RICHMOND, Va. (AP) — In the 15 years that followed the 8,641-mile journey from Chennai, India, she still leaned in a little closer. Maybe asked someone to repeat their question just once more or turned toward her son to make sure she understood the words of a second language she began learning at age 55.
Maliswari Saravanabhavudu, 70, had made peace with that hurdle. Then the pandemic unfurled and made her age a liability.
Reading English and navigating technology became central to accessing COVID-19 information, signing up for a vaccine and receiving email links to book an appointment.
As a retired office assistant at a state-run electricity company, she knew her way around a computer. It’s how she spent hours entertained by celebrity interviews on YouTube and searching for online sewing classes in between juggling grandkids and that night’s dinner.
This was different. When Virginia dropped eligibility to residents ages 65 and older, Saravanabhavudu did what she had to do. The appointment link didn’t come until Henrico County community health workers stepped in, reserving her a slot in an upcoming immigrant and refugee clinic offering among the hardest-to-reach populations another chance at receiving a dose.
Within a month, Saravanabhavudu became one of the 100 soon-to-be vaccinated names printed weekly.
On a recent afternoon, Elham Khairi held the list in one hand and draped a blue-tinged scarf from her home country of Sudan around her shoulders with the other.
“Ah yes,” she said, tapping the clipboard with an uncapped pen and pointing toward the name of someone coming in an hour. “This one has stories to tell.”
A community health worker, Khairi spent her days listening to them. She knew, as only an immigrant could, the ache of leaving a country they love so deeply and having only the memories. The release of sharing the stories they cling to so they don’t forget. The urge to ask for some help while adjusting to a life thousands of miles from home.
Checking in on those afraid to reach out became all the more crucial in a pandemic where jobs worked overwhelmingly by immigrants and refugees were hailed as “essential” and exposure to a lethal virus only worsened.
What she heard most was a need for reliable coronavirus information and access to the vaccines. That was the weight of the 100 names Khairi looked at: her quiet vow to not let them down.
“We save them, we save everyone,” Khairi said.
She peered around at the immigrant and refugee vaccine clinic made possible through the community her and her team — her “rockstars” — built over years of door-to-door house calls, supermarket and laundromat visits and church services where they became trusted faces in Richmond and its surrounding counties.
The events prioritized people with language and transportation barriers and difficulties navigating the pre-registration process, and vaccine recipients hailed from India, Bosnia, Republic of the Congo, Nepal, and dozens of other countries.
The bigger clinics were great for those who can access them, Khairi said. This was an alternative for the people who have struggled to.
Its location is not made public to avoid overwhelming the small space or risking walk-ins they can’t take.
Unlike mass clinics, each vaccination takes place in the same individual rooms many newly arrived immigrants and refugees in the Richmond area have received their immunizations. Brenett Dickerson, a public health nurse who runs the clinic, dashes back and forth, directing volunteers, guiding residents to waiting rooms and handing out snacks before joking with Khairi that she would likely eat them all if no one were looking.
In the three months since vaccinations began, that has been Dickerson’s routine: telling people coming in not to worry. Letting them know someone cares.
Statewide, nearly 1.1 million people were born outside of the U.S. More than a third are from Latin America, nearly 42% from Asia and about 11% from Africa, according to figures compiled by Virginia’s Department of Social Services. At least 180 different languages are spoken, and more than half are U.S. citizens.
Disaggregated COVID-19 data that extends past gender, age, race and ethnicity is largely unavailable across the U.S., making it impossible to know the extent of the pandemic’s impact on immigrants and refugees. But public health officials have tied the level of risk to workplaces, including hospitals, COVID-19 units and other frontline healthcare industries, language barriers and limited access to medical care that’s historically overlapped with immigrant populations.
“They will be the one who bags your groceries in the store. They are the ones who deliver your Uber Eats. They are the ones maintaining your house,” Khairi said. “They are the ones in your daily life as you have the privilege of staying at home and don’t have to be on the front line.”
As her voice trailed off, two residents with their arms linked locked eyes with Khairi and grinned behind their masks.
“Thank you,” they whispered.
In immigrant populations, word-of-mouth tactics have led to misinformation stating that vaccination centers like the one in Arthur Ashe Center take walk-ins — they don’t — and prompted some to show up and be turned away.
With state and federal websites not always having proper translations for languages outside of English and Spanish, the chances of false rumors circulating have heightened.
The statewide call center with more than 100 languages didn’t launch until two months after vaccinations began, and the Virginia Department of Health translated its flyer to the state’s top six spoken languages besides English in recent weeks.
Outreach workers stationed across Richmond and vaccine clinics in its surrounding counties have watched for these incidents and approach residents if they hear an accent. Then they connect them with the immigrant and refugee clinics.
Shubhi Soni, who normally conducts staffing and training for VDH’s major sites, listens for the last names. Patel and Shah are common ones for convenience store owners in the Richmond area, Soni said, and a decent indicator that they speak Gujarati, one of four languages spoken by Soni and more than 50 million people with origins in western India.
With Soni — and health workers like Khairi — embedded in their communities, there was one less language roadblock. One more person to dispel misinformation.
In these clinics, vaccine recipients can bring a family member or friend and interpreters are on call in case their language wasn’t one spoken among staff. Khairi said with the knowledge on staff, there’s rarely been a need to use it.
Next was tackling technology.
Soni developed a system to manually register immigrants and refugees into spreadsheets shared with the outreach teams monitoring and running the clinics, removing the stressor for residents who experience trouble getting the pre-registration process to work.
After receiving the first shot, community health workers ask for best contact and dates for the second round at the same location. The information later gets sent to the state to document and track vaccinations.
The stand-in removed the uncertainty of not knowing what comes next, Soni said.
Saravanabhavudu sat on the gray fabric chair in her pink-sequined blouse, counting down the 15 minutes until her newfound freedom, and a chance to soon hold her 90-year-old mother in India once it’s safe to travel long distances.
She smiled at the idea before walking toward the exit, where public health workers rang the bell to cheer on her fully vaccinated status. Some whistled in celebration.
After a year of grit and despair, it was a welcome sound.