My Love Fast

I started a fast today to stand in solidarity with people across the nation to move for reforms to the nation’s immigration laws. I was moved to action when I first came to Arizona. Fell in love with the place. Was in love with my new husband. I had just left my family. Was content to discover a new place. I started to know about the deaths in the desert immediately. I was a student of human rights! I started to go to the frontera frequently. Mostly I wanted to help. Didn’t know how or what, but I went. The early images for me were of seas of migrant people waiting to be delivered. And I mean literally waiting to be delivered across the border from the US to Mexico. I can never forget, and will always remember the wounds on people’s feet. Torn and bleeding. Skin, flesh, and bone. I took pictures to a national public health conference, and received attention and good conversation with other activists. Was even hit on in the worst way. I felt that I was delivering a message to the nation’s best public health minds. Surely, once people saw the pictures I had, and that it was happening on American soil, they too would be galvanized and we would build a public health work force to solve this humanitarian crisis.

I guess it was the wrong crowd at the wrong time. I found my kindred people on the frontera. Those who made it their work to be in service always. Everywhere. So on the frontera, I sit with people, serve food, ask how they are feeling and ask about their feet. Nurses hustle in the medical unit corridor to wrap feet with mole skin. Dangerous wounds that are also deadly. A diabetic woman with skin torn from her heels expressed how she really didn’t know she would be walking in the desert like that. She said she would never do that again. Actually, the realities that the great many faced were not far off from those they imagined. To prepare, women bought birth control for the journey, just in case. Children found themselves alone in the darknesses of the desert. Wandering a border that was not even in between countries they knew anything about. Even those of us who love it, traverse only willingly. I got the sense that not everyone was willing. Kind of like in some public health initiatives.

On the opposite side of the aid station, a parking lot made of dirt threw around dust from about 100 people waiting to give “rides” to the migrants. They weren’t taxis. Also in that small space of the aid station, coyote parking lot, fence, buses of migrants, we had the luck to have the National Guard, Border Patrol, Mexican Police, and the Federales, all surrounding the 400 or so migrants who walked back into Mexico with bleeding feet.

The public health force never materialized. My plans changed.

Today I fast in solidarity with over 170 Asian American and Pacific Islander people and families to move our nation toward a just system of law, humanitarian protection, and rights for migrants and all those who seek life elsewhere. I am proud to represent the entities that I work on behalf of: Asian Pacific Community in Action, the National Asian Pacific American Women’s Forum, Health Through Action Arizona. And for all Arizonans – we could have changed this earlier. Don’t stand down now. Arise.

National Asian Pacific American Women’s Forum napawf.org
NO More Deaths nmd.org
Humaneborders.org
Asian Pacific Community in Action apcaaz.org
Health Through Action Arizona htaaarizona.com
AIM for Equity facebook.com/aimforequity
National Council of Asian Pacific Americans – ncapaonline.org
We Belong Together webelongtogether.org


Zeenat Hasan, Health Through Action Director
Asian Pacific Community in Action

Moving on . . .

Dear Friends and Colleagues,

I am writing to inform you that I have accepted the position of Associate Director for the ASU Southwest Interdisciplinary Research Center (SIRC). My last day at APCA will be July 19th. While I am very excited to be joining a nationally recognized research center, I will also miss being centrally involved in the ambitious enterprise known as the Asian Pacific Community in Action.

I have relished my seven years with APCA. Through the good and the tough times, the work of APCA has never been less than a labor of love for me. I take great pride in the fact that we have become a highly respected and nationally known Asian American and Pacific Islander (AAPI) health organization in the course of just a few years. More importantly, we have provided educational, clinical, and referral services to thousands of AAPI community members – a good number of whom are living longer and healthier lives due to our work. In addition, we have taken a leadership role in involving the AAPI community in the political decision-making process through our Health Through Action Arizona coalition, and we are continuing to test social enterprise approaches through our Bridging Cultures language access program.

I want to thank our Board of Directors for their support throughout my tenure as Executive Director, particularly Dr. Albert Celoza, whose thoughtful guidance and encouragement as Board President has made a great difference in my work at APCA. Most of all, I thank the dozen or so people who have served as APCA employees since I began work in July 2006. These individuals, particularly the six current staff members, have honorably and passionately represented APCA on a daily basis. Moreover, they have patiently weathered fluctuations in our operating resources with nary a complaint and have still managed to put the needs of the community above their own. I could not have asked for better company on my journey. 

