Uranium Contaminates Water Across California's Central Valley
Mexican Indigenous Immigrants' Dire Need for Medical Interpreters
In Fresno, 'Unprecedented Increase' in ER Visits Due to Rough Fire
Is Pollution From Asia Making the Central Valley's Bad Air Even Worse?
Fresno Considers Ending Health Services for the Undocumented
In Fresno, High School Program Aims at Lack of Provider Diversity
Central Valley Community Fights for Clean Drinking Water
Recruiting – and Retaining – Doctors in California’s San Joaquin Valley
Small Farmer In Central Valley Takes His Strawberries 'Farm to School'
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FM","link":"/"}},"stateofhealth_120396":{"type":"posts","id":"stateofhealth_120396","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"120396","score":null,"sort":[1449610967000]},"guestAuthors":[],"slug":"uranium-contaminates-water-california-central-valley","title":"Uranium Contaminates Water Across California's Central Valley","publishDate":1449610967,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>In a trailer park tucked among the irrigated orchards outside Fresno that help make California's San Joaquin Valley the richest farm region in the world, 16-year-old Giselle Alvarez, one of the few English speakers in this community of farmworkers, puzzles over the notices posted on front doors: There's a danger in their drinking water.\u003c/p>\n\u003caside class=\"pullquote alignright\">'This has been a decades-long process that has occurred. It’s going to take many decades to reverse.”\u003cbr>\n\u003ccite>Bryant Jurgens, U.S. Geological Survey hydrologist\u003c/cite>\u003c/aside>\n\u003cp>Tests for uranium, the notices warn, show a level considered unsafe by federal and state standards. The trailer park's owners are legally required to post the warnings. But the notices are awkwardly worded and in English, a language few of the park's dozens of Spanish-speaking families can read.\u003c/p>\n\u003cp>\"It says you can drink the water -- but if you drink the water over a period of time, you can get cancer,\" said Alvarez, whose working-class family has no choice but to keep drinking and cooking with the tainted tap water daily, as they have since Alvarez was just learning to walk. \"They really don't explain.\"\u003c/p>\n\u003cp>Uranium, the stuff of nuclear fuel for power plants and atom bombs, \u003ca href=\"http://pubs.usgs.gov/circ/1358/\" target=\"_blank\">increasingly is showing up in drinking water systems \u003c/a>in major farming regions of the U.S. West — a naturally occurring but unexpected byproduct of irrigation, of drought, and of the overpumping of natural underground water reserves.\u003c/p>\n\u003cp>An Associated Press investigation in Central California — along with the U.S. Central Plains, among the areas most affected — found authorities are doing little to inform the public at large of the growing risk.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>At particular risk are the San Joaquin Valley families who rely on private wells; as many as one out of every four of them are unknowingly drinking dangerous amounts of uranium, researchers determined this year and last. Government authorities say long-term exposure to uranium can damage kidneys and raise cancer risks, and scientists say it can have other harmful effects.\u003c/p>\n\u003cp>In this swath of farmland, roughly 250 miles long and encompassing major cities, including Fresno, Bakersfield, and Modesto, the pre-treated water of up to one in 10 public systems has uranium levels that exceed federal and state safety standards, the \u003ca href=\"http://pubs.usgs.gov/circ/1358/\" target=\"_blank\">U.S. Geological Survey has found\u003c/a>.\u003c/p>\n\u003cp>More broadly, nearly 2 million people in California's Central Valley and in the U.S. Midwest live within a half-mile of groundwater containing uranium over the safety standards, University of Nebraska researchers said in a study published in September.\u003c/p>\n\u003cp>Everything from state agencies to tiny rural schools are scrambling to deal with hundreds of tainted public wells — more regulated than private wells under safe-drinking-water laws.\u003c/p>\n\u003cp>That includes water wells at Westport Elementary School, where 450 children from rural families study outside the Central California farm hub of Modesto.\u003c/p>\n\u003cp>At Westport's playground, schoolchildren take a break from tetherball to sip from fountains marked with Spanish and English placards: \"SAFE TO DRINK.\"\u003c/p>\n\u003cp>The school, which draws on its own wells for its drinking fountains, sinks and cafeteria, is one of about 10 water systems in the farm region that have installed uranium removal facilities in recent years. Prices range from $65,000 for the smallest system to millions of dollars.\u003c/p>\n\u003cp>[contextly_sidebar id=\"rPJv8j1Ci8bZ6nTksYCUVlSr51iN6Pw7\"]Just off Westport's playground, a school maintenance chief jangles the keys to the school's treatment operation, locked in a shed the size of a garage. Inside, a system of tubes, dials and canisters resembling large scuba tanks removes up to a pound a year of uranium from the school's wells.\u003c/p>\n\u003cp>The uranium gleaned from the school's well water and other Central California water systems is handled like the nuclear material it is — taken away by workers in masks, gloves and other protective garments, said Ron Dollar, a vice president at Water Remediation Technology, a Colorado-based firm.\u003c/p>\n\u003cp>It is then processed into nuclear fuel for power plants, Dollar said.\u003c/p>\n\u003cp>Before treatment, Westport's water tested up to four times state and federal limits. After treatment, it's safe for the children, teachers and staff to drink.\u003c/p>\n\u003cp>Other Central California farm schools opt to buy bottled water in place of drinking fountains, which are off limits because of uranium and other contaminants.\u003c/p>\n\u003cp>\"We don't have a choice,\" said Terri Lancaster, principal of the 260 students at Waukena Elementary School in rural Tulare County. \"You do what you have to do.\"\u003c/p>\n\u003cp>Until winning a state grant to pay for trucked-in drinking water, her school was spending $10,000 a year from its general fund on bottled water.\u003c/p>\n\u003cp>Meanwhile, the city of Modesto, with a half-million residents, recently spent more than $500,000 to start blending water from one contaminated well to dilute the uranium to safe levels. The city has retired a half-dozen other wells with excess levels of uranium.\u003c/p>\n\u003cp>State officials don't track spending on uranium-contaminated wells. But the state's Water Resources Control Board identified at least $16.7 million the state has spent since 2010 helping public water systems deal with high levels of uranium.\u003c/p>\n\u003cp>In coming years, more public water systems likely will be compelled to invest in such costly fixes, said Miranda Fram, a researcher with the U.S. Geological Survey in Sacramento.\u003c/p>\n\u003cp>Fram and colleagues at USGS have taken the lead over the past decade in identifying the problem in farm centers, including Central California, which produces a quarter of the country's agriculture.\u003c/p>\n\u003cp>Geologists and water experts are still piecing together the ways in which levels of uranium exceeding federal and state health standards are seeping into more public water systems and household wells in major farm areas.\u003c/p>\n\u003cp>Fram and her colleagues believe the amount of uranium increased in Central Valley drinking water supplies over the last 150 years with the spread of farming.\u003c/p>\n\u003cp>In California, as in the Rockies, mountain snowmelt washes uranium-laden sediment to the flatlands, where groundwater is used to irrigate crops.\u003c/p>\n\u003cp>Irrigation allows year-round farming, and the irrigated plants naturally create a weak acid that is leeching more and more uranium from sediment, said Fram and Bryant Jurgens, another USGS researcher.\u003c/p>\n\u003cp>\u003cstrong>Ongoing Drought is a Factor\u003c/strong>\u003c/p>\n\u003cp>Groundwater pumping pulls the contaminated water down into the earth, where it is tapped by wells that supply drinking water.\u003c/p>\n\u003cp>California is now experiencing its driest four-year span on record, and farmers and other users are pumping groundwater at the highest rates ever, helping to pull yet more uranium into areas of aquifers tapped by water wells.\u003c/p>\n\u003cp>\"This has been a decades-long process that has occurred,\" Jurgens said.\u003c/p>\n\u003cp>And even if authorities were to intervene to somehow curb uranium contamination — and no such effort is under way — \"we expect that it's going to take many decades to reverse this,\" Jurgens said.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We should not have any doubts as to whether drinking water with uranium in it is a problem or not. It is.' \u003ccite>Doug Brugge, professor of public health, Tufts University School of Medicine\u003c/cite>\u003c/aside>\n\u003cp>The USGS calculates that the average level of uranium in public-supply wells of the eastern San Joaquin Valley increased 17 percent from 1990 to the mid-2000s. The number of public-supply wells with unsafe levels of uranium, meantime, climbed from 7 percent to 10 percent over the same period there.\u003c/p>\n\u003cp>But the problem remains so unpublicized that even Fresno County farmer Mark Sorensen — who grows grapes and blueberries in one of the most impacted parts of the country, and deals with water issues routinely as a leader of the local farm bureau — admits to not knowing about it.\u003c/p>\n\u003cp>\"To be honest, I have never spoken to anybody about uranium,\" said Sorensen, a fifth-generation farmer. \"I've never even heard of it in drinking water.\"\u003c/p>\n\u003cp>Scientists have long known that uranium can damage kidneys and increase the risks of cancer when consumed over a year or more, which is why authorities have set maximum levels for drinking water.\u003c/p>\n\u003cp>Drinking water tainted by uranium is the chief concern — but uranium also sticks to potatoes, radishes and other root vegetables if they're not properly washed. (While studies have confirmed livestock and people can ingest high levels of uranium by eating contaminated vegetation, scientists have yet to fully research the dangers involved.)\u003c/p>\n\u003cp>Though people think mainly about uranium's radioactivity, the danger in water mainly comes from the toxic chemical effects of the metal.\u003c/p>\n\u003cp>Old public health models for uranium date back to the U.S. uranium boom of the 1940s and 1950s, when the U.S. Atomic Energy Commission set off a nuclear-age mining boom in the Central Valley and other points West as the country sought to build uranium stockpiles. Countless miners succumbed to cancer from breathing radioactive gas.\u003c/p>\n\u003cp>But those models now need revising to deal with the larger population exposed through sources like drinking water, academics say.\u003c/p>\n\u003cp>\"We should not have any doubts as to whether drinking water with uranium in it is a problem or not. It is,\" said Doug Brugge, professor of public health and community medicine at Tufts University School of Medicine in Boston. \"The larger the population that's drinking this water, the more people that are going to be affected.\"\u003c/p>\n\u003cp>Because \"there has not been an appreciation of the number of people exposed, it has received a lot less attention\" than it should, said researcher Johnnye Lewis at the University of New Mexico, which along with Brugge's team is studying the health impacts of uranium on communities.\u003c/p>\n\u003cp>Research teams at Tufts and the University of New Mexico also link long-term exposure to signs of reproductive and genetic damage, among other problems.\u003c/p>\n\u003cp>In California, changes in water standards since the late 2000s have mandated testing for uranium in public water systems, and the state frequently helps public water systems deal with wells testing at high levels.\u003c/p>\n\u003cp>\u003cstrong>'I'm Sure A Lot of People Are Unaware'\u003c/strong>\u003c/p>\n\u003cp>For private well owners and small water systems, however, officials were unable to point to any public health campaigns in the most affected areas or any help with testing or dealing with wells that do test for high levels.\u003c/p>\n\u003cp>USGS researchers recently sampled 170 domestic water wells in the San Joaquin Valley, and found 20 to 25 percent bore uranium at levels that broke federal and state limits.\u003c/p>\n\u003cp>State and federal regulators say the U.S. Congress, outlining drinking water standards, has limited its enforcement authority to public water systems. \"Your home's your castle. If you've got a well at home, that's your business,\" said Bruce Macler, a San Francisco-based water program toxicologist for the U.S. Environmental Protection Agency.\u003c/p>\n\u003cp>Uranium is on the radar of California water officials, but the officials are\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/03/13/nitrates-in-california-drinking-water-new-attention-from-state-water-board/?_ga=1.249130563.514739197.1438904388\" target=\"_blank\"> paying more attention to other farming-related contaminants\u003c/a>, including nitrates, as well as simply having enough water in the fourth year of the state's drought, said John Borkovich, head of water quality at the state Water Resources Control Board.\u003c/p>\n\u003cp>\"When it comes to private domestic wells, we do what we can to get the word out,\" Borkovich said. \"It's safe to say that there's always more that can be done.\"\u003c/p>\n\u003cp>The Associated Press commissioned sampling of wells at five homes in the countryside outside Modesto, to look more closely at whether unregulated private wells that families depend on were as vulnerable as contaminated public water systems nearby.\u003c/p>\n\u003cp>The results: Water from two of the five wells contained dangerous levels of uranium.\u003c/p>\n\u003cp>None of the five families, however, had ever heard that uranium could be a problem in groundwater — let alone that it was a problem in their area.\u003c/p>\n\u003cp>\"That's something I'm sure a lot of people are unaware of,\" said Reyna Rico, whose rural home overlooking farm fields had a well that tested three times the federal and state health limits.\u003c/p>\n\u003cp>\"It would be nice to be informed, so we can make an informed decision, and those wells can be tested,\" said a resident nearby, Michelle Norleen, who was relieved to know that her own water — unlike those of two of her neighbors — tested below the limits in the AP sampling.\u003c/p>\n\u003cp>Even for bigger water systems for which government help is available, accessing safe water doesn't always come quickly. That's true at the Double L Mobile Ranch outside Fresno, where Giselle Alvarez lives in a one-room trailer with her mother and father.\u003c/p>\n\u003cp>Authorities have recorded years of tests showing dangerous levels of uranium in the water provided to the Double L's low-income residents.\u003c/p>\n\u003cp>The park's owner, Carl Hunt, minimized the health risks to the families who live there.\u003c/p>\n\u003cp>\"Not afraid of that water at all,\" Hunt told the AP.\u003c/p>\n\u003cp>An independent water test commissioned by the AP found water at Hunt's trailer park remained over the limits for uranium.\u003c/p>\n\u003cp>Officials trying to set up delivery of safe water for the Double L's families have arranged with a local farm town, Kerman, to run its own water lines out to the trailer park — but Kerman is awaiting funding to deal with its own, uranium-contaminated well first. State officials expect it will take another three years to get safe water to the trailer park.\u003c/p>\n\u003cp>For now, families in the rural trailer park mostly throw away the regular water notices, unable to comprehend their meaning. Suspicious in general of the park's tap water, families at the Double L who can afford it buy bottled water.\u003c/p>\n\u003cp>That doesn't include Alvarez's family.\u003c/p>\n\u003cp>\"We can't really do anything about it,\" she says on the wooden steps of her mobile home. \"As you can see, we're not rich.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Manuel Valdes and Serdar Tumgoren contributed to this report.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"As many as one in four San Joaquin Valley families with private wells are unknowingly drinking dangerous amounts of uranium.","status":"publish","parent":0,"modified":1449688404,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":67,"wordCount":2316},"headData":{"title":"Uranium Contaminates Water Across California's Central Valley | KQED","description":"As many as one in four San Joaquin Valley families with private wells are unknowingly drinking dangerous amounts of uranium.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Uranium Contaminates Water Across California's Central Valley","datePublished":"2015-12-08T21:42:47.000Z","dateModified":"2015-12-09T19:13:24.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"120396 http://ww2.kqed.org/stateofhealth/?p=120396","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/12/08/uranium-contaminates-water-california-central-valley/","disqusTitle":"Uranium Contaminates Water Across California's Central Valley","source":"Associated Press","nprByline":"Ellen Knickmeyer and Scott Smith ","path":"/stateofhealth/120396/uranium-contaminates-water-california-central-valley","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a trailer park tucked among the irrigated orchards outside Fresno that help make California's San Joaquin Valley the richest farm region in the world, 16-year-old Giselle Alvarez, one of the few English speakers in this community of farmworkers, puzzles over the notices posted on front doors: There's a danger in their drinking water.\u003c/p>\n\u003caside class=\"pullquote alignright\">'This has been a decades-long process that has occurred. It’s going to take many decades to reverse.”\u003cbr>\n\u003ccite>Bryant Jurgens, U.S. Geological Survey hydrologist\u003c/cite>\u003c/aside>\n\u003cp>Tests for uranium, the notices warn, show a level considered unsafe by federal and state standards. The trailer park's owners are legally required to post the warnings. But the notices are awkwardly worded and in English, a language few of the park's dozens of Spanish-speaking families can read.\u003c/p>\n\u003cp>\"It says you can drink the water -- but if you drink the water over a period of time, you can get cancer,\" said Alvarez, whose working-class family has no choice but to keep drinking and cooking with the tainted tap water daily, as they have since Alvarez was just learning to walk. \"They really don't explain.\"\u003c/p>\n\u003cp>Uranium, the stuff of nuclear fuel for power plants and atom bombs, \u003ca href=\"http://pubs.usgs.gov/circ/1358/\" target=\"_blank\">increasingly is showing up in drinking water systems \u003c/a>in major farming regions of the U.S. West — a naturally occurring but unexpected byproduct of irrigation, of drought, and of the overpumping of natural underground water reserves.\u003c/p>\n\u003cp>An Associated Press investigation in Central California — along with the U.S. Central Plains, among the areas most affected — found authorities are doing little to inform the public at large of the growing risk.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At particular risk are the San Joaquin Valley families who rely on private wells; as many as one out of every four of them are unknowingly drinking dangerous amounts of uranium, researchers determined this year and last. Government authorities say long-term exposure to uranium can damage kidneys and raise cancer risks, and scientists say it can have other harmful effects.\u003c/p>\n\u003cp>In this swath of farmland, roughly 250 miles long and encompassing major cities, including Fresno, Bakersfield, and Modesto, the pre-treated water of up to one in 10 public systems has uranium levels that exceed federal and state safety standards, the \u003ca href=\"http://pubs.usgs.gov/circ/1358/\" target=\"_blank\">U.S. Geological Survey has found\u003c/a>.