María B Cubillos

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Interview Text and Audio

Abstract

Maria Cubillos moved to the United States from Colombia. She has lived in the United States for twenty six years, living in Miami, Florida and various towns in North Carolina. Cubillos works as an endodontic assistant in an office in Raleigh. She obtained little dental experience working in Colombia but was able to find a job working in a dental office as an assistant upon arriving in Miami. In the interview Cubillos discusses the differences in access to medical and dental care in the United States compared to Colombia.

R0462_Audio.mp3

Transcript

Makani Dollinger: My name is Makani Dollinger and I am interviewing Maria
Cubillos in Garner, NC. It is April 3rd, 2011 2:10pm and we are outside of a coffee shop.
Ok, Maria. Where are you from?
Maria Cubillos: I am from Colombia, South America.
MD: And how long have you been living in North Carolina?
MC: In North Carolina for about fifteen years now.
MD: And did you come from Colombia to North Carolina?
MC: No, no. We emigrated from Colombia to Miami, Florida. Stayed there for
eleven years, and then we moved up here.
MD: And we is your family?
MC: My husband, my daughter, and myself.
MD: From Miami, did you move to your current residence now?
MC: No, we, we actually moved to Greenville, which is east of, you know, ECU.
East of here. And then we lived there for about three, four years, and then we moved to
where we are now, which is Clayton.
MD: Ok. Tell me about where you have worked and where you're working now.
MC: I worked on, in a dental field in Miami for a couple of dentists. General
dentists. Dr. G and Dr. A and then I worked for, in Greenville I worked an endodontist,
which is the people that do root canals. For Dr. M. Then I moved here and I worked for
the state, for the department of oral surgery that works for inmates that only do--. I worked
at a prison, a central prison, and they had a hospital. I worked for the state for about three
years, and then I met my current boss. He took me out of prison. (Laughter). Yeah I
worked there for, you know, I worked there with the endo students. When you go to endo,
as an endodontist, you have to practice in North Carolina three years and, and people
actually do root canals. So they have this clinic at the CP, and every inmate that needs a
root canal has to come here. So I worked with them.
MD: And that made you qualified to work with the endodontist?
MC: Well, yes. And in also what I did in Greenville I learned, and I learned more
often here than I used to be for because I never really did. General dentists here they
mostly don't do root canals. So that's what helped me learn a little bit, and then in here I
learned oral surgery and endodontics when I worked with the CP.
MD: Did you have any experience as an assistant or hygienist in Colombia or
only Miami?
MC: Actually only in Miami because in Colombia when I just got married one of
my good friends was a dentist, she was a dentist, and I worked with her like before I got
pregnant with Laura for a little bit, and she taught me a little bit of what I—. Back then,
you know, this is at the beginning of the 80s so back then we didn't even use gloves. You
know, so, so it's a long time ago.
MD: And your dentist in Miami allowed you to work there with the experience
that you had?
MC: Yes, yes. They did, and then they sent me to school too. Yeah.
MD: Oh.
MC: I had to go to school and get certified, you know, to do things in the office
and get x-ray certification and all that you have to go to school so.
MD: Did they compensate you for that?
MC: They did, they paid for my classes, yes.
MD: Wow.
MC: Yes. And the reason why is I used to babysit for Dr. A.'s children you know.
He, so nobody wanted to work on Saturdays, he used to work on Saturdays, and nobody
wanted to assist him on Saturdays, so, and he needed somebody that would be bilingual
too. So he asked me if I would help him and they would teach me a lot of it. And I said,
"Well, I'll try." And that's how basically got into this field, you know.
MD: Did you, by the time that you moved to Miami were you fluent in English?
MC: No, no. No because see in Colombia from the point I start elementary school
they teach you English, but the English when you come here is like, it's another language
so what I had to do is I had to come to Miami and I work mostly with English-speaking
people and then I had to go to school at nights, you know.
MD: Were the classes taught in English?
MC: The classes were taught in English, but it was a different levels of people.
Like, I had people that were grandparents and me and then other. Also, the education that
we all had was different, so sometimes I knew more than the teacher for some things, you
know. But then they, they taught me how to pronounce things and read the English.
Because, you know, it's difficult. English is a difficult language compared to Spanish.
MD: Have you personally, away from work, had any health experiences in a
hospital or dentist office? Any medical issues or, tell me about your access to healthcare
and how you perceive that in the United States. Whether it's in a hospital or in a dentist
office or in an emergency room.
