Siraji Hassan keeps extra hand sanitizer and face masks in his car.
The executive director of United Somali Bantu of Greater Pittsburgh knew the pandemic was going to be a "big issue" for his community, and these days he works to fill the gaps where resources are not available.
“I always walk along with a bunch of [hand sanitizer and face masks] just in case a family don’t have it,” said Hassan, 24. “I just hand it to them. I’m like, ‘Here you go, make sure you have it on.’ So that’s what I’ve been doing nonstop.”
Among Pittsburgh's immigrant and refugee populations and communities of color, education on COVID-19 and assistance amid the pandemic have come, mostly, from those within. Outside of their communities, residents have faced challenges receiving medical information, navigating language barriers and accessing social services.
Abdikadir Lugundi, president of the nonprofit Somali Bantu Community Association of Pittsburgh [SBCAP], who was born in Kenya and came to Pittsburgh around 2004, said community members have been sharing news and information on WhatsApp and ensuring families have what they need.
“We have a community here just trying our best to spread the information,” Lugundi, 21, said.
Somali Bantu community members primarily speak Kizigua and Maay Maay, two dialects that often lack medical interpreters, said Aweys Mwaliya, executive director of SBCAP.
The Allegheny County Health Department provides information in Somali and Swahili while offering some services in Maay Maay and Kizigua, but not all Somali Bantu who know Maay Maay or Kizigua also speak Somali or Swahili.
“We already had our own challenge when it comes to language, medically and also legally,” Mwaliya said. “None of these languages really have any interpreters nationally in the United States and also locally here.”
Mwaliya, 38, was born in Somalia and arrived in the United States as a refugee in 2004. Somali Bantu began resettling in the U.S. after the outbreak of the Somali Civil War in 1991 forcibly removed many from their homes. First settling in Salt Lake City, Utah, Mwaliya is now one of about 300 Somali Bantu who reside in Pittsburgh.
Language barriers for Somali refugees
From the onset of the pandemic, SBCAP has worked to translate and share health guidelines for residents, including those concerning social distancing, Mwaliya said. The association has also shared videos from the Centers for Disease Control and Prevention [CDC] that have been translated into Maay Maay.
The Department of Human Services [DHS] and the health department hosted listening sessions in April with leaders of immigrant and refugee communities that saw an increase in COVID-19 cases, spokesperson Amie Downs said in a statement.
“As part of our conversation with the Somali Bantu community leaders about their needs, we learned that Swahili is helpful for their community,” Downs said.
The county health department translates its daily COVID-19 alerts into Swahili, one of the five most common foreign languages spoken in the county, Downs said. The other languages offered are Arabic, Chinese, Nepali and Spanish. Additional guidance for preventing the spread of COVID-19 is offered in languages including Swahili and Somali.
Case investigation and contact tracing teams can access a service that translates Maay Maay, Kizigua and 226 other languages, Downs said. The department’s COVID-19 hotline also takes calls through United Way of Southwestern Pennsylvania, which can translate Maay Maay and Somali and can accommodate local dialects through a third-party service.
Through translation services from nonprofits, community organizations and government agencies, Somali Bantu residents are well-informed in regards to information about COVID-19, Mwaliya said.
He’s concerned, however, for community members who may visit hospitals and be unable to communicate with medical professionals in a language they speak.
“The challenges were there already,” Mwaliya said. “When [SBCAP receives] information from outside, we do translate to our people, but when … they go to visit [a] hospital, then it’s becoming a challenge because they don’t have interpreters.”
But UPMC in a statement claimed that in-person interpretation in Maay Maay, Kizigua, Somali and Swahili is offered through staff interpreters and outside agencies. The hospital’s remote interpretation vendor also covers more than 200 languages via phone and more than 30 via video, said María Cecilia Dancisin, manager of the International Department at UPMC Children’s Hospital of Pittsburgh, in the statement.
Allegheny Health Network did not respond to multiple requests for comment.
SBCAP is willing to work with hospitals to address language barriers, Mwaliya said.
“[SBCAP was] doing the interpreting part without any funding because [these are our families], but it is the responsibility of the hospital to get funding for [interpreters],” he said. “[Patients] deserve and they have a right to be having a language interpreter or someone to help them.”
Uninsurance in the Latinx community
The Latino community has also faced challenges receiving information about COVID-19, said Diego Chaves-Gnecco, founder and director of the SALUD PARA NIÑOS program at UPMC Children’s Hospital of Pittsburgh, which aims to address disparities Latinos may experience in accessing health care.
