A Boost For The Chronically Ill

Group Offers Help To Spanish-Only Speakers

March 27, 2006
By MONICA POLANCO, Courant Staff Writer

Doctors in Colombia worked for 20 hours to repair the damage acid reflux had wrought on Mariana Heredia's larynx, vocal cords and trachea.

They removed the unhealthy tissue in September and repaired a hernia in Heredia's stomach that was the culprit. The surgery, obtained with the help of a group called Sin Barreras: The Latino Outreach Project, has given Heredia hope.

"I think I would have died waiting," said Heredia, 42, of Hartford. "I didn't know where else to go."

Sin Barreras - Spanish for "without barriers" - aims to help chronically ill Spanish-only speakers in Connecticut navigate the often tangled web of services they need.

Lydia Velez Herrera, 37, of Bristol, is the director of Sin Barreras. Jennifer Jaff, 49, of Farmington, works with Herrera and runs a nonprofit called Advocacy for Patients with Chronic Illness. Sin Barreras is part of the advocacy group. Jaff , a lawyer, handles legal matters, and Velez Herrera, who speaks Spanish, communicates with Sin Barreras' clients.

The free service is badly needed, said Attorney General Richard Blumenthal.

"I think this service can be immensely important in providing a critical link and a lifeline for people whose primary language is Spanish," Blumenthal said. "My hope is that it will attract sufficient resources to serve large numbers of people."

Health insurance companies in Connecticut frequently deny claims from chronically ill patients for a variety of reasons, including what the companies consider ineffective treatment and imagined illnesses, Blumenthal said. Patients who speak only Spanish may be less likely to challenge a denied claim because of the language barrier, he said.

"This technical jargon is difficult for anyone to understand and the procedures are often confusing," he said. "For someone who feels that they would be easily understood if only for the language barrier, they may feel sort of embarrassed to question authority."

In addition, some Spanish-only speakers think they don't have the right to challenge an insurance company, said Jorge L. Rivera, founder and executive director of Mi Casa Family Services and Educational Center in Hartford.

"That's one of the biggest problems that I've seen ... that people don't know how to navigate the system," Rivera said.

Rivera credits Sin Barreras with obtaining a humanitarian visa for his father-in-law, Elias Mejia. Mejia feared his leg would be amputated in his native Dominican Republic, where medical technology is not as advanced as it is in the United States.

This month, doctors told Mejia that he didn't have circulatory problems and didn't need an amputation.

"That was great news," Rivera said.

Rivera said he's excited that Sin Barreras this month began offering help to about a dozen Mi Casa clients.

"Thank God that she [Jaff] agreed to bring that service here," Rivera said.

Building Trust

Velez Herrera's and Jaff's advocacy efforts are rooted in their experiences with chronic illness.

Velez Herrera's 17-year-old daughter has bipolar disorder and Jaff, a former state assistant attorney general and patient's rights expert, has Crohn's disease, which causes a host of ailments such as diarrhea, abdominal pain and rectal bleeding.

"My concern was that Latinos who were Spanish-speaking were not receiving as much information as the English-speaking population," Velez Herrera said. "I was really hopeful that this would be my way of giving back to the world."

Together, the women complement each other, Jaff said.

"Part of the reason our partnership works so well is that I'm sick," she said. "She's my legs on top of everything else."

So far, Sin Barreras has helped about 50 people with problems such as health care access, domestic violence and Medicare Part D, Velez Herrera said. Because many of their clients need help in more than one area, it's not unusual for Jaff and Velez Herrera to help families solve housing problems and find donated food.

The women have offered their assistance through a mixture of grants, contracts and donations, but as their client base grows, so does their need for more money.

"We're really at a crossroads here," Jaff said. "We're at a point where we're going to make a decision in a couple of months whether this is going to fly."

The service has become more than merely a Spanish-language equivalent of Jaff's Advocacy for Patients with Chronic Illness.

Unlike Jaff's English-speaking clients, many of whom contact her through her website, Sin Barreras clients tend to learn about the organization through word of mouth and have a greater desire to meet Velez Herrera and Jaff.

"It seems to us, that Spanish-speaking patients really want to see us and they need to establish the trust that only comes from face-to-face contact," Jaff said.

Sin Barreras clients also hear a key message, Jaff said: "We kind of have to start at a different starting point of saying, `It's OK to fight for your rights - in fact, it's expected."

Relief

Mariana Heredia, a married mother of three, struggled with her illness for 10 years.

Her condition deprived her of oxygen, causing fainting spells. When doctors in the United States told her they would have to remove her vocal cords in order to treat her, Heredia sought treatment in Colombia.

Sin Barreras persuaded Heredia's health insurance provider to pay for the $51,000 surgery and provided Heredia's family with food and airfare to Colombia.

Heredia is still recovering. Because she overstayed her one-year sick leave, Heredia has been fired from her housekeeping job and is without insurance, Jaff said.

Now, Sin Barreras will help Heredia apply for Medicaid, Jaff said.

"I'm very thankful," Heredia said. "If one day I had the opportunity to work with them, I would very happily do it. Without them, I don't know what would have happened to me."