Speaking of good company, I also want to thank the many individuals and agencies that have become APCA partners over the past several years. This includes our friends at the state and county health departments, other non-profit organizations, academic partners, health care providers, foundations, colleagues at AAPI health organizations throughout the country, our volunteers, and others too numerous to reference here. I will greatly miss the interactions found among like-minded people interested in serving the greater good.  

However, it is time for me to start a new chapter in my professional life. Having spent a considerable amount of time in the government and non-profit sectors, I hope to bring what I’ve learned to the critically important work of health disparities research. Just as APCA allowed me to more fully explore my Asian ethnicity, I expect my time at SIRC to allow my academic interests to blossom. 

However, this is not goodbye. From my perch at SIRC and through personal interest, I plan to stay involved in addressing the many challenges facing Asian Americans, Pacific Islanders and refugee communities in Arizona. Indeed, my time at APCA has firmly convinced me of the deep truth in Margaret Mead’s well-known quote: "Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has."  As APCA Executive Director, it has been my privilege to work shoulder to shoulder with many, many people to help change our little corner of the world, and I look forward to continuing the fight.

Please stay in touch. At SIRC, I can be reached at (602) 496-0700, or for the time being I can be reached by email at doughir@msn.com.

Regards,

Doug



Doug Hirano, MPH, APCA Executive Director

Cambodia Revisited

I’m just back from a three-week volunteer assignment in Cambodia. I can honestly say that I have a different worldview based upon this experience. Please check in on my travel blog, http://dougincambodia.wordpress.com, to read about my experiences and see some photos. 

- Doug Hirano, MPH, APCA Executive Director

APCA Attends Obama Speech on Immigration Reform

Last week I had the opportunity to attend a major speech by President Obama at a high school in Las Vegas. The speech outlined the pillars of the President’s vision for immigration reform. What most impressed me was not necessarily the substance of his speech (a bipartisan group of Senators had preempted him by issuing a largely similar immigration reform plan the day before) but his style and communication skills. Sitting no more than 40 feet from him (VIP seating – thanks to the Asian Pacific Islander American Health Forum), I could immediately see that he has an innate charisma and an ability to powerfully connect with his audience. I think everyone could sense his passion and dedication to the issue of immigration reform. In addition to outlining his immigration plan, he introduced an audience member who had received a deportation deferral through the President’s Executive Order. This served to put a human face on the issue of immigration – very smart. 

Click here to see a video of his speech. For those with eagle eyes, note that at 23:49 of the speech, I am pictured sitting on the far left of the screen as President Obama talks about the audience member. I happened to be sitting next to two colleagues: to my right is Jeff Caballero, Executive Director of the Association of Asian Pacific Community Health Organizations (AAPCHO), and to his right is Pier Simeri, Community Relations Director, City of Avondale.  
      

- Doug Hirano, MPH, APCA Executive Director

Citizen Who

What is it to be an American? To what does being an American citizen obligate us and entitle us? Eric Liu – actor, musician, attorney, and author – examined these and other questions in a one-man show at the Scottsdale Center for the Performing Arts last week. The sold out show (I arrived too late for a seat) was videotaped and is archived for viewing here.  Particularly for Asian Americans and other immigrant populations, watching this performance is time well spent. The show was sponsored by Zocalo Public Square, a project of the ASU Center for Social Cohesion and the New America Foundation. 

- Doug Hirano, MPH, APCA Executive Director

In the rear view mirror: 2012

The year 2012 was our 10th anniversary – a time for reflection and celebration. We are proud of our progress in the past ten years and looking forward to unprecedented work in the next ten years. However, from a budgetary standpoint, 2012 was a year in which the recession and budget cuts finally caught up with us a bit. We were fortunate to add some short-term contract work conducting community assessments and a multi-year contract through the Kids’ Health Link program of the Children’s Action Alliance.

I am grateful to our staff members for their passionate and productive work on behalf of the Asian American and Pacific Islander communities in Maricopa County. Behind the scenes, they touch the lives of thousands of AAPI families and individuals every year. In addition, our board of directors continues to provide sound leadership and organizational support. Our volunteers, partners and supporters deserve much credit as well.

