From Sickbed to Jail, for Lack of Medical Interpreting
New America Media, News Feature, Hilary Abramson, Posted: May 30, 2006
Editor's Note: The case of a Laotian mother of six reveals the suffering that can occur when authorities fail to provide medical interpretation. Hilary Abramson, a contributing editor of New America Media, has been researching language access in U.S. health care with a grant from the Fund for Investigative Journalism.
SAN FRANCISCO--She had tuberculosis and failed to refill the medicine that made her sick. So they took her by gunpoint to jail, where she slept on the floor, cleaned up inmates' waste, shuffled in chains to a clinic and court, and saw neither a lawyer nor a medical interpreter for nearly a year.
Today -- five years after winning a $1.2-million civil rights settlement from the central California county of Fresno -- a small Laotian woman named Hongkham Souvannarath says she will never seek help from another American doctor.
"I pray every day that I do not get sick," says the 64-year-old mother, who has learned "a little" English, but prefers to speak Lao and have one of her six children interpret for accuracy. "I am afraid of the health department and American doctors. Escaping communists as a refugee from Laos was easier than jail in Fresno. No one talked to me in my language. I did nothing wrong. I thought they would kill me."
To many people working to make language access laws more effective, the Souvannarath case is the mother of all settlements, because it reflects how much suffering can occur when authorities fail to provide medical interpreting. Souvannarath still cannot believe this happened in America.
"The people who did this to me," says Souvannarath, "had to be people who disguised themselves as sheriffs. No amount of money could make up for what I went through. My neighbors thought I was arrested for being a drug pusher. My young children were afraid to leave home and go to school and only allowed to see me for one hour a week. I just wanted my dignity back, my soul."
It was Souvannarath's dream to come to America to save two of her four daughters, who have a genetic blood disorder. In 1984 she sold a ring to buy alcohol to incapacitate soldiers standing guard near the Mekong river, so she could flee to a refugee camp in Thailand. She snuck back across that river a year later to free her husband, a driver for the Communists who was in jailed and risked being executed for helping her.
Eventually, Souvannarath was able to move to the United States and settle in Fresno. There, she complained of feeling as if "marbles were rolling around inside" her chest. Biopsies revealed tuberculosis in the lower lining of her left lung.
Health officials used her teenage daughters as interpreters. Souvannarath was frustrated that her daughters had interpreted that she would suffer only one cut. She instead had seven incisions in her back and regimen of four tuberculosis medications, to be taken for six months. Never knowing that she had the right to demand a free medical interpreter, she blamed her daughters for misinterpretation.
Souvannarath was arrested after the health department concluded that she had multiple-drug-resistant tuberculosis and was resisting treatment. Attorney Catherine Campbell says that Fresno county health officials never sent a sample to a state lab, as required for diagnosis, and three months after taking basic medication for the disease, Souvannarath's lung was clear, "indicating she probably never had the resistant tuberculosis."
Drugs for this serious, second-stage tuberculosis made Souvnnarath so ill that she told county health officials through a daughter that she would move in with her oldest son in the Midwest and seek treatment there.
When her medications ran out and she felt much better, Souvannarath didn't refill the prescription. Her son's roommates misunderstood phone calls from Fresno clinic staff, who assumed the planned move was a ruse. They sent officers to arrest her.
"During her entire relationship with the Chest Clinic, translation deficiencies...led to [Souvannarath's] inability to understand the implications of her decision not to take her medications," wrote attorney Campbell in court documents.
The Fresno County Health Department provided only Hmong speakers to interpret for her, though Souvannarath doesn't speak the language. According to Souvannarath, one Hmong interpreter somehow communicated that she shouldn't take the medications because they were killing her. Another Hmong interpreter misunderstood Souvannarath and told authorities that she was suicidal when she was not, which resulted in a two-day incarceration in a dark, cold jail basement cell. For 11 months, her daughters, who were as confused as Souvannarath, were her only real interpreters.
While she languished in jail, Souvannarath's daughters and father lived on about $1,400 a month from disability and Social Security, $500 of which went for rent. The children lived on noodles, eggs and junk food.
After one of her sons called the Ohio organization that had sponsored Souvannarath's journey as a refugee to the United States, Souvannarath finally received legal advice that led to her freedom and three years of litigation.
After paying legal fees and taxes, Souvannarath banked $400,000 of her settlement. She spent $170,000 to buy a house with enough yard space to grow kumquats, peppers, avocados and bamboo, and erect a shrine to encase the ashes of her youngest son, a college student who was killed in an auto accident a few months after Souvannarath's release from jail. The rest of the money went to her other children.
Souvannarath got her soul back. After she was released from jail, she returned for a two-hour ceremony. A Buddhist priest held a butterfly net to retrieve her soul from the dank spaces she inhabited. Opposing counsel attended along with her family and attorneys. Inmates cheered from behind bars.
Today, one daughter says Souvannarath took a job with a graveyard shift because she cannot sleep. She works cutting chickens at Foster Farms for $7.25 an hour.
