More than Just a Number: How Community Health Workers are Supporting North Carolina’s Most Vulnerable During COVID-19 and Why We Must Continue to Invest in Them
Posted: December 30, 2021

Op-Ed by Andrew Herrera – November 2021

For 20 straight months, we have heard and read more numbers than we comprehend about underserved communities across North Carolina and how they have been disproportionately affected by the COVID-19 pandemic. In May and June 2020 alone, Latinx communities represented 44 percent of the state’s cases, while African Americans made up only 22 percent of North Carolina’s population but accounted for 33 percent of coronavirus cases and 35 percent of deaths. The imbalance only continued in 2021 when at the beginning of this year, only two and a half percent of members of the Hispanic community had received their first vaccine, even though they accounted for 10 percent of the state’s population. 

These numbers, however, represent much more than data. They represent families, husbands and wives, children, and grandparents. They are frontline workers, men and women at the cash register who ring up your groceries and make sure necessities are stocked. Men and women who continue to deliver mail, work in food processing plants and healthcare facilities, fix the roads and potholes that impact our morning commutes, builders and other jobs deemed essential. They do not have the option to work from home and their work cannot stop, because our lives and, most of all, their families’ lives depend on it.

Take Maria as an example. A mother in Charlotte, N.C., who found herself at a loss and alone in the early months of the pandemic. She needed to find a way to put food on her table for the next two weeks. Her 12-year-old daughter tested positive for COVID-19, which meant Maria – a stock clerk at a local grocery store – would not be able to return to work for two weeks. For her family, no paycheck meant no food. As an immigrant from Guatemala, Maria barely spoke English and had little knowledge about the global health crisis that was unfolding around her, or the resources that could support her and her family.

Families, like Maria’s, often fall outside of the healthcare system, a problem that has been amplified amid the COVID-19 pandemic. Combining that with other factors like poverty, racism, immigration, and language barriers, we find a community that has ultimately been forgotten and left out of the conversation. So, as a society, how do we reach these people, earn their trust, and ensure they have the information, resources, and care to survive this pandemic and health crises in the future? We must focus on a community-based approach.

Let me explain. When the coronavirus began to lead nightly news headlines in March 2020, Curamericas Global, a global health nonprofit in Raleigh, activated plans at its project sites around the world that were derived from the organization’s Community-Based, Impact-Oriented (CBIO) methodology. For nearly 40 years, Curamericas has used this approach when partnering with underserved communities to make measurable and sustainable improvements in their health and wellbeing. 

When the pandemic hit, Curamericas was hard at work in Guatemala and Kenya, translating information about the coronavirus into native languages and teaching community members skills that we in the United States often take for granted, like handwashing and social distancing. I mean, how do you translate social distancing into Swahili and Mayan?

Here at home, my colleagues and I started to notice that most of the information we were receiving from local, state, and federal government entities was in all English and not readily available in Spanish. So, we reached out to our partners at the Guatemalan Consulate in Raleigh and, sure enough, they confirmed that they were desperate to get information to more than 15,000 families across the Carolinas that had visited them over the last several years. So, we turned to volunteers and partners who could speak Spanish, developed an online database, collected information from local health departments and gathered resources from across the state. From there, volunteers picked up the phone and started dialing, hoping to get through to individuals in need, like Maria.

 “Hola,” said a stranger’s voice when Maria picked up her phone. In Spanish, the caller went on to explain that he was reaching out on behalf of the Guatemalan Consulate and Curamericas. He wanted to know if he could help answer any questions about the coronavirus and the impact it could have on her family. Sure, Maria had heard heightened conversations about this coronavirus and even seen flyers come through the mail. The problem: they were all in English. 

Now, there was a perfect stranger on the other end of the line, speaking Maria’s language and offering to provide information and resources about this health emergency. Maria broke down, sharing the dire situation she faced and asked if there was anywhere she could turn to for food. After 15 minutes, the caller provided an address and telephone number for a local church that had a food pantry near Maria’s neighborhood. The online database we created allowed him to quickly locate the resource and sign Maria up to receive food for the next two weeks. 

Those volunteers are very similar to Community Health Workers or CHWs. CHWs are trained to go into underserved communities to deliver public health information, but also listen, interpret, explain, pray and, even at times, cry with the families they meet. It is essential that CHWs speak a community’s native language and look like the community that they are serving – as that is often the foundation of the long-standing relationships they establish throughout their work. 

 Soon after the initiation of this phone bank, Curamericas was introduced to North Carolina’s Department of Health and Human Services, which was also focused on a community-based solution to reach the state’s most vulnerable and historically marginalized communities. By August 2020, my team and I were charged with training and guiding more than 200 CHWs across 26 counties to reach these families.

To make this program work, we relied heavily on community-based organizations across the state, leveraging the relationships they had already established. These organizations have been in these communities long before the pandemic, already doing the critical work families so desperately needed, from hosting food pantries to tutoring, advocating for students in schools, and connecting families to vital resources to pay their bills, have transportation to work and so much more. 

However, due to small budgets and staff, red tape and because they are independent of the system, they did not have the support or funding to act quickly in crises, like the pandemic. So, Curamericas served as a bridge between the local organizations and the state. We focused on building capacity for them and providing support for accounting, data collection and new technology. 

In Henderson, N.C., one woman praised CHWs from Gang Free, Inc., who prayed with her day in and day out, for 35 days until her daughter was released from the ICU after battling COVID.

In Durham, N.C., Together for Resilient Youth, also known as TRY, held countless webinars and Q&A sessions so CHWs could speak to members of the community, who were anxious about receiving the vaccine. Hearing from their own community members, in both English and Spanish, helped calm fears and set the record straight on misconceptions. Now, mothers and children are working with CHWs within their own communities to talk with their friends, their families, and total strangers about the vaccine – helping us dispel myths and giving people the courage to get the shot.

Across the state, teams of CHWs were deployed to go into neighborhoods and host events. They understood the culture of those they were trying to help, while also speaking their language. Out of the more than 200 CHWs, 95 percent were people of color, and more than 50 percent spoke Spanish. There is a natural trust because they look like the community that they’re serving, they can communicate with the communities they’re serving and they’re from the communities that they’re serving.

In just six months, our combined efforts resulted in more than 617,000 people receiving education or information about the COVID-19 vaccine, and 12,000 vaccine registrations. Our work does not stop here. Now that they have been trained, Community Health Workers continue to work within their nonprofit organizations to identify and connect underserved families with vital resources, including food, COVID-19 testing sites, unemployment offices, informational updates on vaccine booster shots and vaccine eligibility for children, transportation resources and more. They meet families where they are so they can best understand their needs and connect them to the appropriate resources and open a door to share more about COVID-19.

So, what’s next and how do we get closer to equitable access for all? We must listen. By listening, we become partners. As partners, we can lead others to invest in communities. Listening, partnering, leading, and investing can all result in sustainability. Sustainability goes beyond the pandemic. It’s generational. We can’t stop now; humanity is more than just a number.

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