Providence Journal
Saturday, April 18, 2009
By Karen Lee Ziner
Journal Staff Writer
PROVIDENCE
Pain often robbed Seth Svay’s sleep and cloudy vision troubled her days. Like many elderly survivors of Cambodia’s “Killing Fields” — a genocide that left up to 2 million dead in her country — Svay suffered lingering emotional trauma. She rarely left the house, not even to visit the doctor.
But then Svay learned of a new home health-care agency, Independence Health Services, started in Providence by a Cambodian refugee, a Gulf War veteran and his mother, a nurse.
Their core clientele are Southeast Asians, who for cultural reasons and language barriers, often go without proper medical care. Yet national studies reflect disproportionate rates of post-traumatic stress, diabetes and other chronic conditions in that population.
The agency’s outreach coordinator, Marc “Poe” Harrison (who Anglicized his name), was tortured during the 1975-79 genocide in Cambodia. Khmer Rouge soldiers killed his father, and his brother died from suspected defoliant poisoning. Colin Hanrahan, who devotes his nights and weekends to the agency, served with the National Guard in Saudi Arabia and is a fraud investigator with the state Department of Labor. The nursing director, Joan Hanrahan, Colin’s mother, is an associate director of nursing at Rhode Island Hospital.
The three have pooled more than $70,000 of their money toward the agency, located at One Richmond Square. Harrison said he is grateful to this country for helping him and other Cambodian refugees survive, and “I want to give back.”
Harrison said that as traditional extended families disappear, many elders “are very, very isolated when their children get married and move away.” They also may ignore health issues until the situation is dire enough to call 911. Often, they retreat to the Cambodian temple — a traditional community center — rather than seek medical care. For some, “it’s too late,” he said.
HARRISON, who formerly worked as a quality-control engineer, was inspired by a cousin who started a similar agency in Ohio. But Harrison couldn’t do it alone.
Several years earlier, he met Colin Hanrahan at an art exhibit about Cambodian refugees at Brown University. As a National Guardsman, Colin Hanrahan had helped run a POW camp in Saudi Arabia during the first Gulf war. “It was kind of like a refugee mission. There were 13-year-old kids to 80-year-old men,” said Colin Hanrahan. “That’s what kind of got me interested” in attending the art exhibit.
Intrigued by Cambodian culture and sympathetic to Harrison’s story, Colin Hanrahan stepped in to help.
Harrison and the Hanrahans obtained a state operating license last October. They accept Medicaid patients and have applied for Medicare certification.
Victoria Almeida, vice chairwoman of the Rhode Island Health Services Council, said, “What we looked at and what our criteria are, is their competence, their character and their standing in the community.”
She added: “They made a point of saying sometimes the only health care available is to call 911, when a person is already ill or very ill. It seems obvious to me, that sometimes emergent treatment is too late. Or if it’s not too late, it’s expensive.”
“I think reasonable minds,” she said, “can’t differ on the premise that preventative health care is not only good for the person from a medical and holistic point of view, but it is also financially prudent for the community and for health-care systems.”Building on that, Harrison and Colin Hanrahan last fall assisted Brown University medical student Margaret Chang with a six-month study of barriers to health-care access in Rhode Island’s Southeast Asian community. They organized Cambodian, Hmong and Laotian focus groups.
The study followed a 2007 conference at Brown aimed at informing the public about “the health emergency affecting Cambodian refugees in the United States.” The conference, sponsored by Khmer Health Advocates in Hartford and Brown Medical School, underscored that population’s escalating needs, even as funding shortages were forcing Cambodian community-based organizations to close their doors.
Chang said that although there are at least 20,000 Southeast Asians living in Rhode Island, health-care providers who regularly treat them in emergency rooms and primary care clinics “don’t know how to interact with them, and don’t know their problems.”
Chang cited her own experience with an elderly Cambodian patient at a local clinic.