\u003c/p>\n\u003cp>More broadly, nearly 2 million people in California's Central Valley and in the U.S. Midwest live within a half-mile of groundwater containing uranium over the safety standards, University of Nebraska researchers said in a study published in September.\u003c/p>\n\u003cp>Everything from state agencies to tiny rural schools are scrambling to deal with hundreds of tainted public wells — more regulated than private wells under safe-drinking-water laws.\u003c/p>\n\u003cp>That includes water wells at Westport Elementary School, where 450 children from rural families study outside the Central California farm hub of Modesto.\u003c/p>\n\u003cp>At Westport's playground, schoolchildren take a break from tetherball to sip from fountains marked with Spanish and English placards: \"SAFE TO DRINK.\"\u003c/p>\n\u003cp>The school, which draws on its own wells for its drinking fountains, sinks and cafeteria, is one of about 10 water systems in the farm region that have installed uranium removal facilities in recent years. Prices range from $65,000 for the smallest system to millions of dollars.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Just off Westport's playground, a school maintenance chief jangles the keys to the school's treatment operation, locked in a shed the size of a garage. Inside, a system of tubes, dials and canisters resembling large scuba tanks removes up to a pound a year of uranium from the school's wells.\u003c/p>\n\u003cp>The uranium gleaned from the school's well water and other Central California water systems is handled like the nuclear material it is — taken away by workers in masks, gloves and other protective garments, said Ron Dollar, a vice president at Water Remediation Technology, a Colorado-based firm.\u003c/p>\n\u003cp>It is then processed into nuclear fuel for power plants, Dollar said.\u003c/p>\n\u003cp>Before treatment, Westport's water tested up to four times state and federal limits. After treatment, it's safe for the children, teachers and staff to drink.\u003c/p>\n\u003cp>Other Central California farm schools opt to buy bottled water in place of drinking fountains, which are off limits because of uranium and other contaminants.\u003c/p>\n\u003cp>\"We don't have a choice,\" said Terri Lancaster, principal of the 260 students at Waukena Elementary School in rural Tulare County. \"You do what you have to do.\"\u003c/p>\n\u003cp>Until winning a state grant to pay for trucked-in drinking water, her school was spending $10,000 a year from its general fund on bottled water.\u003c/p>\n\u003cp>Meanwhile, the city of Modesto, with a half-million residents, recently spent more than $500,000 to start blending water from one contaminated well to dilute the uranium to safe levels. The city has retired a half-dozen other wells with excess levels of uranium.\u003c/p>\n\u003cp>State officials don't track spending on uranium-contaminated wells. But the state's Water Resources Control Board identified at least $16.7 million the state has spent since 2010 helping public water systems deal with high levels of uranium.\u003c/p>\n\u003cp>In coming years, more public water systems likely will be compelled to invest in such costly fixes, said Miranda Fram, a researcher with the U.S. Geological Survey in Sacramento.\u003c/p>\n\u003cp>Fram and colleagues at USGS have taken the lead over the past decade in identifying the problem in farm centers, including Central California, which produces a quarter of the country's agriculture.\u003c/p>\n\u003cp>Geologists and water experts are still piecing together the ways in which levels of uranium exceeding federal and state health standards are seeping into more public water systems and household wells in major farm areas.\u003c/p>\n\u003cp>Fram and her colleagues believe the amount of uranium increased in Central Valley drinking water supplies over the last 150 years with the spread of farming.\u003c/p>\n\u003cp>In California, as in the Rockies, mountain snowmelt washes uranium-laden sediment to the flatlands, where groundwater is used to irrigate crops.\u003c/p>\n\u003cp>Irrigation allows year-round farming, and the irrigated plants naturally create a weak acid that is leeching more and more uranium from sediment, said Fram and Bryant Jurgens, another USGS researcher.\u003c/p>\n\u003cp>\u003cstrong>Ongoing Drought is a Factor\u003c/strong>\u003c/p>\n\u003cp>Groundwater pumping pulls the contaminated water down into the earth, where it is tapped by wells that supply drinking water.\u003c/p>\n\u003cp>California is now experiencing its driest four-year span on record, and farmers and other users are pumping groundwater at the highest rates ever, helping to pull yet more uranium into areas of aquifers tapped by water wells.\u003c/p>\n\u003cp>\"This has been a decades-long process that has occurred,\" Jurgens said.\u003c/p>\n\u003cp>And even if authorities were to intervene to somehow curb uranium contamination — and no such effort is under way — \"we expect that it's going to take many decades to reverse this,\" Jurgens said.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We should not have any doubts as to whether drinking water with uranium in it is a problem or not. It is.' \u003ccite>Doug Brugge, professor of public health, Tufts University School of Medicine\u003c/cite>\u003c/aside>\n\u003cp>The USGS calculates that the average level of uranium in public-supply wells of the eastern San Joaquin Valley increased 17 percent from 1990 to the mid-2000s. The number of public-supply wells with unsafe levels of uranium, meantime, climbed from 7 percent to 10 percent over the same period there.\u003c/p>\n\u003cp>But the problem remains so unpublicized that even Fresno County farmer Mark Sorensen — who grows grapes and blueberries in one of the most impacted parts of the country, and deals with water issues routinely as a leader of the local farm bureau — admits to not knowing about it.\u003c/p>\n\u003cp>\"To be honest, I have never spoken to anybody about uranium,\" said Sorensen, a fifth-generation farmer. \"I've never even heard of it in drinking water.\"\u003c/p>\n\u003cp>Scientists have long known that uranium can damage kidneys and increase the risks of cancer when consumed over a year or more, which is why authorities have set maximum levels for drinking water.\u003c/p>\n\u003cp>Drinking water tainted by uranium is the chief concern — but uranium also sticks to potatoes, radishes and other root vegetables if they're not properly washed. (While studies have confirmed livestock and people can ingest high levels of uranium by eating contaminated vegetation, scientists have yet to fully research the dangers involved.)\u003c/p>\n\u003cp>Though people think mainly about uranium's radioactivity, the danger in water mainly comes from the toxic chemical effects of the metal.\u003c/p>\n\u003cp>Old public health models for uranium date back to the U.S. uranium boom of the 1940s and 1950s, when the U.S. Atomic Energy Commission set off a nuclear-age mining boom in the Central Valley and other points West as the country sought to build uranium stockpiles. Countless miners succumbed to cancer from breathing radioactive gas.\u003c/p>\n\u003cp>But those models now need revising to deal with the larger population exposed through sources like drinking water, academics say.\u003c/p>\n\u003cp>\"We should not have any doubts as to whether drinking water with uranium in it is a problem or not. It is,\" said Doug Brugge, professor of public health and community medicine at Tufts University School of Medicine in Boston. \"The larger the population that's drinking this water, the more people that are going to be affected.\"\u003c/p>\n\u003cp>Because \"there has not been an appreciation of the number of people exposed, it has received a lot less attention\" than it should, said researcher Johnnye Lewis at the University of New Mexico, which along with Brugge's team is studying the health impacts of uranium on communities.\u003c/p>\n\u003cp>Research teams at Tufts and the University of New Mexico also link long-term exposure to signs of reproductive and genetic damage, among other problems.\u003c/p>\n\u003cp>In California, changes in water standards since the late 2000s have mandated testing for uranium in public water systems, and the state frequently helps public water systems deal with wells testing at high levels.\u003c/p>\n\u003cp>\u003cstrong>'I'm Sure A Lot of People Are Unaware'\u003c/strong>\u003c/p>\n\u003cp>For private well owners and small water systems, however, officials were unable to point to any public health campaigns in the most affected areas or any help with testing or dealing with wells that do test for high levels.\u003c/p>\n\u003cp>USGS researchers recently sampled 170 domestic water wells in the San Joaquin Valley, and found 20 to 25 percent bore uranium at levels that broke federal and state limits.\u003c/p>\n\u003cp>State and federal regulators say the U.S. Congress, outlining drinking water standards, has limited its enforcement authority to public water systems. \"Your home's your castle. If you've got a well at home, that's your business,\" said Bruce Macler, a San Francisco-based water program toxicologist for the U.S. Environmental Protection Agency.\u003c/p>\n\u003cp>Uranium is on the radar of California water officials, but the officials are\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/03/13/nitrates-in-california-drinking-water-new-attention-from-state-water-board/?_ga=1.249130563.514739197.1438904388\" target=\"_blank\"> paying more attention to other farming-related contaminants\u003c/a>, including nitrates, as well as simply having enough water in the fourth year of the state's drought, said John Borkovich, head of water quality at the state Water Resources Control Board.\u003c/p>\n\u003cp>\"When it comes to private domestic wells, we do what we can to get the word out,\" Borkovich said. \"It's safe to say that there's always more that can be done.\"\u003c/p>\n\u003cp>The Associated Press commissioned sampling of wells at five homes in the countryside outside Modesto, to look more closely at whether unregulated private wells that families depend on were as vulnerable as contaminated public water systems nearby.\u003c/p>\n\u003cp>The results: Water from two of the five wells contained dangerous levels of uranium.\u003c/p>\n\u003cp>None of the five families, however, had ever heard that uranium could be a problem in groundwater — let alone that it was a problem in their area.\u003c/p>\n\u003cp>\"That's something I'm sure a lot of people are unaware of,\" said Reyna Rico, whose rural home overlooking farm fields had a well that tested three times the federal and state health limits.\u003c/p>\n\u003cp>\"It would be nice to be informed, so we can make an informed decision, and those wells can be tested,\" said a resident nearby, Michelle Norleen, who was relieved to know that her own water — unlike those of two of her neighbors — tested below the limits in the AP sampling.\u003c/p>\n\u003cp>Even for bigger water systems for which government help is available, accessing safe water doesn't always come quickly. That's true at the Double L Mobile Ranch outside Fresno, where Giselle Alvarez lives in a one-room trailer with her mother and father.\u003c/p>\n\u003cp>Authorities have recorded years of tests showing dangerous levels of uranium in the water provided to the Double L's low-income residents.\u003c/p>\n\u003cp>The park's owner, Carl Hunt, minimized the health risks to the families who live there.\u003c/p>\n\u003cp>\"Not afraid of that water at all,\" Hunt told the AP.\u003c/p>\n\u003cp>An independent water test commissioned by the AP found water at Hunt's trailer park remained over the limits for uranium.\u003c/p>\n\u003cp>Officials trying to set up delivery of safe water for the Double L's families have arranged with a local farm town, Kerman, to run its own water lines out to the trailer park — but Kerman is awaiting funding to deal with its own, uranium-contaminated well first. State officials expect it will take another three years to get safe water to the trailer park.\u003c/p>\n\u003cp>For now, families in the rural trailer park mostly throw away the regular water notices, unable to comprehend their meaning. Suspicious in general of the park's tap water, families at the Double L who can afford it buy bottled water.\u003c/p>\n\u003cp>That doesn't include Alvarez's family.\u003c/p>\n\u003cp>\"We can't really do anything about it,\" she says on the wooden steps of her mobile home. \"As you can see, we're not rich.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Manuel Valdes and Serdar Tumgoren contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/120396/uranium-contaminates-water-california-central-valley","authors":["byline_stateofhealth_120396"],"categories":["stateofhealth_11"],"tags":["stateofhealth_280","stateofhealth_2519","stateofhealth_461","stateofhealth_2610"],"featImg":"stateofhealth_120448","label":"source_stateofhealth_120396"},"stateofhealth_83818":{"type":"posts","id":"stateofhealth_83818","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"83818","score":null,"sort":[1443451543000]},"guestAuthors":[],"slug":"need-a-medical-interpreter-try-looking-in-californias-strawberry-fields","title":"Mexican Indigenous Immigrants' Dire Need for Medical Interpreters","publishDate":1443451543,"format":"image","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Imagine you are rushed to the hospital as pain radiates through your chest. Doctors whirl around you, but you don’t know what's happening because everyone is speaking a foreign language.\u003c/p>\n\u003cp>That’s what happened to farmworker Angelina Diaz-Ramirez, 50, after she had a heart attack in a Monterey County green bean field in 2012.\u003c/p>\n\u003cp>The foreman of her work crew took her to the main road and put her in an ambulance, alone. Diaz-Ramirez is an immigrant from Mexico, and while there were Spanish-speaking staff, she was still isolated by a language barrier.\u003c/p>\n\u003cp>That's because Diaz-Ramirez, like a third of California farmworkers, speaks a language indigenous to southern Mexico. She doesn’t understand Spanish. Her language, Triqui, is as different from Spanish as Navajo is from English.\u003c/p>\n\u003cp>https://vimeo.com/140479930\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>At the hospital, without a Triqui interpreter, “no one explained anything to me,” said Diaz-Ramirez.\u003c/p>\n\u003cp>“I was scared, but I didn’t have a choice,\" she said.\u003c/p>\n\u003cp>As anesthesia blotted out the operating room, Diaz-Ramirez had no idea a surgeon was about to cut open her chest to implant a pacemaker.\u003c/p>\n\u003cp>\u003cstrong>Medical Interpreters Are Key\u003c/strong>\u003c/p>\n\u003cp>Diaz-Ramirez’s case highlights the importance of trained medical interpreters, researchers say.\u003c/p>\n\u003caside class=\"pullquote alignright\">'No one explained anything to me. I was scared but I didn't have a choice.'\u003ccite>Angelina Diaz-Ramirez, Triqui farmworker who had heart surgery without an interpreter\u003c/cite>\u003c/aside>\n\u003cp>Interpreters are “absolutely necessary,” said Alicia Fernandez, a medical interpretation expert at UC San Francisco, because quality health care and basic informed consent are nearly impossible without one.\u003c/p>\n\u003cp>Interpreters “enormously increase patient understanding and satisfaction,” said Fernandez. She adds that interpreters also “increase physician satisfaction with the care they deliver.”\u003c/p>\n\u003cp>Medicine, she said, is not an antiseptic, scientific process. Doctors can’t just scan, medicate and operate. Clear communication is essential for accurate diagnosis and effective treatment.\u003c/p>\n\u003cp>[contextly_sidebar id=\"2KQd30QKKYZZL3bwvUkl6icTu31wfvST\"]\u003c/p>\n\u003cp>That’s why using improvised sign language, or asking a child to interpret -- just \"getting by\" -- is simply not good enough, said Fernandez.\u003c/p>\n\u003cp>“Getting by leads to mistakes,” she said. “And mistakes can be tragic, for both the patient and the physician.”\u003c/p>\n\u003cp>\u003cstrong>Indigenous Farmworkers Without Interpreters\u003c/strong>\u003c/p>\n\u003cp>Erica Gastelum, a pediatrician in Fresno, regrets that she rarely has access to an interpreter for her Mixteco-speaking patients. She says without one, “You're not able to provide equal care to all comers.”\u003c/p>\n\u003cfigure id=\"attachment_83923\" class=\"wp-caption alignleft\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Lagnuage-map.png\">\u003cimg class=\"wp-image-83923 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Lagnuage-map-400x225.png\" alt=\"This map shows where Mexican indigenous languages originate. Triqui and Mixteco belong to the oto-mangue family, in southwest of the country (Jeremy Raff/KQED). \" width=\"400\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">This map shows where Mexican indigenous languages originate. Triqui and Mixteco belong to the oto-mangue family, in the southwest of the country. (Jeremy Raff/KQED).\u003c/figcaption>\u003c/figure>\n\u003cp>She remembers a 1-year-old boy with fatal congenital heart disease. Doctors had exhausted every option, and the family was gathered in the intensive care unit.\u003c/p>\n\u003cp>“This is it, this is the moment where we’re going to disconnect the tubes,” said Gastelum. “It seemed like they understood. But in such a crucial moment like that, it would have been so much better to have a culturally sensitive, in-person interpreter.”\u003c/p>\n\u003cp>Most hospitals, including Gastelum’s, have telephone services that should let doctors call up an interpreter for any language. In practice, though, the system doesn’t always work for more unusual languages.\u003c/p>\n\u003cp>“When you try to use the phone interpreter line to get the indigenous speaker, you’ll be on hold for like two hours,” said Jasmine Walker, also a pediatrician in Fresno. “Then when you get them, they don't actually speak the language that you need.”\u003c/p>\n\u003cp>Seth Holmes is a physician who lived and worked alongside Triqui migrant farmworkers for 10 years and wrote about his experiences in the book \"\u003ca href=\"http://www.ucpress.edu/book.php?isbn=9780520275140\" target=\"_blank\">Fresh Fruit, Broken Bodies\u003c/a>.\" As the migrants followed crops up and down the West Coast, they often asked Holmes to accompany them to health clinics.\u003c/p>\n\u003cp>In dozens of clinics throughout California, Washington and Oregon, he said, “I have never seen any Triqui person get a medical interpreter.”\u003c/p>\n\u003cp>Hospitals may underestimate how many indigenous patients they have -- and how many interpreters they need -- because many providers assume all Mexicans speak Spanish. Some indigenous people may be afraid to call attention to themselves by asking for an interpreter because they are undocumented.\u003c/p>\n\u003cp>“They don't know that they’re entitled to someone who speaks their language,” said Leoncio Vasquez, who has been training interpreters for 15 years.\u003c/p>\n\u003cp>Any health care facility receiving public money has a legal obligation under both state and federal law to provide an interpreter to every patient who needs one. But only a few health care providers have made\u003ca href=\"http://www.indigenousfarmworkers.org/\" target=\"_blank\"> California’s 120,000 indigenous farmworkers\u003c/a> an explicit priority.\u003c/p>\n\u003cp>\u003cstrong>Interpreting a Big Opportunity for Some Farmworkers\u003c/strong>\u003c/p>\n\u003cp>Brigida Gonzalez, wearing a big \"Qualified Interpreter\" badge, hustles around Natividad Medical Center in Salinas. It's a big building and she’s needed all over.\u003c/p>\n\u003cp>Today she’s a professional employee at a big hospital. A year ago, she was picking strawberries nearby.\u003c/p>\n\u003cfigure id=\"attachment_83917\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Brigida-Patient3-e1443272915487.png\">\u003cimg class=\"wp-image-83917 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Brigida-Patient3-400x225.png\" alt=\"Interpreter Brigida Gonzalez\" width=\"400\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Before interpreter training, Brigida Gonzalez (R) worked in the strawberry fields nearby. \u003ccite>(Jeremy Raff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In the fields one day, another picker noticed Gonzalez spoke English -- a rarity in agriculture -- and suggested she look into Natividad’s training program.