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Transcript: Response and Recovery: Dr. Luz Garcini

 

Ali Noornai [00:00:11] This week, what immigrant pandemic experiences can teach us about resilience and how this can help us build support systems that work for all.

 

Dr. Luz Garcini [00:00:26] So we went through data and analyzed and studied what are some of these resilience factors that help them survive in the face of uncertainty? And we found dry courage, optimism, cognitive reframing their reality, staying in the present moment, engaging with full heart and staying with the four core values and reminding themselves as to what is the purpose of everyday life that keeps them strong and keeps them focused to get through it.

 

Dr. Luz Garcini [00:00:58] From the National Immigration Forum, I’m Ali Noorani, and this is Only in America.

 

Dr. Luz Garcini [00:01:13] Pandemics, as this year is constantly reminded us, are about much more than just a virus. They’re about who can access treatment or feel safe seeking it out. They’re about who can work from home or access federal live, who is given the tools they need to weather the storm and, well, who is left to figure it out on their own. For many Americans, this past year has brought a level of uncertainty and fear like never before. Compounding factors like unstable employment, housing insecurity and health concerns have left millions in a state of chronic stress. In many ways, this uncertainty and fear is really not all that different from what many undocumented immigrants have been facing for years, from looming threats of deportation to a lack of health care access, this chronic insecurity has been a reality for millions of folks living and working in the US for as long as our broken immigration system has been around. On top of that, as we’ve discussed previously in the series, immigrants are disproportionately impacted by the pandemic, both the virus itself and the economic hardships it’s brought, not to mention years of anti-immigrant rhetoric and policies. My guest today studies the impact of stress and trauma in immigrant communities. She’s seen how the long term insecurity weathered by the undocumented community has built knowledge and resilience. And based on her research, she believes it can teach us a lot about how to support other vulnerable populations who are struggling with pandemic related grief and trauma.

 

Underwriting [00:03:05] Support for the National Immigration Forum comes from the Carnegie Corporation of New York, supporting innovations in education, democratic engagement and strengthening international peace and security and from Humanity United. When humanity is united, we can bring a powerful force for human dignity.

 

Dr. Luz Garcini [00:03:30] My guest this week is Dr. Luz Garcini. Dr. Garcini is a nonresident fellow at the Center for the United States and Mexico, part of Rice University’s Baker Institute for Public Policy. Her research focuses on the study of trauma, loss and grief among Latino immigrants. She currently works with Proyecto Voces, or Project Voices, which involves both community outreach and research to document and address the complex health needs of undocumented Mexican immigrants and deportees. Dr. Garcini is particularly interested in how stress and trauma manifest in immigrant communities and how their physical affects can echo across generations. She has an incredible personal story that she shared with me how we need to build a pipeline of talent that meets the health needs of the immigrant community and how the new administration can help break the cycle of mistrust and fear that leaves immigrants more vulnerable.

 

Ali Noornai [00:04:25] So, Dr. Garcia, thank you so much for joining us. Really, really appreciate this. And I’m so looking forward to learning from everything that you’ve been doing. So to begin with, tell me a little about yourself. How did you get to where you are today?

 

Dr. Luz Garcini [00:04:38] So, OK, I take my costume off. I always call the degree and the professional title the costume. But I am a Mexican origin. I am an immigrant. I came to this country probably about twenty seven years ago now. And what you see is very different to what got here. So I came here actually running away from safety issues in Mexico, thinking of it as a temporary move. I immigrated. I was in my early twenties with two kids. I was married very young when I was 16. By the time I was 19, I had two kids and I was a high school dropout. Like many women in my country, I just did not think of pursuing an education. I just thought, you get married and you build your family and that’s what you focus on your life is. But we came into this country, not speaking English, without any much money. And I started actually receiving some services at organizations that help immigrants with the transition and the adjustment and fell in love with the people there. And they didn’t have anyone who would start working with some of the parents and teaching Spanish classes. So they asked me if I could do it. And I was like, well, I could barely know how to do with my own children. So they gave me a book and I fell in love talking to the immigrants. And one thing led to another. A lot of mentors started jumping on board and said, why don’t you get a GED? That was like, well, I don’t speak English. I was like well the GED is offered in Spanish. So that’s how I did it. And I fell in love with learning. I went for many years, probably about five years to a community college and remedial classes to try to get a degree. And I think that is the reason why many people come to the United States, right? In search for opportunity and this country gives it to you. Things that you will never think about building become a possibility here. There’s a lot of people who reach out to you and give you a hand and open the doors. And here I am, you know, many years later with three master’s degree and a PhD and doing the job that I love with immigrant populations that I could never think possible. So he has been a magical adventure. And I have the honor of also now working on mentoring many of the students that have similar stories, whose parents came, my first generation immigrants with very limited resources, many of them undocumented. And in only one generation we see children who are attorneys who are physicians. So it’s a fascinating journey.

