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Mass. EMT training seeks to close cultural gap

By Eduardo A. de Oliveira
Boston Globe
Copyright 2008 Globe Newspaper Company

FRAMINGHAM, Mass. — A $62,000 survey project, funded by the MetroWest Community Health Care Foundation and conducted by Massachusetts Bay Community College, aims to improve “cultural competency” among emergency responders in the Framingham area, who are often called upon to serve members of the immigrant community.

Through early next month, six college professionals and 10 volunteers will compile concerns about emergency service providers, primarily from focus groups whose members are drawn from the area’s Brazilian and Hispanic communities. To collect information from the point of view of service providers, the project has also sent informational surveys to 52 suburban public safety departments; so far, nine of the surveys have been returned.

Project organizers will use the collected information to compile a training manual to help police officers, firefighters, and ambulance drivers better understand cultural impediments to effective delivery of services, such as the effects of bad experiences immigrants may have had with authority figures in their home countries.

The training is also being designed to help navigate all-too-common language barriers, said the project’s coordinator, Christina Bolduc.

“Sometimes immigrants don’t understand the first responders’ questions, who mistake their answers, too,” she said.

“How can paramedics know that somebody in my family is allergic to penicillin?” asked Wallace Nascimento, a Framingham resident for 20 years and president of the nonprofit Allan Kardec Spiritist Society of Marlborough, and a volunteer helping project organizers.

A local advocacy group, the Brazilian American Association, or BRAMAS, is also working with project organizers to penetrate area immigrant communities, not always to complete success. Of 40 people called by organizers to participate in a recent focus group at MassBay, only seven attended the meeting.

“We have a serious problem,” said Ilma Paixão of BRAMAS, “when people think that their opinions don’t matter. We bring the authorities to hear their concerns and they don’t show up. How to explain that?”

BRAMAS president Frank Kavanagh said results so far indicate that most experiences with emergency responders are positive and exceed expectations. “But emergency-response personnel tend to begin communications by insisting on identification, and for individuals who are already in a state of stress, that raises anxiety or resistance to treatment,” he said.

By August, said Bolduc, the training portion of the project is expected to be complete. At that time, participating emergency professionals will be asked to answer a questionnaire to determine the immediate impact that the training had on their understanding of cultural competency.

To continue the work done in the project, MassBay’s paramedic and EMT training courses will incorporate cultural competency into their curriculums in September.

“This project should have happened a long time ago,” said Nascimento. “All that immigrants want is to be treated like everyone else.”

The project comes in the wake of several efforts to build a more trusting relationship between local immigrants and the authorities. One such effort was a recent four-part series, called “Law and Justice Seminar for Immigrant Populations,” organized by the Framingham Police Department.

In the first event of the series, held on Nov. 8, three federal Immigration and Customs Enforcement agents responded to questions from 35 Brazilian leaders. Some in the immigrant community said the seminars represented a rare opportunity to get direct answers to their questions. Subsequent seminars brought together town officials, politicians, and Middlesex District Attorney Gerard T. Leone Jr.