“Trusted Messenger” Guides Ailing Newcomers

Jocelin hobbled through the doors of Unidad Latina en Acción’s Howe Street headquarters with a leg she had nearly lost, a mind spiraling with trauma, and a $64,000 medical bill.

Inside, she found a volunteer who had survived his own journey to New Haven as an undocumented immigrant — and who helped her find and afford the medical care she sorely needed.

That volunteer is community health worker José Antonio Armas Alvarez, who has been working with Fair Haven Community Health Care as a member of Unidad Latina en Acción (ULA) for the last six months, connecting undocumented community members to health care.

Armas Alvarez is a ​“trusted messenger,” in public health parlance: Drawing from his own life experience, he can vouch for the community health center as a safe place for undocumented immigrants fearful of large bills and institutional services.

He said his role includes helping patients establish medical care, reminding them to follow-up about health conditions, and helping them pay for the care they receive.

He played that role with Jocelin.

When Jocelin first arrived in New Haven, she had ample reason to mistrust her doctors. 

The day before crossing the U.S. border, Jocelin recalled, she slept in the Mexican desert with four other immigrants originally from Ecuador. The coyote leading them to the United States had been sexually harassing her throughout their journey, and that night was no different. When Jocelin rejected and confronted him, she said, ​“he was upset with me.”

The next day, the group climbed a portion of a towering border wall built by former President Donald Trump. When Jocelin reached the top of the wall, the man whom she’d paid to lead her safely to the border pushed her down the other side. Jocelin fell into Texas on her leg and found herself unable to move, in overwhelming pain.

“My first thought was that my bone was out of my leg,” Jocelin said in Spanish as ULA’s John Lugo translated to English. She turned to the other immigrants and ​“begged them not to leave me alone.”

One man agreed to help her. He carried her on his back, set her down, and left with a promise to find her a makeshift splint. But he came back with nothing and began to sexually assault her. ​“I was on the floor, and he was on top of me, and I was begging him,” Jocelin said. ​“I was lucky. The sunrise was coming up. He got scared and left.”

Jocelin managed to retrieve her cell phone. She called her brother, the first person she could think of, back in Ecuador. Following his advice, she called 911. ​“It took them two hours to find me,” she said.

Two border patrol agents finally arrived with an ambulance to drive Jocelin to the hospital. Jocelin’s broken leg was black and blue, but the doctors who treated her did not perform an x‑ray exam, she said. They simply gave her a cast and some painkillers. 

Border officials located Jocelin’s aunt, who was living in New Haven, and sent her to an immigration detention center for two days to wait for a flight.

After the plane landed, Jocelin’s aunt rushed her to the emergency room at Yale-New Haven Hospital. The emergency room physician told Jocelin that if she’d waited one more day, she would have had to have her leg amputated. Hospital physicians performed surgery on Jocelin’s bone and tendon.

Soon after, Jocelin’s aunt directed her to ULA, where she arrived with no idea how she would pay her $64,000 medical bill.

Armas Alvarez and the ULA staff worked with Yale-New Haven Health to eliminate Jocelin’s debt. Armas Alvarez referred Jocelin to La Clínica Hispana of the Connecticut Mental Health Center for psychological support.

He also encouraged her to establish primary care at a clinic ​“close to your house, it’s in your neighborhood” — Fair Haven Community Health Care (FHCHC).

Jocelin wouldn’t have sought out that care without a Spanish-speaking guide, she said.

When he encourages people to seek out medical care, Armas Alvarez often tells them that ​“before they can work, they have to take care of themselves.” He frequently meets people who are worried about the cost of health care, and he reassures them that there are resources out there to help them. 

One of those patients was Roselia Aquino, who was first treated at FHCHC in the early 2000s. Aquino said that she accrued $9,000 in cumulative debt and felt reluctant to return to the health center for years. (FHCHC spokesperson Karen Nemiah, who listened as Aquino spoke, said the center could work with her to address the debt.)

Recently, Aquino recollected in Spanish, ​“I was having a lot of pain below my stomach.” Armas Alvarez convinced her to see a gynecologist at FHCHC. 

“I was really happy, because I paid $20 for my health,” Aquino said.

FHCHC offers payment options on a sliding scale basis; the center is required by law to charge some amount for its services due to the federal funding it receives, according to Nemiah. Armas Alvarez also often sends patients to the weekly Haven Free Clinic through the Yale School of Medicine, which can provide medical care without any cost.

In addition to linking people to medical resources, Armas Alvarez is helping to assess the needs of local immigrants. In partnership with FHCHC, Armas Alvarez has interviewed nearly 200 immigrants about factors like housing and food insecurity that could be impacting their health. He’s reached out to immigrants who walk through ULA’s doors as well as people he meets on Grand Avenue. Of the first 127 people he interviewed, 75.2 percent said they worried about losing their housing and 6.4 percent reported that they did not have a stable place to live.

Armas Alvarez can relate to those answers. He recently found himself living out of his car after losing his job and separating from his wife. ULA eventually connected him with a friend who could house him temporarily, but he still doesn’t have a home of his own. As a volunteer, Armas Alvarez works with ULA and FHCHC for no pay.

Four months after Jocelin first arrived in New Haven, her leg feels only ​“a little” less painful, and the trauma of her journey to New Haven still haunts her.

Though she’s grateful for her aunt, the busy house with four kids can feel overwhelming. Jocelin’s doctors expect that her leg will fully heal in four more months; for now, she wears a medical boot on her injured foot. She climbs out of chairs with the help of nearby furniture and moves by leaning on a metal walker with tennis balls for feet. 

Over time, Armas Alvarez became not only the person who helped her find health care, but also a friend. Jocelin herself signed up to volunteer with ULA; she helps members fill out forms for the organization, which has become her community. Lugo said that ULA hopes to help Jocelin apply for a special visa due to the violence and medical neglect that she survived.

Last week, Jocelin went to her first primary care appointment at FHCHC. The doctor was ​“attentive” and asked a lot of questions, she said. 

“It was a big difference between here and the way they treated me at the border,” Jocelin said. ​“Here, they treat me like a human being.”

If you are a survivor of sexual violence and would like to connect with a trained listener, the RAINN National Sexual Assault Hotline operates 24 hours a day, 7 days a week, in both English and Spanish. You can chat online here or call 800 – 656-HOPE (4673).