I think 2013 will be an exciting year. We have some exciting grant proposals currently under review, and we are in discussion about some other new opportunities. However, before we leave 2012, I thought I should provide a quick synopsis of some of our achievements for the year: 

Research and Assessment 

• Conducted a comprehensive community health assessment of north-central Phoenix on behalf of Desert Mission

• Conducted focus groups and a community survey for the REACH (Racial and Ethnic Approaches to Community Health) project of the Arizona Department of Health Services

• Disseminated more than 1,500 copies of “State of Asian Americans and Pacific Islanders in Arizona, Volume 2: Health Risks, Disparities and Community Responses” 

• Initiated a Social Baseline Survey of three Arizona mining communities in conjunction with EPG and BHP Copper, Inc.

• Established a Scientific Advisory Committee to provide consultation and technical assistance to APCA on scientific program, policy and research matters

• Published an article in the journal Progress in Community Health Partnerships on the status of Asian American and Pacific Islander health research

Community Organizing and Engagement
 

• Continued “Health Through Action Arizona” activities, including dissemination of the policy blueprint and conduct of “Know Your Rights” language justice workshops to more than 300 community members

• Four APCA staff members completed “Connect to Power”, a year-long advocacy and leadership training sponsored by St. Luke’s Health Initiative

• Helped establish a new community wellness coalition in south Phoenix known as “Cultivating South Phoenix”

• Participated in the development of the Arizona Smoke Free Living (ASFL) coalition, which is focusing on establishing smoke-free multi-unit housing facilities in the Phoenix metropolitan area

• Participated in a bipartisan coalition that developed a national platform for immigration reform known as “SANE”

• Collaborated with the Asian & Pacific Islander American Health Forum to help create a new nationwide AAPI health advocacy network known as “AIM (Advocate, Impact and Mobilize) for Equity”

• In partnership with other community-based agencies, held a voter registration drive within the AAPI community

Community Education and Services
 

• Presented a play about suicide prevention called “Quiet Cries”, which was attended by 80 community members

• Published articles on the importance of hepatitis B screening among Asian Americans and Pacific Islanders in journals of the Arizona Medical Association (Arizona Medicine), the Maricopa Medical Society (Round Up), and the Pima County Medical Society (Sombrero)

• Established the availability in Arizona of smoking cessation telephone counseling in Chinese, Vietnamese and Korean through the California-based Asian Quit Line

• Joined Kids Health Link, a coalition that enrolls families into the AHCCCS and KidsCare programs and also continued to assist AAPI community members in receiving services through local community health centers

• Coordinated free diabetes and cardiovascular disease screenings in a variety of community settings to more than 250 individuals

• Provided free hepatitis B testing to 262 individuals and participated on the national CDC viral hepatitis campaign steering committee

• Added new contracts for medical interpretation through the “Bridging Cultures: Connecting Lives through Language” program, trained more than 20 individuals in medical interpretation, and assisted hundreds of patients in receiving in-language medical care

• Educated more than 400 community members regarding breast cancer prevention and referred more than 100 women for low-cost mammograms and pap smears

• Recruited more than 40 community members to participate in emergency preparedness exercises and trainings coordinated by the Maricopa County Department of Public Health

Other
 

• APCA executive director was selected as a 2012 Virginia G. Piper Fellow

• Held a “Taste of Asia” 10-year anniversary fundraising dinner, with 300 attendees

• Served as featured speakers at the following workshops and conferences: 

• 10th Annual Conference of the ASU Southwest Interdisciplinary Research Center 

• 23rd Annual Conference of the National Adult Protective Services Association

• Social Determinants of Health workshop, Arizona Department of Health Services

• ASU Trans-disciplinary Training for Health Disparities Science Seminar Series "Social Determinants of Health: Service and Policy Implications” - ASU Center for Applied Behavioral Health Policy

- Doug Hirano, MPH, APCA Executive Director

Regular physical activity: better than an apple a day?

A new study provides further evidence that a physically active lifestyle can extend the quantity and quality of life. The study found that there was a gain in life expectancy of 3.4 years for individuals who averaged 150 – 300 minutes of physical activity per week – when compared to individuals with no regular physical activity. Study results applied to individuals 40 years of age and older.  Similar results in a study in Taiwan suggest the longevity benefits are transnational and cross cultural. Importantly, physical activity provided a benefit for individuals across the spectrum of body mass index, meaning that even obese individuals could expect to see some life expectancy gains with regular physical activity.  Click here for a link to the study.

