Hannah Crummé: Can I ask you your name?
Connie Nguyen-Truong: My name is Dr. Connie Nguyen-Truong. My background, I’ve been practicing as a clinical nurse specifically in intermediate care and progressive care for seventeen years now. So nearly two decades as a nurse and that’s in acute care. I’m also currently an assistant professor at Washington State University College of Nursing. I’m on the Vancouver campus and I started there in August, 2015. I’m an emerging nurse scientist.
HC: Can you tell me a little bit about yourself and your family and your life in Portland?
CT: Yes. I’ll start out about my family. With my parents, Mr. John Van Nguyen, people know him as Nam because he changed his name legally to John. His wife, my mother, is Mrs. Trang Yen Thi Nguyen. They had arrived in Portland in 1975. At that time, they were settling in and they were living in what they referred to as the Northwest Flanders area. And living in an apartment. They had come from California because that was where they were at a camp. That was where they met and got married.
In terms of life in Portland, there were challenges that they faced. One of which is a language barrier and learning the customs and culture. The other was finding employment. And so because they had Father Park, who was their sponsor, and Father Park is from a faith based organization, the Rose Church, which is in Portland close by Sandy Boulevard area in Portland. That was someone that was a resource person that they could go to to ask questions. They said that they had friends and peers as well, which was really helpful. In terms of life in Portland, the Immigrant and Refugee Community Organization, they went by another name, which was Indochinese Cultural Center. That was opened in 1976 and my mother was pregnant with me at that time and I’m their first baby [ … ] child I should say [Laughs]
They said that that really made a big difference because that was what my parents wanted to be thinking about -- wanting to be self sufficient. They wanted to have employment. My father said it’s really important that both Mom and I attend a school and we want to raise a family in Portland. So that’s an overview.
HC: That’s a great synopsis. I’m going to ask you a few questions about a few bits of that. To get it on the recording, although I’ve asked you some of this already.
CT: [Laughs] That’s ok.
HC: What part of Vietnam were your parents from?
CT: My mother was from a northern region of Vietnam and my father was from the southern region of Vietnam. And my mother, she was living more in an urban city area in Hanoi. And then my father, he grew up in a rural area because his family owned a farm. They were farmers. So it is very different -- north and south, city versus rural.
HC: And how did they meet?
CT: They actually met on a camp since they had fled the Vietnam War in 1975. So they met each other in Guam but they actually didn’t have an opportunity to talk with each other. My father actually said that he just saw this young woman who just appeared really strong with muscles and was doing laundry and was carrying this basket. He said he would look at himself and he’s like, “I am thin. I am small, compared to your mom who had muscles.” So he just remembered seeing her. She said, [apathetic tone] “Yeah I saw him.” [Laughs] That’s how she said. But then they met because there was a transition from Guam to the other refugee camp that was in California. There was a lot of volunteers but one of the main organizations they remember was Red Cross. They actually talked and met each other formally in the camp. There was like big camps like a big cafeteria. They would see each other more so there. And there were these small camps -- when I say camp I should mean tent. There were small tents for individuals or households. So that’s like your own mini home. That’s where they formally met.
HC: And they married in California?
CT: Yes. They married in California. They said, “We married in the camp.” They said the cafeteria was transformed by the volunteers to make it look more like… they said it looked really fancy…. In what ways that they were able to. And that everyone that was in the camp was all welcome to attend the wedding ceremony. They said it was very beautiful.
HC: And pretty quickly after that, they moved to Portland?
CT: Yes. and then they moved to Portland, Oregon because they have peers -- their friends and they learned that there’s this place, Portland, Oregon. Wanting to find employment, that was one of the big things. And then being able to have that independence because they’d been in the refugee camp in Guam. And then here, refugee camp in California. And then also since they got married, my father wanted to show that he would be able to provide for his wife and future children. So this is a way for my mother to be able to say, “Goodbye.” Not like a goodbye forever, but be able to have independence from her mother and from her brother-in-law and sister -- who had their own two children. And my mother used to be the caretaker. This was a way, again, to have that independence. Which was important.
HC: And so when they first came to Portland, what jobs did they do?
CT: They said that with the language barrier it was really important to be able to find a position where that was not going to be like the essential piece that would be a requirement. So they really needed to have support with that. Father Park was very instrumental in trying to find [employment.] Because my mother, both of them were attending school, they were attending Madison High School. And then my mother became pregnant with me. So she needed to focus on the really important work which was to make sure she stayed safe and healthy. She said, “I just couldn’t barely move anymore.” So then my father was able to secure two jobs. One of which was painting. With that one, he has a photo, and he’s just covered in paint. He’s like, “I don’t know, but I don’t think I should have been breathing in all that paint.” Because they didn’t have all those masks and gear back then. It was just, “Here’s your brush.” You just do a good job, and paint these rooms. He said that what was great was that he knew how to say “hi” and “thank you.” So he was appreciative. Then the other one was working at what sounds like a gas station was what I was understanding.
HC: Does the Vietnam War continue to affect the community in Portland?
HC: How so?
CT: I can give a more explicit example from my parent’s perspectives. Especially where I remembered my father saying that he would have nightmares. My mother as well. Also my mother experienced day terrors. Just sounds. It’s really hard to be around a lot of sounds. It can bring back a trigger because my father fought in the Vietnam war alongside the US military. He was in the air force. That’s something that he said has been really hard for him. Things were still really new. But he still has moments. He’s been trying to distance himself more and more. But before he would try and talk with his peers and his friends. I remembered, with my siblings, it was like taking out diapers. He would put out these diapers to show how they strategically were able to escape. But then soon the war stories were starting to impact him too. So he would try to find other kinds of ways to distance. He doesn’t wear his uniform because that was really hard. He said he was separated from his parents when he got drafted. Him saying that, it’s hard for him to talk about that piece.