 

Ali Noornai [00:07:24] So give me a sense of what a typical day for Dr. Garcini looks like. Given that just amazing story of kind – what does your day look like?

 

Dr. Luz Garcini [00:07:35] I think that should be an interesting question for my research coordinator, because she thinks is madness. So. Well, you know-

 

Ali Noornai [00:07:44] the story itself is pretty…

 

Dr. Luz Garcini [00:07:46] Yes. But my work is always different. It’s never boring. I jump from one issue to another one. I have to keep up with the political context and what’s happening at the forefront in the new crisis. I go from writing, from teaching students, from running research projects. You know, I have my head into very, very diverse health areas, from covid vaccination to covid testing, to how stress gets under the skin of immigrants with trauma, to dealing with bereavement and loss. I mean, you name it, I’m there because I think what we seem to forget sometimes is that immigrants are everywhere and our affected by everything. So my work really fits into everything, sometimes I jump into I get calls for media interviews and I just quickly jump into one. It’s just from one thing to another. Sometimes it starts very early and doesn’t end very late. It jumps over the weekends. But it is a fascinating adventure, is always learning, always learning. Whatever person I come across, particularly our participants,they have Wonderful Life stories that can teach us about resilience, about what do you do, how do you build strength in the face of adversity. So I feel very, very fortunate to have the job I do.

 

Ali Noornai [00:09:12] And so what have you been seeing within the community that you serve for the last year, as we’re just about a year into this pandemic and whether it’s in terms of prevention measures or mental health trauma, from your perspective, how has covid-19 impacted the immigrant community?

 

Dr. Luz Garcini [00:09:30] So it’s very interesting because it’s a dichotomy. I have seen so much loss, and the biggest one is the loss of human life. As you know, a lot of the Latino immigrant community have higher incidence of death rates due to covid-19 for many reasons. We know that a lot of these immigrants are at the forefront of taking many of the jobs that are out there and that raises exposer to them. There’s been financial losses, you know, loss of employment that has taken a toll, emotional losses that have happened also. But on the other hand, I have seen the resilience in the we’re going to make it through. We made it through before. This is just one more. We just have to learn how to get through. So we recently actually wrote a paper who’s currently on the review on the resilience. And it is what have we learned from the undocumented experience that we can apply to surviving Covid? Because a lot of the things that covid hit us was with uncertainty, right? We didn’t know what was this new virus. We didn’t know how to stop it. We didn’t know how to treat it. We didn’t know from all the confusing information what works, what doesn’t work, how can I be fully protected, and it brought to us? A lot of uncertainty, a lot of fear, because we didn’t know if we were going to have access to the resources that we needed to keep safe, if we were going to be able to keep our jobs. And I think that affected everybody some more than others. But my argument one, well, this is no different to the undocumented experience on the daily lives. They live like this since they left their countries. So how is it that they survived? So we went through data and analyzed and studied what are some of these resilience factors that helped them survive in the face of uncertainty? And we found, right, courage, optimism, cognitive reframing, their reality, staying in the present moment, engaging with full heart and staying with the four core values and reminding themselves as to what is the purpose of everyday life that keeps them strong and keeps them focused to get through it. So we have seen a tremendous amount of resilience throughout this pandemic that I think are some lessons learned that we can use to apply it to other populations, to people who are facing death and dying, which many people have done it, people dealing with chronic illnesses, people dealing with forced family separations. So there is, I think, a lot of lessons learned and a wealth of knowledge as to how these communities have faced. Because we need to remember use not only the covid pandemic. This happened at a time where the anti-immigrant rhetoric and actions were at a tremendous level, so they were being hit on two fronts. It was like compounded stressors building on themselves, and they’re still standing. So to me, that is just an amazing lesson.