- Doug Hirano, MPH, APCA Executive Director

A true American hero

On the eve of Election Day, we can all use a reminder about the preciousness of the right to vote in this country. Click here to read about a 93-year-old World War II veteran diagnosed with terminal cancer whose last act as an American citizen was to cast an absentee ballot in the upcoming election. Mr. Frank Tanabe passed away a week after the photo was taken. This story is for those of us who need a little extra encouragement to go to their polling place and vote.



- Doug Hirano, MPH, APCA Executive Director

New APCA Scientific Advisory Council

The APCA Scientific Advisory Council is off and running. The Council met for the first time on August 29th. This new council was established to provide advice to our organization on all issues of science. This will include review of written documents such as screening protocols and grant proposals. It will also include consultation on specific scientific or medical issues as they arise. We have put together a world-class group of scientists with expertise in women’s health, mental health, oncology, gastroenterology, medical anthropology, nursing, epidemiology, clinical research and health promotion. Here’s a list of our members and their affiliations:

• James Campbell, MD (chair)
• Heyoung McBride, MD, Arizona Oncology Services
• Linda Larkey, PhD, Arizona State University
• Mark Wong, MD, Banner Samaritan Medical Center
• Tim Flood, MD, Arizona Department of Health Services
• Angela Chen, PhD, Arizona State University
• Jennifer Weil, MD, National Institutes of Health
• Wendy Astudillo, NP, Phoenix Veterans Affairs Health Care System
• Seline Szkupinski-Quiroga, PhD, Arizona State University

Our first meeting was focused on getting to know each other and providing an introduction to APCA and its work. We had a preliminary discussion about diabetes screening and prevention and the need for tracking short-term outcomes to measure impact. Thanks so much to Dr. Jim Campbell for his willingness to chair this group. We plan to meet again in November and have more focused discussions on issues affecting the health of Asian Americans and Pacific Islanders in Maricopa County.

-Doug Hirano, MPH, APCA Exceutive Director

A Fatal Miscommunication

On early Friday morning, June 15, 2012, Mai Vo Bor, 37, and her elderly Vietnamese American parents were in a car heading west on the I-10 near Tonopah, about 50 miles west of downtown Phoenix. They were returning from a vacation in California. For some reason, they exited the freeway at 411th Avenue and were involved in a single-car accident about a half-mile off the freeway. The accident resulted in minor injuries to the parents and disabled the vehicle. Ms. Bor left her parents with the vehicle and went to seek help. Tragically, her body was found a mile from the accident scene later that same day. The Maricopa County Sheriff’s Office is still trying to determine if her death was due to exposure, injuries sustained during the accident, or perhaps foul play. Results of an autopsy are pending.

Myself, I don’t need to see a copy of the autopsy report to know the real cause of her death. It was not exposure, accident-related injuries, or foul play. I believe that Mai Vo Bor died due to a language barrier. Sheriff’s officers admit that they could not communicate with her parents because they spoke Vietnamese only. Had they been able to communicate with Mai’s parents, the officers would have almost certainly learned that Mai was on foot somewhere in the vicinity seeking help. Instead, the officers cleaned up debris from the crash, cleared away the disabled vehicle and transported Mai’s parents to the hospital, leaving the 37-year-old woman alone in the desolate area.

It was only later that day around 3 pm that an interpreter at the hospital learned from Mai’s parents that Mai had also been involved in the accident and was still missing. A search team found her naked body a few hours later.

Now, there are many unanswered questions related to this tragedy. Why did the family pull off of I-10 at Tonopah? What caused the single-vehicle accident? What was her time of death? Why was she found unclothed? There are probably a dozen other questions of interest to the investigation. However, I would argue that the most important question is this: Why did the officers not communicate with the parents at the scene of the accident? Do officers have access to remote telephonic language interpretation services? If not, then why not? If so, why did the officers choose not to utilize the system to interview the parents?

This is not to place blame on the Maricopa County Sheriff’s Office. But it is important to emphasize that Asian Americans are the fastest growing racial/ethnic group in Arizona, and 40% are of limited English proficiency. Language access is critically important in the kind of emergency situations faced by our public safety officers on a daily basis. Personally, I hope that Ms. Bor’s death will not be in vain and that the Sheriff’s Office and other government agencies will review their policies, protocols and systems around language access to ensure that all Arizona residents, regardless of language spoken, have equal and expedient access to high quality public services.  It can be the difference between life and death.