MC: Like in what sense? Like—
MD: Just any experiences that you've had. Maybe problems that you've run into
from the doctors not speaking Spanish—
MC: I see.
MD: Or not being able to access that from where you were living.
MC: Right, right. Well personally, I see it many times, you know. Like when the
doctors don't speak the, the language of the patient is very difficult because you can't
communicate well. So, I, what I had, like when I was working at CP, which it was a
hospital, it was for inmates, but it was a hospital, I many times had to go to translate at
the, the psychiatric area, which is very interesting to me to translate for somebody that is
being interviewed by a psychologist, for example. I mean, can you imagine? Because I
can't transmit, I can transmit words but not feelings, you know. So that was, you would
think that they would have at this time and age somebody that would a doctor bilingual,
right? When it comes to that. And also in the clinic where I was working, I had to
translate sometimes for some inmates that were Spanish-speaking, but it was, you know
it's easy for me to do that part more than to translate for psychologists.
But, like where I am right now one of the doctors is pretty much fluent in Spanish.
The other one is not, but one of the things he has done is he's done and I appreciate on
him is that he would probably mimic things for you if he has to, you know. So, he may
not be able to speak the language, but he wanted to make the patient comfortable, and he
would do any kind of mimic. So that to me it's, it's meaningful in the sense that he, you
know, he doesn't like when people don't understand him, but he tries, you know.
But, some people, I don't think they care, you know. Some doctors that I know of,
they don't care, you know, if the patient understands or not. So that's not, to me that's not
healthcare, you know.
MD: Do you think that the doctors that do come off like that, that they don't care
about that patient population coming into their office, that they're not advertising to them
at all?
MC: I think they don't think they need them as patients, you know. So, it boils
down to whether if they are in like a public healthcare its like an assembly line, you know.
I hate to use that word but.. .But if they are in a private practice then I've seen doctors
that either look for assistants that are bilingual, or they learn some words or they have
something that the patient...Or they tell the patient please bring somebody (motorcycle)
Or they tell the patient 'Please bring somebody that can translates for you,' you know.
Because ultimately but, you know, this is an English-speaking country, you know. I, I
think I understand that, but like in North Carolina because we have so much Spanish speaking
people, if you are in private practice, and if you wanted to accommodate that
population, you need to have somebody in the office or, or at least somebody that they
can call and say 'Can you translate this for the patient?' you know.
MD: Do you see new doctors and new dentists emerging in North Carolina that
are reaching towards being bilingual and reaching towards that patient population or have
you seen--?
MC: I, I haven't seen that no. I see like, I see like in Raleigh I know a few doctors
that are Spanish, a couple of dentists that I know that are good and they're Spanish. But, I
haven't seen like new students trying to... like, like one of my bosses he's trying to learn
Spanish and he's, he, he even, last year he was taking private lessons, you know. Going
through the trouble to do that, it means that the person cares for the population. And, hey,
it's in his interest, you know. I mean, he's going to be known as a bilingual and
sometimes they call our office and they ask us if we're bilingual and I said, "Yeah." You
know, even if you great the person in their language, even if you do that, that means a lot
for them.
MD: Does your dentist that you work for now want that patient population or is it
that that patient population wants him? So I guess what I'm asking is do you think that
dental care or endodontics is becoming more accessible to native Spanish-speakers
because they can either afford it?
MC: Right.
MD: Or do you think it is your dentist and other dentists reaching out to these
people?
MC: I, I think it's both ways. And one thing is that you see sometimes, you know,
Spanish people they may have gold earrings and gold chains and.. .and they don't want to
save their teeth, you know. Some do that. So they do have the money to pay for a
treatment, and so some of them want to do that, some of the Spanish people want to do
that. And some of the doctors want to reach out to them. So, I'm thinking that it's both
ways in that sense. Because obviously, if you had, if you're, if you're learning the
language it's because you want to attract that people too, and you want to help them, you
know. So...
MD: And, from what you can remember from your experience in Columbia, what
were, what was access to dental care like there compared to—
MC: It, it's very, it's very good actually. And it's very reasonable to compared to
here, you know. Lets, if I wanted to say prices, you know, I just want to say, well what I
know about root canals, you can pay for a $100 root canal down there, and how much is a
root canal here, you know? So it is very.. .1 mean you can have access to a lot of dental
care there, if you want to have good dental care.
MD: Do you see a lot of your friends or family members at home, did they reach
out to that access or...?
