reflections of a medical interpreter living on Virginia's eastern shore

Author: kamctigue

“¿Tienes hambre?” Quick tips for eating on The Shore

Royal Farms

(Wawa’s seaside cousin)

Location: various   |   Menu: click here   |   Hours: 24/7 daily

This franchise is both a gas station and a fast-food destination, self-described as “your go-to place day or night for breakfast, lunch, snacks, dinner, gasoline, diesel fuel, and all the things you need!” With locations spread across four states- Pennsylvania, Delaware, Maryland and Virginia- the presence of Royal Farms in the Commonwealth is distinctly a “Shore thing”. Six out of ten Virginia locations dot the Delmarva peninsula- see map below.

Royal Farms gas station and fast-food destination has ten locations in the Commonwealth of Virginia, six of which are on the Eastern Shore. (image created with Google maps free software)

Royal Farms gas station and fast-food destination has ten locations in the Commonwealth of Virginia, six of which are on the Eastern Shore. The remaining four lie on the southern side of the Bay Bridge, in Norfolk suburbs.
  | image created with Google maps free software |

24-hours a day, I recommend any of the chicken options, which range from hand-breaded + “world famous” sandwiches, to available-any-time breakfast croissants, and of course my personal favorite, chicken tenders. For a delicious side option, one of my co-workers here at ESRHS swears by the hand-cut western fries, which she and other locals usually call “wedges”, to my initial confusion. I will add, for impartiality’s sake, that a second coworker summarizes the entire Royal Farms menu as “not that great”.

While many customers would protest that critique, it is hard to defend the nutritional value of the majority-fried fare. But at the end of the day, Royal Farms stakes out a spot in this post for its unlimited operating hours (24/7), which are particularly awesome in a rural area, where stores and restaurants seem to open and close as they please. Plus, its food-ordering kiosks and cheery interior resemble Wawa (a northeastern phenom), but the stores still feel different enough to make this out-of-towner-author feel adventurous.

Don't be fooled by the short 'n' sweet menu- this place is worth your time and (minimal) money for a taco or two. (image courtesy of the blogger)

Don’t be fooled by the short ‘n’ sweet menu- this place is worth your time and (minimal) money for a taco or dos.
| image courtesy of author |

Pichar Dos

(taco truck)

Location: 20525 Market St, Onancock, VA 23417

Menu: see left

Hours: 11:00AM- 6:00ishPM daily

This unassuming, faded orange-color food truck will always hold a special place in my memory of the Eastern Shore, as it provided the first meal I ate here, during my orientation day lunch hour. Apart from necessitating an ATM withdrawal, it was the perfect way to start my adventure. The $2.00 tacos are made-to-order, accompanied by cucumber salad, green sauce picante, and packaged in enough Styrofoam and plastic to simultaneously induce guilt and a sense of authenticity.

Although Pichar Dos is definitely known as “a taco truck”, the other menu items- all recipes brought from south of the border by dueña Cecilia- are just as popular. A must-try is the torta milanesa, a hot sandwich with breaded, thinly sliced meat and veggies: a traditional Mexican favorite. And whatever you purchase, be sure to enjoy it seated at one of the two picnic tables which rest in direct sunlight, just off the side of the road. That is, if you are lucky enough to find a spot before the daily lunch rush of workers arrives.

Don’s Seafood & Chicken House

(Smith Island cake vendor)

Location: 1344 Ocean Highway, Pocomoke, MD 21851

Menu: click here

Hours: 11:00AM-10:00PM daily

This final tip is catered to my sweet tooth, but also serves as local trivia. Smith Island cake, historically a yellow cake with fudge icing and 8-10 thinly stacked layers, is a Delmarva favorite, withstanding the test of time and currently available in nearly every flavor imaginable. While Smith Island cake is sold throughout the region, Don’s Seafood & Chicken House is conveniently located off the main drag, and accepts custom orders, in addition to maintaining a variety of slices in-house.