- Doug Hirano, MPH, APCA Executive Director

The Loudest Duck Gets Shot: Why Asian Americans are Dying in Silence

A few weeks ago, I had a chance to make a presentation at the Arizona Department of Health Services regarding Asian American health disparities. Thank you to the Arizona Health Disparities Center for inviting me to speak and for coordinating this series of workshops around social and racial/ethnic inequalities in health.

I titled my workshop “The Loudest Duck Gets Shot: Why Asian Americans are Dying in Silence.”  My contention is that a “perfect storm” of factors continues to compromise the political effectiveness of Asian Americans in this country and that the result in at least one case (chronic hepatitis B infection and liver disease, which disproportionately impact Asian Americans) is that Asian Americans are dying unnecessarily.

The “perfect storm” begins with a cultural disinclination to make waves (“the loudest duck get shot” is a Chinese proverb) and a proclivity towards “face-saving” (keeping problems within the family). In my mind, these tendencies continue to allow the “model minority” to also be the “invisible minority”.  Elected officials and government don’t hear from their Asian American constituents, and not surprisingly, little gets done to address a preventable health problem like hepatitis B infection, which is killing Asian Americans on a daily basis.  

Another factor has an historical context. Asian Americans, like other people of color in this country, have a longstanding history of being oppressed and disempowered. For Asian Americans, this marginalization began not long after their entry into this country – beginning with the 1892 Chinese Exclusion Act and culminating in the 1924 Asian Exclusion Act, which for 40 years essentially halted all Asian immigration into the United States. To this day, many American-born Asian Americans are asked, “Where are you really from?” as if we are less than real Americans. Dr. Frank Yu coined the term “perpetual foreigner” to describe this state of marginal Americanism. It’s harder to impact the outcome of a game if you’ve been relegated to the sidelines. 

There are other important factors. Asian Americans are a very diverse group, constituting peoples from the Far East, Southeast Asia and South Asia – many of whom literally don’t speak the same language and some of whom are historically bitter enemies. Building political solidarity among such diverse groups can be challenging at best.

My point is that Asian Americans need to be better organized and more vocal to address their own policy and systems related needs. In this country, “the loudest duck gets fed.” So, again using hepatitis B as an example, in addition to fighting the good fight and trying to scrape together resources to conduct hepatitis B education and screening among Asian Americans (working within the system), we also need to put a spotlight on and work to redress the inequities in overall hepatitis B funding (working the system). HIV/AIDS advocates learned this lesson decades ago, and that is largely why federal HIV/AIDS funding dwarfs viral hepatitis funding (even though far more Americans are infected with hepatitis B and hepatitis C, and far more die from these infections). I would venture to suggest that their advocacy, which resulted in a steep increase in federal investment in terms of HIV/AIDS prevention, screening, treatment and research, has saved hundreds of thousands of lives in the meantime. Asian Americans with hepatitis B infection deserve no less – but we must organize and speak up.

I’ve placed my workshop slides here on our website if you would like to view the full presentation.


- Doug Hirano, MPH, APCA Executive Director

The Weight of the Nation

On May 14th, HBO will be premiering a new a series called the “Weight of the Nation”. The focus of this series is on the epidemic of overweight and obesity in this country.

One of the key themes in this series is that the physical and social environment in which people live has a lot to do with their risk of becoming overweight or obese. This is counter to the idea which suggests that obesity is largely an individual problem related to discipline, willpower and personal responsibility.  

In anticipation of the series premiere, the Washington Post has published a brief interview with one of the series’ primary contributors, Marlene Schwartz, Deputy Director of the Rudd Center for Food Policy and Obesity and Yale University. I’m providing a link to this interview because I think Dr. Schwartz provides a simple, clear-eyed and compelling rationale for focusing efforts on the systems, policies and environments that predispose individuals and communities towards obesity, as opposed for instance to a purely educational approach.
  
I hope that this new series spurs much more dialogue on the matter.

- Doug Hirano, MPH, APCA Executive Director

Asian American Health Research: What Community Agencies on the Front Lines Need to Know

In response to a call for papers on Asian American and Pacific Islander health research, I put some thoughts on paper as to the type of research I think is needed for community agencies like APCA to more effective in its work. The paper, entitled “Asian American Health Research: What Community Agencies on the Front Lines Need to Know,” was accepted last year and has now made its way to print in the Spring 2012 issue of Progress in Community Health Partnerships: Research, Education, and Action. In this issue, I’m proud to be published alongside such friends and colleagues as Dr. Marguerite Ro, Dr. Winston Tseng, and Dr. Simona Kwon, among many others. I was also privileged to do an accompanying podcast related to my article. The transcript of the podcast is also published in this issue. To access copies of articles in this issue, click here.