\u003c/p>\n\u003cp>Staff at Natividad were thrilled to hear from Gonzalez, “because it was so hard to find someone who spoke English, Spanish and an indigenous language like Mixteco and Triqui,” she said.\u003c/p>\n\u003cp>Gonzalez completed Natividad's six-month training program for indigenous interpreters, the first of its kind, and now works there part time.\u003c/p>\n\u003cp>\u003cstrong>Not Just Hospitals\u003c/strong>\u003c/p>\n\u003cp>The need for trilingual interpreters like Gonzalez is growing, and it's not just hospitals.\u003c/p>\n\u003cp>Four hours down the coast in Oxnard, all three school districts have hired Mixteco interpreters, and the police have one on contract.\u003c/p>\n\u003cp>Altogether, there are about 20 Mixteco speakers making a good living with their language skills in Ventura County.\u003c/p>\n\u003cp>These opportunities are one reason why Argelia Zarate, the Oxnard school district’s first full-time Mixteco interpreter, encourages students to practice their Mixteco so they don’t lose it.\u003c/p>\n\u003cfigure id=\"attachment_83919\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Argelia-1-of-1-e1443466270661.jpg\">\u003cimg class=\"size-full wp-image-83919\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Argelia-1-of-1-e1443466270661.jpg\" alt=\"Argelia Zarate, a Mixteco interpreter at the Oxnard School District, encourages students to practice their native languages.\" width=\"1920\" height=\"1280\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Argelia Zarate, a Mixteco interpreter at the Oxnard School District, encourages students to practice their native languages. \u003ccite>(Jeremy Raff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I didn't go to college, yet I have this job,” said Zarate, “because the community is growing so big that they don't need bilinguals-- they need trilinguals.”\u003c/p>\n\u003cp>The U.S. Bureau of Labor Statistics expects employment of interpreters and translators to grow by\u003ca href=\"http://www.bls.gov/ooh/media-and-communication/interpreters-and-translators.htm\" target=\"_blank\"> 46 percent between 2012 and 2022.\u003c/a> Driving that demand is the \u003ca href=\"http://www.census.gov/content/dam/Census/library/publications/2013/acs/acs-22.pdf\" target=\"_blank\">158 percent increase since 1980 \u003c/a>in the number of people who speak a language other than English at home.\u003c/p>\n\u003cp>Nationally, the median hourly wage for interpreters is $25, compared with $9.09 for farm work.\u003c/p>\n\u003cp>Zarate says the better pay, stable hours and a chance to serve her community all make interpreting a big step up from field work.\u003c/p>\n\u003cp>“Here everybody is nice to you: they talk to you, appreciate what you do,” Zarate said at the elementary school where she works. “In the fields, they treat you like you’re nothing, a slave working for a little bit of money.”\u003c/p>\n\u003cp>The Mixteco/Indigena Community Organizing Project has trained dozens of interpreters in Ventura County and has pressured public agencies to make use of them.\u003c/p>\n\u003cfigure id=\"attachment_83920\" class=\"wp-caption alignright\" style=\"max-width: 5010px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Argelia-2-of-2.jpg\">\u003cimg class=\"size-full wp-image-83920\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Argelia-2-of-2.jpg\" alt=\"Maria, 6, arrived in Oxnard, CA, from the Mexican state of Oaxaca recently and speaks only Mixteco (Jeremy Raff/KQED).\" width=\"5010\" height=\"3340\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2.jpg 5010w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-960x640.jpg 960w\" sizes=\"(max-width: 5010px) 100vw, 5010px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Maria, 6, arrived in Oxnard, CA, from the Mexican state of Oaxaca recently and speaks only Mixteco. (Jeremy Raff/KQED).\u003c/figcaption>\u003c/figure>\n\u003cp>Today, “Ventura County has invested in having better language access than most parts of California, and honestly most parts of Oaxaca,” said Margaret Sawyer, the group’s development director, referring to the Mexican state that many Mixteco migrants are from.\u003c/p>\n\u003cp>\u003cstrong>Barriers Remain\u003c/strong>\u003c/p>\n\u003cp>Not everyone trilingual can make the switch from farm work, though, because there are only a few full-time jobs.\u003c/p>\n\u003cp>Instead, most hospitals rely on freelance part-time interpreters, who have a hard time making a living.\u003c/p>\n\u003cp>“They will have you for two or three hours, then you’re done for the whole day,” said Israel Vasquez, a trilingual interpreter. “You can’t really live off that.” He eventually quit because he couldn’t get enough hours.\u003c/p>\n\u003cp>“Making a living specifically in health care interpreting right now is not really going to happen,” said Don Schinske, executive director of the California Healthcare Interpreting Association.\u003c/p>\n\u003cp>Part of the problem, Schinske said, is that even though federal law requires hospitals to provide interpreters, there is not a direct federal funding stream to pay for those services.\u003c/p>\n\u003cp>“You get a lot of this sentiment from hospitals: ‘Look, we’re trying to get people services in their language, but it is a nicety, not a necessity,’ ” said Schinske.\u003c/p>\n\u003cp>The indigenous interpretation programs at Natividad Medical Center are funded by private donations from agricultural businesses in the area, who have contributed $1.7 million since 2010.\u003c/p>\n\u003cp>Meanwhile, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160AB635\" target=\"_blank\">a bill \u003c/a>that would make it easier for hospitals to get federal money for medical interpreters has stalled in the California Legislature.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/225965640\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>\u003cstrong>Wasted Resource\u003c/strong>\u003c/p>\n\u003cp>Farmworker Angelina Diaz-Ramirez returned home after her surgery with a new pacemaker ticking in her chest -- and a stack of printed instructions that she couldn’t read.\u003c/p>\n\u003cp>“I didn’t know what to do,\" she said, through an interpreter. \"I had strong pain. Should I call them back?”\u003c/p>\n\u003cp>Diaz-Ramirez didn’t know who her cardiologist was, how to get an appointment or which medications to take. It's just the kind of confusion that a trained medical interpreter can prevent.\u003c/p>\n\u003cp>\"I just felt very sad,\" she said.\u003c/p>\n\u003cp>Every week, indigenous people with these same questions visit Leoncio Vasquez, the interpreter trainer in Fresno.\u003c/p>\n\u003cp>He looks through their paperwork, pieces together a backstory, and helps them figure out what to do next -- something that should have happened at the hospital or clinic, with one of the dozens of interpreters Vasquez has already trained.\u003c/p>\n\u003cp>But those interpreters “can’t find jobs related to interpreting,” said Vasquez. What do they do instead? “Some go back to the fields to do farm work.”\u003c/p>\n\u003cp>To Vasquez, it's a waste. He says that until more hospitals recognize these immigrants’ valuable language skills, trained interpreters will stay in the fields, picking strawberries.\u003c/p>\n\u003cp>\u003cem>This piece was produced with support from the Institute for Justice and Journalism.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ci>California has the seventh-largest economy in the world, and immigrants have a long history in building that prosperity. Today one out of every three working people in California is an immigrant — a share that has grown in recent decades. Our state is shaped by these workers and entrepreneurs — 6 million people who’ve found a job in the Golden State. In our series “\u003ca href=\"http://ww2.kqed.org/news/series/california-immigrants-at-work\">Immigrant Shift\u003c/a>,” KQED and The California Report explore the impact they have, the challenges they face and the policies that affect them.\u003c/i>\u003c/p>\n\n","blocks":[],"excerpt":"One in three California farmworkers speaks an indigenous language and barely understands Spanish. ","status":"publish","parent":0,"modified":1443477793,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":67,"wordCount":1896},"headData":{"title":"Mexican Indigenous Immigrants' Dire Need for Medical Interpreters | KQED","description":"One in three California farmworkers speaks an indigenous language and barely understands Spanish. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Mexican Indigenous Immigrants' Dire Need for Medical Interpreters","datePublished":"2015-09-28T14:45:43.000Z","dateModified":"2015-09-28T22:03:13.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"83818 http://ww2.kqed.org/stateofhealth/?p=83818","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/09/28/need-a-medical-interpreter-try-looking-in-californias-strawberry-fields/","disqusTitle":"Mexican Indigenous Immigrants' Dire Need for Medical Interpreters","path":"/stateofhealth/83818/need-a-medical-interpreter-try-looking-in-californias-strawberry-fields","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Imagine you are rushed to the hospital as pain radiates through your chest. Doctors whirl around you, but you don’t know what's happening because everyone is speaking a foreign language.\u003c/p>\n\u003cp>That’s what happened to farmworker Angelina Diaz-Ramirez, 50, after she had a heart attack in a Monterey County green bean field in 2012.\u003c/p>\n\u003cp>The foreman of her work crew took her to the main road and put her in an ambulance, alone. Diaz-Ramirez is an immigrant from Mexico, and while there were Spanish-speaking staff, she was still isolated by a language barrier.\u003c/p>\n\u003cp>That's because Diaz-Ramirez, like a third of California farmworkers, speaks a language indigenous to southern Mexico. She doesn’t understand Spanish. Her language, Triqui, is as different from Spanish as Navajo is from English.\u003c/p>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"vimeoLink","attributes":{"named":{"vimeoId":"140479930"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At the hospital, without a Triqui interpreter, “no one explained anything to me,” said Diaz-Ramirez.\u003c/p>\n\u003cp>“I was scared, but I didn’t have a choice,\" she said.\u003c/p>\n\u003cp>As anesthesia blotted out the operating room, Diaz-Ramirez had no idea a surgeon was about to cut open her chest to implant a pacemaker.\u003c/p>\n\u003cp>\u003cstrong>Medical Interpreters Are Key\u003c/strong>\u003c/p>\n\u003cp>Diaz-Ramirez’s case highlights the importance of trained medical interpreters, researchers say.\u003c/p>\n\u003caside class=\"pullquote alignright\">'No one explained anything to me. I was scared but I didn't have a choice.'\u003ccite>Angelina Diaz-Ramirez, Triqui farmworker who had heart surgery without an interpreter\u003c/cite>\u003c/aside>\n\u003cp>Interpreters are “absolutely necessary,” said Alicia Fernandez, a medical interpretation expert at UC San Francisco, because quality health care and basic informed consent are nearly impossible without one.\u003c/p>\n\u003cp>Interpreters “enormously increase patient understanding and satisfaction,” said Fernandez. She adds that interpreters also “increase physician satisfaction with the care they deliver.”\u003c/p>\n\u003cp>Medicine, she said, is not an antiseptic, scientific process. Doctors can’t just scan, medicate and operate. Clear communication is essential for accurate diagnosis and effective treatment.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>That’s why using improvised sign language, or asking a child to interpret -- just \"getting by\" -- is simply not good enough, said Fernandez.\u003c/p>\n\u003cp>“Getting by leads to mistakes,” she said. “And mistakes can be tragic, for both the patient and the physician.”\u003c/p>\n\u003cp>\u003cstrong>Indigenous Farmworkers Without Interpreters\u003c/strong>\u003c/p>\n\u003cp>Erica Gastelum, a pediatrician in Fresno, regrets that she rarely has access to an interpreter for her Mixteco-speaking patients. She says without one, “You're not able to provide equal care to all comers.”\u003c/p>\n\u003cfigure id=\"attachment_83923\" class=\"wp-caption alignleft\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Lagnuage-map.png\">\u003cimg class=\"wp-image-83923 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Lagnuage-map-400x225.png\" alt=\"This map shows where Mexican indigenous languages originate. Triqui and Mixteco belong to the oto-mangue family, in southwest of the country (Jeremy Raff/KQED). \" width=\"400\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">This map shows where Mexican indigenous languages originate. Triqui and Mixteco belong to the oto-mangue family, in the southwest of the country. (Jeremy Raff/KQED).\u003c/figcaption>\u003c/figure>\n\u003cp>She remembers a 1-year-old boy with fatal congenital heart disease. Doctors had exhausted every option, and the family was gathered in the intensive care unit.\u003c/p>\n\u003cp>“This is it, this is the moment where we’re going to disconnect the tubes,” said Gastelum. “It seemed like they understood. But in such a crucial moment like that, it would have been so much better to have a culturally sensitive, in-person interpreter.”\u003c/p>\n\u003cp>Most hospitals, including Gastelum’s, have telephone services that should let doctors call up an interpreter for any language. In practice, though, the system doesn’t always work for more unusual languages.\u003c/p>\n\u003cp>“When you try to use the phone interpreter line to get the indigenous speaker, you’ll be on hold for like two hours,” said Jasmine Walker, also a pediatrician in Fresno. “Then when you get them, they don't actually speak the language that you need.”\u003c/p>\n\u003cp>Seth Holmes is a physician who lived and worked alongside Triqui migrant farmworkers for 10 years and wrote about his experiences in the book \"\u003ca href=\"http://www.ucpress.edu/book.php?isbn=9780520275140\" target=\"_blank\">Fresh Fruit, Broken Bodies\u003c/a>.\" As the migrants followed crops up and down the West Coast, they often asked Holmes to accompany them to health clinics.\u003c/p>\n\u003cp>In dozens of clinics throughout California, Washington and Oregon, he said, “I have never seen any Triqui person get a medical interpreter.”\u003c/p>\n\u003cp>Hospitals may underestimate how many indigenous patients they have -- and how many interpreters they need -- because many providers assume all Mexicans speak Spanish. Some indigenous people may be afraid to call attention to themselves by asking for an interpreter because they are undocumented.\u003c/p>\n\u003cp>“They don't know that they’re entitled to someone who speaks their language,” said Leoncio Vasquez, who has been training interpreters for 15 years.\u003c/p>\n\u003cp>Any health care facility receiving public money has a legal obligation under both state and federal law to provide an interpreter to every patient who needs one. But only a few health care providers have made\u003ca href=\"http://www.indigenousfarmworkers.org/\" target=\"_blank\"> California’s 120,000 indigenous farmworkers\u003c/a> an explicit priority.\u003c/p>\n\u003cp>\u003cstrong>Interpreting a Big Opportunity for Some Farmworkers\u003c/strong>\u003c/p>\n\u003cp>Brigida Gonzalez, wearing a big \"Qualified Interpreter\" badge, hustles around Natividad Medical Center in Salinas. It's a big building and she’s needed all over.\u003c/p>\n\u003cp>Today she’s a professional employee at a big hospital. A year ago, she was picking strawberries nearby.\u003c/p>\n\u003cfigure id=\"attachment_83917\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Brigida-Patient3-e1443272915487.png\">\u003cimg class=\"wp-image-83917 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Brigida-Patient3-400x225.png\" alt=\"Interpreter Brigida Gonzalez\" width=\"400\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Before interpreter training, Brigida Gonzalez (R) worked in the strawberry fields nearby. \u003ccite>(Jeremy Raff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In the fields one day, another picker noticed Gonzalez spoke English -- a rarity in agriculture -- and suggested she look into Natividad’s training program.\u003c/p>\n\u003cp>Staff at Natividad were thrilled to hear from Gonzalez, “because it was so hard to find someone who spoke English, Spanish and an indigenous language like Mixteco and Triqui,” she said.\u003c/p>\n\u003cp>Gonzalez completed Natividad's six-month training program for indigenous interpreters, the first of its kind, and now works there part time.\u003c/p>\n\u003cp>\u003cstrong>Not Just Hospitals\u003c/strong>\u003c/p>\n\u003cp>The need for trilingual interpreters like Gonzalez is growing, and it's not just hospitals.\u003c/p>\n\u003cp>Four hours down the coast in Oxnard, all three school districts have hired Mixteco interpreters, and the police have one on contract.\u003c/p>\n\u003cp>Altogether, there are about 20 Mixteco speakers making a good living with their language skills in Ventura County.\u003c/p>\n\u003cp>These opportunities are one reason why Argelia Zarate, the Oxnard school district’s first full-time Mixteco interpreter, encourages students to practice their Mixteco so they don’t lose it.\u003c/p>\n\u003cfigure id=\"attachment_83919\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Argelia-1-of-1-e1443466270661.jpg\">\u003cimg class=\"size-full wp-image-83919\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Argelia-1-of-1-e1443466270661.jpg\" alt=\"Argelia Zarate, a Mixteco interpreter at the Oxnard School District, encourages students to practice their native languages.\" width=\"1920\" height=\"1280\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Argelia Zarate, a Mixteco interpreter at the Oxnard School District, encourages students to practice their native languages. \u003ccite>(Jeremy Raff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I didn't go to college, yet I have this job,” said Zarate, “because the community is growing so big that they don't need bilinguals-- they need trilinguals.”\u003c/p>\n\u003cp>The U.S. Bureau of Labor Statistics expects employment of interpreters and translators to grow by\u003ca href=\"http://www.bls.gov/ooh/media-and-communication/interpreters-and-translators.htm\" target=\"_blank\"> 46 percent between 2012 and 2022.\u003c/a> Driving that demand is the \u003ca href=\"http://www.census.gov/content/dam/Census/library/publications/2013/acs/acs-22.pdf\" target=\"_blank\">158 percent increase since 1980 \u003c/a>in the number of people who speak a language other than English at home.\u003c/p>\n\u003cp>Nationally, the median hourly wage for interpreters is $25, compared with $9.09 for farm work.\u003c/p>\n\u003cp>Zarate says the better pay, stable hours and a chance to serve her community all make interpreting a big step up from field work.\u003c/p>\n\u003cp>“Here everybody is nice to you: they talk to you, appreciate what you do,” Zarate said at the elementary school where she works. “In the fields, they treat you like you’re nothing, a slave working for a little bit of money.”\u003c/p>\n\u003cp>The Mixteco/Indigena Community Organizing Project has trained dozens of interpreters in Ventura County and has pressured public agencies to make use of them.\u003c/p>\n\u003cfigure id=\"attachment_83920\" class=\"wp-caption alignright\" style=\"max-width: 5010px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Argelia-2-of-2.jpg\">\u003cimg class=\"size-full wp-image-83920\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Argelia-2-of-2.jpg\" alt=\"Maria, 6, arrived in Oxnard, CA, from the Mexican state of Oaxaca recently and speaks only Mixteco (Jeremy Raff/KQED).\" width=\"5010\" height=\"3340\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2.jpg 5010w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-960x640.jpg 960w\" sizes=\"(max-width: 5010px) 100vw, 5010px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Maria, 6, arrived in Oxnard, CA, from the Mexican state of Oaxaca recently and speaks only Mixteco. (Jeremy Raff/KQED).\u003c/figcaption>\u003c/figure>\n\u003cp>Today, “Ventura County has invested in having better language access than most parts of California, and honestly most parts of Oaxaca,” said Margaret Sawyer, the group’s development director, referring to the Mexican state that many Mixteco migrants are from.