Smith Island cake is a Delmarva favorite, traditionally a yellow cake with chocolate frosting, though many variations are sold today. (image courtesy of Adventures of a Couponista)

Smith Island cake is a Delmarva favorite, traditionally a yellow cake with chocolate frosting, though many variations are sold today.
 | image courtesy of Adventures of a Couponista

As the name suggests, this dessert originated on Smith Island, Maryland, which has been inhabited by an English-settler community since the 17th century, and today remains decently isolated from mainstream influence, accessible solely by ferry. During a recent staff luncheon at the aforementioned Don’s, I tried the double chocolate, mango and “original” flavors, and could not tell you my favorite. However, having consumed a respectable amount of cake in my lifetime, my expertise does conclude that there must be something magical folded within the plentiful layers of this dessert; it is as satisfying as it is light, and almost refreshing; this is particularly true of the fruit-infused varieties.

Beyond the dessert section, I encourage further examination of Don’s menu, which is comprised of numerous mouth-watering entrees, many at a reasonable price. And finally, we should all take a moment to admire Maryland’s decision to legislate Smith Island cake as the official  state dessert, effective 01 October 2008. Considering “ice cream” holds the respective title for the Commonwealth, I would say we Virginians are missing out. Or maybe we should all attempt a quick VA-MD border crossing, and take our cake, a la mode?

Ciao for now!

Local culinary suggestions or questions? Contact me.

When (my) worlds collide: public media, labor rights + rural health

A 2004 Toyota Camry is "home" to my favorite news source. (image courtesy of GTA Car Kits)

A 2004 Toyota Camry is “home” to my favorite news source.
(image courtesy of GTA Car Kits)

To further explain my ~catchy~ title, let me announce to cyberspace what my immediate friends and family are probably tired of hearing from me: I love NPR. The wide-range of topics, the digestible length of segments (think: why everyone is obsessed with TED talks), and the perfectly cultivated mix of both national and local coverage are just a few of my quick pitches for the incredible appeal, and therefore value, of public radio.

A semi-hectic lifestyle this summer has further deepened my appreciation for- and reliance on- NPR. It is always there, occupying the lower dial of my FM car radio, no matter where my travels take me. (And downloadable podcasts further enhance accessibility!) So naturally, I was nerdily excited to discover that occupational health in the meat & poultry industry would be an extended focus of programming on my local station this week. With Tyson Foods and Perdue Farms being the #1 and #2 largest employers in Accomack County (my current residence), enlisting both year-round and migrant workers, this was definitely a topic I was eager to hear more about (county data p. 38- click here).

As NPR informed me, this industry is not historically known for its workplace safety, consistently boasting the highest injury rate in the manufacturing sector (GAO report, p. 13) . On the other hand, the U.S. Government Accountability Office (GAO) recently found overall injury rates trending downward over the past decade, according to a comprehensive report released in May 2016; “injury and illness rates of total recordable cases in the meat and poultry industry declined from an estimated 9.8 cases per 100 full-time workers in calendar year 2004 to 5.7 cases in 2013,” (GAO report, p. 18).

However, with a title like Additional Data Needed to Address Continued Hazards in the Meat and Poultry Industry introducing this report, there is clearly room for improvement. And indeed, GAO has identified under-reporting of work-related injury and illness a major obstacle to progress in the industry. This under-reporting is likely a result of the dichotomous metric used to track data: full-days of work missed by an employee. For instance, an employee- particularly a seasonal, novice or otherwise disadvantaged one- may elect to ignore or “grin-and-bear” an occupational health concern, in order to maximize his or her job security.

Map of current and pending poultry industry facilities in Accomack County in 2015. This county comprises approximately one half of the geographic area of the Eastern Shore of Virginia, with Northampton County lying just south. (image courtesy of Accomack County Department of Planning)

Map of current and pending poultry industry facilities in Accomack County in 2015. This county comprises approximately one half of the geographic area of the Eastern Shore of Virginia, with Northampton County lying just south.
(image courtesy of Accomack County Department of Planning)

Several days ago in the clinic, I interpreted for a thirty-something-old man complaining of recurrent shoulder pain, attributed to his repetitive movement, gutting chickens at work (a position known as “presenter“, because the birds are presented for inspection immediately afterward). Due to the persistent quality of the shoulder pain, even while medicated, the physician recommended that this patient temporarily limit his work activity. As both an informed observer, and the GAO report, may have predicted, the patient explained to his doctor the unlikelihood of his supervisor accommodating such a request.