Also the other piece to it is because he’s seeing that my mom is experiencing that. She remembers bombs just going all around her. Her mother and brother and sister, everyone was trying, you just grab what you can at that time. They were strapping jewelry, gold pieces on her. She has physical scars from the gold bars. When she looks at that it’s a trigger for her. She tries not to look at the physical scars on her body. For my father, he hasn’t been able to go back. So when he hears other people that are able to go back to visit their family in Vietnam, for him he said that at that time it was either because he fought in the Vietnam war, if he goes back there he could be imprisoned and be tortured. So that was something that really impacted. It’s like all these different ways. Even wanting to be able to be with his parents, he couldn’t do that. So they would communicate by letters. So that was something. He said it's actually a hardship if he wanted to talk on the phone with his mother or father because they would have to make a whole day to walk to the village where there was a phone to be able to talk on. Even though they do it. He wanted to be a thoughtful son because his parents were older. But when they passed away and he wasn’t able to see them and he says, “All I wanted to do was buy them a bowl.” In Vietnam it is called pho and that’s a signature dish entree. It’s a beef, rice, noodle soup. That’s all he wanted to at least do, is to buy that. To serve his parents and be able to buy that. That part impacts. I’ll hear that and he continues, every year, I see him distancing himself more, more more, from things that remind him about the war. Because of it tearing him apart from the people that gave him life.
His mother, he said that when she passed away, they found that she kept his belt and his comb and she actually rapped it around her thigh. They didn’t even know. Nobody knew that she did that. She didn’t even tell him. It wasn’t until she was dying, she was trying to tell the older brother, that she was saving money so that when Nam (Connie’s father) comes back home she was going to have a welcoming party. She had the money and his belt and his comb. So it’s really hard. [Cries.]
HC: That is very hard. And it’s very touching. When did she die?
CT: She passed away when I was a teenager. It was actually not too long after when it was the first time that I got to hear her voice. Like her actual voice over the phone. Because she was getting so ill and it sounded like it had to do with kidney failure. And he [Connie’s father] said that it would have been so hard on his mother for him to sponsor her to come over because of the culture shock and not even knowing if she can make the flight. That was the exact year, it’s hard for me to pinpoint, but I know that I was in high school when she had passed away. So that was really hard for him. Because his father passed away and he was very quiet. But when his mother passed away he was in tears. We did not see that side. He is a stoic man. He is a strong man. But that is his mother. And it was hard. That’s when we really saw him [ … ]
Anything on the show that looks like its about a war or military. Especially if it’s about the Vietnam war, it’s a trigger. He just has to separate. Sounds, as I mentioned. So he’s learned along-the-way what sounds will get him. He’s in this hypervigilant mode, like on guard at all times. I have not ever seen him let his guard down. He’s just always looking, because he doesn’t know if someone is going to come and try and kill him or the family. I’ll see those kinds of things.
HC: And you said that’s part of why they moved to Vancouver eventually?
CT: My mom, having day terrors, she needed to feel safe in the home. When she gets this sense that something doesn’t quite feel right then she doesn’t sleep she justs lays there. Then my father says, “It’s time for us to move to another place.” So they moved to Vancouver. That was short lived too. Then they moved back to Portland. That’s like the go-to home that they think of is Portland.
HC: Were there organizations in Portland that helped them establish themselves here?
CT: Yes. Earlier I mentioned about the Immigrant and Refugee Community Organization, and please let know if I already repeated myself [Laughs]
HC: It’s better that we record it. I don’t think you’ve already repeated it, but it’s better that we get it down. I’m so sorry about that.
CT: No [Laughs] I just want to make sure its recorded too.
HC: I don’t think you said anything about IRCO yet on the recording.
CT: Oh good. And so 1975 is the year of lots of different things happening. It’s a theme -- new beginnings with the plural “S” at the end. I mentioned about the Guam and then the camp in California and then they moved to north Portland and then going to school full time. And then they learned about IRCO because now they’re in Halsey Square, they moved to Halsey which is a more southeast side and that’s where they had met other Vietnamese families that identified as being refugees. Then he was friends with the older brother, who is our recent former executive director at the Immigrant and Refugee Organization known as IRCO, Mr. Sokhom Tauch well, my father was friends with the older brother of Mr. Sokhom Tauch. He said that Mr. Sokhom Tauch was really young and was calling my father “uncle.” My father said somehow he moved his way up there and became the executive director of IRCO. It was more informal, then it became formal and he learned how that there is this place that is helping families and individuals to adjust to Western society. There are these services. He’s like, “What’s this all about?”
The first engagement with IRCO was actually in 1976 when my mother was pregnant with me as their first baby. So that was exciting. And they felt scared too. They wanted to make sure that they could have a healthy baby. IRCO helped to connect my parents to nutrition programs. For example, the WIC; the Women, Infants, and Children Program. And then also there were classes that were focused specifically about English. Even though they were in school, that also helped for them to have another way to continue to learn the language. And then you get one-on-one. IRCO connected them to it so they could take English classes too. And then they met other people. So there was that sense of community there. IRCO was an essential part in my prenatal care. Because of the services that they provided, I was born as a healthy baby. My parents said that I was born on the Hill, at the Oregon Health and Science University. To know that their baby was healthy, it just shows how critical [ … ] They said, “We’re were so thankful that IRCO was there and that we brought in a healthy baby.” And they’re contributing. They said, “We’re contributing to society. We’re both in school, I’m working two jobs, I’m making sure because we want to be self sufficient.” And that’s part of the mission of IRCO is adjusting to be self sufficient.
HC: And you said that they then started volunteering with IRCO after that?
CT: Yes. My father said that they both were already doing that - volunteering. He eventually owned a car. He became known as the person that had the car that could take you places … it was neighborly. He said that with IRCO it was not formal on paper. It’s “we’re here and we’re helping.”
