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Interpreters Crucial to Quality Care
Hematoma, dysphagia, arrhythmia, EKG, embolism, A1c level, epidermis, echocardiogram…
Medical terms bewilder many people.
“It’s hard enough, even if you know the English language, to decipher medical language,” agrees Marvin Cody, one of three full-time Navajo medical interpreters at Flagstaff Medical Center, part of the Northern Arizona Healthcare system.
“What makes us unique is that we know medical language along with the Navajo language and English language.”
Specially trained and certified, the Navajo medical interpreters primarily serve elderly Navajo patients, family members, and medical staff caring for them. The interpreter service is free and operates with a decade of support from the John and Sophie Ottens Foundation and Northern Arizona Healthcare Foundation.
In many hospitals, language barriers are overcome by a network of remote, on-demand language services. The Navajo language, though, presents unique challenges best served by in-person interpreters.
First, the Navajo language is complex. It was unwritten until modern times, and it is one of the most demanding languages to learn for English speakers.
Secondly, there are English words that have no Navajo equivalents, especially in the health field.
“There are a lot of medical or biological terms that don’t exist in Navajo,” Cody said. “We all learn about a cell in biology. But in Navajo, there’s no word for it.”
“For me, it’s important to keep the language alive. It’s important to preserving Navajo ways and traditions.”
— Vernice Wagner
There are cultural sensitivities, too. Discussing a medical power of attorney, advanced directives, and do not resuscitate (DNR) orders must be handled delicately.
“Among the Navajo, it’s considered a curse if you’re telling them about death and dying,” Cody explained. “It’s like you’re prophesying their death. We must be careful in how we speak about these things.
With Navajo and Hopi lands nearby, more than a third of patients at Flagstaff Medical Center are Native people. One particular day in March, the hospital had 195 patients, 80 of whom were Native Americans. The vast majority of those were elderly Navajos.
Hospital physicians see the interpreters’ work as crucial.
They assist in our interactions with patients and “improve our patients’ quality of care,” according to NAH hospitalist Dr. Christina Veenstra.
Since a hospital is an around-the-clock operation, a small team of fluent Navajo speakers who work other jobs at the medical center fills in when the full-time interpreters are off. Together they made nearly 6,300 patient visits in 2019.
Besides helping medical teams, the interpreters say they bring familiarity and trust to Navajo patients.
When a Navajo introduces themself to another Navajo, they always refer to their respective clans, said interpreter Gerry Fuson. Clan names, she added, not only indicate where you come from but also the essence of who you are.
“When you establish that relationship with a patient, it helps them to loosen up, to feel more comfortable talking with you,” said Vernice Wagner, the latest interpreter to join the team.
For many elderly Navajos, the interpreter service is critical. But Fuson wonders if it will be necessary a few decades from now.
“Maybe we will be needed for another 10 or 15 more years, but after that, we’ll have to see.”
Even as it’s one of the most widely spoken Native American tongues, UNESCO classifies Navajo as a “vulnerable” language. The pervasive use of English in schools and youths seeking jobs away from their homeland has led to a decline in Navajo people learning their native language.
In 2011, the U.S. Census Bureau counted 169,369 Navajo speakers in the U.S. Of those, less than 12,000 spoke little or no English.
Wagner said she became an interpreter to help people overcome illness and help preserve Navajo language.
“For me, it’s important to keep the language alive. It’s important to preserving Navajo ways and traditions.”
The Ottens Foundation, which has long supported Native American causes, is closing this year. It gave a final $500,000 gift to the Navajo medical interpreters service to benefit the program through 2024.
Northern Arizona Healthcare Foundation gives additional support to the interpreters and other NAH programs that serve Native American patients. Among these are an onsite Native Healer at Flagstaff Medical Center and a Navajo video series explaining palliative care options.
You can help champion these programs by directing a donation to
Health First Foundation.
