Sudarshan Pyakurel, M.A., is the Executive Director of Bhutanese Community of Central Ohio (BCCO) , and a community leader and advocate for social justice. In September 2020, Mr. Pyakurel joined the Office of Minority Health (OMH) for a virtual symposium highlighting state, tribal, territorial, and community-based efforts to address COVID-19 among racial and ethnic minority and American Indian and Alaska Native populations.
OMH is focused on the success, sustainability, and spread of health equity-promoting policies, programs, and practices. As part of its blog series, “Advancing the Response to COVID-19,” OMH followed up with Mr. Pyakurel to discuss how the Bhutanese Response Assistance Volunteer Effort (BRAVE) project has evolved to continue serving refugee, immigrant, and Limited English Proficiency (LEP) communities throughout the COVID-19 pandemic.
How have your community leaders applied principles of cultural competency in the Bhutanese community?
Applying cultural competency is an ongoing challenge. I think COVID greatly exposed not only the gaps in the system but also opened the fault lines that were hidden underneath the social and racial inequality. For minorities and people of color, it more or less felt like jumping out of a frying pan and into the fire.
We are still strongly advocating for implementing culturally and linguistically appropriate services, but at this time it seems a tall order. Understandably, the health system has also faced unprecedented challenges, but the system was never built for addressing LEP community needs. COVID exposed it, and now it’s time for us to rethink the whole system. Never again should fellow residents in the U.S. feel that they are left in the cold. There were many cases where people who did not speak English were sent home, although they were as acutely infected with the disease at the same rates as others who spoke English.
How has BRAVE worked to address the communication gap in the media since your presentation at the OMH Virtual Symposium in September 2020?
I see the BRAVE Project in two phases: Phase One was, of course, completely dedicated to educating community members about the disease, sharing strategies on staying safe, and how to get food and supplies; learning about symptoms; screening COVID-19; and keeping fellow community members. The volunteer nurses played the shero/hero roles. We also worked on providing families with personal protective equipment (PPE), food, and groceries, and providing financial support for some families. It was a huge logistical and communication challenge. Thankfully, with the support from the community volunteers, we were able to reach families in 12 cities in seven states.
The vaccine was great news; it’s where BRAVE Phase Two started. Using the tools and technology that we perfected in Phase One, we started talking about vaccine safety. Thankfully, the community seems to be receptive to the vaccine, so we devoted our time and energy to promoting the vaccine, helping schedule appointments, and setting up community vaccination clinics at different community centers across the states. This is still an ongoing process.
Now that vaccines are recommended for anyone age 5 and over, how has the BRAVE Process Model evolved to ensure you’re reaching the various age groups?
Thankfully, the Process Model was so versatile and adaptive that we were able to use it seamlessly for Phase Two without any change. I am confident that the Process Model can be used in other crisis situations as well. So, whether it was about distributing PPE, disseminating the new information on vaccine approval for ages 5 and above, or booster shots, it has helped us keep the work and reach out to our community in the same manner. Of course, a lot has changed. Now fellow members can access information and get access to resources through various mediums, but people who face barriers due to language, and at a structural level, trust the BRAVE volunteers and reach out to them. It has evolved to establish two-way communication channels as a result.
How has the BRAVE model been adopted and implemented in other states and regions since the start of the pandemic?
In Phase One, it was more of a centralized approach. Meaning a great deal of information, ideas, and training were disseminated through Columbus, OH, where the project was started. Two BRAVE Volunteer Coordinators in each of the 12 BRAVE locations were directly coordinated and communicated with on a daily basis. We wanted to make sure we were all on the same page, but we also realized that the right information was a valuable commodity at that time, and it was appropriate and important that we communicate the same message. Social media and Zoom meetings greatly helped us achieve that.
In Phase Two, each of the BRAVE locations was free to modify, update, and use the Process Model independently. By that time, they were also linked with health care providers and resources locally, which required them to adopt and implement the model differently.
What additional COVID-19 resources are available to immigrant and refugee communities?
When it comes to health care, immigrants and refugee communities are used to standing at the end of the line, so to speak; they depend on the residual health care system. You can simply make the analysis that, in a multi-tier health care system, the best care is offered to those who are at the top of the food chain. It’s such an irony that refugees and immigrants support the same health care industry as essential workers as foot soldiers.
In my community, people depend on each other for support and advice. They are using home remedies more than medicine faithfully because that is what they can trust. It was also the reason that we had to start something like the BRAVE project. We knew early on the system would not favor the minority, especially the LEP, communities.
Related Resources
Watch Mr. Pyakurel’s original virtual symposium presentation on OMH’s YouTube channel.
Learn more about Cultural and Linguistic Competency and the National CLAS Standards.
If English is not your primary language and you have difficulty communicating effectively in English, you may need an interpreter or document translation to have meaningful access to programs funded by the Department of Health and Human Services (HHS). Find out more about HHS LEP resources.
Last Edited: 07/13/2022