Qiu qi Li and his wife Mei zhen Dong knew it was important for them to take care of their health. But the couple knew little about how to access services in their local community that could save their lives.
For example, the Lis were unaware that free cancer screenings were available to them at Christiana Care’s Helen F. Graham Cancer Center. The center is one of the first National Cancer Institute Community Cancer Centers Program-awarded sites in the United States. It also is only three scant miles from Golden Palace in Newark, the Li-owned restaurant.
Like other Chinese Delawareans, language and cultural barriers hindered the Lis’ ability to access cancer services available in their community. In fact, it was not uncommon for Chinese Delawareans to travel as far as Chinatown in New York City to access the same live-saving screenings that are available only a few miles from home.
Fortunately, Xiangfen “Fen” Gu is helping the Lis and other Delawareans of Chinese descent overcome these challenges. After moving to Delaware from Nanjing, China, two years ago, Fen has been scouring New Castle County—from the streets of Wilmington to the strip malls of Middletown—for Chinese eateries. She’s visiting those restaurants not to eat, but to educate.
“Most Chinese people don’t go to the doctor until they feel bad,” Fen says. “And when they work at restaurants, they’re very busy and often have no insurance.”
So Fen goes to them. Her position was made possible by a grant from the National Cancer Institute with funding from the American Recovery and Reinvestment Act of 2009 (ARRA)—also referred to as the “stimulus” bill.
After she visited the Lis, the couple took preventive steps to undergo screenings through the Screening for Life program, a cooperative effort of the Delaware Division of Public Health, the U.S. Centers for Disease Control and Prevention and health institutions such as Christiana Care.
Mr. Li underwent a colonoscopy, which turned out to be a lifesaver, as the test caught several polyps that he subsequently had removed. On the insistence of Fen, Mrs. Li underwent a colonoscopy, a Pap smear and a mammogram. Fen even accompanied Mrs. Li during her breast cancer screening and explained the procedure to her in Chinese.
“You are doing such an important job for people that don’t speak English,” Mr. Li said through a translator. “We are very lucky to have Fen.”
One of the major priorities of NCCCP is to serve communities disproportionally affected by cancer due to historic barriers. For some minority populations, that can mean publicizing screenings in neighborhoods where people live. The effort is more of a challenge with the Chinese community, which tends to be loosely-knit in Delaware.
They tend to be spread out across the First State instead of clustered in a handful of neighborhoods, so Fen’s effort has focused on restaurants and churches, temples and other places where Chinese people gather to work or worship.
Christiana Care’s effort to bring the education and information directly to the people—no matter where they are living—reflects the health system’s commitment to reaching out to neighbors in underserved communities, says Nora C. Katurakes, manager, Community Health Outreach and Education.
For example, a Christiana Care event in November at the New Castle Chinese Evangelical Church provided to 48 women information about breast cancer screening. On one Friday each month, members of the outreach team visit the New Castle Farmer’s Market, on U.S. Rte. 13, where a considerable number of vendors are Asian. And on March 10, a health fair reached more than 65 people at the Chinese American Community Center in Hockessin, where 50 individuals were screened for cardiovascular disease and bone density.
“If you don’t have a place where people congregate,” Katurakes says, “they’re not going to get the information. And if you go to an event and are told you need to do something, you’re not going to just go run and do it. … It’s a prevention model. People need to take time to process—to say, OK, do I need to do this or not.”
Fen’s success in helping local Chinese residents has prompted Katurakes to describe her as a “godsend.”
Fen already has shared information with more than 300 people. She approaches her job, which will continue through June under ARRA funding, with a determination that has led her to pull into every strip mall she notices. (There almost always is a Chinese restaurant in strip malls, she notes.) She began preparing with online searches, using GPS to augment what she finds.
Addresses and phone numbers sometimes lead to dead ends, so the effort at times can seem like a scavenger hunt. She takes notes at each stop and jots on a takeout menu what the people there need— say—one mammogram, two pap smears and a colonoscopy. For those who are not receptive to her visits—some mistakenly think she’s trying to sell insurance—Fen follows up.
On a recent Friday afternoon, Fen’s mission brought her to the business of Su Ru Chen and her husband Chong Shu Su on Philadelphia Pike, Unique Chinese and Japanese Restaurant. It was the 88th Chinese restaurant Fen had visited.
Chen, 33, sat with her over a couple of bowls of rice and pork at one of three tables inside the small storefront. On the table were a small assortment of medical brochures and a model of a breast. Fen showed her how to perform a self-examination for breast cancer. It was Chen’s first exposure to the simple and potentially lifesaving measure.
If someone like Fen had been available for one of Chen’s grandmothers, the restaurateur said, her cancer might have been discovered during a screening, not in response to swollen legs. By then, Chen said, it was too late.
“If there were no such person as [Fen],” Chen said, through a translator, “we wouldn’t know [Christiana Care] was here.”
Today, Fen continues to trace the roads of a state with which she still is familiarizing herself. At each restaurant and church she enters, a smile accents her Mandarin greeting. By the time she leaves, the people she has met have learned what is available not three hours away in New York, but in their own adopted state.
Photo gallery: Health fair at Chinese American Community Center, Hockessin, Del.
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