Stories
Access to dental care can be a challenge for many adults in northern Arizona, especially for those without adequate insurance or the financial means to pay out-of-pocket for services. This challenge is what the Dental Days program aims to address—by offering mobile, no-cost dental clinics, Dental Days is helping to bridge the gap for adults who struggle to access necessary dental care due to income limitations, insurance restrictions, and a lack of available providers. Founded in August of 2022—and made possible by collaboration between volunteers, local healthcare providers, and key community organizations—the program has seen remarkable growth. The most recent event, held in December 2024, served 89 individuals—making it the most successful clinic yet. “Every event is filled with excitement and warmth,” explains Executive Committee Member Alicia Yaeger-Booth, who has a background in public health and nonprofit leadership. “The gratitude from our patients is incredibly inspiring.” Filling a Need Flagstaff’s Dental Days program provides free dental screenings and treatments during its Saturday clinics, which have already become a crucial resource for those in need. Alicia explains this resource is exactly why the program was founded. “There is a significant gap between the customary need-based determinations of eligibility and actual need, and these clinics address the issues of adult access to dental services, AHCCCS (Medicaid) coverage limitations, and income barriers to oral health care,” she says. “In Coconino County, there is just one adult AHCCCS provider, and it is not currently taking new adult patients. Plus, due to the high minimum wage in Flagstaff, a person working minimum wage may not qualify for AHCCCS.” To ensure that the program is as accessible as possible, Dental Days holds pre-screening sessions on Friday afternoon before each Saturday clinic, allowing patients to be evaluated ahead of time. This makes it easier for those with busy work schedules to take advantage of the service. Additionally, the team has learned to continuously improve, from refining their registration process to leveraging technology to streamline operations. Alicia explains that this growth and opportunity is made possible by support from Health First Foundation. “HFF provided us with a little over $82,000 for supplies, equipment, and a trailer, and being able to purchase or rent what we needed helped that event take place,” says Alicia. “It’s made a huge difference in our ability to serve more people and expand to new venues.” A Bright Future The Dental Days program continues to grow, and the team is committed to reaching more individuals who lack access to dental care. With three successful clinics already under their belt, the team hopes to eventually offer as many as 4 events per year. “We’re seeing the same people return to our clinics, which tells us we’re meeting a real need,” Alicia says. “The stories people share and the gratitude from returned clients who have no other dental home is unbelievably rewarding.” As the program continues to serve Flagstaff and the surrounding areas, Alicia says the team is dedicated to providing high-quality, compassionate care to every patient who walks through the door. “Our volunteers are incredible—they’re the ones who make these clinics run. It’s really a community effort, and it’s what makes this program so special. People are eager to help because they care about improving the lives of their neighbors.” To learn more about how you can support critical northern Arizona programs like Dental Days, contact us.
Donor-advised funds present a unique opportunity personalize gifts to go exactly where you think is the greatest need, and one example of this potential is the Lullaby Project. Developed by Carnegie Hall’s Weill Music Institute, this project has proven track record of enhancing maternal health and in helping to bring expecting or recent mothers and their child closer together. The idea is simple—by pairing a mother with a musician to compose a custom lullaby specifically for their newborn, it helps the parent make a stronger connection with their child. Forging this bond through music is crucial, because early childhood milestones like language, social skills, and walking all emerge in the first three years of a child’s life and are dependent on a healthy pregnancy, safe birth, and a nurturing relationship for the newborn. As participating mothers work on and talk about their lullaby, they share positive emotions and relationships, create a new or rediscovered sense of personal meaning and achievement, and foster hopes for themselves—and their newborn—for the future. Research conducted by Wolof Bron has shown that mothers in Lullaby Project writing sessions use 450% more mental well-being statements than when they talk about the experience outside the session. Even more, these experiences can instill within mothers a confidence in their own abilities, both as parents and individuals. The Flagstaff Symphony Orchestra currently employs four songwriters to work with residents of northern Arizona, with a primary focus on underserved populations, and since May 2023, The Guidance Center’s (TGC) “Moms and Babies First!” program has provided a steady stream of participants. TGC Program Coordinator Lizette Melis shares that the presence of the Lullaby Project has led to more engagement in services offered to women in behavioral health, and the Flagstaff Unified School District has welcomed Lullaby Project into their Teenage Parent Program (TAPP) at Summit High School. After an inaugural semester of three participants in Fall 2023, seven more students have signed up to write a lullaby in Spring 2024. This project has incredible impact on a critical segment of our community, and it was made possible through the generosity of a donor via a donor-advised fund. You can have this same impact—learn more about giving to HFF, and read more about donor-advised funds to the right. What is a donor-advised fund? The Lullaby Project was funded through a donor-advised fund, which is an account where you can deposit assets for donation to charity over time. What’s great about this method is the collaboration and personalization provided to you—a sponsoring organization like HFF manages that account, so you can recommend how to invest the assets and where to donate them. You can also claim a tax deduction for making contributions to the fund. Once assets are deposited into a donor-advised fund, the sponsoring organization has legal control over them. But as long as you choose a charity that’s recognized by the IRS and as a U.S. charitable organization, the sponsoring organization will use your charities of choice.
