March 27, 2006
By MONICA POLANCO, Courant Staff Writer
Doctors in Colombia worked for 20 hours
to repair the damage acid reflux had wrought on Mariana Heredia's
larynx, vocal cords and trachea.
They removed the unhealthy tissue in
September and repaired a hernia in Heredia's stomach that was the
culprit. The surgery, obtained with the help of a group called Sin
Barreras: The Latino Outreach Project, has given Heredia hope.
"I think I would have died waiting,"
said Heredia, 42, of Hartford. "I didn't know where else to
Sin Barreras - Spanish for "without
barriers" - aims to help chronically ill Spanish-only speakers
in Connecticut navigate the often tangled web of services they need.
Lydia Velez Herrera, 37, of Bristol,
is the director of Sin Barreras. Jennifer Jaff, 49, of Farmington,
works with Herrera and runs a nonprofit called Advocacy for Patients
with Chronic Illness. Sin Barreras is part of the advocacy group.
Jaff , a lawyer, handles legal matters, and Velez Herrera, who speaks
Spanish, communicates with Sin Barreras' clients.
The free service is badly needed, said
Attorney General Richard Blumenthal.
"I think this service can be immensely
important in providing a critical link and a lifeline for people
whose primary language is Spanish," Blumenthal said. "My
hope is that it will attract sufficient resources to serve large
numbers of people."
Health insurance companies in Connecticut
frequently deny claims from chronically ill patients for a variety
of reasons, including what the companies consider ineffective treatment
and imagined illnesses, Blumenthal said. Patients who speak only
Spanish may be less likely to challenge a denied claim because of
the language barrier, he said.
"This technical jargon is difficult
for anyone to understand and the procedures are often confusing,"
he said. "For someone who feels that they would be easily understood
if only for the language barrier, they may feel sort of embarrassed
to question authority."
In addition, some Spanish-only speakers
think they don't have the right to challenge an insurance company,
said Jorge L. Rivera, founder and executive director of Mi Casa
Family Services and Educational Center in Hartford.
"That's one of the biggest problems
that I've seen ... that people don't know how to navigate the system,"
Rivera credits Sin Barreras with obtaining
a humanitarian visa for his father-in-law, Elias Mejia. Mejia feared
his leg would be amputated in his native Dominican Republic, where
medical technology is not as advanced as it is in the United States.
This month, doctors told Mejia that
he didn't have circulatory problems and didn't need an amputation.
"That was great news," Rivera
Rivera said he's excited that Sin Barreras
this month began offering help to about a dozen Mi Casa clients.
"Thank God that she [Jaff] agreed
to bring that service here," Rivera said.
Velez Herrera's and Jaff's advocacy
efforts are rooted in their experiences with chronic illness.
Velez Herrera's 17-year-old daughter
has bipolar disorder and Jaff, a former state assistant attorney
general and patient's rights expert, has Crohn's disease, which
causes a host of ailments such as diarrhea, abdominal pain and rectal
"My concern was that Latinos who
were Spanish-speaking were not receiving as much information as
the English-speaking population," Velez Herrera said. "I
was really hopeful that this would be my way of giving back to the
Together, the women complement each other, Jaff said.
"Part of the reason our partnership
works so well is that I'm sick," she said. "She's my legs
on top of everything else."
So far, Sin Barreras has helped about 50 people with problems such
as health care access, domestic violence and Medicare Part D, Velez
Herrera said. Because many of their clients need help in more than
one area, it's not unusual for Jaff and Velez Herrera to help families
solve housing problems and find donated food.
The women have offered their assistance
through a mixture of grants, contracts and donations, but as their
client base grows, so does their need for more money.
"We're really at a crossroads
here," Jaff said. "We're at a point where we're going
to make a decision in a couple of months whether this is going to
The service has become more than merely
a Spanish-language equivalent of Jaff's Advocacy for Patients with
Unlike Jaff's English-speaking clients,
many of whom contact her through her website, Sin Barreras clients
tend to learn about the organization through word of mouth and have
a greater desire to meet Velez Herrera and Jaff.
"It seems to us, that Spanish-speaking
patients really want to see us and they need to establish the trust
that only comes from face-to-face contact," Jaff said.
Sin Barreras clients also hear a key
message, Jaff said: "We kind of have to start at a different
starting point of saying, `It's OK to fight for your rights - in
fact, it's expected."
Mariana Heredia, a married mother of
three, struggled with her illness for 10 years.
Her condition deprived her of oxygen,
causing fainting spells. When doctors in the United States told
her they would have to remove her vocal cords in order to treat
her, Heredia sought treatment in Colombia.
Sin Barreras persuaded Heredia's health
insurance provider to pay for the $51,000 surgery and provided Heredia's
family with food and airfare to Colombia.
Heredia is still recovering. Because
she overstayed her one-year sick leave, Heredia has been fired from
her housekeeping job and is without insurance, Jaff said.
Now, Sin Barreras will help Heredia
apply for Medicaid, Jaff said.
"I'm very thankful," Heredia
said. "If one day I had the opportunity to work with them,
I would very happily do it. Without them, I don't know what would
have happened to me."
Reprinted with permission of the Hartford Courant.
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