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Crosscurrents logo 2021

Starting Over: The after effects of migration

Leila Day
Concepción Caballero Antonio at her workplace. "


Concepción Caballero Antonio is sitting at a table at the Mission Neighborhood Health Center, listening to one of her compañeras sing.



“Zapote, orange, pink,” she says, pointing out the bright tissue paper she’s using to make flower decorations.


Today she’s with a group of about ten other men and women. They come every Wednesday to do projects like this one – and to learn about nutrition.

Coming here is very important to her.


“If I wasn’t here, I’d just be crying. A lot of sadness, thinking about things – because the change hasn’t been easy.”


The change she’s talking about is having Type 2 Diabetes. She says it wasn’t something she had in El Salvador, but shortly after she arrived she started having symptoms – blurred vision, vaginal bleeding, fatigue. She was diagnosed here at the clinic. Although it’s been three years since then, it’s still hard.


“When people ask me, I never tell them of my sickness,” she says with her head down. “I’m embarrassed. I’m afraid people maybe won’t want to be around me.”


When people arrive in the U.S., they undergo mandatory physical examinations. And sometimes the results are startling. Concepción had left most of her family back in El Salvador; her health wasn’t something she worried about. But after receiving her diagnosis, she thought it might be a death sentence.


“In my country, I knew a lot of people who were diabetic and they had their feet removed.”


Diabetes is a disease that occurs often in Latino populations. The U.S. Office of Minority Healthreported that Hispanics are almost twice as likely to be diagnosed with diabetes when compared to non-Hispanic whites.


Research shows that diabetes is directly linked to socio-economic conditions. Mental stress raises the blood-glucose levels. And migration is incredibly stressful, according to Dr. Ricardo Alvarez, medical director at the Mission Neighborhood Health Center.


“Imagine what it would be like if we transplanted ourselves in another culture – where we had to deal with housing, learn a language, figure out how to feed ourselves – and had to do it with minimal or no support,” he says.


He explains that these stresses can then affect hormone levels, like insulin regulation, which is the main problem in diabetes. And that can lead to larger problems.


“It’s going to affect your nerves, your eyes, retinopathy, your heart. It’s going to affect every organ system in your body,” he says.


Alvarez says the center has seen a decline in Latino clients as the neighborhood has changed. The Latino population in the Mission is down 50% since the year 2000. But that’s the population that the clinic mainly still serves, with healthcare and through these workshops.


Iran Pont sits at the table talking to the clients. They are excited about a cookbook they will be making with healthy recipes. Pont is a chronic care coordinator and dietitian who leads the weekly workshops here. She says some of her clients are arriving in need of major support.


“El Salvador, Nicaragua, Guatemala – they come from very poor countries, and they come to escape from poverty and sometimes death, basically,” Pont says.


Over the years, she’s seen the direct link between migration and diabetes.


“The stress level of not eating and not drinking water ... is so high, by the time we get them here they have diabetes.”


But Concepción says she tries not to get too stressed out. She goes to Zumba class often, which makes her feel better. Her finances though, are still troubling. Bills are adding up now. Her first year of services at the clinic were free, but now she’s paying $50 a month for doctor visits, and another $50 a month to see a psychologist. Right now her biggest worry is whether she can afford the $500 it will cost to fix an ingrown toenail. Coming here to the weekly workshop helps her to not dwell on it.


“It relaxes me a lot. Helps me forget a lot of things,” she says.


And sometimes it helps her remember some of the good things. Like when a compañera at the clinic bursts into a song, one that Concepción joins in on – she remembers it very well from El Salvador.


Leila Day is a Senior Producer at Pineapple Street Media and is the Executive Producer and co-host of The Stoop Podcast, stories about the black diaspora. Her work has been featured on NPR, 99% Invisible, the BBC as well as other outlets. Before The Stoop, she was an editor at Al Jazeera's podcast network and worked on creating and editing award winning narrative driven journalism. She began her career in journalism at KALW where she worked as a health care and criminal justice reporter. During that time she contributed as an editor, taught audio storytelling to inmates at San Quentin, and helped develop curriculum for training upcoming reporters.