We are grateful to the many people who support Health First Foundation with their time, talent, and treasure. Each year, we recognize a few of these supporters for their outstanding commitment to our mission of improving health and well-being in northern Arizona. “These honorees embody our mission by addressing critical health needs in our region,” said Health First President and CEO Sandra Kowalski. “Their efforts have made a lasting difference that resonates profoundly across our northern Arizona communities.” These are our 2023 Community Health Champions. Wayne Robert Fox: A Legacy of Financial Stewardship Posthumously honored, the late Wayne Robert Fox served as the treasurer and finance chair of our board of directors from 2019 to 2022. After retiring from a remarkable 34-year career at Northern Arizona University, Wayne played a pivotal role in guiding the financial and investment strategies of Health First Foundation amidst the unprecedented challenges posed by the pandemic. His strategic thinking, innovative approach, and resourceful nonprofit financial management during this critical period were invaluable. Wayne’s dedication to the Health First cause and northern Arizona and its people remains a shining example of selfless service to others. Patrick Schweiss: Shining the Spotlight on Mental Health Awareness Patrick Schweiss, executive director of the Sedona International Film Festival, is recognized for his commitment to the arts and community well-being. Under his guidance, the film festival collaborated with Health First Foundation to advocate for mental health awareness via live theater performances. This initiative reached hundreds of theatergoers and 1,400 local high school students, culminating in 20 residents completing Mental Health First Aid training. We are deeply grateful to Pat for harnessing the power of the performing arts to shine a spotlight on mental health education and awareness. Brandon Griffith & Griffith Blue Heart Nonprofit: Saving Lives by Training and Equipping Law Enforcement Brandon Griffith, a decorated law enforcement officer and sudden cardiac arrest survivor, is the founder of Griffith Blue Heart – a nonprofit committed to providing training and AEDs so that law enforcement officers can effectively respond to time-sensitive medical emergencies. With funding from Health First Foundation, Brandon and his team trained and equipped Flagstaff police officers to provide life-saving assistance in cases of cardiac arrest and other emergencies. The result: Flagstaff police have already helped save several lives. Devoted and tireless in their efforts, the Griffith Blue Heart team is a testament to their motto: Earn each day. A Tradition of Recognition: Community Health Champion Awards The Community Health Champion awards, presented annually at the discretion of the Health First Foundation president and board of directors, are a tribute to individuals who epitomize the Health First mission. Their stories inspire us to be agents of positive change in our communities, reminding us that we can make a lasting impact on community health and well-being through collaboration and commitment.