So they connected other people that didn’t know about IRCO, because IRCO was new. [They said] that IRCO has these services to help us, to get on our feet. Then we can be self sufficient. That's what I would hear from him -- “Be efficient, so we can be independent and take care of ourselves and our families.” They were instrumental. Also there was a great thing about IRCO. [IRCO] provided that meeting space so that they could talk about community needs. From the people -- they’re out there, so they know what people are talking about. They’ll bring it and they’ll share it. So either it was something that IRCO may take on or it’s the people that will come every week. And then they’re like, “We can address that.” So that was a really great piece of the story that I would hear from my father and mother.
HC: Were there other meeting spaces within the community that brought the community together?
CT: Yes. The other one is the Lavang Parish which is a faith based organization and that is on Sandy Boulevard. Because of the sharing of the religious identification, they had their meeting spaces too. There’s mass service -- they have a cafeteria. So that’s where you can have those conversations -- meeting with people. They also had opportunities if you wanted to volunteer. So both my parents volunteered at the Lavang Parish for quite some time. All the way through till I was in high school.
It was that sense of community -- you give back to the community. “The community gave to me and I want to give back.” That’s what I would hear from my parents. They [the Lavang Parish] want to preserve culture. So they have events like the Vietnamese New Year or maybe they have something where another priest is invited or maybe it’s the archbishop or something. They’ll have their annual events and my father would like help to build the stage and my mother would help in the kitchen, cafeteria so that there’s food for those that come that gather. It was really nice. It was that sense of community -- people really giving up their time. They [her parents] said it was important to do.
HC: That’s great. What were your first impressions of the US and Portland. You grew up here, but what do you remember from being a child?
CT: At home it was important that I spoke Vietnamese. In the home it’s Vietnam. Outside the home it’s the United States of America or in this case Portland, Oregon. So that’s different. There were maybe things like you raise your hand when you speak. When I’m at home I ask permission to speak. Ok those are some similarities. But when it came to, “Here’s your homework and ask your parents to help you.” I was thinking, “Well, they work. They need to have their rest too.” And if I’m not really understanding the assignment, perhaps those instructions could have been more clarified -- just to say. So there were some things, looking back, where even though I could speak English and I was doing it quite well as a child [ … ] But I also remember they had what was called ESL, the English as a Second Language Program. But it wasn’t interactive. It was where I would sit there, they’d put a headphone set on me. I would hear words, sentences, and then I would need to repeat them.
My young life, being exposed to life in Portland was definitely through school but also people assuming that either I didn’t understand English, so then they would speak louder to me and really slowly, and I would tell them, “I can hear you and I do speak English.” “Oh!” Would be the phrase. This was from teachers and my peers. But I wasn’t argumentative it was just more being truthful -- “Oh I can hear you.” But then also it was hard because then there were times when there were others that would speak Vietnamese in school. I was like, “Woah! We can speak the same language. I don’t know who you are… but.” Then I would just start talking to them in the language. We would laugh. And then a teacher who is like monitoring -- and this is cafeteria time, like lunchtime, it's your own time to socialize -- and as long as you are behaving really well -- but she specifically asked us not to speak in whatever language we were speaking -- it needs to be in English. I didn’t understand that. Usually I would see this list of class rules. You would read it so you all understand what it is. I did not. As a child you learn things concretely. So that’s not sensitive. I can say that more matter-of-fact. I definitely would not have said that back then. But that was hard. My parents said it was so important -- “the mother’s tongue.” to experience the difference in Western and Eastern culture in that way was very challenging. Then I attended Vietnamese school where I would learn about the religion and then also learning about the history, the geography, and then also the language. So I was going to school six days a week and then if I needed to have further instruction from parents or my grandparents it’s kind of like a seperate seven days a week of school. But that’s what I continue to find in terms of that difference. What does it mean right now to be an Oregonian or Portlander? Trying to understand why did it have to be in this dichotomous way? It felt like it’s like I am a hybrid. When I say I’m Vietnamese, someone says, “You don’t really look quite Vietnamese. You look more Chinese, Japanese, or Korean, because your skin is so light.” I would hear that. It wasn’t meant to be negative. It was for those who identified as Vietnamese and they didn’t see the more rich tone in me. My skin burns easily so my mom protected me from being outside a lot so I didn’t get the deep tan like my brother and sister. I don’t know why they got to be outside more than me [Laughs.]
HC: It’s probably protected you from skin cancer.
CT: [Laughs] Yeah I think so now too.
HC: How did you decide to go into nursing?
CT: When I got exposed to even understanding what it means -- like what does “health occupation” mean -- was actually in high school. I attended Benson High School and they actually had the Health Occupations Program and then they had the Vocational Program. I actually started out in the Vocational Program because I wanted to follow what my father did. He’s an engineer and I thought, “He is so smart ... With the math.” I love thinking in that way. Getting hands on. But he said it was really challenging and not because he didn’t think I was capable but that it’s a different way of thinking and working. So then I started to hear peers talk about, “oh here’s this Health Occupations Programs.” One was close to nursing. It’s certified nursing assistant. I would hear someone say, “You’re going to have to bathe people and clean their bottoms.” I was thinking, “I want to take care of people, what is this class about?”
I got to learn about health occupations like for medical assistants, dentistry. But there was something about certified nursing assistant. Then I was curious about what nurses do. Because it is different from being a certified nursing assistant and caring for one older adult. My peer had someone that she cared for. Granted we’re in high school. But there was something that was just a shift where it brought back these memories of how much my parents were doing so much community things to help the community be healthy. And then, here I am physically caring for someone and being respectful because that’s someone's body. And this is an older adult. Then I saw her pictures as a young woman, young child like all displayed and it was so touching. I said, “I want to do something that makes me be able to be respectful to someone’s life.” They’ve led this life and they now need someone that they can trust to care for them in this way. And it’s an intimate way. There’s a lot of trust. This is hard work. I saw a nurse doing medications, they were looking at charts, it got me intrigued. So then I spoke to my parents about it. They were concerned because they have a different perception about nursing in Vietnam. They just wanted to make sure that whatever career I choose that it was something that is sustainable. That longevity piece. And so I got to learn more about that as I went through high school. And that really solidified it. But I also wanted to venture out too. So I was like, “Pharmacy? Become pharmacist or nurse?” Then I learned really quickly after the first year in pre-pharmacy, because I started talking to someone who was doing pre-nursing, and I was like, “Yes. I definitely want to be a nurse. Ok.” I spent a year at Oregon State University. “Now I really know I want to be a nurse.” So then that led me to a pathway to see [nursing] schools.