 

Ali Noornai [00:12:51] Getting pressures from both the rhetoric as well as the pandemic. Did that lead the immigrant community to be more insular and the way they were living or were the circumstances such that they didn’t have the benefit of being insular? I mean, look, many of us never have to leave our houses because we can work from home. So how do people grapple with that?

 

Dr. Luz Garcini [00:13:11] I think this is a community that, and I say this with pain because they were level level essential and they wanted to prove it. So they step up to the plate and they were out there and they were helping and they were serving if you needed someone to work, they were the first ones who said, I’ll take it, you know, and I heard these from different employers that said, I’ll take it, I’ll do it, I need to bring food to the table, to my family, and to send even to the sending countries, right? Because the other countries from where they immigrated, their families left behind, were also struggling. So they did not recruit it to themselves. They continued to push forward. However, I think the attacks that continue to happen in that mix of you’re essential, yet you don’t have access, right? Unfortunately, yes, you can have testing. But if you don’t have the right documentation, you know, you can have it or is going to cost you more money or the information is not going to be tailored to you, and we will see the same thing with the vaccination, right? We do not do it anonymously or in a way that is accommodating and protecting them. So it’s it leads to deception. It leads to defeat. And I think the mental health toll eventually is taking place on these communities. So we need to stand up to the place and it’s time for paying back, time for being back for all that they have given us during these hard times.

 

Ali Noornai [00:14:46] And so from a policy perspective, for those who are deemed essential for then stepped up to be essential, what needs to happen either in terms of the vaccination or otherwise?

 

Dr. Luz Garcini [00:14:57] First of all, the funding which has been threatened to be withdrawn from safety net providers, you know, all those community clinics that attend to the needs of these immigrants, withdrawing funding from those institutions will be a big mistake. There needs to be channels to deliver that to the communities. Our people trust those places, trust community based agencies. So definitely advocacy efforts that can continue to provide funding to those places and they can start devising ways in which we can guarantee that their personal information is going to be protected. These happen with our DACA recipients, right? When they came forward and provided the information and we learn about breaches of confidentiality, they became very vulnerable because they knew when the announcement of the potential termination of DACA was made, they could be deported at any time. They knew where they were located, where they were, where their families were. So the communities have learned not to trust and they’re afraid to come forward with any sort of personal information that is going to harm them. And now, one interesting thing that we find in our research is that this not only affected the undocumented individual, him or herself. You know, I always say that the undocumented experience affects the community, the families and everybody that surrounds with them, because we started seeing fear on permanent legal residents that said, well, you know, if I go get tested and I turn out positive, then the government is going to have a record that I’ve been positive. And at any point they can take out my green card citizenship or they’re going to take my children away. The fear started spreading. And I think that was- that was very difficult. So we need to ensure that the protections of confidential information find ways to do and disseminate this in a way that is anonymous and that is protected. That’s another one. And allow immigrants to purchase insurance in the insurance marketplace. You know, up to this moment, we know is very, very difficult for undocumented immigrants to get access to health insurance. Obviously, we need to do a culture of educating them as to what and why it’s important to have health insurance, but that is key to provide access, right? And the other one is access to legal resources. You know, everybody deserves a right to have access to attorneys, to a channel of information that can inform them of their rights and a lot of them have been denied of that access.

 

Ali Noornai [00:17:40] So going back to the first one, I think you’re talking about in terms of what can happen with one’s information, do you see the issue of misinformation and deception within Spanish language media or in essence, how are people getting their information these days? And what is the most trusted pathway for information among the immigrant community?

 

Dr. Luz Garcini [00:18:02] The problem has been that many, many layers, right? I mean, when you see the maximum authority, the president of the United States, directly attacking, you know, from across all channels, you know, that makes you very, very scared. The other one is social media, right? Fear inducing rumors get passed on of what you heard and then he gets a little bit distorted. But I think all of us experience some sort of fear, you know, in terms of the information that was provided about covid in how we didn’t know how to react or what not to do, but I think the most reliable source of information for this community is directly to trust the providers, to networks, to community based agency, to faith based leaders. So I think there is a way for organizations and the government to start working with this grassroots organizations to deliver the information to our immigrant communities in a way that is culturally and contextually sensitive, because that is another thing, right? You cannot deliver health messages, if you don’t frame them in the right way. If you don’t frame them within a collectivistic sense as to why you need to take care of yourself so that you can take care of others. The other thing that is important to do is we need to listen to the communities. They will talk to us if we just go and say, what do you need? What do you need to trust? All of this information, I mean, I didn’t make it out of my head. This was provided to us by the community, community health workers, labor workers, promotores, promotoras de salud are a fantastic resource. How can we integrate it into traditional medicine channels so that they can be recognized and given the space they need to to do that work in their communities and to deliver that information. But so far, there’s no funding sources to support the war. They’re very limited in their only short term.