MC: Some, yeah. My family does because we, we were taught that way. Some
others don't (laughter). Because they're not, you know, like, I have a cousin, she's a
dentist, and she says some people want to come here and then get their teeth out when I
can save the teeth, but they don't want to spend the money on that, you know. So, there's
still that level of education that people don't, some of them don't understand that you
need to save. But most of the Columbians, most of them, they do want to save their teeth
this time and age, you know. So...
MD: Is that because they haven't had dental hygiene education or is it that their
families don't?
MC: They didn't have it years ago, but now its different, you know. Now you
know that sugar is bad for your teeth and all this stuff You know now people wanted to,
well, they're better educated now and then they're more dentists spread out, you know.
Like when my parents grew up, which it was not like that, so...
MD: So the education is definitely—
MC: It's much better. Definitely, yeah, yeah.
MD: And what about the access? Is it still the same as far as cost? It's much less
still?
MC: Yeah, I mean it's definitely...you mean compared to here?
MD: Compared to here.
MC: Oh yes, definitely. Yeah, it's much, much less, yeah.
MD: Would that prevent immigrants from Colombia, for example, who saw that
easy access in Colombia and could get a root canal done for $100? Would they avoid
doing that here?
MC: A lot do, yes. I mean I have had patients at the office that are, you know that
I, they come and say, you know, I say, "You need a root canal to save this tooth," and
they'll say, "Oh, can I have a prescription so I can buy me time to go home and get it
done?" And this is what I said, I said, "Okay, it's fine, you know, you can have
prescription and you may become, you may get in a lot of pain in the meantime, and not
have time to go back. Or, you cannot find a good dentist down there that do it well. And
then you come back in here, and then a year later you're going to have a problem, and
who's going to fix it? You're going to have to come back to us and it's going to cost you
more." So that's what I said, you know. Everybody has a choice, they have to make their
own, you know.
But sometimes you can also have bad quality and there is good dentists and there
is bad dentists too, you know. You have to be careful who you choose.
MD: Is that because of the various routes of education that they take to be
dentists?
MC: That is correct. Also products, you know. We do definitely have money to
buy very good products here, and then the, the quality of the products that you buy there
maybe not, they may be not as good as it is here. In that place it would be ( ). When you
have cosmetic work and things of that nature, too.
MD: Do you, or you dentist, or anybody that you know in the dental fieldwork in
any of the free clinics that they offer?
MC: We do actually. We work, this is how, actually this coming weeks I have a
patient from Wake Smiles. And one of my dentists, my doctors goes to dental society
meetings so that's how they get, you know, their names out, and then they call us and
they ask can you do a root canal for this and that person and we actually have a patient in
a couple of weeks coming that is Spanish. So, yes we do, that's how we do it. But, also
they do a lot of, sometimes I know people. Like in my congregation that cannot literally
afford root canals and they've done it not once, but many times, like that. But I know that
they can't afford it. So they're very nice about people like that so...
MD: Tell me more about the...Wake for Smiles?
MC: Wake Smiles.
MD: Wake Smiles. Is that directed towards patients that can't afford different
procedures?
MC: Yeah, and it, I think what they do is they look because they go to the dental
society meetings and they find different specialists, you know. Let's say you need a
crown and a root canal. So we do the root canal and then Dr. B does the crown or
whatever, and they call those doctors and set them up with the patients. That's how they
do it. Which I think is really good.
MD: Yes.
MC: You know, because like when the patient I work on is missing a front tooth,
imagine if you're of ( ) and missing a front tooth and if you're a woman, that's terrible,
you know. So that's what we have. And, yeah I think it's great. So that's how it works. I
think the patient has to go to the Wake Smiles and qualify for that.
MD: Do you see a lot of Hispanic patients and Spanish-speaking patients reaching
out to that program?
MC: Yes, a lot.
MD: Do you have any idea how they become knowledgeable of the program?
MC: It could be I, it would, I'm not sure. So I don't know if I should answer the
question or not, but I think it has to be when they go to their clinics, like when the go to
WakeMed clinic and they don't have any obviously insurance so that's how they've been
told go to this place and, you know, see if you can qualify.
MD: I have volunteered as a dental assistant in various free clinics that we offer.
One of them is the Dental SHAC in Carrboro, and it's put on by the dental students, UNC
Dental students, and I work there as an assistant, and a huge percentage of our patient
population is Spanish-speaking.
MC: Spanish, yeah.
MD: And often times they run into the language barrier between doctor and
patient, and on nights when I'm there it's really helpful because they don't have that
bilingual aspect with the dentist. And those patients that come in don't...it's not that they
don't care about they interaction, it's just that they want, they think that the dentist knows
best so they'll let them whatever.
MC: Whatever, uh-huh.
