A Brooklyn Ambulance Service Speaks Chinese, Like Its Patients

In the back of an ambulance the other day, an anxious father-to-be rattled off his wife’s medical history in Cantonese as she went into labor. It took the two emergency medical technicians onboard, both fluent in Chinese, just seconds to act, and they pulled the ambulance over to the side of the Franklin D. Roosevelt Drive in Manhattan after learning that the couple’s first child had been born quickly. In less than two minutes, they delivered a howling baby boy. “The fact that I can speak their language was a tremendous help,” said Jason Lau, 26, one of the medical technicians who helped deliver the baby. The dramatic birth was a first for a new service started by a private ambulance company in Brooklyn that provides Chinese language emergency medical care to New York City’s growing population of Chinese immigrants. The company’s three amubulances with Chinese-speaking health care workers have already responded to calls beyond Brooklyn — including Chinatown in Manhattan and Flushing, Queens. The service was started last month by Alonzo Rapisarda, 42, who lives in the Bay Ridge neighborhood of Brooklyn and traces his family’s roots to a great-grandfather who immigrated to the United States from Italy. During the three generations of Rapisardas who have run the family business, Midwood Ambulance, the south Brooklyn area has changed, from historically Jewish and Italian to largely Chinese. Bensonhurst, one of its main service areas, is now home to one of the city’s largest concentration of Chinese residents. From 2000 to 2013 the number of foreign-born Chinese in the borough increased by nearly 50 percent, to 128,000 from 86,000, according to the census. Unlike city-run ambulances, which respond to 911 emergency calls, private ambulance companies have their own direct phone numbers and will, among other services, transport ill patients from their doctor’s offices to hospitals or take women in labor to hospitals. The city is home to a small network of private ambulance companies that cater to certain neighborhoods, including a few that serve non-English speakers, such as Chevra Hatzalah, whose workers speak Hebrew, and Assist Ambulance, which focuses on Russian-speaking patients. Ambulances operated by the city, as well as private companies, do have access to telephone-based translation services, but people facing medical issues often find it easier and more comforting to speak to emergency responders in their native language, according to doctors, and emergency medical provider. Over the years, Mr. Rapisarda’s regular crews — 107 ambulances in all — found that they were frequently unable to speak with their patients. “If you can’t communicate with your paramedic, you could leave out something, or the paramedic could misunderstand something,” Mr. Rapisarda said. He said patients sometimes confused chest pain for indigestion, particularly older people. His workers, he feared, “might miss something if you’re not fully able to understand them, or them, you.” Several years ago, he started hiring Chinese-speaking dispatchers, paramedics and emergency medical technicians. But it was only last year, after Mr. Rapisarda heard a story from a local doctor, that the idea of a dedicated fleet and a 24-hour Chinese dispatch was born. The doctor, Gary Chen, an internal medicine specialist in Bensonhurst, said an older couple who were sick waited through the weekend for a Monday appointment with their Chinese-speaking doctor rather than call an ambulance because they were afraid they would not be understood. Dr. Chen’s neighbors suggested that the community needed its own ambulances, and Mr. Rapisarda agreed. Now Mr. Rapisarda has three ambulances emblazoned with English and Chinese characters traveling around the city. He said the response had been so positive that he was hiring more Chinese-speaking workers and had ordered three more ambulances, each of which costs $76,000. On a recent day in the company’s parking depot in the Gravesend section of Brooklyn, newly hired employees practiced carrying a dummy strapped to a chair up and down a steep staircase. He said this was an essential skill in the city. In New York and around the country, emergency responders have historically been white and male, said Scott Moore, a human resources and operations consultant with the American Ambulance Association, a national trade organization, and an emergency medical technician for 26 years. Beyond translating words, Mr. Moore said, a diverse emergency response fleet can add cultural competency to how their work is done. Last year, Mr. Moore’s organization issued its first handbook for intercultural communication. “Demographic trends across the United States indicate a growing need for better cross-cultural communication skills among health care professionals,” the guidebook begins. The profession is “becoming more aware of the challenges” that a diverse patient population presents, Mr. Moore said, “and understanding that care is something more than maybe just taking medical care of them.” The Midwood Ambulance service has teamed up with the United Chinese Association of Brooklyn, a community organization, which is helping spread the word about the service. Steve Chung, the association’s president, said the service was drawing rave reviews from the community and, in particular, accolades for Mr. Rapisarda. Mr. Chung noted the only-in-New-York factor that the new Chinese-language ambulance fleet was started by an Italian-American. But there is a history of collaboration — a long one — between the communities, he said. “Think about it, in Marco Polo’s time, he visited China and we gave him good things: spaghetti and pizza,” Mr. Chung said with a laugh. “I think this is the best thing about human culture — we know each other and we’re sharing and who knows what good things pop-up.”