 

Ali Noornai [00:20:03] And what we’re talking about here, in many ways, is helping people answer the questions that they’re going to have around the vaccination and being able to answer those questions through a trusted source. Is that fair?

 

Dr. Luz Garcini [00:20:14] Yes, absolutely. I think we need to overcome a lot of the needs and the beliefs that are related to the vaccination. We need to explain to people about the novelty of the vaccine, how the vaccine was made. People are concerned that the vaccine was made in a rush, but they don’t understand that vaccination in the process of making these vaccines has been done in the past with other diseases. We need to explain that to them. We need to explain to them what to do in cases of side effects. One of the biggest barriers in testing was like, OK, I go get tested and if I am positive, then what? I prefer not to know, because I know I don’t have access to a hospital, I know I cannot get the treatment. So why am I going to find something if I don’t know what the next step is? So they were asking for that. They need a lot of navigation skills to navigate a health care system and our legal systems in order to push forward.

 

Ali Noornai [00:21:15] So let’s take a step back here. And we now have a new administration and we have a Congress that’s starting to wrap its hands around immigration reforms. That was the community seeing this change in administration, whether that’s people who are here in the states or people, whether in Mexico or further south, because, yes, we’re talking before we hit record, we are seeing migration begin again, but we’re not seeing the numbers, say, from 2019, but we have to be able to communicate these changes or these just even potential changes very carefully.

 

Dr. Luz Garcini [00:21:45] Yes, I think I would like to use the word cautious, so our communities it’s very difficult to trust. I mean, we have a history, right? The immigrant community has been let down across party political party boundaries. Right, I mean, we have a history of high deportations during President Obama’s administration. You know that the non consolidation of the DACA proposal happened and the community felt very let down, even though the steps starting to get in the right direction. You know, then we switch political parties and we saw very aggressive actions. So at this point, you know, the community is like, well, there’s a lot of promises. Are they going to take place and are they going to happen? So I think it’s important for the new administration, I think they do have the heart in making a change and helping people, but not to overpromise, because overpromising can let our communities down and again feed into the cycle of mistrust and fear. And it’s also important that we become very aware that whatever policies gets implemented in the United States have far reaching effects to the messages that go to the sending countries. You know, we need to be careful on a path to legalization because that can also trigger a flood of immigrants under conditions that are very unsafe, that are very hazardous at the moment with a public health crisis and safety crisis that we’ve seen throughout Mexico and in Central America. So how can we do it in a way that is safe for the immigrants that are already here, for the immigrants that are waiting in the border? We can’t forget that we still have tented camps there waiting for asylum and refugee status and for those that are thinking about migrating.

 

Ali Noornai [00:23:37] You’re absolutely right. And I think cautiousness is definitely the right word, both for the community to be cautious, but also the communications. I want to go back to something you said earlier about mental health impacts of the pandemic. Could you give me a sense of what you predict or see in terms of long term mental health impacts for the immigrant community know just coming out of the last year?

 