\u003c/p>\n\u003cp>\u003cstrong>Barriers Remain\u003c/strong>\u003c/p>\n\u003cp>Not everyone trilingual can make the switch from farm work, though, because there are only a few full-time jobs.\u003c/p>\n\u003cp>Instead, most hospitals rely on freelance part-time interpreters, who have a hard time making a living.\u003c/p>\n\u003cp>“They will have you for two or three hours, then you’re done for the whole day,” said Israel Vasquez, a trilingual interpreter. “You can’t really live off that.” He eventually quit because he couldn’t get enough hours.\u003c/p>\n\u003cp>“Making a living specifically in health care interpreting right now is not really going to happen,” said Don Schinske, executive director of the California Healthcare Interpreting Association.\u003c/p>\n\u003cp>Part of the problem, Schinske said, is that even though federal law requires hospitals to provide interpreters, there is not a direct federal funding stream to pay for those services.\u003c/p>\n\u003cp>“You get a lot of this sentiment from hospitals: ‘Look, we’re trying to get people services in their language, but it is a nicety, not a necessity,’ ” said Schinske.\u003c/p>\n\u003cp>The indigenous interpretation programs at Natividad Medical Center are funded by private donations from agricultural businesses in the area, who have contributed $1.7 million since 2010.\u003c/p>\n\u003cp>Meanwhile, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160AB635\" target=\"_blank\">a bill \u003c/a>that would make it easier for hospitals to get federal money for medical interpreters has stalled in the California Legislature.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/225965640&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/225965640'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Wasted Resource\u003c/strong>\u003c/p>\n\u003cp>Farmworker Angelina Diaz-Ramirez returned home after her surgery with a new pacemaker ticking in her chest -- and a stack of printed instructions that she couldn’t read.\u003c/p>\n\u003cp>“I didn’t know what to do,\" she said, through an interpreter. \"I had strong pain. Should I call them back?”\u003c/p>\n\u003cp>Diaz-Ramirez didn’t know who her cardiologist was, how to get an appointment or which medications to take. It's just the kind of confusion that a trained medical interpreter can prevent.\u003c/p>\n\u003cp>\"I just felt very sad,\" she said.\u003c/p>\n\u003cp>Every week, indigenous people with these same questions visit Leoncio Vasquez, the interpreter trainer in Fresno.\u003c/p>\n\u003cp>He looks through their paperwork, pieces together a backstory, and helps them figure out what to do next -- something that should have happened at the hospital or clinic, with one of the dozens of interpreters Vasquez has already trained.\u003c/p>\n\u003cp>But those interpreters “can’t find jobs related to interpreting,” said Vasquez. What do they do instead? “Some go back to the fields to do farm work.”\u003c/p>\n\u003cp>To Vasquez, it's a waste. He says that until more hospitals recognize these immigrants’ valuable language skills, trained interpreters will stay in the fields, picking strawberries.\u003c/p>\n\u003cp>\u003cem>This piece was produced with support from the Institute for Justice and Journalism.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ci>California has the seventh-largest economy in the world, and immigrants have a long history in building that prosperity. Today one out of every three working people in California is an immigrant — a share that has grown in recent decades. Our state is shaped by these workers and entrepreneurs — 6 million people who’ve found a job in the Golden State. In our series “\u003ca href=\"http://ww2.kqed.org/news/series/california-immigrants-at-work\">Immigrant Shift\u003c/a>,” KQED and The California Report explore the impact they have, the challenges they face and the policies that affect them.\u003c/i>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/83818/need-a-medical-interpreter-try-looking-in-californias-strawberry-fields","authors":["230"],"categories":["stateofhealth_11"],"tags":["stateofhealth_280","stateofhealth_249","stateofhealth_407","stateofhealth_325","stateofhealth_53","stateofhealth_2519","stateofhealth_251"],"featImg":"stateofhealth_83922","label":"stateofhealth"},"stateofhealth_76380":{"type":"posts","id":"stateofhealth_76380","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"76380","score":null,"sort":[1442011572000]},"guestAuthors":[],"slug":"in-fresno-unprecedented-increase-in-er-visits-due-to-rough-fire","title":"In Fresno, 'Unprecedented Increase' in ER Visits Due to Rough Fire","publishDate":1442011572,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Fresno health officials are alerting county residents to limit all outdoor activities as the Rough Fire \"\u003ca href=\"http://ww2.kqed.org/news/2015/x08/18/campgrounds-closed-as-fast-moving-sierra-fire-burns-20000-acres\" target=\"_blank\">rains ash\u003c/a>\" on Fresno.\u003c/p>\n\u003cp>Fresno County's department of public health reports an \"unprecedented increase\" in emergency room visits. Over the last 72 hours, local ERs have seen:\u003c/p>\n\u003cul>\n\u003cli>411 percent increase in visits due to respiratory issues\u003c/li>\n\u003cli>90 percent increase in visits due to cough\u003c/li>\n\u003c/ul>\n\u003cp>Health officials say that half of the patients affected fall into two groups: those aged 15-24 and those over age 65. KQED's Sasha Khokha \u003ca href=\"http://ww2.kqed.org/news/2015/x08/18/campgrounds-closed-as-fast-moving-sierra-fire-burns-20000-acres\" target=\"_blank\">reports\u003c/a> that even children with healthy lungs are showing up in the ER with burning eyes and a hacking cough.\u003c/p>\n\u003cp>\"It's definitely scary,\" said Dolores Weller, head of the Central Valley Air Quality Coalition, an advocacy group. \"We've been getting a lot of phone calls from concerned parents, coaches, school officials, and day care centers.\"\u003c/p>\n\u003cp>Weller said that many callers were confused because air district monitors are designed to measure fine particulate matter and not larger particulates like ash. So air quality levels \u003ca href=\"http://www.valleyair.org/programs/raan/raan_index.htm?x=FRSGRLND\" target=\"_blank\">measure lower \u003c/a>than a reflection of the true risk.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"If you see ash or smell smoke it is a level 4 hazard,\" says \u003ca href=\"http://www.co.fresno.ca.us/uploadedFiles/Departments/Public_Health/Divisions/PPC/Health_Messages/NEW%20DPH%20ALERT%20Increased%20Health%20Impact%20to%20Fresno%20County%20Residents%20Due%20to%20Rough%20Fire%209-11-15%20Final.pdf\" target=\"_blank\">the alert\u003c/a>, \"and all outdoor activities should be limited.\"\u003c/p>\n\u003cp>In response to the health alert, Fresno Unified School District has canceled all sporting events, including football games, scheduled for Friday evening. All practices, both indoor and outdoor, are also canceled. Fresno Unified's middle school football games are canceled Saturday.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Smoky conditions are expected to continue over the next several days.\u003c/p>\n\n","blocks":[],"excerpt":"Health officials urge people to stay indoors, and schools have canceled all sporting events. ","status":"publish","parent":0,"modified":1442014614,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":10,"wordCount":259},"headData":{"title":"In Fresno, 'Unprecedented Increase' in ER Visits Due to Rough Fire | KQED","description":"Health officials urge people to stay indoors, and schools have canceled all sporting events. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"In Fresno, 'Unprecedented Increase' in ER Visits Due to Rough Fire","datePublished":"2015-09-11T22:46:12.000Z","dateModified":"2015-09-11T23:36:54.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"76380 http://ww2.kqed.org/stateofhealth/?p=76380","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/09/11/in-fresno-unprecedented-increase-in-er-visits-due-to-rough-fire/","disqusTitle":"In Fresno, 'Unprecedented Increase' in ER Visits Due to Rough Fire","path":"/stateofhealth/76380/in-fresno-unprecedented-increase-in-er-visits-due-to-rough-fire","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Fresno health officials are alerting county residents to limit all outdoor activities as the Rough Fire \"\u003ca href=\"http://ww2.kqed.org/news/2015/x08/18/campgrounds-closed-as-fast-moving-sierra-fire-burns-20000-acres\" target=\"_blank\">rains ash\u003c/a>\" on Fresno.\u003c/p>\n\u003cp>Fresno County's department of public health reports an \"unprecedented increase\" in emergency room visits. Over the last 72 hours, local ERs have seen:\u003c/p>\n\u003cul>\n\u003cli>411 percent increase in visits due to respiratory issues\u003c/li>\n\u003cli>90 percent increase in visits due to cough\u003c/li>\n\u003c/ul>\n\u003cp>Health officials say that half of the patients affected fall into two groups: those aged 15-24 and those over age 65. KQED's Sasha Khokha \u003ca href=\"http://ww2.kqed.org/news/2015/x08/18/campgrounds-closed-as-fast-moving-sierra-fire-burns-20000-acres\" target=\"_blank\">reports\u003c/a> that even children with healthy lungs are showing up in the ER with burning eyes and a hacking cough.\u003c/p>\n\u003cp>\"It's definitely scary,\" said Dolores Weller, head of the Central Valley Air Quality Coalition, an advocacy group. \"We've been getting a lot of phone calls from concerned parents, coaches, school officials, and day care centers.\"\u003c/p>\n\u003cp>Weller said that many callers were confused because air district monitors are designed to measure fine particulate matter and not larger particulates like ash. So air quality levels \u003ca href=\"http://www.valleyair.org/programs/raan/raan_index.htm?x=FRSGRLND\" target=\"_blank\">measure lower \u003c/a>than a reflection of the true risk.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"If you see ash or smell smoke it is a level 4 hazard,\" says \u003ca href=\"http://www.co.fresno.ca.us/uploadedFiles/Departments/Public_Health/Divisions/PPC/Health_Messages/NEW%20DPH%20ALERT%20Increased%20Health%20Impact%20to%20Fresno%20County%20Residents%20Due%20to%20Rough%20Fire%209-11-15%20Final.pdf\" target=\"_blank\">the alert\u003c/a>, \"and all outdoor activities should be limited.\"\u003c/p>\n\u003cp>In response to the health alert, Fresno Unified School District has canceled all sporting events, including football games, scheduled for Friday evening. All practices, both indoor and outdoor, are also canceled. Fresno Unified's middle school football games are canceled Saturday.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Smoky conditions are expected to continue over the next several days.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/76380/in-fresno-unprecedented-increase-in-er-visits-due-to-rough-fire","authors":["240"],"categories":["stateofhealth_11"],"tags":["stateofhealth_21","stateofhealth_23","stateofhealth_280"],"featImg":"stateofhealth_76381","label":"stateofhealth"},"stateofhealth_24782":{"type":"posts","id":"stateofhealth_24782","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"24782","score":null,"sort":[1427821459000]},"guestAuthors":[],"slug":"is-pollution-from-asia-making-the-central-valleys-bad-air-even-worse","title":"Is Pollution From Asia Making the Central Valley's Bad Air Even Worse?","publishDate":1427821459,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_24787\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS729_farms0613-21-e1427821121824.jpg\">\u003cimg class=\"size-large wp-image-24787\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS729_farms0613-21-640x428.jpg\" alt=\"(David McNew/Getty Images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Advocates say the San Joaquin Valley Air District should focus on sources it can control, like farming machinery. (David McNew/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alice Daniel\u003c/strong>\u003c/p>\n\u003cp>California’s Central Valley grapples with some of the dirtiest air in the nation. The culprits range from its vast agriculture industry to trucks on Highway 99. But one local air district is tagging a source far away: Asia.\u003c/p>\n\u003cp>“The world in so many ways is getting smaller in respect to what we always thought was our own backyard issue: ozone,” says David Lighthall, the health science advisor for the San Joaquin Valley Air Pollution Control District.\u003c/p>\n\u003cp>Lighthall is one of the organizers of an \u003ca title=\"http://www.valleyair.org/topc/\" href=\"http://www.valleyair.org/topc/\" target=\"_blank\">ozone pollution conference\u003c/a> starting Tuesday where scientists from California, China, Colorado and other places will discuss trends in global ozone.\u003c/p>\n\u003cp>Scientists say pollutants from fast-growing Asian countries like China are blowing across the Pacific Ocean and increasing ozone levels in vulnerable areas that include parts of California. But how much of a difference that foreign -- or \"transboundary\" -- ozone makes in the Central Valley is debatable.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Lighthall says that on some days this additional pollution is enough to prevent the district from meeting federal clean air health standards. The Valley's bowl-shaped geography traps pollutants, sometimes for days at a time -- and that includes pollutants from other places, Lighthall says.\u003c/p>\n\u003cp>He says there's an \"upward trend\" in transboundary ozone and the ozone is now \"mixing down and really making a difference on certain days as to whether we actually meet the standard ... or whether we don’t meet it,” Lighthall says.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/198583646\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>But the EPA disagrees. It says that on the Valley’s worst air days, most ozone pollution comes from local sources. In fact, last year the air district unsuccessfully petitioned the EPA to exempt it from penalties for violating a health standard blaming it on smog from Asia.\u003c/p>\n\u003cp>Some local health advocates say the air district is straying too far from home.\u003c/p>\n\u003cp>“The air district is famous for looking for loopholes,” says Delores Weller, director of the Central Valley Air Quality Coalition, an advocacy group.\u003c/p>\n\u003cp>She says the district is focusing on sources it can’t control and should do everything it can first to tackle homegrown pollution.\u003c/p>\n\u003cp>“It would be great to see an agriculture, farming operations and air pollution conference based here in the Valley as opposed to a trans-boundary ozone conference,” Weller says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But the air district says it must research all sources of air pollution to know exactly what it’s dealing with and how best to mitigate. It’s even \u003ca title=\"http://www.latimes.com/science/la-me-pacific-smog-20150201-story.html#page=1\" href=\"http://www.latimes.com/science/la-me-pacific-smog-20150201-story.html#page=1\" target=\"_blank\">funding research at U.C. Davis \u003c/a>to assess the effects of ozone from Asia.\u003c/p>\n\n","blocks":[],"excerpt":"The air district says pollution from Asia makes a difference on certain days. Advocates say the district is looking for loopholes.","status":"publish","parent":0,"modified":1427994853,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":494},"headData":{"title":"Is Pollution From Asia Making the Central Valley's Bad Air Even Worse? | KQED","description":"The air district says pollution from Asia makes a difference on certain days. Advocates say the district is looking for loopholes.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Is Pollution From Asia Making the Central Valley's Bad Air Even Worse?","datePublished":"2015-03-31T17:04:19.000Z","dateModified":"2015-04-02T17:14:13.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"24782 http://blogs.kqed.org/stateofhealth/?p=24782","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/03/31/is-pollution-from-asia-making-the-central-valleys-bad-air-even-worse/","disqusTitle":"Is Pollution From Asia Making the Central Valley's Bad Air Even Worse?","path":"/stateofhealth/24782/is-pollution-from-asia-making-the-central-valleys-bad-air-even-worse","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24787\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS729_farms0613-21-e1427821121824.jpg\">\u003cimg class=\"size-large wp-image-24787\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS729_farms0613-21-640x428.jpg\" alt=\"(David McNew/Getty Images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Advocates say the San Joaquin Valley Air District should focus on sources it can control, like farming machinery. (David McNew/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alice Daniel\u003c/strong>\u003c/p>\n\u003cp>California’s Central Valley grapples with some of the dirtiest air in the nation. The culprits range from its vast agriculture industry to trucks on Highway 99. But one local air district is tagging a source far away: Asia.\u003c/p>\n\u003cp>“The world in so many ways is getting smaller in respect to what we always thought was our own backyard issue: ozone,” says David Lighthall, the health science advisor for the San Joaquin Valley Air Pollution Control District.\u003c/p>\n\u003cp>Lighthall is one of the organizers of an \u003ca title=\"http://www.valleyair.org/topc/\" href=\"http://www.valleyair.org/topc/\" target=\"_blank\">ozone pollution conference\u003c/a> starting Tuesday where scientists from California, China, Colorado and other places will discuss trends in global ozone.\u003c/p>\n\u003cp>Scientists say pollutants from fast-growing Asian countries like China are blowing across the Pacific Ocean and increasing ozone levels in vulnerable areas that include parts of California. But how much of a difference that foreign -- or \"transboundary\" -- ozone makes in the Central Valley is debatable.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Lighthall says that on some days this additional pollution is enough to prevent the district from meeting federal clean air health standards. The Valley's bowl-shaped geography traps pollutants, sometimes for days at a time -- and that includes pollutants from other places, Lighthall says.\u003c/p>\n\u003cp>He says there's an \"upward trend\" in transboundary ozone and the ozone is now \"mixing down and really making a difference on certain days as to whether we actually meet the standard ... or whether we don’t meet it,” Lighthall says.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/198583646&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/198583646'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But the EPA disagrees. It says that on the Valley’s worst air days, most ozone pollution comes from local sources. In fact, last year the air district unsuccessfully petitioned the EPA to exempt it from penalties for violating a health standard blaming it on smog from Asia.\u003c/p>\n\u003cp>Some local health advocates say the air district is straying too far from home.\u003c/p>\n\u003cp>“The air district is famous for looking for loopholes,” says Delores Weller, director of the Central Valley Air Quality Coalition, an advocacy group.\u003c/p>\n\u003cp>She says the district is focusing on sources it can’t control and should do everything it can first to tackle homegrown pollution.\u003c/p>\n\u003cp>“It would be great to see an agriculture, farming operations and air pollution conference based here in the Valley as opposed to a trans-boundary ozone conference,” Weller says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But the air district says it must research all sources of air pollution to know exactly what it’s dealing with and how best to mitigate. It’s even \u003ca title=\"http://www.latimes.com/science/la-me-pacific-smog-20150201-story.html#page=1\" href=\"http://www.latimes.com/science/la-me-pacific-smog-20150201-story.html#page=1\" target=\"_blank\">funding research at U.C. Davis \u003c/a>to assess the effects of ozone from Asia.