“He had probably one of the most grotesque looking wounds I’ve ever seen. He had uncontrolled diabetes. He’d had surgery to clean out his wound once. There was no follow-up plan, no transportation to the wound clinic,” said Chang. “In the meantime, he was just sitting at home, and the wound was getting worse.”
Chang said, “This should not have happened. The problem is there aren’t enough health-care services to make sure this gentleman kept his follow-up appointments. The Southeast Asian population is particularly marginalized. That’s something that particularly haunts me.”
Chang said the study’s findings will soon be circulated to health-care providers across the state. It recommends that the state do more to increase the number of certified Southeast Asian interpreters in Rhode Island, and encourage the start-up of home health agencies to provide care for Southeast Asians, particularly elderly patients.
The Independence Health Services, which has about eight employees in all, has recently hired two Cambodian certified nursing assistants, and plans to hire more Southeast Asians — including Hmong and Laotians, to match them with elderly from their home countries. Colin Hanrahan said they plan to hire more people within the next year. At present, they care for about a dozen patients.
The agency provides interpreter services in Cambodian, and calls on local language banks as needed for Spanish and other languages.
SVAY, who is in her late 60s, is one of the agency’s newest patients. She lives in the West End of Providence in the heart of a Cambodian settlement community that originated in the early 1980s.
With Harrison interpreting, Svay said her husband and many other family members were killed by Khmer Rouge soldiers during the holocaust. She endured forced labor. “We had to build a road and carry all the dirt. That’s why I have so much pain,” she said.
Svay said she has been so tired “that sometimes I don’t have the strength to cook at all,” and leaves the house only to walk to the grocery store or visit the Buddhist temple on the next street.
Svay is being treated for several medical conditions, including depression stemming from post-traumatic stress. A home health aid visits weekly to help with Svay’s personal needs and to ensure she takes her medications properly.
She said, “I’m very, very happy” with the treatment. “I’m feeling better.”
Independence Health Services can be reached at (401) 437-8337 or by e-mail at IHS@att.net.
Saturday, April 18, 2009
By Karen Lee Ziner
Journal Staff Writer
PROVIDENCE
Pain often robbed Seth Svay’s sleep and cloudy vision troubled her days. Like many elderly survivors of Cambodia’s “Killing Fields” — a genocide that left up to 2 million dead in her country — Svay suffered lingering emotional trauma. She rarely left the house, not even to visit the doctor.
But then Svay learned of a new home health-care agency, Independence Health Services, started in Providence by a Cambodian refugee, a Gulf War veteran and his mother, a nurse.
Their core clientele are Southeast Asians, who for cultural reasons and language barriers, often go without proper medical care. Yet national studies reflect disproportionate rates of post-traumatic stress, diabetes and other chronic conditions in that population.
The agency’s outreach coordinator, Marc “Poe” Harrison (who Anglicized his name), was tortured during the 1975-79 genocide in Cambodia. Khmer Rouge soldiers killed his father, and his brother died from suspected defoliant poisoning. Colin Hanrahan, who devotes his nights and weekends to the agency, served with the National Guard in Saudi Arabia and is a fraud investigator with the state Department of Labor. The nursing director, Joan Hanrahan, Colin’s mother, is an associate director of nursing at Rhode Island Hospital.
The three have pooled more than $70,000 of their money toward the agency, located at One Richmond Square. Harrison said he is grateful to this country for helping him and other Cambodian refugees survive, and “I want to give back.”
Harrison said that as traditional extended families disappear, many elders “are very, very isolated when their children get married and move away.” They also may ignore health issues until the situation is dire enough to call 911. Often, they retreat to the Cambodian temple — a traditional community center — rather than seek medical care. For some, “it’s too late,” he said.
HARRISON, who formerly worked as a quality-control engineer, was inspired by a cousin who started a similar agency in Ohio. But Harrison couldn’t do it alone.