Cardiac arrest is a life-threatening medical emergency that can strike anyone, anywhere, anytime. Unfortunately, when it happens outside of a hospital setting, the chances of survival are often grim. In Coconino County, more than 200 people die each year from out-of-hospital cardiac arrest, underscoring the urgent need for timely and effective intervention. Experiencing a cardiac arrest can be a terrifying ordeal. When the heart suddenly stops beating effectively, it deprives the body of oxygen, leading to organ damage and death. Immediate action is crucial to increase the chances of survival. Research shows that early resuscitation and defibrillation can significantly improve outcomes in cardiac arrest cases. In 2022, Griffith Blue Heart Nonprofit aimed to increase the chances of survival in the Flagstaff community by earning a Health First Foundation grant. The grant brought new training and equipment to Flagstaff police, enabling them to respond effectively to time-sensitive medical emergencies. With impressive response times, police are well-positioned to play a vital role in saving lives. That’s why Griffith Blue Heart training targets law enforcement. Often the first to arrive at an emergency scene, officers are uniquely positioned to provide high-performance resuscitation and rapid defibrillation before emergency medical services arrive. These interventions can be lifesaving in cardiac arrest and situations like drowning, drug overdose, and profuse bleeding. The Griffith Blue Heart team conducted three intensive day-long training sessions for Flagstaff Police Department officers. These sessions simulated emergencies police might encounter during daily patrols, providing them with knowledge and hands-on experience to respond effectively in high-stress situations. Another critical component of the Griffith Blue Heart initiative was the deployment of automatic external defibrillators (AEDs) in patrol vehicles. An AED is a portable device that can analyze a person’s heart rhythm and, when necessary, deliver an electrical shock to help the heart reestablish an effective rhythm. These devices are instrumental in treating sudden cardiac arrest, where time is of the essence. Through the grant, Griffith Blue Heart equipped 54 Flagstaff Police Department patrol vehicles with AEDs, ensuring officers have access to this lifesaving technology when responding to emergencies. Saving lives in the Flagstaff community has been a collaborative effort. The dedication and commitment of Flagstaff police officers, who now have the training and tools to make a difference in critical situations, have been nothing short of heroic. Additionally, Guardian Medical Transport in Flagstaff provided valuable support to this initiative by assisting with training, registration and deployment of the AEDs, and upkeep of the defibrillators. The impact of this initiative is tangible. The training and AEDs, coupled with the dedication of Flagstaff police officers, have already helped save at least seven lives, including an infant. The partnership between Health First Foundation, Griffith Blue Heart, and the Flagstaff Police Department serves as a shining example of what can be achieved when a community comes together to address a pressing issue. With the grant, training, and deployment of AEDs in patrol vehicles, Flagstaff is a safer place to live, work, and play. The full impact of this initiative will be felt for generations and beyond. As Griffith Blue Heart founder and CEO Brandon Griffith says, “When one life is saved, it rings on for eternity.”
To help advance quality primary care in the region, Health First funded the establishment of team-based care in North Country HealthCare’s family residency program. The goal: Teach new physicians and their colleagues a coordinated approach to patient care and improve health outcomes. Team-based care is health providers working collaboratively with patients and caregivers to accomplish shared goals and achieve coordinated, quality care. Such care works to minimize the occurrence and severity of disease, offer better disease management, limit emergency department visits, and lower healthcare costs. A Health First grant enabled the residency clinic to explore team-care models, determine what worked, and implement new care approaches that benefit patients and their families. Residents learned the approaches and value of team care during the grant project. They implemented daily huddles to discuss patient care and utilized a new tool to identify patient gaps and streamline clinic visits. With these innovations, patients experienced more focused and efficient care. As part of the program, the residency team established monthly interdisciplinary case conferencing to address the complex care needs of HIV/AIDS patients. “We get together and do a deep dive into the patient – their medical history, their care, what resources they have, what’s holding their progress back, all of it,” explains Dr. Sarah Coles, the residency director. “In the end, we come together with an agenda and a care plan specific to that patient.” One resident made this encouraging observation: “Participating in case conferencing has benefited both me and my patient. As a primary care physician, I work hard to ensure that my patients receive high-quality care. Sometimes, though, we are limited by time, costs, and competing priorities. Case conferencing has helped to bridge that gap and improve the care patients receive.” A federally qualified health center, North Country focuses on people who often can’t afford care at 11 locations across northern Arizona. The health center’s family care residency program is the only one in the region. While this grant project was confined to the residency clinic and the 7,000 patients seen during the grant period, the impact will grow in two ways. First, with a newfound understanding of the power of collaborative medicine, graduating residents will take the holistic, team-care approach to their practices impacting future patients. Additionally, North Country HealthCare plans to expand the model throughout the organization, giving all its patients the benefit of quality, team-based primary care.