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/24782/is-pollution-from-asia-making-the-central-valleys-bad-air-even-worse","authors":["8344"],"categories":["stateofhealth_11"],"tags":["stateofhealth_280","stateofhealth_461"],"featImg":"stateofhealth_24787","label":"stateofhealth"},"stateofhealth_20876":{"type":"posts","id":"stateofhealth_20876","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"20876","score":null,"sort":[1408438847000]},"guestAuthors":[],"slug":"fresno-considers-ending-health-services-for-the-undocumented","title":"Fresno Considers Ending Health Services for the Undocumented","publishDate":1408438847,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_20877\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/Health4All.-e1408409981550.jpg\">\u003cimg class=\"size-large wp-image-20877\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/Health4All.-640x428.jpg\" alt=\"Fresno residents demonstrate their support for a county health program that covers care for undocumented immigrants (Courtesy: Fresno Building Healthy Communities)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Fresno residents demonstrate their support for a county health program that covers care for undocumented immigrants (Courtesy: Fresno Building Healthy Communities)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>\u003cstrong>Update\u003c/strong>: Fresno County's Board of Supervisors \u003ca href=\"http://www.fresnobee.com/2014/08/19/4077428_fresno-county-to-end-contract.html?sp=/99/217/&rh=1\" target=\"_blank\">voted 4-1\u003c/a> to end the contract providing care to the poor and to undocumented immigrants. \u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Original Post:\u003c/strong>\u003c/p>\n\u003cp>Brandon Hauk’s job is about to get a lot harder. The health of about 7,000 patients he helps at Clinica Sierra Vista in Fresno is in the hands of the county board of supervisors – they are set to vote Tuesday whether or not to shut down a program that covers specialty care for the undocumented.\u003c/p>\n\u003cp>Hauk doesn’t want to think about how he’s going to explain that to people when their primary care doctor says they need to see a cardiologist, pulmonologist, or endocrinologist.\u003c/p>\n\u003cp>“What do you say to somebody that has chronic illness and we can’t refer them out? Sorry?” says Hauk. “I mean, how can you tell someone that has abdominal bleeds, I’m sorry, but we can’t help you.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Fresno’s Medically Indigent Services Program was set up decades ago to provide health coverage for the poor, and later, the undocumented. But now that the Affordable Care Act has gone into effect, the county says it doesn’t need the program anymore. Now tens of thousands of uninsured Fresnans have health coverage through Obamacare. More than that, the county says it can’t afford to keep the program going. \u003c!--more-->\u003c/p>\n\u003cp>“With the reduction in the number of individuals who need to seek services in the Medically Indigent Services Program, there’s also a reduction in funding used to support that program,” says David Pomaville, director of Fresno county’s department of public health.\u003c/p>\n\u003cp>Closing or restricting the program could leave 6,000 undocumented Fresnans without care. The Affordable Care Act does not cover the undocumented. And, after a recent court battle, the county no longer has a legal obligation to cover them.\u003c/p>\n\u003cp>Pomaville says it would cost the county up to $21 million to continue coverage for the undocumented, but the county is short about $10 million. He says his department has already trimmed everywhere else possible.\u003c/p>\n\u003cp>“It is a balancing act,” he says. “The communicable disease investigators that are out investigating cases and trying to identify sources, we are stretched. The public health laboratory that we operate here; the sexually transmitted disease programs are really stretched as far as we can stretch them.”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/163862246&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Most counties in California do not provide health care services to the undocumented. Only about half a dozen do, mainly in urban areas like the Bay Area and Los Angeles. When the recession hit in 2008, Sacramento and Yolo counties dropped their coverage for the undocumented, and Contra Costa discontinued it for undocumented adults.\u003c/p>\n\u003cp>“In Fresno county, we’ve been able to hold on and deliver those services for longer than most counties have been able to,” Pomaville says.\u003c/p>\n\u003cp>But health care advocates say Fresno isn’t like most other counties. The economy depends on undocumented farm workers. Advocates say canceling the program ignores the contributions farm workers have made to the community.\u003c/p>\n\u003cp>“The question has become, does Fresno County value their farm workers?” says Sandra Celedon-Castro, manager of the advocacy group Fresno Building Healthy Communities. “Disease does not know immigration status. We’re going to be left with a population of folks in our community that are really sick, that are left to fend for themselves. What kind of community are we if we’re okay with that happening?”\u003c/p>\n\u003cp>The group organized a \"Health4All\" event earlier this month, where two hundred people gathered to protest the closure of the health program to undocumented immigrants.\u003c/p>\n\u003cp>“It would be really, really bad news,” says Grisanti Valencia. Her mother, who is undocumented, has terrible pain and numbness in her leg from a series of work injuries. Her neighbor is recovering from leukemia. “My mother, she’s already scared. She knows a lot of people, and those people are scared.”\u003c/p>\n\u003cp>Undocumented people can still get some care at Fresno’s community clinics, or the Emergency Room. But it’s the specialty care that gets lost if this program shuts down. That means no neurological consults, no cancer treatment.\u003c/p>\n\u003cp>“To me, it’s committing murder – getting rid of this program,” Valencia says. “Because you’re just letting these people die.”\u003c/p>\n\u003cp>The final decision rests with the county’s five supervisors. Most of them do not see it as the county’s responsibility to pay for care for the undocumented.\u003c/p>\n\u003cp>“If we are having a difficult time providing social services and a safety net for individuals that are documented American citizens, what allows individuals who are here illegally to derive and obtain that benefit?” says Andreas Borgeas, chairman of the board.\u003c/p>\n\u003cp>He asks why Fresno should do what Congress refused to.\u003c/p>\n\u003cp>“The onus seems to be on the county to provide undocumented coverage when the Affordable Care Act does not. It specifically does not,” he says.\u003c/p>\n\u003cp>He acknowledged that health care for farm workers is a good idea, in theory. It makes economic sense for Fresno. But farmers and lawmakers at every level point at each other when it comes down to who should pay for it.\u003c/p>\n\u003cp>Borgeas says community clinics that receive federal funding, like Clinica Sierra Vista, should be the ones to pick up the slack.\u003c/p>\n\u003cp>“I would be willing to explore that,” says Schilling, Sierra’s CEO. “It’s an issue of who would work for the kind of compensation I can offer?”\u003c/p>\n\u003cp>Fresno, like many other rural counties, has a shortage of specialist doctors in the area. Getting them to work for the reimbursement rates provided by state and federal programs is an even bigger challenge, Schilling says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“If $125 or $150 buys a surgical consult, or a neurological consult, I’m game. Come on over,” he says. “The problem is, no one’s going to come work for me for that kind of money. They want substantially more than that.”\u003c/p>\n\n","blocks":[],"excerpt":"Closing the program would leave 6,000 undocumented Fresnans without care. ","status":"publish","parent":0,"modified":1408560628,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":true,"iframeSrcs":["https://w.soundcloud.com/player/"],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":30,"wordCount":1066},"headData":{"title":"Fresno Considers Ending Health Services for the Undocumented | KQED","description":"Closing the program would leave 6,000 undocumented Fresnans without care. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Fresno Considers Ending Health Services for the Undocumented","datePublished":"2014-08-19T09:00:47.000Z","dateModified":"2014-08-20T18:50:28.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"20876 http://blogs.kqed.org/stateofhealth/?p=20876","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/08/19/fresno-considers-ending-health-services-for-the-undocumented/","disqusTitle":"Fresno Considers Ending Health Services for the Undocumented","path":"/stateofhealth/20876/fresno-considers-ending-health-services-for-the-undocumented","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20877\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/Health4All.-e1408409981550.jpg\">\u003cimg class=\"size-large wp-image-20877\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/Health4All.-640x428.jpg\" alt=\"Fresno residents demonstrate their support for a county health program that covers care for undocumented immigrants (Courtesy: Fresno Building Healthy Communities)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Fresno residents demonstrate their support for a county health program that covers care for undocumented immigrants (Courtesy: Fresno Building Healthy Communities)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>\u003cstrong>Update\u003c/strong>: Fresno County's Board of Supervisors \u003ca href=\"http://www.fresnobee.com/2014/08/19/4077428_fresno-county-to-end-contract.html?sp=/99/217/&rh=1\" target=\"_blank\">voted 4-1\u003c/a> to end the contract providing care to the poor and to undocumented immigrants. \u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Original Post:\u003c/strong>\u003c/p>\n\u003cp>Brandon Hauk’s job is about to get a lot harder. The health of about 7,000 patients he helps at Clinica Sierra Vista in Fresno is in the hands of the county board of supervisors – they are set to vote Tuesday whether or not to shut down a program that covers specialty care for the undocumented.\u003c/p>\n\u003cp>Hauk doesn’t want to think about how he’s going to explain that to people when their primary care doctor says they need to see a cardiologist, pulmonologist, or endocrinologist.\u003c/p>\n\u003cp>“What do you say to somebody that has chronic illness and we can’t refer them out? Sorry?” says Hauk. “I mean, how can you tell someone that has abdominal bleeds, I’m sorry, but we can’t help you.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Fresno’s Medically Indigent Services Program was set up decades ago to provide health coverage for the poor, and later, the undocumented. But now that the Affordable Care Act has gone into effect, the county says it doesn’t need the program anymore. Now tens of thousands of uninsured Fresnans have health coverage through Obamacare. More than that, the county says it can’t afford to keep the program going. \u003c!--more-->\u003c/p>\n\u003cp>“With the reduction in the number of individuals who need to seek services in the Medically Indigent Services Program, there’s also a reduction in funding used to support that program,” says David Pomaville, director of Fresno county’s department of public health.\u003c/p>\n\u003cp>Closing or restricting the program could leave 6,000 undocumented Fresnans without care. The Affordable Care Act does not cover the undocumented. And, after a recent court battle, the county no longer has a legal obligation to cover them.\u003c/p>\n\u003cp>Pomaville says it would cost the county up to $21 million to continue coverage for the undocumented, but the county is short about $10 million. He says his department has already trimmed everywhere else possible.\u003c/p>\n\u003cp>“It is a balancing act,” he says. “The communicable disease investigators that are out investigating cases and trying to identify sources, we are stretched. The public health laboratory that we operate here; the sexually transmitted disease programs are really stretched as far as we can stretch them.”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/163862246&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Most counties in California do not provide health care services to the undocumented. Only about half a dozen do, mainly in urban areas like the Bay Area and Los Angeles. When the recession hit in 2008, Sacramento and Yolo counties dropped their coverage for the undocumented, and Contra Costa discontinued it for undocumented adults.\u003c/p>\n\u003cp>“In Fresno county, we’ve been able to hold on and deliver those services for longer than most counties have been able to,” Pomaville says.\u003c/p>\n\u003cp>But health care advocates say Fresno isn’t like most other counties. The economy depends on undocumented farm workers. Advocates say canceling the program ignores the contributions farm workers have made to the community.\u003c/p>\n\u003cp>“The question has become, does Fresno County value their farm workers?” says Sandra Celedon-Castro, manager of the advocacy group Fresno Building Healthy Communities. “Disease does not know immigration status. We’re going to be left with a population of folks in our community that are really sick, that are left to fend for themselves. What kind of community are we if we’re okay with that happening?”\u003c/p>\n\u003cp>The group organized a \"Health4All\" event earlier this month, where two hundred people gathered to protest the closure of the health program to undocumented immigrants.\u003c/p>\n\u003cp>“It would be really, really bad news,” says Grisanti Valencia. Her mother, who is undocumented, has terrible pain and numbness in her leg from a series of work injuries. Her neighbor is recovering from leukemia. “My mother, she’s already scared. She knows a lot of people, and those people are scared.”\u003c/p>\n\u003cp>Undocumented people can still get some care at Fresno’s community clinics, or the Emergency Room. But it’s the specialty care that gets lost if this program shuts down. That means no neurological consults, no cancer treatment.\u003c/p>\n\u003cp>“To me, it’s committing murder – getting rid of this program,” Valencia says. “Because you’re just letting these people die.”\u003c/p>\n\u003cp>The final decision rests with the county’s five supervisors. Most of them do not see it as the county’s responsibility to pay for care for the undocumented.\u003c/p>\n\u003cp>“If we are having a difficult time providing social services and a safety net for individuals that are documented American citizens, what allows individuals who are here illegally to derive and obtain that benefit?” says Andreas Borgeas, chairman of the board.\u003c/p>\n\u003cp>He asks why Fresno should do what Congress refused to.\u003c/p>\n\u003cp>“The onus seems to be on the county to provide undocumented coverage when the Affordable Care Act does not. It specifically does not,” he says.\u003c/p>\n\u003cp>He acknowledged that health care for farm workers is a good idea, in theory. It makes economic sense for Fresno. But farmers and lawmakers at every level point at each other when it comes down to who should pay for it.\u003c/p>\n\u003cp>Borgeas says community clinics that receive federal funding, like Clinica Sierra Vista, should be the ones to pick up the slack.\u003c/p>\n\u003cp>“I would be willing to explore that,” says Schilling, Sierra’s CEO. “It’s an issue of who would work for the kind of compensation I can offer?”\u003c/p>\n\u003cp>Fresno, like many other rural counties, has a shortage of specialist doctors in the area. Getting them to work for the reimbursement rates provided by state and federal programs is an even bigger challenge, Schilling says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“If $125 or $150 buys a surgical consult, or a neurological consult, I’m game. Come on over,” he says. “The problem is, no one’s going to come work for me for that kind of money. They want substantially more than that.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/20876/fresno-considers-ending-health-services-for-the-undocumented","authors":["3205"],"categories":["stateofhealth_11","stateofhealth_14"],"tags":["stateofhealth_280","stateofhealth_489"],"featImg":"stateofhealth_20877","label":"stateofhealth"},"stateofhealth_19506":{"type":"posts","id":"stateofhealth_19506","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"19506","score":null,"sort":[1402635758000]},"guestAuthors":[],"slug":"in-fresno-high-school-program-aims-at-lack-of-provider-diversity","title":"In Fresno, High School Program Aims at Lack of Provider Diversity","publishDate":1402635758,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_19510\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/2014-UCSF-Sr.-Trip-UCSF-SOM-Copy.jpg\">\u003cimg class=\"size-large wp-image-19510\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/2014-UCSF-Sr.-Trip-UCSF-SOM-Copy-640x425.jpg\" alt=\"Graduating seniors from the three Doctors Academy sites in Fresno. Dr. Katherine Flores, founder of the academy, stands in the front row. (Courtesy: Doctors Academy)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Graduating seniors from the three Doctors Academy sites in Fresno. Dr. Katherine Flores, founder of the academy, stands in the front row. Flores grew up in a farmworker family. (Courtesy: UCSF Fresno)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alice Daniel,\u003c/strong> \u003ca href=\"http://www.californiahealthline.org/insight/2014/doctors-academy-addresses-lack-of-diversity-among-medical-providers-in-central-valley\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>Stephanie Huerta grew up in a farmworker family in rural Caruthers, 15 miles southwest of Fresno. Her parents are from Mexico and neither had the opportunity to finish high school -- or in her mom's case, middle school.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'You can have a dream but if you don't have the tools to attain that dream, you're really stymied.' \u003c/aside>\n\u003cp>At 14, Huerta got pregnant and gave birth at the beginning of her freshman year in high school. Huerta was a very good student and, with the help of a counselor, she got through that school year even while caring for an infant. Her sophomore year, a new program called the Doctors Academy started at Caruthers High School. That was seven years ago, and it changed Huerta's life.\u003c/p>\n\u003cp>\"Looking back it was the best decision I could have made,\" said Huerta, now about to become a college graduate. \"I would have still been in Caruthers, maybe going to city college. I would have been pregnant again because that's the cycle quite honestly. And I would have been too scared to go anywhere,\" she added.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Three high schools in Fresno County now have a \u003ca style=\"color: #6d1618\" href=\"http://www.fresno.ucsf.edu/latinocenter/daabout.html\" target=\"_blank\">Doctors Academy\u003c/a>, a rigorous health education program aimed at under-represented students. It started at Sunnyside High School in 1999, then Caruthers and Selma high schools in 2007. This year, 81 students graduated from the three schools.\u003c/p>\n\u003cp>\u003cstrong>Students Benefit From Rigorous Academic Foundation\u003c/strong>\u003c/p>\n\u003cp>Students attend Doctors Academy classes every day. First and foremost, they learn the tools of studying. It pays off. So far, 100 percent of the students who stick with the program have graduated and 99 percent later attend four-year colleges. The attrition rate is about 10 percent, and those students continue to be tracked by the program.\u003c/p>\n\u003cp>This year, Huerta will graduate from UC-Santa Cruz with a degree in human biology and a minor in Latin American Studies. She said she wants to become a physician assistant. Her fiancé and the father of her child, Angel Álvarez, another Doctors Academy and UC-Santa Cruz student, plans to get a masters degree in school counseling at Fresno State.\u003c/p>\n\u003cp>Lots of people have helped them along, Huerta said, but the founder and director of the Doctors Academy -- Katherine Flores -- really paved the way. Flores also grew up in a farmworker family, raised by her grandparents. She graduated from Stanford and went to medical school at UC-Davis.