Several years earlier, he met Colin Hanrahan at an art exhibit about Cambodian refugees at Brown University. As a National Guardsman, Colin Hanrahan had helped run a POW camp in Saudi Arabia during the first Gulf war. “It was kind of like a refugee mission. There were 13-year-old kids to 80-year-old men,” said Colin Hanrahan. “That’s what kind of got me interested” in attending the art exhibit.
Intrigued by Cambodian culture and sympathetic to Harrison’s story, Colin Hanrahan stepped in to help.
Harrison and the Hanrahans obtained a state operating license last October. They accept Medicaid patients and have applied for Medicare certification.
Victoria Almeida, vice chairwoman of the Rhode Island Health Services Council, said, “What we looked at and what our criteria are, is their competence, their character and their standing in the community.”
She added: “They made a point of saying sometimes the only health care available is to call 911, when a person is already ill or very ill. It seems obvious to me, that sometimes emergent treatment is too late. Or if it’s not too late, it’s expensive.”
“I think reasonable minds,” she said, “can’t differ on the premise that preventative health care is not only good for the person from a medical and holistic point of view, but it is also financially prudent for the community and for health-care systems.”Building on that, Harrison and Colin Hanrahan last fall assisted Brown University medical student Margaret Chang with a six-month study of barriers to health-care access in Rhode Island’s Southeast Asian community. They organized Cambodian, Hmong and Laotian focus groups.
The study followed a 2007 conference at Brown aimed at informing the public about “the health emergency affecting Cambodian refugees in the United States.” The conference, sponsored by Khmer Health Advocates in Hartford and Brown Medical School, underscored that population’s escalating needs, even as funding shortages were forcing Cambodian community-based organizations to close their doors.
Chang said that although there are at least 20,000 Southeast Asians living in Rhode Island, health-care providers who regularly treat them in emergency rooms and primary care clinics “don’t know how to interact with them, and don’t know their problems.”
Chang cited her own experience with an elderly Cambodian patient at a local clinic.
“He had probably one of the most grotesque looking wounds I’ve ever seen. He had uncontrolled diabetes. He’d had surgery to clean out his wound once. There was no follow-up plan, no transportation to the wound clinic,” said Chang. “In the meantime, he was just sitting at home, and the wound was getting worse.”
Chang said, “This should not have happened. The problem is there aren’t enough health-care services to make sure this gentleman kept his follow-up appointments. The Southeast Asian population is particularly marginalized. That’s something that particularly haunts me.”
Chang said the study’s findings will soon be circulated to health-care providers across the state. It recommends that the state do more to increase the number of certified Southeast Asian interpreters in Rhode Island, and encourage the start-up of home health agencies to provide care for Southeast Asians, particularly elderly patients.
The Independence Health Services, which has about eight employees in all, has recently hired two Cambodian certified nursing assistants, and plans to hire more Southeast Asians — including Hmong and Laotians, to match them with elderly from their home countries. Colin Hanrahan said they plan to hire more people within the next year. At present, they care for about a dozen patients.
The agency provides interpreter services in Cambodian, and calls on local language banks as needed for Spanish and other languages.
SVAY, who is in her late 60s, is one of the agency’s newest patients. She lives in the West End of Providence in the heart of a Cambodian settlement community that originated in the early 1980s.
With Harrison interpreting, Svay said her husband and many other family members were killed by Khmer Rouge soldiers during the holocaust. She endured forced labor. “We had to build a road and carry all the dirt. That’s why I have so much pain,” she said.
Svay said she has been so tired “that sometimes I don’t have the strength to cook at all,” and leaves the house only to walk to the grocery store or visit the Buddhist temple on the next street.
Svay is being treated for several medical conditions, including depression stemming from post-traumatic stress. A home health aid visits weekly to help with Svay’s personal needs and to ensure she takes her medications properly.
She said, “I’m very, very happy” with the treatment. “I’m feeling better.”
Independence Health Services can be reached at (401) 437-8337 or by e-mail at IHS@att.net.
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