"I like to work," she says. "I sleep in the day and plan to become American citizen. Then, maybe I can find an easier job that pays more."
Photos by John Alden/J.A. Photo
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User Comments
Ketsada Phoumavongsa on Jun 28, 2006 at 06:06:43 said:
Wow… after I read this article I was in shock… first off, because I’m from Laos. Second, because I’m also a Laotian interpreter, mostly in the legal field. I was born in Laos, came to America when I was 3 years old, and now in my late 20’s. But because of having my grandparents living with my family, it help me learned my native language, which I greatly appreciate!
I have experience a family crises in MN. MN is known to have a huge population of Hmong. Because I was a niece, they did not allow me to interpret for my family, while visiting my uncle in the hospital who was in ICU, who had a 15% chance of making it. The interpreter was way off on what the doctor was telling my parents, so I questioned the doctor myself. Some words are just not in our vocabulary whether it is legal or medical.
I know that there are classes out there to teach everyone English, but classes are base on 2nd, 3rd or 4th grader level. Not at a college level, where they would know the medical terminology…if that was the case I think that everyone who comes to America to seek freedom, a better life for themselves and their families, will become doctors themselves!!!
Not that I want to be another person that picks on you, Barbara Lampkin, I see you are ignorant person, close minded, who thinks of themselves as higher than everyone else who doesn’t know how to speak English, because of the fact that you know English?
Kita on Jun 12, 2006 at 04:32:49 said:
Just because Souvannarath isn't a citizen, doesn't makes her an illegal immigrant. If you read the article it says her son called the organization that sponsored to the U.S., meaning she entered this country legally. Get the facts straight Barbara.
Lucrecia Aleman on Jun 10, 2006 at 13:25:44 said:
Yes, many non-English speakers are here illegaly but as for learning English, I agree that is should be a high priority for immigrants but am also aware of the difficulty that this is for older immigrants. People like Mrs. Lampkin should only open their ignorant mouths when they can learn to speak a foreign language fluently after their 20's. It's no easy task let alone the nuances of medical and legal terms. Even Americans have trouble with this type of terminology so how can people who barely master the language be expected to make themselves clear when they barely know what is happening to them?
Lucrecia Aleman
Certified Judicial/Medical Interpreter
Heng L. Foong on Jun 08, 2006 at 03:39:03 said:
In response to Barbara Lampkin's laments. Many of the multiethnic people of Laos secretly helped the CIA during the Vietnam war; and still face prosecution. They fled their homeland as refugees and yes, there were shots fired, and they were fired on behalf of American soldiers. So let's continue this discussion when you, Ms. Lampkin, have to leave all your belongings behind, watch your family members be decimated as you fight for democracy. As for learning English, I'm all for it but remember that in the context of health care, miscommunication can be deadly so until our ethnocentric country can figure out than learning another language other than English is vital, then access to interpretation must be supported.
Tyler on Jun 05, 2006 at 03:09:58 said:
This story reminds of me the Ann Fadiman book "The Spirit Catches You and You Fall" about the clash of two cultures; the Hmong values versus that of the Western. I highly recommend it to everyone else.
Barbara Lampkin on Jun 02, 2006 at 00:06:06 said:
The woman was here illegaly, she should have learned english. But of course in this country you dont have to..There giving our country away.
With out a shot being fired.....
Lynn Elfers on Jun 01, 2006 at 12:10:18 said:
I am a medical interpreter and teach medical interpreting to my staff. This article was wonderful!!
LYNN ELFERS
Affordable Language Serivces.
Jorge Carbajosa on May 31, 2006 at 23:27:56 said:
There is a fascist approach towards tuberculosis in the United States.
Many innocent people in the U.S. are charged with crimes and put in jail for unbelievable reasons.
This story doesn't surprise me.
Alexis Endurance on May 31, 2006 at 07:31:00 said:
The interpreter misunderstood Souvannarath and told authorities, that she was suicidal when she was not, which resulted in a two-day incarceration in a dark, cold jail basement cell.
-->Absolutely a horrible judge,who sentenced her to jail,this was not helpful.
The judge should have sent her to a hospital,just hearing about a suicide attempt.
Our court systems are always,putting innocent people in jails,juveniles and prisons,this is their remedy,at the tax payers expense.
The Judge should have been sued !
Why are they not, held accountable.
Many lives have been drastically ruined,because of their negligence.
This is just one tiny little sentence,compared to the 25 to life sentences,being handed out like candy,for other non-violent crimes,like the three strike law.
Our courts need to be reformed,too many outrageous sentencing skeme's,due to the unnecessary laws,which we allow to be passed, politician's use fear tactics,stirring up the fear mongering,just for a vote,in the name of public safety.
People are being falsely arrested,we are all subject to this abuse,at any time,all it takes is a false,or mistaken allegation.
The correctional facilities are in great crisis,they are past,being overcrowded diseases,are spreading quickly!!