Meet one of the ‘cultural brokers’ helping Minnesota’s Karen community access health care

NINA MOINI: Minnesota is home to the largest Karen community in the country. Many are refugees from Burma, now called Myanmar. And cultural differences and language barriers make it exceptionally difficult to navigate the American health care system, which is complicated enough on its own.

To bridge the gap for Karen immigrants and other groups, health care organizations hire professionals who come from the same communities, and they're helping to find health care and other services. M Health Fairview in the Twin Cities has six of these cultural brokers who represent the Hmong, Karen, African-American, Native American, and Latine communities.

Lah Tha Pwee recently joined them as an additional cultural broker working with the Karen community. She herself is an immigrant from Thailand. She joins us now to talk about her role.

Welcome, Lah.

LAH THA PWEE: Hi.

NINA MOINI: Thank you so much for being here. Can you tell us a bit about what you do in your role as a cultural broker?

LAH THA PWEE: Sure. Well, in my role, I do a lot of things for my community. I help my community navigate and understand the court systems, the health care systems, and providing them education on mental health, and where to seek out help, and the benefits of seeking mental health services.

And I help them scheduling just simple appointments to see their doctor or provider. When you can't speak English sometimes that becomes issues.

And sometimes I will accompany them to their appointments if needed. And also helping the community member and parents understand the school systems, like school enrollments and programs the schools are offerings. Different schools have different programming so helping parents understand what the schools are offering.

And I also help with community-- help community connect to benefits, helping them apply to benefits, housing-related issues, and just help fill service gaps as much as possible.

NINA MOINI: Amazing. And I think what the point that I'm hearing from you, too, is that all of these things are related to health, right. Your housing situation, job situation, ability to get around, so this is a really critical role that you're playing. But I bet when you introduce yourself, you don't say, "Hello, I'm here as a cultural broker." So I wonder, how do you approach people in saying, "Hey, I'm here to help."?

LAH THA PWEE: So when I tell them I am working for M Health Fairview, a lot of times people think I work in the hospital settings, and I am not. It's even hard to explain this process to my own parents.

I said-- well, previously, I work at the Karen Organization of Minnesota, and as you know, I recently joined M Health Fairview. I told them, well, I will be working with M Health Fairview now. And they were like, "Are you going to be working as a nurse?" What are you-- what are you doing?

I told them, no, although I am employed by, I guess, like, hospital setting kind of things, I work in the community advancement side, and it's kind of hard to explain that. I told them that I will be doing exactly the same thing as what I was doing at KOM.

But when I introduce myself to my clients, I just say my name is so-and-so, I am employed by M Health Fairview, but I work in partnership with the Karen Organizations of Minnesota. And when I say that, they open up because they know what to do. So they're more open up to me.

I don't say that I'm a culture broker, this is what I do, and stuff like that. I say that, well, I'm here to help, but I'm working closely with KOM. That's what I always say.

NINA MOINI: Sure. And I bet you're seeing more of these crossovers with organizations and health care providers coming together and trying to bridge some of the misunderstandings that could take place. So why do you think your role is so important in the community and roles like yours?

LAH THA PWEE: Yeah. My role is, well, the culture broker roles, I think, it's amazing because there might be a lot of programs and services out there, but it's not like the culture broker. With a culture broker, we are always there for our community member. There are no limits to how long they can be in the program. Let's say once I enroll someone, I might not have to check in on them often, but they can always reach out to me, and I'm always there to assist and support them.

NINA MOINI: Yeah. And I do wonder just, what are some of the cultural differences-- it's probably different for everybody-- that could make health care in Minnesota more difficult, maybe specific to the Karen community?

LAH THA PWEE: I'm sorry. Can you repeat that?

NINA MOINI: Sure. Just wondering, what some of the cultural differences or challenges that you run into might include.

LAH THA PWEE: Well, I would say that our youth who grew up here can adapt easier, whereas our older populations have a harder time. And I will say that-- so 10, 15 years ago, we don't really have a lot of Karen grocery stores so it's hard for my parents to get culturally relevant food. But now, we have a lot of grocery stores owned by Karen people in Minnesota, Saint Paul areas. And I feel like a lot of older parents now have access to culturally relevant food.

NINA MOINI: Yeah. That's great. Yeah, so you're just kind of pointing them in the direction and saying, hey, these resources have grown, they are available, and I can help set you up with that.

LAH THA PWEE: Yes.

NINA MOINI: I know you also mentioned a bit about mental health. Can you talk a little bit about how you see your community kind of struggling with issues of mental health, grief. The opioid crisis has ravaged the entire country. How do you see people in your community that you're helping struggling with this?

LAH THA PWEE: Definitely. Mental health is still a taboo in our community, but many Karen community workers are doing a lot of education on mental health, including myself, where they can go to support-- to seek mental health.

And I have seen-- when I started working as a cultural broker, I have seen a lot of parents starting to open up about their experience, and helping connect their kids to mental health services, but there are still many community members who are reluctant because they are afraid of being labeled. In our community, we don't have a word for mental health issues. We describe mental health issues as someone with heart problems.

And grieving in our community, like, just in general, we don't-- there isn't like something where it could help us cope with grieving or anything like that, but the Karen community, we are very family-oriented, community-oriented. Whenever someone passed away, we go and support their family. We stay with them and making sure that they have everything they need.

So that's what I really like about my community. And a lot of times, a lot of Christians Karen would often seek support from their religious leaders.

NINA MOINI: Sure.

LAH THA PWEE: And that's a way they are coping with their grief.

NINA MOINI: Yeah. I love what you're saying about even sometimes building bridges within someone's family generationally and depending on the experiences of parents and their children, it sounds like it can be a challenging, but I'm sure really rewarding job. What keeps you going in this area of helping others?

LAH THA PWEE: Thank you for the questions. Well, when I came here, my family and I were struggling a lot. Language barriers is one of the big issues. I always have to act as my mother's personal interpreter.

And I'm sure I'm not the only one. I know a lot of refugees and immigrant children's have to advocate for their parents at a very young age. And I remember interpreting from my mom at her bank, when we go talk to our landlord, and even in the laundromat, grocery store. Like everywhere else we went, I have to be her little interpreter, and I also advocate for her. And it-- and I love that I was able to help her and advocate for her, and that just stayed with me--

NINA MOINI: Sure.

LAH THA PWEE: --as I grow up. I didn't-- so right now, I'm going to school to get my MS degree. Back then, I didn't know what social workers are. I have never heard of a social worker, and have never worked with any social worker throughout my high school. But I guess when I got into college, I get to learn about the program-- the social work program, and I feel like that really connects with me, and this is what I wanted to do.

So I have-- so I went to school to get my-- I went to school for social work. And even with my role right now, I feel like cultural broker, we're not social worker, but a lot of the things we do are really the same as what a social worker would do.

NINA MOINI: So it sounds like this is something that you've been doing naturally in your own life, and now you're paying it forward, and that's amazing. Lah Tha Pwee, thank you for coming on and telling us about your work.

LAH THA PWEE: Thank you so much for having me and giving me the opportunity to talk about my role as a culture broker. Thank you.

NINA MOINI: Absolutely. Thank you. Lah Tha Pwee is the newest Karen cultural broker M Health Fairview. We should mention, by the way, that M Health Fairview is a financial supporter of NPR News.