Edgar Carmona is the CEO of Amigos Sin Fronteras, an organization based in Dallas, Texas, actively involved with the Ventanilla de Salud pilot program. Recently Compassion & Choices’ Latino Engagement team partnered with Amigos Sin Fronteras for an educational session with Community Health Workers (CHW) and cancer survivors about end-of-life options. You can watch a video of the tremendous work in Dallas and nationwide here.
Compassion & Choices: How did you get involved with this work, and why is it important to you?
Edgar: Even though I’m a U.S. citizen, I will always be an immigrant. I think that’s part of the American experience. I found my vocation in the nonprofit sector 20 years ago, and I am always excited to use my experience in new projects. That’s the case for our staff as well; most of them have been in the nonprofit sector for over a decade.
This project is very important because the Spanish-speaking community is a very underserved and often overlooked group. If you worked at a restaurant, in cleaning or construction, your vocabulary in English would be limited, as you don’t have a chance to practice your English skills. Understanding the values and barriers of this community are key to convey successful messages. The makeup of the Spanish-speaking community constantly changes, you never stop learning from them, because just when you think you have mastered your knowledge of the community something occurs, either social or political, that makes you rethink your approach.
Compassion & Choices: How did you hear about Compassion & Choices? From your perspective, why are we working together?
Edgar: I have to give credit to Leslie (Compassion & Choices’ Latino engagement manager). She reached out to us and brought us the knowledge of Compassion & Choices. I received Leslie’s call as I was driving back home from the funeral of a dear staff and friend who had lost her long battle to cancer. Death is a topic where many communities have mixed feelings and even express that talking about end-of-life decisions could be “bad luck,” “jinxing the family” or bringing in “bad vibes.”
Some people have expressed to us how difficult it is for them to be heard by their own family when they want to address their end-of-life decisions, and being shut off with phrases like, “Do not talk about that” or “Don’t be negative,” so that’s another challenge. We have to help people inform their loved ones about this topic and the importance of talking about it openly and in a timely manner.
Leslie and Maria (Compassion & Choices’ director of priority populations) have proven that their style of presenting Compassion & Choices’ message was extremely culturally adequate. At the end of the presentation they held at the Consulate of Mexico in Dallas, the attendees expressed they would like to have an even more detailed presentation. This response was extraordinary. It was obvious they had been holding these questions for a long time, and they had finally found a reliable source they could trust to be educated properly. The style of the presentation of Leslie and Maria had broken the cultural barriers and proved that when a presenter is well-informed of those cultural barriers, even if the topic is challenging or “taboo” it would be well received.
Compassion & Choices: Can tell us about other barriers you see to this specific work with Compassion & Choices and this kind of end-of-life conversation?
Edgar: Talking about death is very challenging, especially when a person has health conditions that make quality of life difficult. However, unfortunately, many people only contemplate talking about this due to a crisis, and it is not the best moment to educate people, as they are overwhelmed by emotions. This work requires consistency, and progress is slow because there are many layers to complete this task. The support system of the patient needs to be educated on the importance of their role executing the wishes of their loved ones.
The best time to convey this information is when there is no imminent death or crisis — we need to normalize this conversation. Yes, we are bringing very uncomfortable — but very real — questions to the table. What would you do if the unexpected happened? What if you got in a car accident? What would you want? What would be your end-of-life decisions? It’s good to talk about the unexpected.
Compassion & Choices: Do you have any initiatives or workshops coming up that you’re particularly proud of and would like to share?
Edgar: Yes, definitely. It’s something that really excites us. Maria and Leslie will be back in Dallas to present the longer workshop that was requested by the community. Also, Compassion & Choices is going to partner with Amigos Sin Fronteras in October during the XXIV Binational Health Fair, which is the largest health mobilization in North Texas. We are looking forward to this event and the second phase of this pilot.
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Patricia A. González-Portillo
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