Doug Hirano, MPH, APCA Executive Director

Reminiscing About the Coming Plague

I recently attended a meeting at the Maricopa County Department of Public Health – ostensibly to review health status data and offer my opinion about the most pressing health issues confronting Maricopa County residents. However, within the course of discussion, I was surprised to learn that dengue fever and malaria are moving northward through Mexico, and both diseases will eventually be taking a toll on Arizona residents. The mere mention of these diseases brought back fond memories and youthful dreams.

As a callow graduate student in public health at UCLA, I had yearned for a career overseas investigating vector-borne diseases like dengue fever and malaria. My professors peppered their epidemiology lectures with stories of their own exploits in exotic foreign lands (one professor, Dr. Telford Work, helped discover West Nile Virus back in the late 1950s), and I imagined myself following in their footsteps.

Indeed, while working in the CDC STD Program, I had the opportunity to interview for a dengue fever epidemiology position in Puerto Rico. I was just certain that this position would jumpstart my brilliant career in global health, and that I would spend a good bit of the rest of my life finding adventure in foreign lands. Unfortunately, I was not selected for the position. I therefore find it ironic that while I never did make it overseas, exotic infectious diseases like dengue fever and malaria are – after all these years – making their way to me.

However, from my perch at APCA, I don’t anticipate playing any role in the fight against either dengue fever or malaria. So, sadly, it would seem that I never will achieve my dream of global health work. Well, not so fast.

The vast majority of people that our agency serves are in fact foreign born and bring to this country a health profile with diverse, global risks. Infectious diseases like tuberculosis and chronic hepatitis B infection are relatively common among new immigrants. So, too, are nutritional deficiencies such as rickets. Immigrants also bring to this country their indigenous conceptions of health. Our understanding of their disease risks, beliefs and behaviors is critical towards effectively working with them on health improvement strategies. As such, our work is partially ethnographic in nature, and we are in a sense cultural brokers of good health. To this end, we often find ourselves thinking globally and acting locally.

So, I’ve come to realize that my dream of global health work is being fulfilled right here in the Phoenix area, and I’m grateful every day for the opportunity to perform this work. And who knows, some day I might just dust off my barely used passport and spend a few weeks volunteering with an international health organization in some far off country. You never know, they might just learn a thing or two from an old global health hand like me.

-Doug Hirano, MPH, APCA Executive Director

A Chance Encounter With a Public Health Icon

This past Saturday morning, our home doorbell rang, and I sprang up with the expectation of greeting someone interested in trimming our mesquite trees or painting our house (both of which do need to be done). However, to my surprise, I found myself greeting Dr. Leland Fairbanks. Dr. Fairbanks is a retired physician well known in Arizona for his tireless work in tobacco control. Indeed, he is a public health icon and one of my local heroes.

He handed me a set of campaign brochures for various candidates for Tempe City Council and patiently explained why he supported each candidate. I listened to him for a bit, thanked him for his information, and assured him that I would be voting in the upcoming election.

We had actually met at an Arizona Public Health Association meeting many years ago, but I don’t believe he remembered me. So, before he walked off, I felt compelled to express my admiration for his past work. But before I could utter anything, he noticed the name on our door (“Casa de Hirano”) and commented that a woman with the last name of “Hirano” used to work on tobacco control with the state health department. I confirmed that my wife Rosalie had directed the state tobacco control program in the late 1990s. He smiled and said to say “hello” and then ambled off to visit with my neighbors.

I recount this story not as a chance encounter with a public health icon, but because I was so inspired that a man in his early 80s was going door to door on a Saturday morning advocating for things in which he believes. If anyone has earned a leisurely Saturday morning, it is he. I promised myself that on Monday morning I would make a few phone calls in support of a hepatitis B funding bill currently under consideration by Congress. Please consider taking a moment in the upcoming week to advocate for something you believe in.

- Doug Hirano, MPH, APCA Executive Director

Suicide among Bhutanese Refugees in United States

What are the risk factors that may be linked to suicidal ideation and/or attempted suicide among Bhutanese refugees to the United States from 2008 to the present?

