Clients often ask Cristina Ramirez, a community health worker at Mercy Regional Medical Center in Lorain, Ohio, to do things that aren’t in her job description. Sometimes, they want her to be with them in the delivery room when their babies are born, or to help set up a ride to the doctor with public transit’s Provide A Ride because they don’t speak English.
Ramirez, who last year received Mercy’s Annual Key of Excellence Award, has a hard time saying, “No.” Part of it is just her nature.
“Cristina is a gentle soul type of person who would do anything to help anybody,” says Beth Finnegan, R.N., Ramirez’s supervisor and director of Mercy’s Resource Mothers program, which helps pregnant women at risk and those with no prenatal care. “And you never hear her say what she’s doing.”
Ramirez, who’s been a Resource Mother for two years, has a close connection with the Spanish-speaking moms, some of whom are migrant workers from Latin America. From the age of 9, Ramirez spent summers laboring in the fields, her family following the harvest every year from Florida to Michigan and Ohio.
In 1997, when she was between jobs and pregnant with her fourth child, Ramirez had her own Resource Mother. “I learned a lot from the educational material,” she says. “You know, every pregnancy’s different. She helped me get Medicaid — I didn’t know I could get that.”
The program links pregnant women with doctors at federally funded health clinics and other social services, helps them to sign up for Medicaid if they qualify, and lines them up with necessities like diapers and cribs. Once the baby is born, community health workers make home visits for up to a year, providing parental education and checking to see how mom and baby are doing. Mothers are encouraged to take English as a Second Language classes, finish their GEDs or take college courses. The Resource Mothers program even arranges for babysitting.
The intervention seems to work: Last year, 95 percent of babies born to mothers in the program had a healthy birth weight of at least 5.5 pounds. The average monthly immunization compliance rate was 98 percent. In addition to the 211 long-term clients (pregnancy through the baby’s first birthday) last year, 667 short-term clients received emergency assistance. Thirty to 35 percent of clients are Spanish-speaking.
Last year, a baby of one of Ramirez’s clients was born with a chromosomal problem and was transferred to Rainbow Babies and Children’s Hospital in Cleveland, about 60 miles away. Ramirez accompanied the mother and interpreted the instructions about tube feeding. “They didn’t have in-person interpreters,” Ramirez explains. “Everything was through computer or phone. The client asked, ‘Is there any way you can come with me?’ ”
A week later, the baby was transferred to hospice. The next morning, Ramirez got a call. “[The hospice] told me the baby wasn’t doing too well,” she recalls. “They needed me to call the family. I called, and we drove out there together.”
Ramirez was with the family when the baby died at 4:30 that afternoon. “They already knew,” she says. “It wasn’t something they weren’t prepared for. They did a good job of preparing their [other] kids for what would happen.”
The next couple of days were a whirlwind. Ramirez made arrangements for a viewing at a funeral home that agreed to donate its services. She helped to interpret the particulars of the death certificate and embalming, and was the go-between for the local funeral home and one in Mexico that was making arrangements for burial.
“Cristina was going to do it, whether I said, ‘No, you can’t do it’ or not,” says Finnegan. “And she didn’t get paid for half of what she did. Really going above and beyond — that’s what she does every day. It gives me chills thinking how important that was to that family.”
It was important to Ramirez, too. “I don’t want to think of myself being in that situation with nobody to go to,” she says. “A lot of times, what the women do is use their older kids to interpret. That’s what I did growing up, for my own parents. I can’t imagine having my kids doing that. I just knew [the family] would feel more comfortable having me there.”