Dr. Luz Garcini [00:23:59] So we have different issues. I think what we’re seeing is a lot of anxiety. It’s interesting because a lot of people think about depression. And always my argument is like, no, we need to think of anxiety and anxiety can be just as debilitating as depression. And when we go to the community and ask them, they say, if I get depressed, I can’t work and I cannot afford not to work because I won’t feed my family. Everything is done through the context of the family. How do I give back to my family? So the pressure becomes incapacitated, but instead they operate at a high level of anxiety that is also not healthy and is associated to the development of chronic diseases, hypertension, diabetes, you know, and exhaustion. A lot of them are not sleeping, are not taking care of their health. So I think eventually that can backfire just as much as depression could. Trauma related stress is also very interesting because one of the trends that we have seen is trauma related stress does not necessarily present, as we traditionally see, as post-traumatic stress disorder in these communities. You know, the diagnosis of post-traumatic stress disorders was created with a Western mentality in mind for the military. So it’s not necessarily the way in which are immigrants present. And also a lot of those symptoms tend to present once the trauma subside. We need to remember that a lot of these immigrants are still embedded into the trauma context. Our data has shown,interestingly, a lot of the trauma has happened pre migration, but continues to happen post migration while living in the United States. Why? Because this population is voiceless. They cannot defend themselves against exploitation. And that’s a big one. They don’t have access to health care in cases of serious threats to their life. Right, if they’re running into an accident at work, if they don’t have treatment, if they get sick with covid and don’t have access, that’s sources of major trauma. So as long as they’re still embedded within that trauma over a long period of time and compounded as a result of multiple stressors, we don’t necessarily see the traditional symptoms. So a lot of the time, people don’t know what to do with it and don’t know how to treat it or how to assess it. So we need to start thinking outside the box as to how we address mental health with these immigrant communities to prevent retraumatization and to restore well-being so that they can continue functioning.

 

Ali Noornai [00:26:38] So then what are the research questions that should be asked by academics? I mean, it’s clear that you have thought a lot about this, but I imagine that there are not many other people in the academic world that are looking through the same prism. So, for others who are thinking about whether it’s mental health research or other clinical research, what are the questions they should be exploring?

 

Dr. Luz Garcini [00:27:00] So one of the studies that I currently have on the way is to understand how stress get under the skin. Right, because I think we talk about the healthy immigrant paradox, right? We see all these immigrants and I just talk about resilience, how resilient they are. Right, but we need to- I think we need to document until when. What is the point when that health advantage over turn and it can turn risk? And I think that bridges into social justice and the protection of human rights. So we can document how that stress slowly gets into the skin and increases risk for inflammation for markers. Now we have fascinating genomics that can tell us will that start affecting the transmission of trauma and stress to further generations? I think we have the technology to do it. What we don’t have is the people to do the work, the pipeline of future researchers, scientists and providers to serve the need. So one of the biggest questions that I think we need to have is how do we build a pipeline? How do we build a pipeline so that we can address the needs of the population? The population is there, but we have very few people to study it. We often do it with very limited resources because there’s usually very limited funding to do this kind of work and most of the time, it takes a long time to do this kind of work, so I think building a pipeline across disciplines is essential to try to understand what’s happening with this population and grant that this population is here to stay. They have children who are US citizens, and I think we need to start thinking as to what are the long term effects of everything that we’ve seen over the past years, within this past year on these children and their future generations, so that we stop the cycle of violence and trauma and stress and loss.

 

Ali Noornai [00:29:07] And that pipeline is developing a pipeline of talent from the community to go on to serve the community much like yourself.

 

Dr. Luz Garcini [00:29:15] Yeah, we need scientists. We need doctors. We need attorneys. We need religious leaders. We need community. We need people across the board. We need historians. We need historians that can capture the histories of these immigrants. We need artists that can draw those things, right? We need producers that can put this in documentaries. We need media people. We need media people who can ask the right questions. So across the board, I think we do need to build a pipeline to tell the stories and to communicate the need, because other than that, we continue to be without enough information.

 

Ali Noornai [00:29:57] Well, I have to say with you and with what you do on a day to day basis, I feel like we’re off to a good start. So thank you. But I do have one more question for you. And the question is just a request to finish this sentence. The name of the podcast is Only in America. So to finish the sentence: Only in America…

 

Dr. Luz Garcini [00:30:14] Only in America, seeds grow.

 

Ali Noornai [00:30:16] Thank you so much for the time, Doctor. I so appreciate it.

 

Dr. Luz Garcini [00:30:19] Thank you.

 

Ali Noornai [00:30:32] Dr. Luz Garcini is a nonresident fellow at the Baker Institute’s Center for the United States and Mexico. You can learn more about Dr. Garcini and Proyecto Voces at our website: ImmigrationForum.org/podcast. And if you like what you hear, please subscribe to Only in America, wherever you’re listening to this episode. Stay tuned for next week’s episode, where we’re going to take a closer look at a vaccine rollout in immigrant communities. Only in America is produced and edited by Joanna Taylor and Becka Wall. Our artwork and graphics are designed by Karla Leyja. I’m Ali Noorani, and I will talk to you next week.

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