This may be more contextual then what you may have wanted. I mention this because family decision making is really important. It isn’t just a decision that I make on my own. I’m going to get input by the people who have been through so much. They know what it means to the importance of having employment that’s sustainable and a career where I will be respected in. And a career that I will also have respect for. And so working is a virtue. To have an opportunity to pursue higher levels of education as a female, is a big thing. I’m the first one in my line of ancestry, the first one to graduate from college. And middle school -- got to include that too -- and then high school. And then also the first to graduate with a Baccalaureate Degree. And the first in my whole line of ancestry to have my Doctor of Philosophy. I also did my Postdoctoral Fellowship after I achieved my PhD. So I’m the first one for that too in my whole line of ancestry. I’m very grateful for the strong women in my family because I would hear stories of the courage and strength that they had done to contribute to society and then to their family. And I wanted to have that balance. I wanted to have both work, life integration. And nursing is an honorable career that needs to be more formally recognized because we’re everywhere. I don’t want to speak “we” as if I am permitted to speak on behalf of nurses. But I mean like, “speciality.” There are various specialities.
HC: What challenges did you experience in your pursuit of higher education in Oregon?
CT: These are thoughtful questions. Broad too. When you say “challenges…”
HC: I guess, in the first instance, most relative to this project, is if you experienced challenges because of Vietnamese heritage or because of cultural background. But also, we are interested in Oregon broadly. So, if you thought the program at OSU wasn’t good for some reason. I mean, I’m sure it’s great… but any challenges that you experienced. But probably most relative would be something that is cultural… or a reaction to your heritage.
CT: I can speak for myself definitely. I tend to be reserved. It’s because of my upbringing. It will work fine if its more traditional. Where you raise your hand if you want to speak up in class. That works. I like that. Because that was what I was expected from whether I was attending elementary and high school. That’s what we did too. But also when I went to the Sunday School that I had mentioned earlier, it was that same rule. College studying is different. It is going to depend on if you’re in a large classroom or a small. The small are the more focused classrooms. It makes it even more apparent when they see that you’re not speaking up in class. So that’s something that I found that was challenging. When a grade is going to be impacted because you didn’t use your verbal voice to speak up or because someone said something and then [the teachers are saying] “you’re endorsing what their saying, you don’t have your own ideas”. But technically if I were to document, and wrote down the actual time of when I thought of that idea, from when the time someone else presents the idea there is a standard deviation. Now, whether or not that person wants to document their time, I can’t speak for that. But I can speak for myself where I did come up with this idea. So when there’s assignments that had to do with, “take a moment to reflect and write this.” I have this question, take a moment to reflect and then I’m going to ask for input. That actually helped for me to have pause. To formulate my thinking and write. Because I tend to think it Vietnamese and then I’ll translate it. That takes time. And then interpreting what I just translated back out.
I started to find that I needed to shift if I wanted to be successful in school. I want to be responsive and be respectful. That this is what is expected in higher education. I also spoke to the professors that are wanting to speak with me. Which I haven’t had an issue of. But I also had to be really thoughtful in how I communicated when I met with my professor so that I can share about this piece. Not because I’m making an excuse. But to invite a dialogue and to see what ways I can ensure that my learning is being achieved. Because I’m being responsive to the qualms that they’re bringing up as well as showing that by doing this I’m also speaking. Not just having a one-on-one, but it’s speaking up. So that’s something that I was being proactive [about.]
I am appreciative that my parents have shared this with me, even back then in elementary school; “If there’s something you don’t understand or something you want your teacher to understand about, schedule a time so you can talk with your teacher.” So I carried that. And I’m glad that I did that. I do it in what I refer to as, what I interpret as “acceptable doses.” So I would make sure [ … ] What’s scary is that when I see someone that I revere is in a position of power, and my grade may have not been the way that they would have wanted, because that’s someone who is my advisor, so their going to advise. One in particular. And this was actually when I had informed that I was going to be pursuing nursing because I was doing pre-pharmacy. The first thing before he even had an opportunity to hear me say anything, he was the only person that I hadn’t really … the one person that didn’t provide a listening space because it was a fifteen minute [meeting] and that’s it. That’s all you had. It was more like I needed to listen to him more than he was talking with me. [He] was saying, “You’ve got to get those grades up. Got get them As, got to get them As.” And I nodded my head. I was like, “Yes sir. I agree with you. I want to get those As too. And like you said you need to and I want to.” And then I shared my plans about pursuing nursing and he didn’t want to hear the rationale. He said, “That’s a good idea.” So it was a short [meeting.] I still had time in my fifteen minutes. But I felt that conversation was done. Those kinds of spaces [ … ] First time meeting that person, last time meeting that person. It was because it was a requirement that you met with your advisor before you register for courses.
I reflected -- and this is something that I appreciate about myself -- I learned from my grandmother. “Just take a moment to think about it. But what do you think for yourself?” It’s like, “Ok, well I did what I did and I’m going to continue to pursue what I am.” But it made me more driven. I would tell my peers and my husband, “I want to have my PhD. Because I know how much I can do.” And this was not too long after I graduated and started practicing as a nurse. Because then I started to see the different kinds of other things that my professors were doing because they had their PhD. I really got to learn in another way. It’s another way of thinking. It’s another skill set. But it opens these doors and these are some example doors where you can generate knowledge to help inform nursing practice. Or this is where someone may look at what you’ve done as a study. This is evidence based so then they’ll translate it. So then it’s called “evidence based practice.” To hear the way in which they were communicating in such an elegant and intellectual scholarly way, I really wanted that. I was one of the few students that really enjoyed the research course that I was taking. I was like, “This is so great.” You know? I’m looking at the study, like what made it strong? How could it be stronger?
