A combination of computer illiteracy, language barriers and lack of outreach create challenges for inoculating Long Beach’s elderly Cambodians.
When Kimsreng Ung moved to Long Beach in 2013, she came alone. She arrived in the United States seeking education, healthcare and, most importantly, safety.
The 74-year-old Long Beach resident is a survivor of the Khmer Rouge, a regime responsible for a years-long genocide that led to the deaths of two million Cambodians in the late ‘70s.
Now, as COVID-19 continues to take root in low-income communities of color, her safety is being threatened. To protect herself from the virus, she needs the vaccine.
But, like other Cambodians, Ung faces a myriad of challenges when it comes to accessing the vaccine. She doesn’t know English. She lives alone. She doesn’t know how to drive. She doesn’t have internet access.
“There are a lot of Cambodians here, but not too many Cambodians have received the vaccines because there’s no news. There’s no education. There’s no advocates or navigators to be here with us, to help us make an appointment for the vaccine,” Ung said in Khmer. “We don’t have internet and we don’t have computers. We’re told to stay at home and we’re afraid.”
To sign up for an appointment, Long Beach residents must use VaxLB, an online appointment and notification system that tells residents when it’s their turn to be vaccinated. As of Feb. 2, over 44,000 vaccines had been distributed in Long Beach under this schema.
“The process of getting the vaccine has been very difficult for me and full of frustration,” Ung said in Khmer. “I have to depend on people to help me.”
As the City of Long Beach continues to roll out vaccines for the City’s seniors, elderly Cambodians are struggling to sign up for vaccines. A combination of computer illiteracy, language barriers and lack of outreach have caused some to believe that elderly Cambodians are being left behind.
Laura Som is looking to change that.
Som, a survivor of the Cambodian Genocide, is the founder and director of the MAYE Center in Long Beach, a space that provides trauma-informed workshops in yoga, tai chi, meditation and civic engagement.
In March of last year, she set up an additional offering to the community: bilingual COVID-19 education classes.
These aren’t the same as workshops from the City of Long Beach, which give updates on the status of the pandemic and suggestions for staying safe from the virus.
When survivors of the genocide immigrated to Long Beach in the ‘80s, many were uneducated. Many Cambodians are illiterate in English. Some never learned how to read or write in Khmer, their native language.
For these reasons, Som is starting at square one.
“You’re really teaching them from the beginning,” Som said. “‘Here’s a cell. Here’s what biology is.’ It takes a lot of time for you to build and cultivate that kind of learning and understanding, especially for a population that is heavily traumatized, where their learning capability is really impacted.”
Som, a graduate of UC Riverside with a degree in biochemistry, said that a single lesson on one aspect of basic biology can take nearly an hour, sometimes two with question-and-answer.
“They don’t know how to use Zoom. They don’t have email. They don’t read and write in English,” she said. “They have to learn how to turn on a computer or an iPad. Most of them don’t even know how to enter a website address to get on there.”
Som said they do know how to use one application: Facebook. Taught by their grandchildren and family members, Cambodians use the application to keep in touch with their family members abroad.
During her education sessions, she runs two Facebook conference calls at once to accommodate the demand for her classes. These elderly Cambodians can’t Google their questions.
During these sessions, Som acts as a real-life search engine. After going over the day’s lesson plan, she fields questions in Khmer: “Are there any foods I should avoid after I get the vaccine?” “Will the vaccine destroy my immune system?” “Do I have to get two vaccines?” “Am I supposed to get one Moderna and one Pfizer vaccine?” “Where can I book an appointment?”
One by one, she doles out potentially life-saving answers to her class. She explains how vaccines work and why it’s important to get two doses to trigger a full immune response. She reminds them to hold onto their vaccination paperwork to prove that they’ve received the first vaccine.
Near the end of Som’s session, she touches base on the progress of her group’s vaccine appointments.
“How many of you have signed up for a vaccine?” she asks the class.
Only a few raise their hands.
“If you want to register, make sure to send me the name and information of the person,” Som said. “I will help you make the appointment.”
Multilingual information only helps if seniors can access it
An estimated 20,000 Cambodians live in Long Beach, though some assert that they’re historically undercounted in the Census. The city is home to the largest number of Cambodians anywhere in the world besides the country itself. Like other underrepresented groups, they are economically disadvantaged compared to their white counterparts.
To address inequities in the vaccine rollout, the City’s health department launched an equity subcommittee in December.
“We’re just trying to get out to where we know the communities who have been most impacted by COVID-19 will be served,” Equity Officer Katie Balderas said. “But also communities who really lack trust in the vaccine because they have been harmed by so many other forms of oppression and barriers.”
Earlier this month, vaccine data from the City showed that about 49% of the people who had been vaccinated in Long Beach were white. Around 21% were Hispanic or Latino, while 20% were Asian and 7.6% were Black.
Since the onset of the pandemic, Hispanic and Latino residents have experienced the highest rates of COVID-19.
