From Sickbed to Jail for Lack of Medical Interpreting
New America Media, News Feature, Hilary Abramson, Posted: May 30, 2006
Editor's note: 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
Article Courtesy New American Media