\u003c/p>\n\u003cp>\"Having been a farmworker myself and having gone to college and having struggled initially, I was acutely aware of the need to have a better academic foundation,\" Flores said. \"You can have a dream but if you don't have the tools to attain that dream, you're really stymied.\"\u003c/p>\n\u003cp>It wasn't that her grandparents weren't interested, she said. They just didn't know. \"That story hasn't changed for a lot of our immigrant families who come to the country looking for better opportunities but don't know how to navigate that. It's the genesis of why we developed the program.\"\u003c/p>\n\u003cp>\u003cstrong>Lack of Health Providers in the Valley Inspires Program\u003c/strong>\u003c/p>\n\u003cp>Flores came up with idea for the Doctors Academy while she was doing her residency at UCSF Fresno -- the UC-San Francisco medical education program at Fresno's Community Regional Medical Center. The rationale for the project was to increase the number of health providers in the Central Valley and to increase the diversity of providers to match the population of the valley.\u003c/p>\n\u003cp>\"Looking at the demographics, looking at how best to do that, we thought about a pipeline,\" said Flores, who partnered with and receives funding from UCSF Fresno. The program also relies heavily on grants and collaborates with city and county school districts.\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"1ThWjMKEQS4kcIrKvEP6nMA7XCpP7fji\"]\u003c/p>\n\u003cp>After a few years, organizers determined that kids needed intervention even earlier than high school; there are now three Junior Doctors Academies at middle schools that feed into Sunnyside. Caruthers will start one in the fall, and Selma hopes to develop one. There's also a college program at Fresno State.\u003c/p>\n\u003cp>The academy focuses on cultural competency and health disparities, as well as leadership building. Students are required to do volunteer work -- known as \"service learning\" -- within the community.\u003c/p>\n\u003cp>\"Helping a community be healthy also means not sitting back and watching things happen,\" said Flores.\u003c/p>\n\u003cp>And there's plenty of clinical exposure. Students spend six weeks of the summer before their junior year at a hospital rotating through different departments. \"Kids get to really see how a hospital system works, the different jobs that are there,\" Flores said.\u003c/p>\n\u003cp>The summer before their senior year, students do a six-week clinical internship. They also put in 80 hours of research and write and present a paper on a particular health problem with the lens on disparity. The program stays in touch with students after they graduate: via quarterly email; job and internship possibilities; help with applications to health professional schools. And long before they go to college, there are parent workshops on financial aid.\u003c/p>\n\u003cp>\u003cstrong>Students Return to the Valley\u003c/strong>\u003c/p>\n\u003cp>Tia Vang was in the first class of the Doctors Academy at Sunnyside. The program helped her see health disparities in her own Hmong community. In fact, a few years after she graduated from UC-Berkeley double majoring in biology and ethnic studies, she volunteered at Stone Soup, a not-for-profit that works primarily with Southeast Asian refugees in Fresno. One of her projects was to look into how language affected access to health care, and she found there were a lot of unmet needs especially for new Hmong refugees and for the elderly.\u003c/p>\n\u003cp>This fall, Vang plans to attend medical school at the University of Washington.\u003c/p>\n\u003cp>\"There are not a lot of Hmong physicians in Fresno,\" Vang said. \"I feel obligated to come back and do something and address health disparity in my community and to collaborate with other ethnic backgrounds.\"\u003c/p>\n\u003cp>It's too early to tell what percentage of kids from the Doctors Academy will stay in and around Fresno. But several kids who chose careers that don't require the time commitment of medical school are already working in the area at the county health department, in social services, as nurses or science teachers. There are even a few lawyers.\u003c/p>\n\u003cp>Nathan Singh, also a graduate of the first class at Sunnyside, said he exemplifies the goals of the program. When he was six, his dad, a taxi driver, was murdered. A passenger shot him eight times. His mom worked hard to raise him and his siblings but they had little money. He says the academy gave him an anchor, a strong purpose during his adolescence. He became passionate about medicine after volunteering at Community Medical Center. This fall, he'll start a residency in family and community medicine in San Diego. He can see himself eventually returning home and he believes in the academy's mission.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"I think that in the next few years, we'll be starting to see the results,\" Singh said. \"The Doctors Academy is really focusing on people returning, and I think Kathy Flores is a phenomenal leader. It's going to make a huge imprint on that city.\"\u003c/p>\n\n","blocks":[],"excerpt":"At Doctors Academy, high school students get special instruction and leadership training in health fields.","status":"publish","parent":0,"modified":1402674521,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":30,"wordCount":1245},"headData":{"title":"In Fresno, High School Program Aims at Lack of Provider Diversity | KQED","description":"At Doctors Academy, high school students get special instruction and leadership training in health fields.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"In Fresno, High School Program Aims at Lack of Provider Diversity","datePublished":"2014-06-13T05:02:38.000Z","dateModified":"2014-06-13T15:48:41.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"19506 http://blogs.kqed.org/stateofhealth/?p=19506","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/06/12/in-fresno-high-school-program-aims-at-lack-of-provider-diversity/","disqusTitle":"In Fresno, High School Program Aims at Lack of Provider Diversity","path":"/stateofhealth/19506/in-fresno-high-school-program-aims-at-lack-of-provider-diversity","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19510\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/2014-UCSF-Sr.-Trip-UCSF-SOM-Copy.jpg\">\u003cimg class=\"size-large wp-image-19510\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/2014-UCSF-Sr.-Trip-UCSF-SOM-Copy-640x425.jpg\" alt=\"Graduating seniors from the three Doctors Academy sites in Fresno. Dr. Katherine Flores, founder of the academy, stands in the front row. (Courtesy: Doctors Academy)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Graduating seniors from the three Doctors Academy sites in Fresno. Dr. Katherine Flores, founder of the academy, stands in the front row. Flores grew up in a farmworker family. (Courtesy: UCSF Fresno)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alice Daniel,\u003c/strong> \u003ca href=\"http://www.californiahealthline.org/insight/2014/doctors-academy-addresses-lack-of-diversity-among-medical-providers-in-central-valley\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>Stephanie Huerta grew up in a farmworker family in rural Caruthers, 15 miles southwest of Fresno. Her parents are from Mexico and neither had the opportunity to finish high school -- or in her mom's case, middle school.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'You can have a dream but if you don't have the tools to attain that dream, you're really stymied.' \u003c/aside>\n\u003cp>At 14, Huerta got pregnant and gave birth at the beginning of her freshman year in high school. Huerta was a very good student and, with the help of a counselor, she got through that school year even while caring for an infant. Her sophomore year, a new program called the Doctors Academy started at Caruthers High School. That was seven years ago, and it changed Huerta's life.\u003c/p>\n\u003cp>\"Looking back it was the best decision I could have made,\" said Huerta, now about to become a college graduate. \"I would have still been in Caruthers, maybe going to city college. I would have been pregnant again because that's the cycle quite honestly. And I would have been too scared to go anywhere,\" she added.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Three high schools in Fresno County now have a \u003ca style=\"color: #6d1618\" href=\"http://www.fresno.ucsf.edu/latinocenter/daabout.html\" target=\"_blank\">Doctors Academy\u003c/a>, a rigorous health education program aimed at under-represented students. It started at Sunnyside High School in 1999, then Caruthers and Selma high schools in 2007. This year, 81 students graduated from the three schools.\u003c/p>\n\u003cp>\u003cstrong>Students Benefit From Rigorous Academic Foundation\u003c/strong>\u003c/p>\n\u003cp>Students attend Doctors Academy classes every day. First and foremost, they learn the tools of studying. It pays off. So far, 100 percent of the students who stick with the program have graduated and 99 percent later attend four-year colleges. The attrition rate is about 10 percent, and those students continue to be tracked by the program.\u003c/p>\n\u003cp>This year, Huerta will graduate from UC-Santa Cruz with a degree in human biology and a minor in Latin American Studies. She said she wants to become a physician assistant. Her fiancé and the father of her child, Angel Álvarez, another Doctors Academy and UC-Santa Cruz student, plans to get a masters degree in school counseling at Fresno State.\u003c/p>\n\u003cp>Lots of people have helped them along, Huerta said, but the founder and director of the Doctors Academy -- Katherine Flores -- really paved the way. Flores also grew up in a farmworker family, raised by her grandparents. She graduated from Stanford and went to medical school at UC-Davis.\u003c/p>\n\u003cp>\"Having been a farmworker myself and having gone to college and having struggled initially, I was acutely aware of the need to have a better academic foundation,\" Flores said. \"You can have a dream but if you don't have the tools to attain that dream, you're really stymied.\"\u003c/p>\n\u003cp>It wasn't that her grandparents weren't interested, she said. They just didn't know. \"That story hasn't changed for a lot of our immigrant families who come to the country looking for better opportunities but don't know how to navigate that. It's the genesis of why we developed the program.\"\u003c/p>\n\u003cp>\u003cstrong>Lack of Health Providers in the Valley Inspires Program\u003c/strong>\u003c/p>\n\u003cp>Flores came up with idea for the Doctors Academy while she was doing her residency at UCSF Fresno -- the UC-San Francisco medical education program at Fresno's Community Regional Medical Center. The rationale for the project was to increase the number of health providers in the Central Valley and to increase the diversity of providers to match the population of the valley.\u003c/p>\n\u003cp>\"Looking at the demographics, looking at how best to do that, we thought about a pipeline,\" said Flores, who partnered with and receives funding from UCSF Fresno. The program also relies heavily on grants and collaborates with city and county school districts.\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"1ThWjMKEQS4kcIrKvEP6nMA7XCpP7fji\"]\u003c/p>\n\u003cp>After a few years, organizers determined that kids needed intervention even earlier than high school; there are now three Junior Doctors Academies at middle schools that feed into Sunnyside. Caruthers will start one in the fall, and Selma hopes to develop one. There's also a college program at Fresno State.\u003c/p>\n\u003cp>The academy focuses on cultural competency and health disparities, as well as leadership building. Students are required to do volunteer work -- known as \"service learning\" -- within the community.\u003c/p>\n\u003cp>\"Helping a community be healthy also means not sitting back and watching things happen,\" said Flores.\u003c/p>\n\u003cp>And there's plenty of clinical exposure. Students spend six weeks of the summer before their junior year at a hospital rotating through different departments. \"Kids get to really see how a hospital system works, the different jobs that are there,\" Flores said.\u003c/p>\n\u003cp>The summer before their senior year, students do a six-week clinical internship. They also put in 80 hours of research and write and present a paper on a particular health problem with the lens on disparity. The program stays in touch with students after they graduate: via quarterly email; job and internship possibilities; help with applications to health professional schools. And long before they go to college, there are parent workshops on financial aid.\u003c/p>\n\u003cp>\u003cstrong>Students Return to the Valley\u003c/strong>\u003c/p>\n\u003cp>Tia Vang was in the first class of the Doctors Academy at Sunnyside. The program helped her see health disparities in her own Hmong community. In fact, a few years after she graduated from UC-Berkeley double majoring in biology and ethnic studies, she volunteered at Stone Soup, a not-for-profit that works primarily with Southeast Asian refugees in Fresno. One of her projects was to look into how language affected access to health care, and she found there were a lot of unmet needs especially for new Hmong refugees and for the elderly.\u003c/p>\n\u003cp>This fall, Vang plans to attend medical school at the University of Washington.\u003c/p>\n\u003cp>\"There are not a lot of Hmong physicians in Fresno,\" Vang said. \"I feel obligated to come back and do something and address health disparity in my community and to collaborate with other ethnic backgrounds.\"\u003c/p>\n\u003cp>It's too early to tell what percentage of kids from the Doctors Academy will stay in and around Fresno. But several kids who chose careers that don't require the time commitment of medical school are already working in the area at the county health department, in social services, as nurses or science teachers. There are even a few lawyers.\u003c/p>\n\u003cp>Nathan Singh, also a graduate of the first class at Sunnyside, said he exemplifies the goals of the program. When he was six, his dad, a taxi driver, was murdered. A passenger shot him eight times. His mom worked hard to raise him and his siblings but they had little money. He says the academy gave him an anchor, a strong purpose during his adolescence. He became passionate about medicine after volunteering at Community Medical Center. This fall, he'll start a residency in family and community medicine in San Diego. He can see himself eventually returning home and he believes in the academy's mission.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"I think that in the next few years, we'll be starting to see the results,\" Singh said. \"The Doctors Academy is really focusing on people returning, and I think Kathy Flores is a phenomenal leader. It's going to make a huge imprint on that city.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/19506/in-fresno-high-school-program-aims-at-lack-of-provider-diversity","authors":["8344"],"categories":["stateofhealth_11"],"tags":["stateofhealth_280"],"featImg":"stateofhealth_19510","label":"stateofhealth"},"stateofhealth_16161":{"type":"posts","id":"stateofhealth_16161","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"16161","score":null,"sort":[1384767042000]},"guestAuthors":[],"slug":"central-valley-community-fights-for-clean-water","title":"Central Valley Community Fights for Clean Drinking Water","publishDate":1384767042,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_16162\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Alice_LanareStory-e1383958739240.jpg\">\u003cimg class=\"size-large wp-image-16162 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Alice_LanareStory-640x480.jpg\" alt=\"(Alice Daniel/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Isabel Solorio (left) and Carrie Bonner talk about water issues outside the Lanare Community Center. (Alice Daniel/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alice Daniel, KQED\u003c/strong>\u003c/p>\n\u003cp>There are no streetlights here in Lanare, no sidewalks, no sewer system in this tiny, rural enclave of 600 smack dab in the middle of farming country in the Central Valley.\u003c/p>\n\u003cp>There is a community center and on this night, many locals are here dancing and eating.\u003c/p>\n\u003cp>“Tonight I make salad and my friend makes beans, and I make beans so just, you know, everybody help,” said Isabel Solorio.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Many people stopped drinking the tap water years ago because it has high levels of arsenic.\u003c/aside>\n\u003cp>Solorio is the president of a local group that holds fundraisers twice a year to support the community center. The group also advocates for clean drinking water –- something Lanare doesn’t have. Lanare did not come out of an organized planning process. Like many unincorporated communities in the San Joaquin Valley, the town arose out of the fields surrounding it.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It was a lot of labor camps, they call them,” said Carrie Bonner, a Lanare resident still tall and strong at 89. “Cotton chopping, picking and cutting grapes. … Whatever season it was, that’s what they would do.”\u003c!--more-->\u003c/p>\n\u003cp>Lanare was once a series of shacks for African-American farmworkers, Bonner says. Her father-in-law ran a juke joint not far from here and was a labor contractor.\u003c/p>\n\u003cp>She said when she first moved to Lanare in the 1950s, there were very few farmworkers who came from Mexico. But as time went on, the population changed. “Now it’s just a few blacks and more Spanish, you know,” she said.\u003c/p>\n\u003cp>\u003cstrong>Water lines arrived in the 70s -- but drinkable water didn't last\u003c/strong>\u003c/p>\n\u003cp>In the 1970s, a Quaker organization helped the people of Lanare build houses and put in water lines. Bonner was one of the first to move into a new home, the one she still lives in today. But she and others stopped drinking the tap water years ago because it has high levels of arsenic.\u003c/p>\n\u003cp>In 2002, the town got some federal grant money to clean the water. “The county allocated it, 1.3 million dollars,” said Veronica Garibay of the Leadership Council for Justice and Accountability.\u003c/p>\n\u003cp>The town used the money to build a water treatment facility in 2006. But there was trouble from the start. Fresno county rubber-stamped the federally funded plant without an adequate cost analysis, said Garibay. It’s expensive to treat arsenic, and costs spiraled beyond what the community could manage. The town had no water meters to track residents’ usage. And some of the pricey filtered water was unintentionally going to irrigate fields. On top of that, the local water district lacked financial and technical expertise.\u003c/p>\n\u003cp>“A board of five volunteers from the community without any background in water operation or maintenance are running a treatment plant,” said Garibay.\u003c/p>\n\u003cp>Lanare couldn’t afford to run it, and the state shut down the plant after just six months. Now the town’s water system is operated by a private company or receiver. Residents pay a monthly bill for running water –- but they still can’t drink it. Instead, many spend $20 to $30 more each month for bottled water. That’s not uncommon in the valley where hundreds more small water districts have problems with pollutants, including nitrates and selenium.\u003c/p>\n\u003cp>\u003cstrong>\"Who gets control of the good water?\"\u003c/strong>\u003c/p>\n\u003cp>“It’s a really complicated story,” said John Capitman, a public policy expert at Fresno State University. “It may be the farming practices of somebody 20 miles away 20 years ago that spoiled the water that your well draws on. So this is something about a long term process of connected aquifers underneath the ground, pumping, history, exploitation. Who gets the control of the good water? It plays out all over the region.”\u003c/p>\n\u003cp>These small, volunteer water districts not only lack the political clout, but also technical and financial wherewithal, he says. “The patience to make it through crazy bureaucratic systems,” he added.