Since last week, our Nepali speaking interpreters have been busy in helping Center for Disease Control and Prevention (CDC) find an answer to the above question. Since 2008 approximately 35,000 Bhutanese refugees have been resettled in the United State. 16 suicide cases in 10 states have been reported to the Office of Refugee Resettlement (ORR). As our interpreters were undergoing two days training session with the CDC staff, another suicide had been reported to ORR. Considering the pattern in which suicide cases are increasing among the newly resettled Bhutanese refugee population, CDC is conducting “Epi-aid” study in collaboration with Office of Refugee Resettlement and Refugee Health Technical Assistance Center at the Massachusetts Department of Public Health.

A random sample of Bhutanese refugees from four states – Georgia, Arizona, New York, and Texas were selected from which a total of 579 Bhutanese refugees, age 18 and older will be interviewed using a set of pre-designed questionnaire which is about 90 minutes long. After two days of intense training on research ethics, informed consent, questionnaire, addressing difficult situations, distressed respondent guidelines, and role play sessions, our Nepali speaking interpreters are ready to assist in face-to-face interviews with Bhutanese refugees. The study findings will help better understand the underlying causes and associated risk factors for suicide in the Bhutanese community, provide evidence-based guidance on prevention of suicide and reducing emotional distress among Bhutanese refugees, and raise awareness of suicide risk factors and mental health resources to Bhutanese refugees in the United States.

There is definitely the need for linguistically competent and culturally appropriate mental health programs in Arizona to address the issues of Bhutanese refugees and also other individuals who have Limited English Proficiency. With the use of our professionally trained interpreters, Bridging Cultures is in a unique position to help bridge the gap between mental health patients and medical professionals/facilities. Our interpreters, some of who are former refugees, found Bhutanese Suicide Prevention study with CDC very meaningful. We are very positive about the outcomes of this study and enthusiastic about the changes it will follow. Please check back with us for more progress on this topic.

Kamana Khadka, Program Manager, Bridging Cultures

“Linsanity” and the Asian American Experience

For the past year, I’ve been following the career of Jeremy Lin for two reasons: he was originally signed by the Golden State Warriors (my hometown basketball team) and because he is an Asian American. As has become well known in the past two weeks, there have been very few Asian American professional basketball players. Consequently, I’ve watched with increasing interest (and yes, glee) his sudden ascent to NBA stardom with the New York Knicks.

But I am becoming more interested in his impact on increasing the visibility of Asian Americans as a whole in this country. He has now graced the covers of Sports Illustrated and Time Magazine. Other magazine covers may soon follow. But the point is that he has singlehandedly reminded mainstream America that there are Asian Americans in this country.

For while we Asian Americans have become fond of complaining about being stereotyped as the “model minority”, the reality is that we have actually been the invisible minority – reduced to intermittent blips in the national consciousness, as comic relief (the “Harold and Kumar” movies), cautionary tales of alienation (Cho and the Virginia Tech mass murders), or cultural stereotypes (overbearing “Tiger moms”).

Well, Jeremy Lin’s story seems to have found a special resonance with mainstream America. He is “the little engine that could” and “the ant that moved the rubber tree plant” (though he is 6’ 3”). He is the embodiment of the favorite American fable that anyone can make it if they try hard enough. He is one of us.

However, we’re learning that fame and attention can come at a cost. Witness the ESPN headline regarding “Chink in the Armor” after a recent Knicks loss in which Lin committed numerous turnovers. Other racial slurs have made it into the media, and more will no doubt follow. He is a “feel good” story for some, but for others he is resurrecting repressed feelings of race hatred and intolerance.

Most importantly, though, Jeremy Lin is bringing long overdue attention to the forgotten minority. Perhaps the CNN producers of the “Latino in America” and “Black in America” series will now consider an “Asian American in America” series. While his story has become a global phenomenon, the Asian American experience is in fact full of equally fascinating and culturally distinctive stories. Let’s hope “Linsanity” is the impetus for Asian Americans to finally find a worthy place in the American consciousness.

- Doug Hirano, MPH, APCA Executive Director

More on Sheriff Joe

A few weeks ago, I participated in a press conference on behalf of the Asian Pacific Community in Action, a Phoenix-based non-profit health services and advocacy organization. We were one of several Asian American agencies and individuals calling for the resignation of Sheriff Joe Arpaio. Since then, I have received several emails, letters and phone calls inquiring as to what Sheriff Joe has done to members of the Asian American community to deserve a call for his resignation.

