Medicine and Migration in Minnesota

In this snowy city where once Norwegians and Swedes had their own hospitals, the 446-bed Hennepin County Medical Center (HCMC) currently spends $3 million on interpreters fluent in 50 languages to translate over 130,000 times a year. Minneapolis is home to the largest Somali community in the United States, some 35-40,000. The Twin Cities also have large Hmong and Latino communities, in addition to Liberian, Sudanese, Russian, and most recently Bhutanese immigrants. HCMC has adjusted its practice to better meet the needs of the diverse immigrant population it serves, a community that comprises 20% of its patient base. (Grady, Denise. “Foreign Ways and War Scars Test Hospital”)

Catering to its patient mix, HCMC’s obstetrics unit is now predominantly female, since Muslim women cannot have their children delivered by male doctors. Imams are often consulted prior to medical procedures, such as drawing blood during the month of Ramadan. No questions are asked about immigration status, and indigent patients are offered a sliding-scale fee, though not all can afford even this. Many of these immigrants are refugees from war-torn countries, and their medical care often includes the surgical removal of shrapnel and more difficult treatment of buried pain. Some 47% of women and 25% of men in the Somali community experienced torture (a number extremely high even for refugees), and their care necessarily includes counseling and holistic treatment. (Grady, Denise. “Foreign Ways and War Scars Test Hospital”)

HCMC’s dedication to its immigrant patient population is surely to be lauded. In an economic climate that has hospitals seriously worried about budgets, this Minneapolis hospital is noteworthy in its continued efforts to better serve its community. It is refreshing to see such a positive community response to the new challenges immigration brings; the impact of these efforts at integration and outreach can be seen in the faces of fellow passengers every time one steps on a bus or the Light Rail in this Silver City.

9/11: A Step Forward, a Step Backward

Seven years after the events in New York City, our nation is taking successful baby steps toward integrating a growing number of Muslim immigrants. On this September 11, Gold’n Plump announced a federally mediated settlement for its Cold Spring meat plant here in Minnesota. Gold’n Plump agreed to allow Muslim laborers an extra ten-minute break to accommodate their daily prayer rituals. Additionally, the chicken-processing plant has also agreed not to require workers to sign a statement agreeing to handle pork, a task that is considered immoral in the Islam faith. (Serres, Chris)

Mediated by the U.S. Equal Employment Opportunity Commission, this case sets a precedent for future rulings on a host of similar workplace environment complaints. Here in Minnesota, the large Somali population has been filling much of the manual labor openings in meat-packing plants and other factories. While a ten-minute break might not seem ground-breaking for most Mid-Westerners, for the thousands of Somalis and for the recent surge of Iraqi refugees this is a welcome long overdue. Earlier in the year several workers were dismissed from a Mission tortilla factory in New Brighton for refusing to adopt the dress code of pants and short-sleeve shirts for religious reasons. (Serres, Chris)

In a nation hyper-sensitive to national defense and homeland security, the Gold’n Plump settlement is significant progress towards integrating an entire people group that has so far existed only on the periphery of American culture. As has always been the case, immigrant groups contribute most to a culture and are most satisfied when they have a sense of belonging within their new land. Integration is the best Department of Homeland Security the United States has ever had. Hopefully this Gold’n Plump settlement signals an era when the United States will spend more on English-as-a-Second-Language classes than it does on military translators, a time when America invests more in its immigrant groups than in creating refugees in distant lands, a new beginning when integration trumps deportation or criminalization as our policy towards newcomers to the American dream.

Sadly, that day is not yet here. In another breaking news item this past week, a prostitution ring was broken up in Austin, MN. Keila Villanueva and Miguel Isep-Roman, both American citizens, ran a brothel and a prostitution ring in Austin and the Twin Cities (Ruzek, Tim).  As is so often the case, the prostitutes were illegal immigrants coerced into selling themselves for money and continued secrecy. While Somalis moved toward a fuller integration in American life this past week, extralegal workers are still living lives of secrecy, still susceptible to being manipulated by corporations trying to save a few dollars or people who see them as a means to an end. As long as public policy continues to hold out no hope for extralegal immigrants to work towards citizenship, we will still have millions of people living without basic human rights. They will work in our factories and our fields, in our brothels and night clubs, not because of lack of experience or potential but merely because they lack some papers. This should not be.

The First of May – the International Day of Workers for Everywhere but the U.S.