\u003c/p>\n\u003cp>And there’s a catch when it comes to technical and financial expertise.\u003c/p>\n\u003cp>\u003cspan>“Those capabilities are also federal requirements in order to get funding,” said Mark Starr, deputy director of the Center for Environmental Health at the California Department of Public Health. His agency is charged with helping these communities comply with the Safe Drinking Water Act.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Millions for water improvements left unspent\u003c/strong>\u003c/p>\n\u003cp>But last spring, the EPA scolded the Department of Public Health for failing to spend hundreds of millions of dollars for water improvements. The state said it is working harder to move the funds more quickly and provide more technical assistance.\u003c/p>\n\u003cp>Lanare recently got grants to take steps toward a permanent solution, said Starr. The grants “were used to install water meters, a project that’s underway -- and also educate Lanare residents about conservation.”\u003c/p>\n\u003cp>A study to explore solutions for Lanare will be completed by June, said Starr. These options include digging a new well, restarting the old treatment plant and hooking into a nearby town’s water treatment facility.\u003c/p>\n\u003cp>Back\u003cem> \u003c/em>at the community center, Isabel Solorio said she knows the town is poor and treating tainted water is expensive. But she and other residents won’t quit pushing for clean water.\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s a lot of work, but you know what? I am so happy when I see part of my community here and tell everybody ‘come on let’s go working together,’” she said. “Because this is your community.”\u003c/p>\n\n","blocks":[],"excerpt":"In the 1970s, a Quaker organization helped the people of Lanare build houses and put in water lines. Bonner was one of the first to move into a new home, the one she still lives in today. But she and others stopped drinking the tap water years ago because it has high levels of arsenic.","status":"publish","parent":0,"modified":1385055931,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":970},"headData":{"title":"Central Valley Community Fights for Clean Drinking Water | KQED","description":"In the 1970s, a Quaker organization helped the people of Lanare build houses and put in water lines. Bonner was one of the first to move into a new home, the one she still lives in today. But she and others stopped drinking the tap water years ago because it has high levels of arsenic.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Central Valley Community Fights for Clean Drinking Water","datePublished":"2013-11-18T09:30:42.000Z","dateModified":"2013-11-21T17:45:31.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"16161 http://blogs.kqed.org/stateofhealth/?p=16161","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/11/18/central-valley-community-fights-for-clean-water/","disqusTitle":"Central Valley Community Fights for Clean Drinking Water","path":"/stateofhealth/16161/central-valley-community-fights-for-clean-water","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16162\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Alice_LanareStory-e1383958739240.jpg\">\u003cimg class=\"size-large wp-image-16162 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Alice_LanareStory-640x480.jpg\" alt=\"(Alice Daniel/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Isabel Solorio (left) and Carrie Bonner talk about water issues outside the Lanare Community Center. (Alice Daniel/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alice Daniel, KQED\u003c/strong>\u003c/p>\n\u003cp>There are no streetlights here in Lanare, no sidewalks, no sewer system in this tiny, rural enclave of 600 smack dab in the middle of farming country in the Central Valley.\u003c/p>\n\u003cp>There is a community center and on this night, many locals are here dancing and eating.\u003c/p>\n\u003cp>“Tonight I make salad and my friend makes beans, and I make beans so just, you know, everybody help,” said Isabel Solorio.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Many people stopped drinking the tap water years ago because it has high levels of arsenic.\u003c/aside>\n\u003cp>Solorio is the president of a local group that holds fundraisers twice a year to support the community center. The group also advocates for clean drinking water –- something Lanare doesn’t have. Lanare did not come out of an organized planning process. Like many unincorporated communities in the San Joaquin Valley, the town arose out of the fields surrounding it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It was a lot of labor camps, they call them,” said Carrie Bonner, a Lanare resident still tall and strong at 89. “Cotton chopping, picking and cutting grapes. … Whatever season it was, that’s what they would do.”\u003c!--more-->\u003c/p>\n\u003cp>Lanare was once a series of shacks for African-American farmworkers, Bonner says. Her father-in-law ran a juke joint not far from here and was a labor contractor.\u003c/p>\n\u003cp>She said when she first moved to Lanare in the 1950s, there were very few farmworkers who came from Mexico. But as time went on, the population changed. “Now it’s just a few blacks and more Spanish, you know,” she said.\u003c/p>\n\u003cp>\u003cstrong>Water lines arrived in the 70s -- but drinkable water didn't last\u003c/strong>\u003c/p>\n\u003cp>In the 1970s, a Quaker organization helped the people of Lanare build houses and put in water lines. Bonner was one of the first to move into a new home, the one she still lives in today. But she and others stopped drinking the tap water years ago because it has high levels of arsenic.\u003c/p>\n\u003cp>In 2002, the town got some federal grant money to clean the water. “The county allocated it, 1.3 million dollars,” said Veronica Garibay of the Leadership Council for Justice and Accountability.\u003c/p>\n\u003cp>The town used the money to build a water treatment facility in 2006. But there was trouble from the start. Fresno county rubber-stamped the federally funded plant without an adequate cost analysis, said Garibay. It’s expensive to treat arsenic, and costs spiraled beyond what the community could manage. The town had no water meters to track residents’ usage. And some of the pricey filtered water was unintentionally going to irrigate fields. On top of that, the local water district lacked financial and technical expertise.\u003c/p>\n\u003cp>“A board of five volunteers from the community without any background in water operation or maintenance are running a treatment plant,” said Garibay.\u003c/p>\n\u003cp>Lanare couldn’t afford to run it, and the state shut down the plant after just six months. Now the town’s water system is operated by a private company or receiver. Residents pay a monthly bill for running water –- but they still can’t drink it. Instead, many spend $20 to $30 more each month for bottled water. That’s not uncommon in the valley where hundreds more small water districts have problems with pollutants, including nitrates and selenium.\u003c/p>\n\u003cp>\u003cstrong>\"Who gets control of the good water?\"\u003c/strong>\u003c/p>\n\u003cp>“It’s a really complicated story,” said John Capitman, a public policy expert at Fresno State University. “It may be the farming practices of somebody 20 miles away 20 years ago that spoiled the water that your well draws on. So this is something about a long term process of connected aquifers underneath the ground, pumping, history, exploitation. Who gets the control of the good water? It plays out all over the region.”\u003c/p>\n\u003cp>These small, volunteer water districts not only lack the political clout, but also technical and financial wherewithal, he says. “The patience to make it through crazy bureaucratic systems,” he added.\u003c/p>\n\u003cp>And there’s a catch when it comes to technical and financial expertise.\u003c/p>\n\u003cp>\u003cspan>“Those capabilities are also federal requirements in order to get funding,” said Mark Starr, deputy director of the Center for Environmental Health at the California Department of Public Health. His agency is charged with helping these communities comply with the Safe Drinking Water Act.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Millions for water improvements left unspent\u003c/strong>\u003c/p>\n\u003cp>But last spring, the EPA scolded the Department of Public Health for failing to spend hundreds of millions of dollars for water improvements. The state said it is working harder to move the funds more quickly and provide more technical assistance.\u003c/p>\n\u003cp>Lanare recently got grants to take steps toward a permanent solution, said Starr. The grants “were used to install water meters, a project that’s underway -- and also educate Lanare residents about conservation.”\u003c/p>\n\u003cp>A study to explore solutions for Lanare will be completed by June, said Starr. These options include digging a new well, restarting the old treatment plant and hooking into a nearby town’s water treatment facility.\u003c/p>\n\u003cp>Back\u003cem> \u003c/em>at the community center, Isabel Solorio said she knows the town is poor and treating tainted water is expensive. But she and other residents won’t quit pushing for clean water.\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s a lot of work, but you know what? I am so happy when I see part of my community here and tell everybody ‘come on let’s go working together,’” she said. “Because this is your community.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/16161/central-valley-community-fights-for-clean-water","authors":["8344"],"categories":["stateofhealth_11"],"tags":["stateofhealth_280","stateofhealth_461"],"featImg":"stateofhealth_16162","label":"stateofhealth"},"stateofhealth_15120":{"type":"posts","id":"stateofhealth_15120","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"15120","score":null,"sort":[1379720257000]},"guestAuthors":[],"slug":"recruiting-and-retaining-doctors-in-californias-san-joaquin-valley","title":"Recruiting – and Retaining – Doctors in California’s San Joaquin Valley","publishDate":1379720257,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_15123\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-15123\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/RS6388_P1030640-scr-640x426.jpg\" alt='Maureen Williams (L) seen here with her daughter Carol Baskin, is 95 years old. Williams recently moved away from Firebaugh, but she returns to see Dr. Oscar Sablan. \"He saved my life several times,\" she says. (Photo: Lisa Morehouse)' width=\"640\" height=\"426\">\u003cfigcaption class=\"wp-caption-text\">Maureen Williams is 95 years old (seen with her daughter Carol Baskin) moved away from Firebaugh recently to be closer to family, but she returns to see Dr. Oscar Sablan. \"He saved my life several times,\" she says. (Photo: Lisa Morehouse)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Lisa Morehouse\u003c/strong>\u003c/p>\n\u003cp>In 1999, in the tiny town of Five Points, 29 farmworkers accidentally entered a field that had just been treated with dangerous organophosphate insecticides. They started vomiting. The labor contractor in charge bypassed local hospitals and brought the crew to his own doctors 50 miles away in the town of Firebaugh. He simply trusted Marcia and Oscar Sablan more.\u003c/p>\n\u003cp>“We have seen a lot of other cases,” said Oscar Sablan, an internist, “and so we were familiar with the symptoms and we knew what to do.”\u003c/p>\n\u003cp>They had lots of atropine on hand, a drug used to treat poison victims if they go into respiratory or cardiac arrest. The farmworkers stripped and lined up to rinse the pesticides off in the clinic’s shower, built just for this type of incident. But with so many patients, Oscar Sablan had to recruit help.\u003c/p>\n\u003cp>“The firemen in town were able to get a kiddie pool and at least wash the people down,” he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Firebaugh is surrounded by crops, and the Sablans estimate that 75 percent of their patients work in the fields, like that labor contractor.\u003c/p>\n\u003cp>Marcia Sablan, who specializes in family medicine, explained, “He knew he could come here. He knew that we would take care of him, so be brought those 29 people over here.”\u003c/p>\n\u003cp>Patients have relied on the Sablans and the Sablan Medical Clinic for more than 30 years, since the couple moved to Firebaugh as young physicians in the\u003ca href=\"http://nhsc.hrsa.gov\" target=\"_blank\"> National Health Service Corps\u003c/a>. They say they wanted to practice where they were needed.\u003c!--more-->\u003c/p>\n\u003cp>This long-term commitment to a community makes the Sablans an exception. Rural regions of California have long faced a shortage of doctors, and in the San Joaquin Valley, \u003ca href=\"http://www.chcf.org/publications/2009/06/fewer-and-more-specialized--a-new-assessment-of-physician-supply-in-california\" target=\"_blank\">studies show\u003c/a> the number of primary care physicians per person is about half the state’s average.\u003c/p>\n\u003cp>Rosie Gomez, a patient of the Sablans, said small towns nearby struggle to hang onto new doctors who come from outside the region.\u003c/p>\n\u003cp>“Once they’ve gained their skills, they leave and they take their skills with them,” she said of these other doctors. “They’ll practice on you, but they don’t stay.”\u003c/p>\n\u003cp>\u003cstrong>Bringing new doctors back home\u003c/strong>\u003c/p>\n\u003cp>A new program, however, is making strides to attract and retain doctors in the state's rural communities. Often, these new doctors are coming home to the neighborhoods they grew up in. Called San Joaquin Valley Program in Medical Education, or PRIME, the program selects and trains medical students to practice in the Valley. It’s a collaboration between UC Davis, UC Merced, and UCSF Fresno.\u003c/p>\n\u003cp>An hour away from Firebaugh in Fresno, five students medical students gather in a small exam room where a doctor teaches them how to give neurological exams. One of them is Christina Thabet, who grew up in Bakersfield. All of the students either hail from the Valley, or have ties to it.\u003c/p>\n\u003cp>“We’re learning on the population we want to work with in the future,” Thabet said, during a break in training. “You can see our families in the eyes of our patients because they grew up here, and kind of had the same challenges that they have in health care that our families had.”\u003c/p>\n\u003cp>Thabit remembers her grandfather, a dairy farmer, having a hard time getting appointments for cardiology and diabetes care. When he did, he had to drive over one hour, one way.\u003c/p>\n\u003cp>Most days, Thabit is training at a Fresno hospital. Once a week, she travels to a clinic in the rural town of Selma, where she sees patients while being supervised by medical faculty. Thabet said she’s working harder than she ever imagined, but she knows she chose the right program.\u003c/p>\n\u003cp>“The clinical experience, the education and the fact that I’m home, I mean, that’s my ideal medical school,” she said. “There was no better fit for me.”\u003c/p>\n\u003cp>\u003cstrong>Doctors as integral members of community\u003c/strong>\u003c/p>\n\u003cp>Back in Firebaugh, Dr. Marcia, as her patients call her, reviews X-rays with a woman who’s worked in cantaloupe fields for three decades. The patient has chronic laryngitis -- and no insurance. She’ll probably have to wait a long time to get an appointment at a hospital in Fresno, so Dr. Marcia searches through drug company samples for a medication that can ease her symptoms until then.\u003c/p>\n\u003cp>The Sablans charge a low sliding fee and negotiate the Medi-Cal labyrinth. It’s all part of a balancing act: making a living while caring for needy patients.\u003c/p>\n\u003cp>In another exam room, Dr. Oscar meets with\u003cem> \u003c/em>95-year-old Mareen Williams, who came to Firebaugh from Oklahoma in the 1930s and picked cotton and cut corn. Even though she moved away recently to be closer to family, she returns to the clinic to see Dr. Oscar.\u003c/p>\n\u003cp>“He saved my life several times,” Williams said.\u003c/p>\n\u003cp>She trusts Sablan with managing her complicated blood condition, and she won’t see another doctor unless he makes the referral. The Sablans' relationships go beyond the clinic: the doctors make house calls, and know their patients as neighbors.\u003c/p>\n\u003cp>“They’re more like folks,” Williams said. “They come to your house. I used to give a big Easter egg hunt. They came out with their children.”\u003c/p>\n\u003cp>The Sablans see health as more than medical care. That’s why, besides putting in long hours at the clinic, Oscar has served on Firebaugh’s school board close to 20 years, and Marcia has been on the city council over 30, working to improve housing, sewage and water systems.\u003c/p>\n\u003cp>“That’s been an overriding thing for me – the built environment [and] how important that is to people’s health,” she said.\u003c/p>\n\u003cp>Patient Rosie Gomez said she can’t picture Firebaugh without the Sablans practicing medicine, even though she knows some day it will happen. Both doctors are in their 60s.\u003c/p>\n\u003cp>“They’re human just like we are,” Gomez said. “They get older and they’re going to want to retire one day and I can’t blame them. But who replaces them?”\u003c/p>\n\u003cp>PRIME is working on this. Now in its third year, the program will continue to pick about six students for each new class. Administrators hope PRIME's success could be a stepping stone towards creating a full medical school in the Valley someday.\u003c/p>\n\u003cp>This won’t solve the immediate physician shortage in San Joaquin Valley and other parts of rural California, but as Gomez said, each medical student could have a real impact on a community, like Firebaugh.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“We’re humble people, but we have medical needs,” she said. “And honestly, for some of these kids to have their light bulb go on and say, you know what? The Sablans made a difference. I can make a difference here, too.”\u003c/p>\n\n","blocks":[],"excerpt":"Patients have relied on the Sablans and the Sablan Medical Clinic for more than 30 years, since the couple moved to Firebaugh as young physicians in the National Health Service Corps. They say they wanted to practice where they were needed.\r\n\r\nThis long-term commitment to a community makes the Sablans an exception. Rural regions of California have long faced a shortage of doctors, and in the San Joaquin Valley, studies show the number of primary care physicians per person is about half the state’s average.","status":"publish","parent":0,"modified":1379720323,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":34,"wordCount":1236},"headData":{"title":"Recruiting – and Retaining – Doctors in California’s San Joaquin Valley | KQED","description":"Patients have relied on the Sablans and the Sablan Medical Clinic for more than 30 years, since the couple moved to Firebaugh as young physicians in the National Health Service Corps. They say they wanted to practice where they were needed.\r\n\r\nThis long-term commitment to a community makes the Sablans an exception. Rural regions of California have long faced a shortage of doctors, and in the San Joaquin Valley, studies show the number of primary care physicians per person is about half the state’s average.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Recruiting – and Retaining – Doctors in California’s San Joaquin Valley","datePublished":"2013-09-20T23:37:37.000Z","dateModified":"2013-09-20T23:38:43.