I knew that I wanted to do something that was for our community. And what could that be? Taking another lens. Here I am practicing in Acute Care. But I also think about, “What are the needs of the community?” Because those are the very people that are coming into the hospital to get care. But they’re waiting so long! What’s happening? Or are they waiting so long? I was like, “Oh, see I just made a statement that hasn’t been supported. That’s just coming out of my thoughts.” So that’s something that I appreciate about the world of nursing and about the world of science.
HC: That’s lovely. So getting to your research, tell us about your research into cancer in the Vietnamese community.
CT: With this one, I can speak about the work that I have led as the principal investigator on the Vietnamese Women’s Health Project. It’s a multi-study within it. With the first Vietnamese Women’s Health Project I was actually hired on as a health educator and research assistant. I had called the director of the Asian Family Center of IRCO -- [Laughs] So it’s like I’m coming back around, where it all began -- to see if they had opportunities in health. I was trying to give examples. I gave them a thought about how there was this statistic that was really concerning that with Vietnamese women they were being diagnosed with cervical cancers nearly five times more than white non-hispanic women and across racial ethnic groups. That’s substantially high. And dying at higher rates. I wanted to see if there was something that I can do to be engaged at a deeper level with the Vietnamese community, to learn about what their needs are. They were so happy that I contacted them. Then a couple days later they asked me to come in for an interview. I didn’t even realize, “Oh so you did have an opening.” Here I am talking about what I was interested in and I was a doctoral student at Oregon Health and Science University. So that’s what got me started is that I was hearing this concern and I knew that I wanted to do something. I was inspired by my mother’s illness. Because I was a teenager and I didn’t know that my mom was sick, sick. She showed her strong self to us because she’s a reserved person and it was really important that we saw her in that way. And my father said that we are going to go visit your mom in the hospital, she had surgery. I’m like, “Surgery?” I was like, “What’s going on here.” And they found a large cyst mass that was just growing and growing and growing. That needed to be cut. That’s how they [Connie’s parents] explained it. It was a gynecological issue. And my mom was trying to tell my father that, “I’m ok. I’m ok. I’m feeling fine. I don’t need the surgery.” She even tried to convince him on the day of surgery to bring her home. She even hid it from her own mother. He had to contact her so we all came to visit. And it was so hard to see her laying there not moving very much. I was like saying, “I’m so sorry Mom, I didn’t know you were sick.” She said, “I’m ok. I’m ok. She was still thinking about us.” That’s the selflessness. Her mother was like, “I’m your mother and you didn’t share it with me.” She was trying to let us know she was ok. And so having that to see that my own mother, she wanted to make sure that we saw her as a good woman. And to have an illness related to a reproductive system -- she didn’t want her children or anybody to think she was a dirty woman.
That inspired me to become a nurse and then to pursue my PhD. And it made me think about all the other Vietnamese women and then to hear about this alarming statistic for this specific cancer. I was already interested around oncology and knew that I wanted to do something around that -- learning about the influence of culture and the beliefs and cultural barriers, other social determinants of health from the organizational healthcare provider and influences, community resources that were available. And so to learn from the principal investigator at that time -- from the qualitative study that we were doing -- and the interview with thirty one Vietnamese American women, and then learning about the illness about screening for that illness. There was already a substantial barrier to women not pursuing PAP testing. Was it because of insurance? Was it because they said, “We’re keeping ourselves clean and we’re doing vaginal washing. Unless we have some kind of mucus buildup then that means that we’re going to need to go seek a provider?” It’s delaying the trajectory in that care.
And so, for my dissertation research I wanted [it] to be a community based participatory dissertation research. It was important to have the people, our people, so I had advisors and liaisons. Using this approach you co-mentor. So I would learn from community partners, they would learn from me. That co-learning is an important principle. So we’re co-mentoring, we’re co-learning with each other -- helping for me to engage, access, and then survey 211 Vietnamese women for the Vietnamese Women’s Health Project too. And then finding these different barriers. One of which was like use of Eastern Asian medicine. The more usage of that, the lower the PAP testing. And then finding that there were women that were not getting [a] recommendation from their healthcare provider. So then the PAP testing would likely be lower than those who did have a health care provider recommendation. Those who have health care insurance versus those who didn’t. Those who did would have higher PAP testing. If they had peer support, they were more likely to have PAP testing -- like a friend telling them -- compared to those who didn’t. Or having a family member telling them and recommending that you should, was higher. So there was all these different reasons and as much as there was all this outreach about different programs available for low [cost] PAP testing, it was such a small percentage in terms of the 211 women that actually knew about the availability of low-cost PAP testing. Or even at no cost. That was something that was really concerning. I did a retrospective analysis on the instrument, to say, “Yes, it was truly a reliable and valid instrument to measure these several cancer screening factors.” Because we want to make sure we show that there is science and rigor and everything that we are saying and doing.
And then for the post-doctoral fellowship, during that time I also applied for the Asian Pacific Islander Community Leadership Institute. It was very competitive. I was so honored to be one of the fortunate ones to be selected. It was only a fifty percent acceptance. So I’m a senior fellow as of today and really wanted to take it to another level. We want to know that the work that we’ve done with this study is going to have a meaningful impact for our Vietnamese community and also other communities. And at that time, the Asian Pacific American Network of Oregon was the lead organization for Oregon House Bill 2134, which is the data equity bill. In terms of designating the Oregon Health Authority and the Department of Health services to be the designated entities to collect granular race/ethnicity which is fine grained ethnicity categorical data that reflects the locally relevant categories for the population served in Oregon. In addition to the Office of Budget and Management at the federal level, they have those categories that we come to know of -- Hispanic, White, African or black, Asian, native Hawaiian, Pacific Islanders, or Alaskan natives, and Native American. We also need those fine grained in adopting national, state, or local practices. I was new to doing policy advocacy. I was also new to testifying and doing a testimonial in front of policy makers. I was really appreciative to get extensive mentoring from partners at the Asian Pacific American Network of Oregon and IRCO as well to be able to deliver an effective, synthesized, evidence based testimony on three studies that we conducted from the Vietnamese Women’s Health Project in less then five minutes. And delivering it in such a way to humanize the data that we learned. Because we can say the data, but we need to have a goal of evoking an emotional connection.