MD: Do you ever get that attitude?
MC: Not, no, not many times. You know, because where I, where I, what I'm
doing right now, it's very expensive, so they definitely want to inquire, like is this going
to last, is it worth it, what are my options. So, and we definitely wouldn't want to do
anything on a patient unless they're aware of what's going on. So, mostly of the ones that
we have, they wanted to know, you know, what are they're options, and what is done,
and what else do they need after that.
MD: And, I've also experienced that these patients were not ever knowledgeable
of different diseases and how to prevent different diseases. In one of the motives I've
made towards that is a pamphlet written in Spanish of, you know for example, Baby-
Bottle Syndrome that mothers with newborns don't know now to put their child—
MC: To sleep.
MD: To sleep with the bottles and I see that reoccurring over and over.
MC: Sometimes I think that the population that we have in Raleigh, in North
Carolina, and sometimes the population that immigrates here from, from border countries,
not that I, because I have friends from Mexico myself that are well, well educated and
very, very, you know, smart, and it's some of the immigrants that come here come from
like village or little towns and they don't get to, they don't, sometimes they don't even
know how to read. So that's a lot of the population that we have here. Not all. And by no
means I don't mean that they are not smart or anything they just didn't have that chance
to get educated. So sometimes they just, you're right, they don't know many things that
are, and sometimes obvious, you know.
MD: Do you have any friends that are, that have taken advantage of either going
to the UNC Dental School for dental work or the free clinics?
MC: Yes, I have, yes. I have, actually, I sent a friend of mine there a couple of
weeks ago to get an extraction done at UNC because she's new here and she doesn't have
any insurance and she's a diabetic and she needed an extraction. We can't do that for her
so she, she went to the, the UNC clinic and they did it there.
MD: Have any of them shared their experiences with you?
MC: She did (laughter). Did you want to hear it? (Laughter)
MD: Yes, please.
MC: Well, she said that they were the first time that she went she was actually
scared because she, her blood, her blood level was like in 300 or—
MD: Blood pressure?
MC: Not her blood pressure, the sugar.
MD: Oh.
MC: She thought it was too high for her to have an extraction. Because she kind
of, I mean, you know, she's knowledgeable of that. So she told the student and then the
student says, "Oh no, it's not a problem." And she goes, "Please make sure!" So the
student asked the doctor in charge and then he didn't do the extraction that day because
of the sugar level was too high. So then, of course, they send her home, make sure that
goes down and then come back. Then she goes back, they do the extraction, but I think
the doctor in charge, the student had a lot of struggle doing it so they, he had to call the
doctor again and get it out. Yeah.
MD: Was the doctor, the student, bilingual?
MC: That's a, I don't know, I don't know. But the first one, I know it was. And
the second one I don't know. She doesn't speak English. So, I didn't ask her that. But the
first doctor that saw her, and then the second one.. .She said they were all very, very nice
to her, but she knew that he was having a hard time taking out that little piece of tooth out.
So, no I don't know if he was bilingual or not to be honest with you. I didn't ask her.
MD: Has she, was she pleased with the rest of the services?
MC: She was, yeah, she was, yeah. She was happy that, you know, that it was
done. She said that it was a lot soreness after that. But she was happy that it was done.
And she actually wanted to get involved so they can do like a treatment plan for her
because she needs on the weekend ( ).
MD: Does that happen often where you'll get patients in your office and then
refer them other places?
MC: We refer them when they can't afford it. Sometimes we send them to UNC
clinic. Yeah, we do it often. Actually I these last weeks we have done once every week.
We have a patient from Brazil because there is a student from Brazil that is doing the
endograd program and my doctors knows him and we send him to him.
MD: Well that's interesting that they are taking advantage of the access to you,
and then going from you.
MC: And we did this lady from Brazil, we had already done a root canal on her,
and then my boss had given her a little discount, but she's going to need another one.
And she says she cannot afford it. So that's why we sent her to the UNC clinic. And then
because of he knows that doctor there is Brazilian so its just, you know, we think it's
perfect for her. And that way she can get treated and it's, it's not as expensive as coming,
it's a lot less than coming to us.
MD: So from what we've talked about it sounds like Spanish-speaking patients
are becoming more and more knowledgeable of access to dental care that is provided in
North Carolina and you're seeing.. .over the years can you say from your experience that
you've seen a greater amount of that population accessing your services?
MC: Oh yes. Definitely, yeah.
MD: Well I don't have any more questions. Did you want to add anything else?
MC: No, it's okay I mean
MD: Okay.
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