Improving mental and behavioral health is a Health First priority. We want to share with you the impact one of our grant-funded programs is having on children and families in the Lake Havasu City area. This oasis in the desert sits in the southwestern part of our region in Mohave County, where 25% of the youth population lives in poverty. Mohave County is a significant mental health provider shortage area and has reported not a single pediatric mental health provider in recent years. To help alleviate the need, Health First Foundation awarded a grant to Arizona’s Children Association to establish outpatient and in-home behavioral and mental health services for children and their families in and around Lake Havasu City. So far, the program has served more than 140 individuals. Robert, 15, is one of them. Robert’s life had been a struggle from the start. Born to a mother who was misusing drugs, he had often been homeless and once took shelter in a junkyard shed. A year ago, he lost the only family member that could provide him care, his grandmother. A friend’s mother took Robert in and sought help for the teenager suffering from depression, anxiety, PTSD, sleep problems, and other issues. Arizona’s Children Association assists Robert and his new family with therapy and other needs through its expanded outpatient program. “As humans on this planet, our number one priority should be to protect our children,” said Robert’s guardian parent. “They need to be protected, and they shouldn’t be hurt.” Robert and his family are among the hundreds of thousands of people touched by Northern Arizona Community Health Grants from Health First Foundation. Our grants help area nonprofits provide care, preventative services, health education, and other assistance to those in need. They are made possible through the generosity of our donors.
“Whole foods are our best foods!” They include well-proportioned lean protein, fresh vegetables, fruit, and whole grains. Nutrition educator Cheryl Lines was addressing a group of residents in the far reaches of northern Arizona. While she spoke, kitchen helpers prepared a velvety carrot-turnip soup and a casserole made with chicken, spaghetti, tomatoes, and fresh spinach. The complimentary class is part of a Health First grant-funded initiative led by Creek Valley Health Clinic of Colorado City. Colorado City and its sister town of Hildale, Utah, have poverty rates hovering around 35 percent. Until Creek Valley Health Clinic opened in late 2019, residents had no local primary care facility and had to drive two hours or more for specialty care. These factors left many with undiagnosed and untreated chronic conditions. Strengthening Nutrition and Activities in our Connected Community (SNACC for short) promotes healthy eating and lifestyles. The program has reached more than 525 rural residents in its first six months with nutrition classes, recipes, and incentives like produce vouchers. At the same time, it distributed 113,000 pounds of nutritious food to clinic patients and other residents. “Everyone is excited about the project. It’s helping educate the community about the importance of eating healthy and being physically active throughout their lives,” said Lines, a Create Better Health Ambassador from Utah State University. Her team and the local Short Creek Dream City Food Bank are partnering with Creek Valley Health Clinic to implement the new SNACC program. Colorado City mother Marjorie Holm attended a recent SNACC nutrition class with her children. “I like to learn how to read labels, but my kids like to smell and taste all the food,” she said. “The classes give me more ideas for recipes and how to cook them. With three children, I’m all about learning all I can about food.” They all tried the soup, a blend of simmered carrots, potatoes, turnips, leeks, and garlic, finished with coconut milk and chopped fresh parsley. (Get the recipe for Creamy Carrot and Turnip Soup.) Another mother attending the class was happy to learn how nutritious foods can come together in one quick recipe. “I’ve never tried chicken with spaghetti and spinach before,” she said. “It works. It’s good. It’s always good to find new ways of cooking.” Getting healthy foods to people and teaching them how to prepare nutritious meals are vital to reducing food insecurity and improving health, according to the nationwide Healthy People 2030 initiative. A healthy diet helps children grow and develop properly and reduces their risk of chronic diseases. Adults who eat healthily tend to live longer and have a lower risk of obesity, heart disease, type 2 diabetes, and certain cancers. Health First Foundation invests in this innovative program and those like it to advance health and well-being for all in northern Arizona. Your donation to Health First helps improve health in underserved communities.