I remember when there was that microphone and someone had to come up and pull the microphone away because I was speaking and I just leaned into the microphone and starting just announcing things more clearly so than nobody moved the microphone away from me at that time. I was looking at the eyes of our state senators for the first time and telling them how important it is. And there wasn’t available data in Oregon so this is what we did to be able to get at the fine grained data to say, “These are the issues that we’re seeing that’s happening with our Vietnamese American women.” There is a cervical cancer disparity. Without having adequate data we wouldn’t be able to think of the best ways to address. It can be ineffective. Those are some of the reasons that we mentioned.
HC: That’s great. You’ve sort of told us, but let me just ask for a synopsis of how you got involved in IRCO’s Women’s Health Project?
CT: So very specifically, it was having a conversation with one of my dissertation committee members, was Dr. Frances Lee-Lin. Because she knew that I was going to apply for the American Cancer Society Doctoral Degree Scholarship and Cancer Nursing Grant -- grants are competitive -- and she said, “Have you talked to someone at IRCO Asian family Center?” And I was like thinking, “Oh no, I haven’t done that.” And so that’s the direct piece. I’m really thankful to my committee member who has been engaged in the community. She was partnering primarily with Asian Health and Service Center, which is a different organization that also serves Vietnamese refugees and immigrants as well other Asian ethnic groups. I got the website and the contact number from Dr. Frances Lee-Lin and then I called Mr. Lee Po Cha, he’s the executive director now of IRCO, but at that time he was the director of Asian Family Center. But it was Danita Huynh who was the manager of the health department, she was the one that I talked to and I’m really thankful that she provided that space for me to share what it is that I’m doing and the grant that I’m applying for and really wanting to show my sincerity. I was like, “Do you have volunteer opportunities?” I was just giving some example ideas so when I received an invitation to be interviewed for a position that they had available, I was like, “Oh!” So then I got to meet the principal investigator Dr. Amy Kobus. [ … ] Importantly they wanted to hire someone that was in Oregon because that was their target population. The project was funded through the National Institute of Health -- National Cancer Institute Grant -- and so it was a two year grant that was in depth qualitative, with key informants, and then individual interviews, and then developing an intervention plan based on that or any next steps.
HC: So that leads to the next question, which is, what impact has your research had on women’s health in Portland? Are you seeing that health practices are changing in the community?
CT: So this is where it’s really important that because we are doing the different projects like I mentioned about the first one, dissertation research was the second, the third one was because I was doing my postdoc [ … ] We had the targeted sample of health care providers -- so health care provider’s perspectives on challenges and facilitators to providing cervical cancer screening in Vietnamese American women. With that, we were getting both the perspectives from advisors and liaisons that I was working with. It grew into a community advisory board that consisted of those that practice in health care as well. So currently we have changed the name to CPACT, Community Participatory Advisory Council Team. Because it’s a pact that we have made with each other in terms of how we [want to] work collaboratively and learn. And “I’m building research skills” [community members] as well as “I’m gaining cultural and language insights” [academic investigator]. One of our meetings that we had, for example, we had a medical physician that identified as Vietnamese and was bilingual and then we had a doctor of nursing practice, a nurse practitioner that also identified as Vietnamese. Then we had someone who has a masters in counseling who is Vietnamese. Then we also have others that have different backgrounds … including students. But like someone [has] a business background and then other health care backgrounds. A nurse. A pharmacist. I mention that, specifically about that growth, because with each study we also do science, outreach, and advocacy. That includes publishing in scientific journals; presenting at conferences; state, national, international; but we also make sure we share that information back with our community. That’s really important. So that’s something that folks learn. There’s something to know that they’ve been contributed thoughts, this is what we should be thinking about to have cultural and linguistic appropriateness in their insights that they share. But also, what does it mean now that you have the findings? Then we analyze it with our advisory council too. We help to interpret. These are interpretations so that we don’t put our own bias on it. I’m saying “our” meaning the academic investigators as well as the community partners that’s been doing the work. Then we have those that help to advise and debrief [on] the findings -- someone who hasn’t been working as intimately and they can provide fresh eyes. They said, “This is so helpful.” So someone who is a representative from Providence Cancer Center, for example -- she’s an outreach manager -- she would share the information back with her colleagues and health care professionals there. She had invited me, for example, years back, this was when I was in my postdoc. We worked together on doing outreach to the community, and she says, “How about like you have a booth and then you can share about the findings that we have from our study. Then they’ll come to the booth, but we want to make it where it is fun. So you ask some questions and then you share about the findings too so that the learning is interactive.” So that’s something that was really great, because then they learned like, “Oh I didn’t know that.”
HC: Where was the booth?
CT: This was at Providence Cancer Center. It’s northeast of Portland, Oregon. That was something that was really great in terms of partnering in that way. There were other topics that were being presented on other kinds of cancer as well. The importance of having males [ … ] even when we say women’s health, it is the health of the people. So that was something that folks were seeing, “Oh your on the project too, and your advising?” “Yes.” So that gentleman would be able to talk about why he’s passionate about women’s health. “Because such-and-such has impacted my mother or my aunt.” That was really empowering for the partners to see how important it is to have the support all the way around. Mothers, fathers, uncles, aunts in that way. So the outreach is really important in terms of sharing that information out with the Vietnamese community on what we learn from this study.
HC: Have you observed that practices are changing in the Vietnamese community as a result?
