Maine Youth Network’s Minorities in Healthcare series

By Ally Cooper

Mohamed herself has a wide range of healthcare experience, which includes working in nursing homes, as a phlebotomist, as a medical assistant, and as a case manager. Throughout her experience she has noticed a trend. “You would only see diversity within the housekeeping workers, not within the people providing the care,” she said. The series has included webinars focused on diversity and on opportunities in the healthcare field.

Coworkers often would turn to Mohamed as a resource on cultural differences, she said. One question that many of her female colleagues asked was, “Why do many of my male Muslim patients seem to flinch away from me when I try to provide care?” Mohamed was able to educate her coworkers on some of the aspects of Muslim culture that were essential to understand in order to provide adequate care. For example, typically Muslim men prefer male caretakers and Mulsim women prefer female caretakers, due to the cultural taboo against physical contact between unmarried members of the opposite sex. While Mohamed emphasized that the Islamic religion allows for exceptions in a medical setting, it can still be unsettling for patients.

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Other cultural differences that Mohamed is often asked about involve diet. Typically, Muslims abstain from drinking alcohol and eating pork. Furthermore, during the holy month of Ramadan, most fast from sunrise to sundown. This month of discipline is a time of celebration and spiritual reflection. But without a diverse representation among staff, healthcare workers may not know about key cultural preferences, and this can impact their ability to provide adequate care. Reflecting on the importance of diversity in healthcare settings was one of the main topics discussed in the three-part webinar series.

One of the speakers was Dr. Nana Ama Qartey, who was born in Michigan and raised in Ghana before returning to the U.S., where she attended medical school. In the “Opportunity and Careers in Healthcare” webinar, Qartey discussed her experience as a Black doctor in America. “Usually, patients don’t question my skills – but they do normally show surprise at my skill. I wonder if they thought I was going to be unintelligent.”

Dr. Sarah Ashitey, another speaker, spoke of the importance of being an example. “There is something to be said about seeing someone who looks like you, doing something that you previously didn’t think you could do. This forum is an opportunity for everyone to see someone who looks like you, who is doing something unique. You could be a respiratory therapist, or a nurse, or a doctor, or anything else. Even as a doctor now, when some of my patients who are Black come to see me, they are amazed and surprised. ‘Oh, my God, I get to see a Black doctor.’ The more that people see you in the field, the more inspired they are. ‘Wow, I can do this. My daughter can do this,’ they say.”

Yasmin Cain grew up in the Philippines and attended a four-year American-accredited nursing program, before immigrating to the U.S. in the 1990s on a program that recruited Filipino nurses due to a nursing shortage. After six months of working in the U.S., she successfully passed the National Council Licensure Examination, or NCLEX, which is the board exam that American nurses are required to pass in order to receive their Registered Nurse license.

As a recent immigrant to the U.S., Cain said, “I think when I moved here, I did not really feel any race, being of Asian descent. When I used to work in Detroit, it was highly diverse. And when I moved to Louisiana, it was the same thing. But when I moved to Maine, I really felt different. A lot of the patients, when I was working with another nurse, would specifically point and say, ‘No, I don’t want her’ (meaning me) ‘to do the procedure. I want you to do it.’ And then they would always ask me a bunch of questions like where did I train, how many years did I go to school, things like that. Things I would never hear them ask another nurse, who was white, and who was also new to the practice. I just made sure that I carried myself professionally and I always smiled and I was always kind. I felt it more in Maine than in any other states or cities that I’ve been before.”

Immigrants and refugees with a variety of healthcare experiences in their home countries face barriers to continue working in the medical field in Maine. According to Mohamed, “A lot of people, often back home, have their license to work as a doctor, but then coming here, their certifications don’t qualify and they have to start from scratch. Oftentimes, they just put their healthcare experiences aside.”

This barrier is something familiar to Mohamed’s family. Her mother, Hawo Adam, worked as a nurse in Yemen, but was unable to continue her career in Maine due to language and state licensure barriers. So Adam worked in housekeeping, eventually in Maine Medical Center’s housekeeping department. When she began to get a better grasp of the language through Portland Adult Education classes, the hospital helped her to obtain certifications. Today she works on the labor and delivery floor as an equipment technician, where she prepares the room and equipment for procedures.

The Maine State Legislature is currently reviewing LD 149, “An Act to Facilitate Licensure for Credentialed Individuals from Other Jurisdictions,” that would allow for a case-by-case review to waive licensure requirements for professionals “… as long as the waiver does not reduce the requisite standards of proficiency for the licensed profession or occupation.” Passage of the bill would be a crucial step toward reducing barriers to licensing for new professionals in Maine. LD 149 was referred to the Committee on Innovation, Development, Economic Advancement, and Business to be discussed during the work session on April 8, 2021.

The Minorities in Healthcare series was developed by Maine Youth Network in partnership with MaineHealth, one of the largest employers in the state with over 23,000 employees, according to Jennifer O’Leary, MaineHealth’s director of workforce development. During the third and final webinar, O’Leary discussed the many opportunities that MaineHealth’s Center for Workforce Development offers. Some of these opportunities, including the Certified Nursing Assistant (CNA) and Phlebotomy School, are paid training programs. For those interested in non-clinical professions, MaineHealth also offers patient service representative positions, and bilingual and multilingual positions.