sí, pues claro," (Yes, of course) I replied. "¿Támbien usted?" (You, too?)
Miguel was very friendly, and seemed happy to be responded to in Spanish! So, we moved closer to take in more of what he was saying. Once we were within a more audible range, he began to speak more excitedly, gesturing to the page affixed to the clipboard in his hands. My Mom and I were close enough to see he was pointing to the pharmacy's standard COVID-19 Immunization Consent Form, with questions like, "Are you sick today?" and "Have you ever fainted or felt dizzy after receiving an immunization?"
The consent form was just like the one we had completed 15 minutes earlier, except his page was printed in Spanish. Likely because we had entered the pharmacy speaking English, my Mom and I were not offered this alternative language option. Truthfully, we didn't even know that the pharmacy had Spanish-language consent forms, but the fact that they were available was a good thing.
Miguel pointed to the Spanish-language health form on his clipboard, and continued speaking Spanish. He explained that when the pharmacist had originally given him the health form in English, he had told them he was unable to read it. And so he had been given the Spanish version. But he was having trouble understanding this form, as well. Miguel asked: ¿Me pueden ayudar? (Can you help me?)
As our conversation unfolded, there were more clues that although Miguel was able to speak Spanish, he had difficulty reading the language on the consent form. He also appeared to have difficulty with writing.
Immediately, it struck me, based on my experience with speakers of languages other than English, that Miguel was probably multilingual in other languages, possibly Indigenous languages that he could navigate without difficulty. It was important to me to relate to him with respect for our multilingual world. But at the moment, I was faced with the challenge of figuring out how best to help him. So, what should we do when language and literacy form practical barriers to public health measures? Let me share what I was able to do...
Collaborating to Complete a Consent Form.
Even though I studied Spanish throughout high school, and even took a class at my local community college, the language was mostly not taught in ways that prepared me with practical skills.
For these reasons, the conversational experience I gained with Spanish remains invaluable to me, especially now that I have been able to return to Southern California, where I grew up. Spanish is important within the Los Angeles Basin area, because this region maintains a diasporic relationship with Latin America.
That's why I'm especially grateful for the time I was able to spend in Mexico. And I look forward to publishing my ethnographic study on much of what I learned about language and community in Mexico, and also in Tanzania, entitled Zombies Speak Swahili. (I will share more details with you, as I get closer to the finish line with this book!)
In the meantime, I've been doing my best--like you--to survive this pandemic. That's why I was at the pharmacy with my Mom, to get our COVID vaccine booster shots. Afterwards, we waited out the requisite observation period.
Once we were in communication with Miguel, a lot of relevant Spanish starting popping into my head. Everyday words like enfermo (sick), fiebre (fever), fecha (date), apellido (last name), firma (signature), número de teléfono (phone number). When Miguel asked how he should respond to the section on the form labeled "Información de Seguro" (Insurance Information), I inferred that his question concerned whether he needed to note his health insurance details. Earlier, I had asked the pharmacist the same question. So, I shared what I had recently learned. He need only put his Driver's License number or telephone number, which is what I had chosen to do.
And then, Miguel asked another question and again tilted the clipboard my way to point to the section labeled "Precauciones y Contraindicaciones" (Precautions and Contraindications). There were questions like, "Have you ever had a serious reaction after receiving an immunization?" Each question had two response options: Sí (Yes) or No (No). The questions included vocabulary that a multilingual user of Spanish, or of different varieties of Spanish, may not be familiar with.
Miguel asked if he could write an "X" in the box next to each yes or no option. We said yes, and jokingly advised him to select no for all of the perfunctory questions. But he still seemed unsure of how to actually draw the "X". So, I asked to borrow his pen, and after reading out the first question (¿Estás enfermo hoy? Are you sick today?) and hearing his response, I etched an "X" into the no box on his behalf.
Then, he pointed towards the bottom of the page, where the signature was required. "Es por su firma (It's for your signature)," I indicated, also pointing. "Y su nombre y apellido regular (And your typical name and last name)." Though Miguel still seemed confused as to how to write out his signature and printed name, he seemed satisfied that he understood better how to complete the form. As he thanked us for our help, and we parted ways, I added, "Suerte, eh? (Good luck to you, ok?)"
A Lesson in Why Bilingualism is a Public Good.
And then, all of a sudden, a Latinx-presenting woman and her elementary school-age daughter appeared in the customer line. Some time went by, as the two of them disappeared out of view at the pharmacy counter. But before long, they emerged, with a pharmacist leading them. Standing outside of immediate earshot, we observed as the pharmacist nervously asked the woman if she might be able to translate into Spanish for her. The pharmacist seemed a bit embarrassed. However, the woman agreed, and then turned to Miguel, still seated, and began speaking with him. Words like "dirección" (address) and "número de teléfono" (telephone number) drifted from their interaction. When Miguel appeared unsure of how to write down the necessary information, the pharmacist suggested that she might write on his behalf, if the woman could support as a translator/ interpreter. The man agreed, and it began to look like he would get more of the help he needed.
I really did wish him well, and I appreciated what he had indirectly taught me about the language resources available (and the lack thereof). It had been surprising to find that there was a Spanish-language consent form available, but no staff able to speak directly with patients in Spanish. After all, we lived in an area where Spanish, along with Korean, Chinese, and Vietnamese were readily spoken. Local elementary schools have also recently begun new Spanish-English dual language immersion programs.
And yet, there remained a language and literacy gap in our local public health system. Have you noticed anything similar occurring at your local pharmacy or healthcare institution? In this case, it had been lucky for the man that we were receptive and sensitive to his request for help, and that myself, and later another woman, were able to converse with him in Spanish. To his credit, he advocated for himself by reaching out to strangers.
But there should be more human infrastructure in place to support multilingualism, in general. So that no one has to rely on chance to be able to access vital information and services. I continue to reflect on this encounter, and explore further resources and discussions of public health access, language, multilingualism, and inclusion. See below for a few links to open access (free!) resources that I've found...!
Further Resources: Multilingualism, public health, and COVID-19.
- Jie Dong (2021). "Language and globalization revisited: Life from the periphery in COVID-19." International Journal of the Sociology of Language.
- Ingrid Piller, Jie Zhang, and Jia (2020). "Linguistic diversity in a time of crisis: Language challenges of the COVID-19 pandemic." Multilingua.
- Erika Kalocsányiová, Ryan Essex, and Damian Poulter (2021). "Risk and health communication during COVID-19: A linguistic landscape analysis." Health Communication.