While this anecdote paints a bleak outlook for meat & poultry industry workers in a region so dependent on the fruits of their labor, recent push-back from the community against some of the nearly 200 newly proposed poultry operation sites along the Delmarva Peninsula demonstrates the potential of collective action to reform. Again using Accomack County as an example, the municipal board passed more stringent chicken housing regulations in February of this year, citing environmental health concerns. Perhaps the individual health of employees and the overall well-being of communities, who are all living in close proximity to a potentially hazardous industry could meet their common goals through collaboration? Could uniting these two related causes help lessen the political gap between environmental groups and poultry business enthusiasts, who frequently see each other as adversaries?

To be honest, questions like these are what I hope to spend my career contemplating, hopefully addressing and are not resolvable in 600 words here today. But for now and for symmetry’s sake, I will conclude with an  extension of my sincerest thanks to public media for always helping contextualize and question the world around me.

Ciao for now!

“Smile!”: Oral health literacy + first week on the job


Eastern Shore Rural Health System (ESRHS) patients can receive dental care at local schools; this photo taken at Metompkin Elementary and courtesy of the ESRHS public webpage.

Of the many services offered by Eastern Shore Rural Health System (ESRHS), the dental program- currently available at 4 out of the 7 ESRHS community health centers and via traveling clinics- is central to the organization’s mission to “enhance the quality of life for people on the Shore, by providing accessible, comprehensive and affordable health services”. In fact, oral health is not only an ESRHS priority, but a national focus, as evidenced by the U.S. Department of Health & Human Services’ recent commitment of $156 million to improve oral health access and outcomes for patients at federally qualified health centers. A portion of this federal grant, totaling $350,000, was awarded to ESRHS during the first week of June 2016.

It is yet to be seen how all of this funding will be used, but under the direction of ESRHS chief dental officer Dr. Scott Wolpin DMD, who boasts extensive experience optimizing the oral health literacy of medically underserved populations living on the Shore, we may expect this to be a target area. For the area’s migrant community in particular, the concept of literacy takes on various meanings, as the majority of these patients are Spanish-speaking, often cannot read or write, and are typically not ‘health-literate’, in the sense that U.S.-trained medical providers are accustomed to.

Faced with these obstacles, Dr. Wolpin emphasizes the critical role that interpreters, community health workers, and adequately trained dental professionals can have in changing the status quo when it comes to oral health literacy. For instance, at an Institute of Medicine-sponsored roundtable on health literacy in February 2013, Wolpin shared his success in deferring to a savvy interpreter; she was able to identify a widespread, cavity-causing practice of putting infants to sleep with a bottle of sugary juice or honey, which had until then eluded the dental staff. From this anecdote, student interpreters, such as myself, can glean that quality work is not based solely on correct vocabulary, but must also be drawn from the cultural, sociologic and anthropologic knowledge we have learned throughout our semesters at The College.

Atlantic Community Health Center is the newest addition to the Eastern Shore Rural Health System (ESRHS) network of sites along the peninsula. Senator Tim Kaine sent video remarks for view at the ribbon-cutting ceremony on 11 June 2013. (video courtesy of ESRHS marketing)

Since beginning my internship this past week at Atlantic Community Health Center, I have already witnessed a deliberate focus on oral health by ESRHS. Providers routinely ask when a patient was last seen by a dentist, encourage oral hygiene by providing free toothbrushes, and arrange for specialist follow-up when a complex dental procedure is necessary. However, a concurrent reality also struck me, upon seeing a child from a migrant family with over a dozen cavities definitely requiring an outside provider’s expertise, and no means of payment. As the referral specialist received one more negative response via telephone, from the last pediatric dentist whom she could think of to accept the case, I cringed imagining the remaining options for this individual.

While I do not have a best-case-scenario-ending to conclude this post with, or even any additional information on this patient’s case (s/o to HIPPA!), to me it demonstrates why efforts to truly connect with patients, though often frustrating or discouraging, are critical. This migrant child’s unmanageable amount of dental decay could have been prevented by better tooth-brushing habits, combined with healthy drink choices.  Though the seasonal nature of the Shore’s migrant population does not lend itself well to comprehensive preventative care, ESRHS does not balk at the challenge. The aforementioned traveling dental clinics visit local schools, where children are already present as participants in the migrant summer program, as their parents spend the daytime at work.

Thanks for reading and stay posted for an insider look at traveling clinics and other in-the-field experiences. Also, feel free to contact me with any topic requests or feedback.

Ciao for now!


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