The hospital created a webinar in May to provide basic health information about COVID-19 to Latino community members, which more than 2,000 people viewed, he said.
In Allegheny County, the Latino community is estimated to represent 2.3% of the population, about 28,000 residents, according to census data.
The lack of available or accessible information comes as Latinos in the U.S. are contracting COVID-19 at disproportionately high rates. Of the 45% of COVID-19 cases reported nationwide as of May 30 that include demographic information, 33% are among the Latino or Hispanic community, the CDC estimates. Hispanics represent only 18% of the population.
Latinos are more susceptible to COVID-19 due to employment in health care or service industries while also having higher rates of uninsurance within the community, Chaves-Gnecco said. Slightly more than 20% of Hispanic or Latino residents under the age of 65 do not have health insurance coverage, according to a 2018 National Health Interview Survey [NHIS].
Health care outcomes are often more successful between patients and providers who share a language and culture, Chaves-Gnecco said. Such similarities are also important for relaying health care advisories within a community, he said.
Showing physical affection — shaking hands, hugging, kissing — is embedded into Latino culture, he said. Adjusting to social distancing guidelines is difficult, but must be done, he said.
“When we say that we are together, we really want to convey this message,” Chaves-Gnecco said, “that the families and the community members have somebody in their corner.”
COVID interrupts rituals and traditions
Within the Somali Bantu community, which is primarily Muslim, visiting those who are sick and attending funerals is an important aspect of culture especially during the holy month of Ramadan, which fell this year between April 23 and May 23. But that can present a problem: Not everyone who attends the funeral services has personal protective equipment, Hassan said.
“I came with [personal protective equipment] to these gatherings,” he said. “Whoever don’t have it, take one. Whoever needs more, let me know.”
The majority of residents are taking precautions to protect themselves from COVID-19, Hassan said, but there’s a stigma surrounding the virus that may prevent community members who’ve contracted the disease from telling others.
“They’re afraid that somebody is going to share that information outside and then they’re not going to get the help from their community, their people,” Hassan said. “They hide it, and that’s the difficult part.”
Community members share information, provide resources
Having a community member share information has proven to be helpful in educating the city’s immigrant and refugee populations on COVID-19, said Leslie Aizenman, director of refugee and immigrant services at Jewish Family and Community Services [JFCS].
“Really the key for the immigrant and refugee community, and this is something we’re working on, is to have insiders from within their community be educated and spread the right information,” she said.
JFCS helps refugees with resettlement, employment and case management, among other services. The organization, which uses interpreters when working with clients, also offers peer support groups and has provided education on COVID-19 to immigrants and refugees.
The organization is one of several that helped create the COVID-19 Cash Assistance Program, which will provide funding to immigrants and refugees who did not receive a federal stimulus payment. Mayor Bill Peduto’s Welcoming Pittsburgh initiative received a $500,000 grant for the program, which local organizations will run, the city announced June 26.
The peer support groups have partnered with DHS and the nonprofit Neighborhood Resilience Project to train bilingual residents to disseminate health information within their communities, Aizenman said.
As soon as stay-at-home orders were issued in March, the Bhutanese Community Association of Pittsburgh [BCAP] made a video in Nepali to provide information on COVID-19, Executive Director Khara Timsina said, but language posed challenges for Bhutanese community members assisting their children with virtual learning. Teachers tried to help by using interpreters, but it was difficult for the interpreters to explain remotely how to navigate a virtual classroom.
Residents also struggled initially to complete unemployment compensation forms due to language barriers and a lack of in-person communication, he said.
BCAP has connected families in need of educational support with a volunteer mentor, Timsina said. The association has also worked with 412 Food Rescue to deliver fresh produce to community members and has collected personal protective equipment and supplies from Global Links, a medical relief and development organization dedicated to supporting health in communities that lack resources, and the Pittsburgh Bureau of Police.
“We [utilized] around 20 to 40 volunteers to reach those supplies to individual homes or apartments, keeping or following the CDC guidelines,” Timsina said.
For SBCAP, it’s important that its community members not suffer. Somali Bantu refugees escaped death and disease during the civil war, but there isn’t anywhere to go to stay safe from COVID-19, Mwaliya said.
“The only safe for community members is to follow the experts,” Mwaliya said. “We need the elderly, they are part of our communities, and there are people who are sick. We need them to be alive.”
Emma Folts is an intern with PublicSource, she can be reached at firstname.lastname@example.org