Som said that, without breaking down statistics of Asians into subcategories, particularly by Cambodians, there’s no way of knowing if Long Beach’s Cambodian community is being equitably inoculated.
“This is a special minority group that has gone through a genocide,” Som said. “Most of them are seniors. They also have preexisting conditions from the torture, from the war and violence they’ve gone through. We need that data to help us.”
The City has taken steps to address equity in the vaccine rollout. Applications and supplemental information on the rollout are available in English, Spanish, Tagalog and Khmer.
Som said this isn’t enough.
When it comes to computer literacy, elderly Cambodians face the same problems as elderly white residents: they’re unfamiliar with the format.
Though the City’s website is offered in Khmer, understanding how to change the language on a webpage can be a task in itself.
They do have another option: calling the City’s vaccine helpline, but they could face long wait times for a response. Currently, the helpline only has two Khmer-speaking employees, according to Balderas. Those two staff members are responsible for all of the callbacks for Khmer-speaking residents.
To bridge the information gap, Som also collaborates with Tony Lai, founder of Khmer TV, one of the only Khmer-language media outlets in the region.
Since many elderly Cambodians have trouble accessing information from the City, Lai offered free airtime to Som to share information about COVID-19. Lai said his channel is popular amongst elderly Cambodian communities because they don’t have anywhere else to turn for information in Khmer.
Ung said that most of her information about the pandemic came from Khmer TV, the MAYE Center and the United Cambodian Community via social media.
“They are watching our channel because they don’t speak English,” Lai said. “They have no other place to go.”
Last week, he received a call from a 93-year-old woman trying to sign up for the vaccine. He tried to help her, but couldn’t figure out how to work VaxLB.
“They cannot do it themselves,” Lai said. “We need to have somebody that can help them from registration to transportation.”
He ended up referring the woman to another community organizer. Lai himself wasn’t aware of the City’s Khmer-language helpline, a testament to the lack of outreach in the Cambodian community.
In the midst of these challenges, the City of Long Beach has pursued a new model for distributing vaccinations, one that’s less reliant on technology—mobile clinics.
Mobile vaccine clinic coming soon
Marc Coleman, a civil rights attorney working alongside Som, commended the City’s vaccine rollout, one which the New York Times called “a model within the state.”
“I have to say, above everything, that the City’s done a great job in getting and disseminating vaccinations, putting equity aside for a second,” he said. “But we shouldn’t be putting equity aside for a second. Where was our equity officer who was supposed to be watching this stuff?”
Long Beach’s approximately 60-member subcommittee has been tasked with just that.
Balancing equity and expediency, committee members are working with city leaders to come up with solutions to inoculate Long Beach’s most COVID-impacted populations.
“The large clinic Convention Center, I think, is one way that we can reach as many people as possible,” Balderas said. “But we also recognize that there are so many barriers to accessing that, whether it be access to the registration site, access to a car, even just trusting that that is a safe place for you.”
Som hadn’t heard of the committee until she spoke at a vaccine study session held by the city council Tuesday, Feb. 2. At the time, the City hadn’t announced any specific plans to inoculate the Cambodian community.
“We’ve got to have more than one door to get to the vaccinations,” Coleman said. “Long Beach only has one door, and it’s a heavily computer-dependent door. You need both computer access, computer proficiency and high bandwidth to meaningfully access [the vaccines].”
Som was invited to join the committee after her comments at a council study session.
Since joining the subcommittee, Som has worked with the mayor and community leaders to address inequities in the vaccine rollout. On Feb. 22, Cambodia Town will receive its first mobile vaccine clinic.
After negotiating with the Health Department, Som and other Cambodian leaders secured 390 doses for the MacArthur Park mobile clinic, up from an initial 200 vaccines. They also negotiated an additional 400 vaccines to be distributed at the Community Medical Wellness Center in the heart of Cambodia Town, Som said.
“We really understand and value the partnership with our community-based organizations and leaders to bring the vaccine to where people are,” Balderas said. “We did a clinic in a historically Black church called St. Mark on [Feb. 10].”
For now, the MacArthur Park mobile clinic is one step forward in inoculating Long Beach’s vulnerable elderly Cambodian population. Som hopes it will be the first of many.
“It’s only now that we’ve become aware of the vaccines and the vaccine appointment process because of Laura,” Ung said. “Without Laura, we wouldn’t know where and how to do it.”
Before attending Som’s sessions, Ung had concerns about the vaccine. She worried that the vaccine would alter her DNA and cause long-term side effects. Now, she’s eager to get a vaccine.
Ung will receive her first dose on Monday, Feb. 22 at the MacArthur Park mobile vaccine clinic.
“Now that I’ve received my appointment, I’m extremely excited,” she said. “It brings me happiness to know I will have protection.”
Kimsreng Ung’s interview in Khmer was facilitated and translated by Laura Som.