Damar Hamlin’s traumatic collapse during a nationally televised NFL game stunned football fans and viewers. Four days later, doctors said the 24-year-old Buffalo Bills player was making a “remarkable recovery” from cardiac arrest. We learned that immediately after Hamlin’s collapse, trainers rushed to the field and administered two necessary interventions – CPR and defibrillation — to save his life. When someone experiences cardiac arrest outside of a hospital setting, they usually don’t survive. In fact, there is less than a 10% chance of survival. Most cases are fatal because the victim doesn’t receive prompt and efficient CPR and defibrillation, as Hamlin did. Health First Foundation Northern Arizona is helping increase survival rates in our community by providing grant funding to equip and train Flagstaff police officers in high-performance resuscitation. The training from the non-profit Griffith Blue Heart goes above and beyond what officers receive when they join the force. Since police typically arrive at priority 911 calls before emergency medical professionals, it makes good sense for them to have the skills to respond immediately. Survival increases when law enforcement officers know how to respond effectively in cardiac, bleeding, drowning, overdose and other urgent medical situations. “Seconds count; seconds matter,” said Lt. Charles Hernandez II of the Flagstaff Police Department. “This training will significantly impact our capabilities and response to emergency situations. It will enable us to save lives.” And it already has. During two incidents – one involving a 1-year-old child who stopped breathing and another involving a man who collapsed while enjoying time with friends – Flagstaff police officers responded and started performing CPR. In each case, emergency medical technicians and physicians noted that quick action from the police officers was vital to the victim’s survival. Health First Foundation funds non-profit health initiatives through its annual Northern Arizona Community Health Grant program. Please consider giving to help support health and well-being in our region. (This article first appeared in February editions of Flagstaff Business News and Quad Cities Business News.)
Our physical and mental health are deeply connected. Yet we typically visit one health provider for physical health needs and a separate provider for mental health care. Integrated care brings them together, addressing both in a coordinated way with primary care providers working side-by-side with licensed clinical social workers, psychologists, case managers, psychologists, and health coaches. Because it focusses on the links between physical, emotional, and mental health, integrated care is often referred to as whole-person care. Supported by Health First Foundation grants, Creek Valley Health Clinic in Colorado City has shown that integrated care improves patient health and contributes to community well-being. The foundation awarded two Northern Arizona Community Health Grants to help launch the clinic’s integrated care initiative. The aim was to lower high rates of chronic health conditions, depression, and suicide in the underserved remote community of 8,000 residents. During the two-year grant period, the clinic served more than 1,450 people with integrated care, resulting in a dramatic decrease in depression among patients – from 26% in 2020 to 16% in mid-2021 and 9.6% in mid-2022. The clinic reported that the suicide rate dropped significantly, from 159 in every 100,000 people in 2018 to 20 in every 100,000 people in 2022. At the same time, it recorded patient improvements in diabetes management, obesity, tobacco use reduction, and blood pressure management. One resident, who received needed emotional support from the program, said it made a difference in her healing and ability to cope. Julia said multiple health problems left her feeling “overwhelmed, discouraged, and depressed.” Her latest setback was an abscess on her leg that took three surgeries to correct. She was recently diagnosed with adult-onset Type 1 diabetes and is being monitored for a liver transplant because her liver is failing from untreated hepatitis. “There was just so much going on; I wasn’t sure I could handle it all,” said the working mother. After the surgeries on her leg, Julia went to the Creek Valley clinic multiple times a week for wound care. “Whenever I went in for a visit, a counselor would come to sit with me and offer help,” she said. “He really helped me with my anxiety. I was so anxious and worried, which really is counterproductive to healing.” The Creek Valley provider gave her several tips and tools to help relieve her anxiety. Those exercises made Julia feel calmer and were vital to keeping her “brain straight” with everything going on. “I’m not the kind of person who would sit down with a therapist and throw out all my problems,” she admitted. “But this was a safe place for me. It was the right thing, at the right time, in the right space.” Health First Foundation grant funding supports accessible and affordable holistic care that treats the whole person – mind, body, and spirit. The foundation believes the integration of physical and mental health care can facilitate improved health and well-being. Based on a sliding-fee scale, Creek Valley Health Clinic has some of the lowest patient costs in Arizona for behavioral health care and relies on grants and donations to ensure that services are affordable to all. “Having the medical and behavioral health professionals work hand-in-hand to provide treatment to patients has been incredibly effective and has made a large impact in the health of our overall community,” said the clinic’s CEO Hunter Adams. “Hundreds of patients have been impacted by this program, and there is no doubt that some lives have been saved.” Health First Foundation relies on donors to help advance health in northern Arizona communities. Please consider giving to support our Northern Arizona Community Health Grant program. (The name of the patient quoted in this article has been changed to protect the patient’s privacy.)
Health First Foundation – Northern Arizona (EIN 81-3137336) is an independent 501(c)(3) nonprofit charity dedicated to advancing health and well-being.
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