CT: That part, based on what I’m hearing from others -- that are the ones that are licensed providers, diagnosing, prescribing -- they’ll use the information to inform their practice to be able to have that communication. It’s like being more aware so that then they can create that space. It’s like [from the perspective of a healthcare provider], “I haven’t had any of my clients, my patients, tell me about this thing about vaganial washing. And that they’re soaking in tubs, they’re not telling me this. This is important.” And so this is something that they are going to be more aware about so that they can have that conversation with their patients. Even those that we were interviewing who were the participants in this study, the healthcare providers, the questions that we were asking, they we were following up and probing. At the end, they’re saying, “this is an important study. The questions that you’re asking, really just [made] me think about it in terms of how I am talking or what are we doing that’s helpful.” It got them to think [ … ] Because of them participating in the study they expressed, “I know it takes time to publish results -- but we’d like to, if it's possible, to be able to see what those findings and others because this is something that can help us in our interactions with our patients.” We thought that that was really important too.
HC: That’s great. What social changes have you observed in the Vietnamese community more broadly over the years?
CT: Can you give me an example?
HC: Before I turned on the microphone you talked about the developing businesses on Sandy Boulevard that you saw over time, maybe like that?
CT: Oh yes. In terms of the social changes with businesses, I remember growing up I didn’t see as many businesses as I see now like on Sandy Boulevard and Southeast Portland. As I was growing up through elementary, middle school, high school, along those years I would hear my father be like, “Oh, my friend now owns shops.” Like there’s this one shop that is on SE 82nd and it’s a mini-market. He actually will hang out there. He’s like, “this is my friend.” And he just hangs out there at the store. He has a friend that owns a supermarket, like a big market, for example. He would be like, “Oh yes! Oh I knew him from when he didn’t even have a market. Now he’s owning this supermarket and its by the Halsey square.” That was where I would hear him talk most often about in terms of where they lived in Portland before. That’s something that just even hearing my parents -- and then to know that that’s their friend or something. Then they will hear other people who are their friends say, “My friend opened a shop!” There’s definitely that word-of-mouth even though I’m hearing it from the perspective of my parents, because I engage with community members too, I will hear them saying, “did you know that there was this one store that’s a jewelry store that now opened up? I thought there was only one but now there’s like two that’s on Sandy.” And then, “Now they’re in the Fubonn market that’s on SE 82nd.” I’ll hear that from folks. It’s also a way to show that when the community is talking it’s like promotion and outreach for these places. Now that we have -- I say “we” -- but now that there’s the Fubonn area it reminded me of when I visited -- it’s called Phuc Loc Tho [in California] -- they have little shops in a mini-mall. To see that here, there’s folks that are gathering. And they have a little bakery inside the Fubonn market. It just creates more gathering places is what it seems like.
Then the pho places -- several pho! There’s even more pho out here on the westside in Oregon. I’m so used to hearing more in the Southeast or Northeast, but now I’m hearing more places over here on the westside of Oregon. To know that they are thriving…
HC: Is the community moving?
CT: It seems like there is more movement here. In high school, hearing “Beaverton” was like, “What’s Beaverton?” And would hear peers and then would hear folks in the community. They are like, “Oh. It’s a new development. New houses.” I would hear that. Now it seems like folks are talking about how either you’re here on the westside, which is one mountain, but then there’s also folks who live in Happy Valley which is on the southeast side -- on the other mountain. Then there’s also the southeast, like the Foster area. And then I do hear when folks say, in terms of the costs, “Always got to think about costs of living.” It sounds like if you live in Happy Valley or hear westside, it sounds like you would need to have more money to be able to buy the home then if you were to live, for example, in the southeast Foster area. My parents, they were able to find a much more reasonable priced home. That’s how they phrased it. The money. I hear the money talk come up when people talk about where folks are gathering and living. Other social places, the Hollywood Senior Center -- they have the Vietnamese Seniors Association at the Hollywood center and that’s on Sandy Boulevard as well. I learned about them during my doctoral program of study and they have their board with [a] president and vice president and secretary. They want to decrease isolation of older adults. So they have events like picnics, their annual celebration (potluck style), poetry reading -- they do that. They also do a memorial service to honor members that have passed away. They keep their membership fee really low. It’s more meant to contribute for things that they are doing whether it’s like for food or they are doing an outing at a park.
There’s also the Vietnamese Senior Citizens of Washington County out here, which is a nonprofit. They rent out -- I think there’s like a meeting place in the Beaverton area by Allen Boulevard, that provides a space that’s, depending on time of day, either no cost or small cost, to hold meeting spaces. Their mission is also to decrease isolation among older adults as well.
HC: That’s lovely. At this point, what community organizations are you involved in?
CT: [ … ] Organizations such as the Asian Pacific American Network of Oregon and then also the VNCO, the Viet Nam Community Organization, which my parents were a part of and volunteering before [ … ] They say, “We old now.” [Connie’s parents referenced being too old now to volunteer] But it’s really about preserving culture. They hold the convention -- that’s the annual Tet convention new year -- where they have thousands of people that come to celebrate the Vietnamese Tet New Year.
HC: Where does that happen?
CT: That one happens according to the lunar calendar. So either end of January or early February depending on [the] lunar calendar.
HC: Does it always occur in the same space?
CT: At this time it seems like it is consistently now more so at the Convention Center because of the large gathering of folks that come to it. To celebrate the new year. It’s really festive [ … ]
HC: So which organizations are you involved in at this point?
