Faces of Community Health, This year Ms. Guevara is celebrating her 11th anniversary working at the center. Prior to this, she had extensive experience working in different community settings.

Faces of Community Health

An Interview with Community Health Worker Francisca Guevara

The Community Outreach Team of the Student Leadership Committee is proud to present the second post in our ongoing series entitled “Faces of Community Health.” In this series, we interview healthcare workers  in the community to better understand how quality care is delivered within this setting.

Our second interview in the series is with Francisca Guevara, the Associate Director for Community Health and Outreach at Charles River Community Health Center. She was very excited to speak to us about what community health work means for her and our abbreviated interview [edited for clarity] is below:

What motivated you to become a community health worker?

I think I was born to help others. This desire came from my own experiences as an immigrant. I remember all the challenges and barriers I faced when I [first] came to the United States. The language, food, and culture – everything was new to me. I felt isolated. I didn’t know how to speak English or help my family and myself to integrate into American culture.

I was fortunate enough to become connected with one of the community health centers and meet with community health workers there who helped me a lot during my first years as an immigrant in the United States. I knew this was a place where I could go and ask any questions as I got acclimated to the new culture.

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

My team and I serve as the bridge between the health center and the community.  We provide outreach services for new clients and help them to navigate the challenging US health care system: whether by providing medical interpretation, setting up appointments, helping them with cultural barriers, or connecting them with appropriate resources.

On average, I work 40 hours per week and 20 of those hours I work directly with patients. We see on average between 15-20 clients a day. Our Brighton team consists of 4 community health workers collaborating with 7 different providers–doctors and nurse practitioners.

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

Throughout the years I have received many different types of formal training, but to become a community health worker the most important skills come from within: you must have compassion, patience, and the desire to help and serve others. That is not learned by training or in school. 

What types of populations do you work with? What types of health issues do you address with your clients and in your work?

The majority of our clients are of Hispanic and Latino origin. I speak Spanish and some Portuguese. Because of my language skills, I work mostly with the Latino community, but I serve anyone who needs help. We also have community health workers and interpreters who speak fluent Portuguese, Haitian Creole, and Vietnamese. We address all types of issues, not only helping our community members physically, but also mentally and socially.

We see clients who live in poverty. The majority of our clients have a low socioeconomic status and we strive to provide comprehensive care for all of our clients. We refer them to the Hunger Prevention program, help them file for food stamps through the Supplemental Nutrition Assistance Program (SNAP), and provide them with access or applications to different financial resources.

We have also launched a Mobile Market in partnership with the Greater Boston Food Bank where we provide free, fresh fruits and vegetables to all our clients regardless of their income status. Over 150 people come to the center to receive free fresh produce on a regular basis.

Can you describe a typical workday with one of your clients? Do you attend appointments with them, visit them in their homes, or spend time coordinating with their providers on the phone?

There is not a typical day for us, anything can happen on a given day!  We help our patients and their families, try to schedule appointments for them, make appropriate phone calls, conduct home visits, manage different tasks prescribed by healthcare providers and assist “walk-in” patients.

Depending on the client’s needs, we have community health workers who speak multiple languages and work on different projects. We also have some specialized programs: we have community health workers who assist soon-to be-moms and provide them with prenatal services and resources, connect them with a pediatrician ahead of time, arrange follow-up appointments, and so on. We also have many successful stories of helping clients experiencing domestic violence issues.

What are your interactions like with other health professionals at the center?

Most of the time it’s very positive and professional. All of our staff members are amazing. We work as a team and share the common goal of helping our clients lead healthier and happier lives. We all empower them and provide support in a non-judgmental way.

How can physicians, nurse practitioners, physician assistants, and others work most effectively with community health workers to promote patient health?

They can take time to understand what our role entails; this way they can help us improve our programs or develop new programs so that we can all work together as a team to impact our patient populations.

What advice would you share with someone interested in becoming a community health worker?

Community health workers change lives. You won’t be making a lot of money in this profession but you’ll become richer in another way. It’s truly rewarding to end each day feeling that you have helped at least one person that day!

People are so appreciative of the work we do. Sometimes they bring us homemade food made from their traditional recipes, and they say “You’re angels! God bless you!” Gestures like that mean everything to us.

Charles River Community Health provides unique services to improve the health of Brighton-Allston and Waltham communities and offer comprehensive, patient-centered, family-friendly care. The health center strives to reduce cultural and socioeconomic barriers to care by treating every person with dignity, respect, and compassion.

Charles River is also committed to getting college and health professions students involved in volunteering opportunities related to community work, and works with students to create opportunities that fit volunteers’ interests and skills. Students have been involved in event photography, administrative activities, event planning, fundraising, and volunteer recruitment and management. Likewise, students can help out in several of the partnerships between the center and other local institutions, including the Greater Boston Food Bank which works to deliver fresh fruits and vegetables to patients. As part of its mission, the center tries to educate and inspire a new generation of doctors, nurse practitioners, and other health professionals to work in community health, and recently co-hosted an event with the SLC. Health professions students interested in learning more should reach out to Sue Lowcock at salowcock@charlesriverhealth.org to learn more about current opportunities and getting involved!

Evgeniya Larionova is a registered nurse and a third-year nurse practitioner student at the MGH Institute of Health Professions. She is a member of the Communication & Narrative Medicine Team of the Student Leadership Committee at the Center for Primary Care at Harvard Medical School.