Yesterday was the first of May.  In the United States, the day would have passed like any other Thursday.  I would have gone to school, taught my immigrant students English as a second language, and would have returned to my house to lesson plan and prepare for another day´s work.  Here in Santiago, however, May 1 is an important holiday.  Not only does it mark the Ascension of Christ – it also is the day to celebrate workers all around the world.  All across Europe, this day is remembered, but here in Galicia El Dia de los Trabajadores is an important festival, all the more important now that immigrants have internationalized the Spanish workforce. 

The narrow cobbled streets here in Santiago are teeming with people, but it is hard to pay them mind.  Vendors are standing in their doorways, offering passersby free samples of the traditionaly Galician almond cookie.  Gaelic bagpipe bands march through the streets, their beautiful music reverberating off the ancient facades of Santiago´s downtown.  I am fortunate enough to witness a traditional Gallegos dance, where the men jig around women who balance a giant loaf of bread upon their heads.  The symbolism for the working class is clearcut, yet hauntingly beautiful – it would do the United States well to have a dance on MTV celebrating life´s simple gifts of our daily bread and friendship.

Above the plaza, the park is full of people.  Pulperias sell grilled octopus, churrerias hawk tasty churros in chocolate, and gitanos advertise their carnival rides to anyone who will listen. It is a veritable sea of people, a river of workers celebrating their collective productivity and diversity as they chomp on cotton candy and ride kiddie rides.  Atop the ferris wheel, I view the entire 100,000 people of Santiago from a vantage point on par with the highest peak of the Saint James Cathedral.  It is easy to be filled with awe when one stops to think about the magnitude of so many life-works going on right now, and I rededicate myself to advocating for the migrant workers who hope to contribute their life´s work to a new country.

The mass at La Cathedral de Apostolo Santiago de Compostelo is stunning.  It is part holy, part bazaar.  Hundreds and hundreds of people mill around the main wings of the church as the various priests conduct the mass.  Dozens of confessional booths are set up for busy workers to confess on this rare weekday holiday.  A red light above the booth intimates that a priest is ready and waiting to listen.  The interior of the church is amazing.  Gold, which must have taken thousands and thousands of workers´tithes to purchase, is shaped into the most impressive angels and saints and Saviors.  Granite walls echo the message of the Father, and the massive double-breasted organ takes up two entire walls.  When those pipes are filled with the liturgy, it is impossible to ignore the Spirit. 

During the service, I meander behind the cantors.  In the background of the priests, there is a passageway which crosses behind a figure of Jesus.  In keeping with tradition, I give him a quick abrazo like so many millions before me. After this warm hug, I pass beneath the cathedral into the crypt where James the Apostle is believed to be buried.  It is cold, stony, and I pray quickly before leaving. 

For the communion prayer, the ancient priest invites several other priests to say prayers in their language.  It is beautiful to hear bequests to God in Spanish, Gallegos, Italian, German, and French.  The priest closes these prayers by stating that God knows the language of our hearts; every worker in the crowd nods with understanding at this.  Watching the people take communion, I see pilgrims who have walked over 100 miles to finish here at the cathedral in Santiago. I see persons who are obviously staying in the finest hotels, and local workers who have not had a holiday in ages.  I see devout women who remind me of my grandmothers, and proud fathers similar to my own. 

The service finishes with a trademark tradition.  As a traditional zither plays music, 5 priests maneuver a long rope which runs up to the very top of the cathedral´s spire.  A holy incense box swings back and forth, gaining momentum like a kid arcing heavenward at the schoolyard.  The aroma of prayer wafts over the crowd, all of whom snap pictures as if the incense container were a death-defying trapeze artist.  Incense everywhere, all the workers looking up, music harmonizing to the sounds of people praying – every one of us is overwhelmed.  Whether this is the last thing a peregrino pilgrim will see on their Camino de Santiago, or this is merely the capstone of the International Day of Workers, it is a memory which will always mark the first of May for me.  How overwhelming, to think of workers the world over clinging to faith in order to derive meaning from each day´s labor.  From Santiago to San Francisco, from the twin cities of Brownsville and Matamoros to the Twin Cities of Minneapolis and Saint Paul, my heart goes out to immigrants working thanklessly, yearning for recognition of their work and their lives, longing for basic rights and hope of citizenship.  When next I celebrate the International Day of Workers, I pray that we all will have done something more for the voiceless workers of our world.