CT: In Oregon, I am currently an elected member on the IRCO Board of Directors. I was invited by the Executive Director Mr. Lee Po Cha and at that time the president was Chanpone . I should say Dr. Chanpone. And then at that time was the interim director, she’s Sophorn Cheang the director now of the IRCO Asian Family Center. So they all nominated me, and then it went through an electoral vote and it was unanimous voting in 2015. So I’ve served ever since. I was invited and served on the IRCO Asian Family Center Advisory Board since 2012 and then I was nominated and elected as co-chair of the board in 2015 and have been serving since. And then I was invited and was appointed by staff of the Asian Pacific Islander Community [Leadership] Institute and its led by IRCO in partnership with the Asian Pacific American Network of Oregon on their steering committee to make sure that we’re reviewing the curriculum and then also helping to address needs that are coming up. How we can support the fellows, because we really want to see more of that visibility and engagement on boards in Oregon. Also if there are things that they are doing once they leave Oregon, are there skill sets that they are carrying with them that can be carried in other roles and aspects in terms around the importance of empowerment and advocacy and equity?
HC: What local, public, or political issues are most important to the Vietnamese community in your perception?
CT: Wow. Important and also broad. So when you say “public or political issues….”
HC: It sounds like issues around health might be important to you or the Vietnamese community more generally. But it might be [ … ] some people we’ve met with have said that changes in housing policy have affected the Vietnamese community. There could be issues around schooling that could affect the Vietnamese community.
CT: Well in terms of the housing, I know that that is something that has been raised by the hospital systems. There’s the people who are homeless and then there’s also the availability itself about affordable housing and the need and how to even address that need. That is an issue. [ … ] [Connie is interrupted by a text message.]
The other thing is that [ … ] community organizing to get people excited. It’s that galvanizing impact that we want too. When we hear “civic engagement,” it’s like, “What’s that?” And voting. Voting is an important piece. I think that to continue to really stress about the need for participation in civic engagement and what that means in terms of even like attending a forum and talking about your community needs. But there’s things about … are there exceptions of organizations? Of, they should be a certain way. And when I say that it’s because there is different advocacy, community color organizations, they have different missions. It’s that overarching [goal] of how to bring the strengths together to mobilize in a direction. That’s the other part. Because there are so many different kinds of importance and needs that come up.
Something that even from the study that I recently completed with my partners at IRCO, Asian Family Center, and with our community partners from the community participatory advisor council team we learned that even around cancer prevention vaccines, some of the participants in the study were thinking that it should be the responsibility of the school system. Or should it be the health care provider? Both. But if they’re not hearing that recommendation, they may not move forward because it’s tied to preventing HPV associated cancers like cervical, anus, vulva, vagina. It can be very private parts and so there’s conversations about what may be able to be done to really think about [this] from the individual, but also how do we connect them to have that vaccination services. To provide [a] culturally safe space to even do that intervention. Because it’s an adoption of it. We don’t want folks to think that they don’t have a choice. They have a choice. But do they have an informed choice? It goes beyond teaching. There’s motivational interviewing, really having it be about the person. So we are trying to think of different ways. We are hopeful and we are wanting to continue to submit grants and waiting to hear if we’ll get a grant at a national level to really help us to move forward in meeting a community identified need. Because there are people that think that [the HPV] vaccine is only meant for girls and not for boys because boys do not have a cervix. Or that this is for those who are sexually active versus it’s prevention. It’s also for young adults as well. [Child interrupts interview.]
HC: I just have one more question. Which is, is there anything that I haven’t asked you about that you think is important to discuss relative to the Vietnamese community or your parents experience or your own experience? Is there anything? I could easily have missed something that’s important.
CT: Something that I think would be important is there is work that is being done -- for example I’ve mentioned this organization before -- the Asian Pacific American Network of Oregon. They’ve really had work with the youth in terms of the importance of having ethnic studies in the school system. To hear from the youth the importance. I heard an example where one of the youth was providing a testimony in front of our policy makers on why they think that it is important to have books and images that look like people, like us. Ethnic studies [ … ] to have more of that history of communities of color and communities at large too. That’s where I think that more and more we need to be thinking about the power in our youth. Because they are thinking about their future generation. We’re getting older. To see this passion, I was like, “Oh my gosh. Where was I in high school?” I was happy about the health occupations that I mentioned to you earlier [ … ]
Here they’re thinking about not only for themselves, but they’re thinking about the collective. It reminded me of why I was inspired [in] the way [that] I was. To hear them being inspired and what it would mean to them and what it would mean to future students, I think is an important thing. For thinking about what it means in higher levels of education; when we’re promoting, we want to say that we’re promoting diversity and inclusion. But also [ … ] what kinds of resources are in place to have retention of faculty of color? For example. Color can mean very different things. It’s like looking at a Crayola box. It can be all across here. But that’s something that I learned from Doctor Dena Hassouneh she’s a full tenured professor at Oregon Health and Science University and she has published extensively in terms of the faculty of color in schools of nursing, medicine, pharmacy, and dentistry -- a national study. She used a grounded theory approach. Really gets at that higher levels of abstraction in terms of a model to example things that are happening and it can be a very touchy subject. But there is work that is being done by scientists and also work that is being done around microaggressions. Where the everyday slights and snubs -- and Dr. Wing Sue, he’s a psychologist and he has published extensively on that concept [such as] the phrases that we ask. Whether it’s intentional or unintentional can cause harm and has been linked to adverse health outcomes. And just being really thoughtful in terms of the words we say before we say it. To think about the meaning that is being conveyed. And if we are receiving a message that sounds a certain way, let’s see if we can provide an opportunity for the other person to expand on what they said. So that we can really get along [Laughs].
HC: That’s a great addition.
CT: That cultural safety is a concept that originated in New Zealand. Coming out of nurse midwifery area. We can walk alongside the provider and the patient and it is not the provider that is saying, “Well, I created a safe space for my patient.” It’s the patient, the clients, they are the ones who tell the provider whether or not they feel safe in their interaction with the provider. The power needs to be shifted to our patients and our clients and our people.
HC: Excellent. Thank you for speaking to us. I’m going to ask you your name again. I’ve been speaking with …
CT: I’m Dr. Connie Nguyen-Truong.
HC: Excellent and I’ve been Hannah Crummé. Thank you very much for speaking with us. Thank you for understanding when I didn’t start the recording initially. Pretty bad. Excellent. Thank you so much.
CT: Thank you