Faces of Community Health

The Community Outreach team of the Student Leadership Committee is proud to present the inaugural blog post in our series called “Faces of Community Health.” In this series, we will interview healthcare workers that work in the community to better understand how quality care is delivered within this setting.

Our first interview in the series is with Beatriz Lopes, a community healthcare worker (CHW) at Charles River Community Health Center in Brighton, Massachusetts. Prior to becoming a CHW, Ms. Lopes worked as an outreach worker for the Massachusetts Alliance of Portuguese Speakers (MAPS), focusing on promoting tobacco cessation in the Portuguese speaking population. Here, Ms. Lopes describes her responsibilities as a community health worker and motivations for doing this work.

What motivated you to become a community health worker?

I am motivated by the language barrier newcomers’ experience. Being from the community, I know the barriers. When I first came to this country, I needed help. I remember how happy I was when I encountered agencies or community leaders who would help and guide newcomers.

What are the specific job duties and responsibilities that you have?

My job is to welcome the Portuguese speaking community, let them know about the services that can improve their wellbeing. I have worked to get my patients into English classes, the Women, Infants and Children (WIC) Supplemental Nutrition programs, Fitness in the City programs and the mobile market [a partnership with Greater Boston Food Bank that gives free vegetables and fruits to patients]. We attend outdoor events and festivals to reach and inform the community. I am also trained as a medical interpreter to help the communication between physicians and Portuguese speaking patients when necessary.

I work about 40 hours per week. About 25 hours per week, I spend with patients and helping with interpretation. The rest of my time is spent on the phone listening to messages, addressing issues within those messages, setting up appointments, and making phone calls to follow up with patients. My time is also spent organizing donations received such as clothing, [books] and food and making sure kids have books to read in the waiting area.

If I can help to make their lives easier by linking them to needed services, I will. It’s such a good feeling.

There are many paths to becoming a community health worker. What training did you receive and how long was the training process? What credentials do you need to become a community healthcare worker?

It’s an ongoing process, I have been to many workshops and conferences related to health prevention. Workshops on topics such as substance abuse, domestic violence, HIV/AIDS, and asthma. There are others, such as family planning, diabetes, weight control, and heart disease. I also took medical terminology and interpreter training, which took six months. Programs such as the community health education center (CHEC) under the Boston Public Health Commission also offer training.

You must go around in the community, [to] study and learn while you are getting to know all the issues affecting the community. I don’t believe there is a specific school for that.

What type of population is your community comprised of? What types of health issues do you address with your clients and your work?

Charles River Community Health Center is open to all communities in the Waltham, Brighton, Allston and Watertown area. Our patients speak English, Spanish, Portuguese, Vietnamese, Russian, Haitian as well as other languages. I am a Portuguese speaker and I work with the Portuguese population. Health issues we help clients address include obesity, high blood pressure, and diabetes.

What skills are needed for someone to become an effective community healthcare worker?

Patience. You must be patient. Sometimes you do everything you can to help the patient and the patient may not compromise, such as a no-show at a doctor’s visit. You must be a good listener, because patients need someone to talk to and you should be there to listen to them. You must be responsible. Also, friendly and outgoing to make people feel comfortable, and show them you can be trusted.

Do you have advice for someone interested in becoming a community health worker?

Get to know your community, talk to different people, different agencies, businesses and churches, and try to understand how the community works. Knowing the culture and the language plays a big part of being a community health worker.

Can you tell me about an instance in which you feel you had a positive impact on your client?

In general, it feels good when you can help patients and they are grateful. In terms of one specific instance, many years ago, I helped a patient use a breathalyzer [incentive spirometer] to show strength of the lungs. He told me that after seeing how weak his lungs were, he decided to quit smoking.

What are the greatest challenges you face while working in the community?

To make patients aware of the importance of prevention. It is difficult because when patients are here, they are so focused on working, finding ways to pay bills, etc. In their mind, prevention is time consuming, they do not have time for appointments and things related to health. We tell them to call in advance in case they need to cancel an office visit and that they need to let us know if they move and have a new address. It is challenging but we should not let things progress too far.

From your perspective, how could community healthcare workers be better supported?

Community health workers need more funding since our work and services are not covered by insurance.

How can other healthcare professionals become educated about the role of community healthcare workers within the healthcare field?

Having community health workers attend and speak at conferences. There could also be a video to show the job we do and the importance of it.

What is the one thing you want other healthcare professionals to know about your work?

We believe the little bit we do will help patients improve their chances towards health prevention and health education and to get on with their lives.

Imarhia Enogieru is a fourth-year medical student at Harvard Medical School and a member of the Community Outreach Team and the Communication and Narrative Medicine Team of the Student Leadership Committee at the Center for Primary Care.