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"15120 http://blogs.kqed.org/stateofhealth/?p=15120","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/09/20/recruiting-and-retaining-doctors-in-californias-san-joaquin-valley/","disqusTitle":"Recruiting – and Retaining – Doctors in California’s San Joaquin Valley","path":"/stateofhealth/15120/recruiting-and-retaining-doctors-in-californias-san-joaquin-valley","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15123\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-15123\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/RS6388_P1030640-scr-640x426.jpg\" alt='Maureen Williams (L) seen here with her daughter Carol Baskin, is 95 years old. Williams recently moved away from Firebaugh, but she returns to see Dr. Oscar Sablan. \"He saved my life several times,\" she says. (Photo: Lisa Morehouse)' width=\"640\" height=\"426\">\u003cfigcaption class=\"wp-caption-text\">Maureen Williams is 95 years old (seen with her daughter Carol Baskin) moved away from Firebaugh recently to be closer to family, but she returns to see Dr. Oscar Sablan. \"He saved my life several times,\" she says. (Photo: Lisa Morehouse)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Lisa Morehouse\u003c/strong>\u003c/p>\n\u003cp>In 1999, in the tiny town of Five Points, 29 farmworkers accidentally entered a field that had just been treated with dangerous organophosphate insecticides. They started vomiting. The labor contractor in charge bypassed local hospitals and brought the crew to his own doctors 50 miles away in the town of Firebaugh. He simply trusted Marcia and Oscar Sablan more.\u003c/p>\n\u003cp>“We have seen a lot of other cases,” said Oscar Sablan, an internist, “and so we were familiar with the symptoms and we knew what to do.”\u003c/p>\n\u003cp>They had lots of atropine on hand, a drug used to treat poison victims if they go into respiratory or cardiac arrest. The farmworkers stripped and lined up to rinse the pesticides off in the clinic’s shower, built just for this type of incident. But with so many patients, Oscar Sablan had to recruit help.\u003c/p>\n\u003cp>“The firemen in town were able to get a kiddie pool and at least wash the people down,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Firebaugh is surrounded by crops, and the Sablans estimate that 75 percent of their patients work in the fields, like that labor contractor.\u003c/p>\n\u003cp>Marcia Sablan, who specializes in family medicine, explained, “He knew he could come here. He knew that we would take care of him, so be brought those 29 people over here.”\u003c/p>\n\u003cp>Patients have relied on the Sablans and the Sablan Medical Clinic for more than 30 years, since the couple moved to Firebaugh as young physicians in the\u003ca href=\"http://nhsc.hrsa.gov\" target=\"_blank\"> National Health Service Corps\u003c/a>. They say they wanted to practice where they were needed.\u003c!--more-->\u003c/p>\n\u003cp>This long-term commitment to a community makes the Sablans an exception. Rural regions of California have long faced a shortage of doctors, and in the San Joaquin Valley, \u003ca href=\"http://www.chcf.org/publications/2009/06/fewer-and-more-specialized--a-new-assessment-of-physician-supply-in-california\" target=\"_blank\">studies show\u003c/a> the number of primary care physicians per person is about half the state’s average.\u003c/p>\n\u003cp>Rosie Gomez, a patient of the Sablans, said small towns nearby struggle to hang onto new doctors who come from outside the region.\u003c/p>\n\u003cp>“Once they’ve gained their skills, they leave and they take their skills with them,” she said of these other doctors. “They’ll practice on you, but they don’t stay.”\u003c/p>\n\u003cp>\u003cstrong>Bringing new doctors back home\u003c/strong>\u003c/p>\n\u003cp>A new program, however, is making strides to attract and retain doctors in the state's rural communities. Often, these new doctors are coming home to the neighborhoods they grew up in. Called San Joaquin Valley Program in Medical Education, or PRIME, the program selects and trains medical students to practice in the Valley. It’s a collaboration between UC Davis, UC Merced, and UCSF Fresno.\u003c/p>\n\u003cp>An hour away from Firebaugh in Fresno, five students medical students gather in a small exam room where a doctor teaches them how to give neurological exams. One of them is Christina Thabet, who grew up in Bakersfield. All of the students either hail from the Valley, or have ties to it.\u003c/p>\n\u003cp>“We’re learning on the population we want to work with in the future,” Thabet said, during a break in training. “You can see our families in the eyes of our patients because they grew up here, and kind of had the same challenges that they have in health care that our families had.”\u003c/p>\n\u003cp>Thabit remembers her grandfather, a dairy farmer, having a hard time getting appointments for cardiology and diabetes care. When he did, he had to drive over one hour, one way.\u003c/p>\n\u003cp>Most days, Thabit is training at a Fresno hospital. Once a week, she travels to a clinic in the rural town of Selma, where she sees patients while being supervised by medical faculty. Thabet said she’s working harder than she ever imagined, but she knows she chose the right program.\u003c/p>\n\u003cp>“The clinical experience, the education and the fact that I’m home, I mean, that’s my ideal medical school,” she said. “There was no better fit for me.”\u003c/p>\n\u003cp>\u003cstrong>Doctors as integral members of community\u003c/strong>\u003c/p>\n\u003cp>Back in Firebaugh, Dr. Marcia, as her patients call her, reviews X-rays with a woman who’s worked in cantaloupe fields for three decades. The patient has chronic laryngitis -- and no insurance. She’ll probably have to wait a long time to get an appointment at a hospital in Fresno, so Dr. Marcia searches through drug company samples for a medication that can ease her symptoms until then.\u003c/p>\n\u003cp>The Sablans charge a low sliding fee and negotiate the Medi-Cal labyrinth. It’s all part of a balancing act: making a living while caring for needy patients.\u003c/p>\n\u003cp>In another exam room, Dr. Oscar meets with\u003cem> \u003c/em>95-year-old Mareen Williams, who came to Firebaugh from Oklahoma in the 1930s and picked cotton and cut corn. Even though she moved away recently to be closer to family, she returns to the clinic to see Dr. Oscar.\u003c/p>\n\u003cp>“He saved my life several times,” Williams said.\u003c/p>\n\u003cp>She trusts Sablan with managing her complicated blood condition, and she won’t see another doctor unless he makes the referral. The Sablans' relationships go beyond the clinic: the doctors make house calls, and know their patients as neighbors.\u003c/p>\n\u003cp>“They’re more like folks,” Williams said. “They come to your house. I used to give a big Easter egg hunt. They came out with their children.”\u003c/p>\n\u003cp>The Sablans see health as more than medical care. That’s why, besides putting in long hours at the clinic, Oscar has served on Firebaugh’s school board close to 20 years, and Marcia has been on the city council over 30, working to improve housing, sewage and water systems.\u003c/p>\n\u003cp>“That’s been an overriding thing for me – the built environment [and] how important that is to people’s health,” she said.\u003c/p>\n\u003cp>Patient Rosie Gomez said she can’t picture Firebaugh without the Sablans practicing medicine, even though she knows some day it will happen. Both doctors are in their 60s.\u003c/p>\n\u003cp>“They’re human just like we are,” Gomez said. “They get older and they’re going to want to retire one day and I can’t blame them. But who replaces them?”\u003c/p>\n\u003cp>PRIME is working on this. Now in its third year, the program will continue to pick about six students for each new class. Administrators hope PRIME's success could be a stepping stone towards creating a full medical school in the Valley someday.\u003c/p>\n\u003cp>This won’t solve the immediate physician shortage in San Joaquin Valley and other parts of rural California, but as Gomez said, each medical student could have a real impact on a community, like Firebaugh.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We’re humble people, but we have medical needs,” she said. “And honestly, for some of these kids to have their light bulb go on and say, you know what? The Sablans made a difference. I can make a difference here, too.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/15120/recruiting-and-retaining-doctors-in-californias-san-joaquin-valley","authors":["240"],"categories":["stateofhealth_11"],"tags":["stateofhealth_280","stateofhealth_325"],"featImg":"stateofhealth_15123","label":"stateofhealth"},"stateofhealth_11883":{"type":"posts","id":"stateofhealth_11883","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"11883","score":null,"sort":[1365012423000]},"guestAuthors":[],"slug":"small-farmer-in-central-valley-takes-his-strawberries-farm-to-school","title":"Small Farmer In Central Valley Takes His Strawberries 'Farm to School'","publishDate":1365012423,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>By \u003ca href=\"http://kvpr.org/people/rebecca-plevin\" target=\"_blank\">Rebecca Plevin\u003c/a>, \u003ca href=\"http://kvpr.org/post/reedley-farmer-goes-farm-school-strawberries\" target=\"_blank\">Valley Public Radio\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_11889\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/03/small-farmer-in-central-valley-takes-his-strawberries-farm-to-school/paesaephan_rebeccaplevin_kvpr/\" rel=\"attachment wp-att-11889\">\u003cimg class=\"size-large wp-image-11889\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/04/PaeSaephan_RebeccaPlevin_KVPR-620x465.jpg\" alt=\"Pao Saephan's strawberries are just days away from being fully ripe. (Rebecca Plevin/Valley Public Radio)\" width=\"620\" height=\"465\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Pao Saephan's strawberries are just days away from being fully ripe. (Rebecca Plevin/Valley Public Radio)\u003c/figcaption>\u003c/figure>\n\u003cp>Pao Saephan crouches down in his sun-drenched field. He cups a red jewel in his hand. In a few more days, his strawberries will be fully ripe. He’ll pick them once they are rosy red from stem to tip.\u003c/p>\n\u003cp>“We want all the strawberries, to be full ripe, full flavor, with 100 percent sugar in them,” says Saephan.\u003c/p>\n\u003cp>In the past, he would sell the fresh berries at his roadside stand, in the small town of Reedley, southeast of Fresno.\u003c/p>\n\u003caside class=\"pullquote alignright\">The goal is for children to “experience fresh produce and make healthy eating choices over a lifetime.”\u003c/aside>\n\u003cp>But this year, he will sell the bulk of his berries directly to the Fresno Unified School District. He says he is thrilled to share the fruits of his labor with Central Valley students.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We have farmed a long time, but this is my passion, to be farming something that feeds local,” says Saephan.\u003c/p>\n\u003cp>Saephan is the first small farmer to sell his produce directly to Fresno Unified. He could pave the way for other small farmers to begin selling their produce directly with the school district.\u003c/p>\n\u003cp>Jose Alvarado, food services director for Fresno Unified notes that the district is located in the \"produce and vegetable capital\" of the world. “We have been taking advantage of that,\" he says, \"but now it’s taking it to another level, from the farmer, when the occasion is right, and it meets our needs. Strawberries were just a natural for us.\"\u003c!--more-->\u003c/p>\n\u003cp>Alvarado hopes every Fresno Unified student can taste Saephan’s strawberries at their peak. His goal, he said, is for children to “experience fresh produce and make healthy eating choices over a lifetime.”\u003c/p>\n\u003cp>Still, he acknowledged that there are several barriers to linking small farms and large school districts. For logistical reasons, it’s often easier for school districts to buy produce from large distributors.\u003c/p>\n\u003cp>“Some school districts like to work with one company: you go to the grocery store, not the cucumber stand, the broccoli stand, the strawberry stand,” Alvarado said.\u003c/p>\n\u003cp>He said another challenge is that some small farmers are not trained in food safety.\u003c/p>\n\u003cp>“Pao is our first step to truly go to the farm – we have worked with other farmers, this is one where the farmer was lacking all the food safety certifications,\" Alvarado said. \"We’re breaking new ground with Pao, and learning what it takes for him to be certified.\"\u003c/p>\n\u003cp>Despite those barriers, Alvarado said there are many benefits to buying produce, and especially strawberries, from local farmers. Among those is the cost.\u003c/p>\n\u003cp>The district serves about 85,000 meals a day. Alvarado’s goal is for each of those meals to include three or four of Saephan’s beauties.\u003c/p>\n\u003cp>“A locally grown strawberry that we buy from the farmer more than likely will be more cost effective for the district,\" Alvarado said. \"But that’s not the driver.\"\u003c/p>\n\u003cp>Beyond dollars, strawberries are one of those fruits that just taste better when they’re picked fully ripe.\u003c/p>\n\u003cp>“The driver is, fresh products that taste good are more likely to be eaten than products that don’t,\" Alvarado said. \"If they don’t eat it, we’re wasting money.\" Plus fruits and vegetables in school lunches that end up in the trash aren't helping children's overall nutrition either.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Fresno Unified students should start seeing Saephan’s berries on the menu in May.\u003c/p>\n\n","blocks":[],"excerpt":"Pao Saephan crouches down in his sun-drenched field. He cups a red jewel in his hand. In a few more days, his strawberries will be fully ripe. He’ll pick them once they are rosy red from stem to tip.\r\n\r\n“We want all the strawberries, to be full ripe, full flavor, with 100 percent sugar in them,” says Saephan.\r\n\r\nIn the past, he would sell the fresh berries at his roadside stand, in the small town of Reedley, southeast of Fresno. But this year, he will sell the bulk of his berries directly to the Fresno Unified School District. He says he is thrilled to share the fruits of his labor with Central Valley students.","status":"publish","parent":0,"modified":1365051015,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":21,"wordCount":621},"headData":{"title":"Small Farmer In Central Valley Takes His Strawberries 'Farm to School' | KQED","description":"Pao Saephan crouches down in his sun-drenched field. He cups a red jewel in his hand. In a few more days, his strawberries will be fully ripe. He’ll pick them once they are rosy red from stem to tip.\r\n\r\n“We want all the strawberries, to be full ripe, full flavor, with 100 percent sugar in them,” says Saephan.\r\n\r\nIn the past, he would sell the fresh berries at his roadside stand, in the small town of Reedley, southeast of Fresno. But this year, he will sell the bulk of his berries directly to the Fresno Unified School District. He says he is thrilled to share the fruits of his labor with Central Valley students.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Small Farmer In Central Valley Takes His Strawberries 'Farm to School'","datePublished":"2013-04-03T18:07:03.000Z","dateModified":"2013-04-04T04:50:15.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"11883 http://blogs.kqed.org/stateofhealth/?p=11883","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/04/03/small-farmer-in-central-valley-takes-his-strawberries-farm-to-school/","disqusTitle":"Small Farmer In Central Valley Takes His Strawberries 'Farm to School'","path":"/stateofhealth/11883/small-farmer-in-central-valley-takes-his-strawberries-farm-to-school","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>By \u003ca href=\"http://kvpr.org/people/rebecca-plevin\" target=\"_blank\">Rebecca Plevin\u003c/a>, \u003ca href=\"http://kvpr.org/post/reedley-farmer-goes-farm-school-strawberries\" target=\"_blank\">Valley Public Radio\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_11889\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/03/small-farmer-in-central-valley-takes-his-strawberries-farm-to-school/paesaephan_rebeccaplevin_kvpr/\" rel=\"attachment wp-att-11889\">\u003cimg class=\"size-large wp-image-11889\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/04/PaeSaephan_RebeccaPlevin_KVPR-620x465.jpg\" alt=\"Pao Saephan's strawberries are just days away from being fully ripe. (Rebecca Plevin/Valley Public Radio)\" width=\"620\" height=\"465\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Pao Saephan's strawberries are just days away from being fully ripe. (Rebecca Plevin/Valley Public Radio)\u003c/figcaption>\u003c/figure>\n\u003cp>Pao Saephan crouches down in his sun-drenched field. He cups a red jewel in his hand. In a few more days, his strawberries will be fully ripe. He’ll pick them once they are rosy red from stem to tip.\u003c/p>\n\u003cp>“We want all the strawberries, to be full ripe, full flavor, with 100 percent sugar in them,” says Saephan.\u003c/p>\n\u003cp>In the past, he would sell the fresh berries at his roadside stand, in the small town of Reedley, southeast of Fresno.\u003c/p>\n\u003caside class=\"pullquote alignright\">The goal is for children to “experience fresh produce and make healthy eating choices over a lifetime.”\u003c/aside>\n\u003cp>But this year, he will sell the bulk of his berries directly to the Fresno Unified School District. He says he is thrilled to share the fruits of his labor with Central Valley students.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We have farmed a long time, but this is my passion, to be farming something that feeds local,” says Saephan.\u003c/p>\n\u003cp>Saephan is the first small farmer to sell his produce directly to Fresno Unified. He could pave the way for other small farmers to begin selling their produce directly with the school district.\u003c/p>\n\u003cp>Jose Alvarado, food services director for Fresno Unified notes that the district is located in the \"produce and vegetable capital\" of the world. “We have been taking advantage of that,\" he says, \"but now it’s taking it to another level, from the farmer, when the occasion is right, and it meets our needs. Strawberries were just a natural for us.\"\u003c!--more-->\u003c/p>\n\u003cp>Alvarado hopes every Fresno Unified student can taste Saephan’s strawberries at their peak. His goal, he said, is for children to “experience fresh produce and make healthy eating choices over a lifetime.”\u003c/p>\n\u003cp>Still, he acknowledged that there are several barriers to linking small farms and large school districts. For logistical reasons, it’s often easier for school districts to buy produce from large distributors.\u003c/p>\n\u003cp>“Some school districts like to work with one company: you go to the grocery store, not the cucumber stand, the broccoli stand, the strawberry stand,” Alvarado said.\u003c/p>\n\u003cp>He said another challenge is that some small farmers are not trained in food safety.\u003c/p>\n\u003cp>“Pao is our first step to truly go to the farm – we have worked with other farmers, this is one where the farmer was lacking all the food safety certifications,\" Alvarado said. \"We’re breaking new ground with Pao, and learning what it takes for him to be certified.\"\u003c/p>\n\u003cp>Despite those barriers, Alvarado said there are many benefits to buying produce, and especially strawberries, from local farmers. Among those is the cost.\u003c/p>\n\u003cp>The district serves about 85,000 meals a day. Alvarado’s goal is for each of those meals to include three or four of Saephan’s beauties.\u003c/p>\n\u003cp>“A locally grown strawberry that we buy from the farmer more than likely will be more cost effective for the district,\" Alvarado said. \"But that’s not the driver.\"\u003c/p>\n\u003cp>Beyond dollars, strawberries are one of those fruits that just taste better when they’re picked fully ripe.\u003c/p>\n\u003cp>“The driver is, fresh products that taste good are more likely to be eaten than products that don’t,\" Alvarado said. \"If they don’t eat it, we’re wasting money.\" Plus fruits and vegetables in school lunches that end up in the trash aren't helping children's overall nutrition either.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Fresno Unified students should start seeing Saephan’s berries on the menu in May.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/11883/small-farmer-in-central-valley-takes-his-strawberries-farm-to-school","authors":["8344"],"categories":["stateofhealth_11","stateofhealth_14"],"tags":["stateofhealth_280","stateofhealth_299","stateofhealth_461"],"featImg":"stateofhealth_11889","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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