My answer is not a simple one. In fact, it is as steeped in history as it is in recent events. Asian Americans have a long history of not being welcome in this country. Beginning with the 1882 Chinese Exclusion Act, significant barriers have been placed upon Asian immigration. In 1924, the National Origins Act essentially closed the doors to immigration from Asian nations. This door was not substantially re-opened until the Immigration Act of 1965.

Obviously, Sheriff Joe Arpaio had nothing to do with historical American policy regarding Asian immigration, and I am not directly aware of discriminatory treatment of Asian Americans at the hand of the Sheriff’s Office. However, I would argue that his racial profiling of the Hispanic community is a salient issue for the Asian American community. As Martin Luther King, Jr. said, “Injustice anywhere is a threat to justice everywhere.” With a majority of Asian Americans being foreign born, it is possible that we could be the future target of “crime suppression” sweeps.

Asian Americans have come a long way in the past 100 years of Arizona statehood. Indeed, we are now the fastest growing racial/ethnic group in Arizona, and the vast majority of us are extremely proud to be Arizona residents. However, until we all can live without fear of unlawful discrimination and racial profiling, I believe we are obligated to speak out. As Martin Luther King, Jr. also said, “Our lives begin to end the day we become silent about things that matter.” It is time for change: Sheriff Joe should go.

-Doug Hirano, MPH, APCA Executive Director

New CDC Data Indicates Asian Americans Underutilize Cancer Screening

The Centers for Disease Control and Prevention (CDC) has just released data regarding the utilization of cancer screening tests (i.e., mammography, Pap smear and colonoscopy) by race/ethnicity. Here’s a direct quote from the report: “Screening rates for all three cancer screening tests were significantly lower among Asians than among whites and blacks.”

As an example, the rate of mammography within the past two years for Asian survey respondents was 64.1%. This compares to 72.8% among whites and 73.2% among blacks. Similarly, Asians received up-to-date colorectal cancer screening at a rate of 46.9%, as compared to 59.8% among whites and 55.0% among blacks. Data is also presented by Asian ethnic subgroups, including Chinese and Filipinos.

Early cancer detection greatly increases the chances of successful treatment. Clearly, Asian American health organizations and their partners must work to address this disparity in cancer screening rates. I would urge you to review this report. Click here for a link to the report.

-Doug Hirano, MPH, APCA Executive Director

Out on a limb against Arpaio

We were recently asked to join other Asian American community members in a press conference demanding the resignation of Maricopa County Sheriff Joe Arpaio. One may wonder why an agency with a mission towards health improvement would want to go out on a limb against a county sheriff. I’m providing the text of my comments as an explanation:

My name is Doug Hirano. I am the executive director of the Asian Pacific Community in Action. We’re a non-profit agency that works on behalf of the rapidly growing Asian American and Pacific Islander community to ensure that they have equal access to the health services and information that can help them achieve good health.

Since 2002, we’ve helped thousands of Asian Americans and Pacific Islanders get immunized, get screened for life-threatening diseases, and find a regular source of medical care. All of our programs are tailored to serve first generation immigrants and refugees facing real challenges of poverty, language, education and unemployment. In our 10 years of service, our work has taught us the power of grassroots advocacy, and so we also work to promote policies and practices that are fair to the needs of all Asian American and Pacific Islander individuals -- regardless of country of origin or citizenship status.

It has become clear that the policies and practices of the Sheriff’s Office are a problem for communities of color, including Asian Americans and Pacific Islanders, many of whom are recent immigrants and refugees. Many of our service recipients come to the United States seeking a just and fair society. Unfortunately, the discrimination, racial profiling and unconstitutional retaliatory actions taken by the Sheriff’s Office are reminiscent of the policies and actions for which they originally left their home countries.

We are concerned that our community members are not seeking the government services they need and are entitled to because of the hostile and fear inducing atmosphere created by the Sheriff’s Office. Data indicate that Asian Americans and Pacific Islanders are over-represented among the very poor, but do not utilize government-funded services such as behavioral health care, cancer screening and nutrition services proportionate to their population size. For an agency charged with improving the health and well being of our communities, this is unacceptable.

We believe that government services and policies are meant to level the playing field for all. We believe that law enforcement must protect everyone’s safety and rights equally. We believe in equal access to justice. Under Sheriff Joe Arpaio, none of these beliefs can be realized. Change is demanded.

As Martin Luther King Jr. once said, “our lives begin to end the day we become silent about things that matter.” We therefore request that Sheriff Joe Arpaio resign from office immediately. Thank you.

- Doug Hirano, MPH, APCA Executive Director