Editor’s Note: This story is part three of a new four-part series from WDET’s Nargis Rahman called, “Shustho: Mind, Body, and Spirit,” exploring health care and health care access for Bangladeshi women.

The Health Unit on Davison Avenue in Detroit (HUDA Clinic) is the largest free health care clinic in Wayne County. It serves uninsured and underinsured patients helping about 5,000 patients annually.

Nurse Practitioner Joann Harrison says about 30% of HUDA’s patients are Bangladeshi women. She says many struggle with mental health and chronic conditions due to lack of access to regular care. 

“There are problems with hypertension and diabetes. I just see a wide variety of issues, a lot of it has to do with not knowing how to manage or not having the resources to manage issues,” she said. 

Within that care, Harrison says Bangladeshi women are more receptive to female health care providers. 

“I think they’re more open to talk with us. Unfortunately, that’s not always the case that we have female providers available or female translators available, but I do feel that when there is someone present, there is more openness, more freedom to speak with us,” she explained. 

The clinic also provides interpreters and translated educational materials. 

Harrison, who is Black, said she is learning more about Bangladeshi culture, including about food and family values, to better serve her patients. “I’m learning all the time about how to help them, especially the women, to better care for themselves and what issues affect them.”  

Dr. Nashita Molla is a Bangladeshi American physician who volunteers at the HUDA Clinic. Part of her care is educating Bangladeshi women about preventive care. 

“In Bangladesh there isn’t a whole lot of cancer screening, so patients don’t have a PCP that they go to continuously and get colonoscopies every 10 years, or pap smears every three to five years,” she said.

Molla said having more Bangladeshi doctors and health care providers who are women could improve care for Bangladeshi women patients. 

“If I’m not there, or, you know, another female Bengali provider is not there, or then they’re not going to be as open with those other providers. They might not do those tests because they don’t understand why they need those things,” she shared. 

Molla said there’s a need for more free clinics and educational materials in Bengali, such as informational videos on diabetes and hypertension, which are rampant among Bangladeshis.  

“I think it helps if there’s another Bengali female saying, like, ‘hey we gotta cut down the portions of how much they’re eating, and cut down on the fried foods, and it’ll mean a lot more coming from them than it would like any other culture,” she said.

Like some patients served at HUDA Clinic, some Bangladeshi women end up in the Emergency Room for primary care because they don’t have adequate insurance.  

Dr. Farjana Alam is an emergency medicine physician who works at several hospitals in metro Detroit.  

She says socioeconomic barriers contribute to these challenges. 

“Poverty is higher in our people. I’ve seen lack of education is higher. And so I think that also plays into effect with all the health literacy gaps which then leads to like issues with chronic illnesses and not having an overall, as great of a health outcomes as, like other people,” she said.  

Alam grew up helping her immigrant parents navigate the health care system.  As a result, she said she understands firsthand how having limited resources affects one’s health.  

Social determinants of health, factors such as limited English proficiency, inadequate insurance and needing help with transportation can make a big difference in health outcomes, she said. 

“You can’t compare someone like a white female from a family who has all the resources in the world, who has all the money in the world, her health outcomes, to this Bangladeshi female who barely finished school, who has all these financial constraints over her; like you can’t compare those health outcomes,” she said.  

Alam said despite these barriers, Bangladeshi women in metro Detroit are empowering themselves by learning English, learning how to drive, and educating their children to assist them to have better health outcomes.  

Read more from this series:

• Bangladeshi women rely on culturally competent care for better health outcomes
• How language access affects health care for Bangladeshi women in Michigan

The Michigan Supreme Court will hear arguments next month over who gets custody of a frozen embryo following a couple’s divorce.

David and Sarah Markiewicz had four children while they were married. Three were conceived via in-vitro fertilization using the husband’s sperm and the wife’s sister providing the eggs.

The final unresolved issue left from their 2020 divorce is possession of the final frozen embryo.

The Michigan Court of Appeals ruled 2-1 in December of 2023 that the frozen embryo would go to the ex-husband because he had the most direct biological connection. The court also rejected an argument that the embryo should go to Sarah Markiewicz under Michigan’s reproductive freedom amendment.

The dissenting opinion argued the ruling ignored a contractual agreement and should be sent back to a trial court to consider the contract in light of the state’s reproductive freedom amendment.

Attorney Liisa Speaker, who chairs the Family Law Section of the State Bar of Michigan, told the Michigan Public Radio Network that people often avoid tough conversations when planning pregnancies using assisted reproductive technologies.

“What if one of them dies before the embryo is implanted and what happens then? They need to be thinking about what happens in the event of a divorce,” she said. “If we have multiple embryos that haven’t been used, what are we going to do with them?”

Speaker said a Supreme Court decision could help set some clear guidance for judges to follow in disputes as IVF pregnancies continue to become more common.

Editor’s Note: This story is part two of a new four-part series from WDET’s Nargis Rahman called, “Shustho: Mind, Body, and Spirit,” exploring health care and health care access for Bangladeshi women.

When the pandemic shut down many doctor’s offices, Family Nurse Practitioner Farzana Noor noticed a growing need among Bangladeshi women seeking care at her clinic in Hamtramck. Noor is the medical director at the Children’s Clinic of Michigan.

“It’s hard for them to go elsewhere to a provider who maybe is not Bangladeshi and hope that they have the same level of understanding of what their needs are and everything that they’re dealing with at home,” Noor said.

As a Bangladeshi-American she understands the struggles firsthand of the women who come to the clinic. That’s why she’s working to close the cultural gap in health care.

Many Bangladeshi women are stay-at-home mothers, often prioritizing their families over their health.

“But they’re missing out on their screenings, like pap smears, and they’re missing out on mammograms, and they’re missing out on this routine screening for diabetes and high cholesterol and high blood pressure,” she said.

Noor says language is another way she can connect with her patients. She speaks multiple Bangla dialects and says that can make a world of difference in treatment and care.

“When they’re able to tell me something in their native language, in their first language, versus if they were telling me something in English, it’s a night and day difference and then it’s like, we go from 10% to like, 110%,” she said.

Seeking primary care in the Emergency Room

Dr. Tabtila Chowdhury is a resident doctor at Henry Ford Health in Detroit. She frequently sees Bangladeshi women in the ER. Many arrive with untreated conditions because they don’t have a primary care physician.

“They’ll come in for the headache, but then they’ll be like, ‘Oh yeah, my blood pressure, your sugar’s been high. And then also, in Bangladesh, I used to take this, like, one medication for, like, you know, seizure-like activity,'” she explained, adding that many new Bangladeshi immigrants only have emergency health insurance and do not have a primary care doctor to manage their daily maintenance medication.

Chowdhury says she sees one or two people per shift with similar concerns. She says many times Bangladeshis have atypical symptoms of illnesses, which can put them at further risk.

For example, they might feel stomach pain and acid reflux for heart attack symptoms. Chowdhury sends them for an EKG if they have such symptoms.

Chowdhury says she feels a responsibility to go the extra mile to take care of her Bangladeshi patients.

“I make it a fact when I’m working, I always pick up all the Bengali patients, and I do a much better, more in depth, just like, dive into, their health care because half the time, people can’t even explain what’s going on with them,” she said.

Health literacy, comprehension and advocacy

Rumyah Rafique has had similar experiences at The Health Unit on Davison Avenue, where she’s a medical interpreter. She offers her services to Bangladeshi patients, finding that women are more receptive to female health care providers.

“I usually can tell if a patient is Bangladeshi, and I always let the provider know that if this is a patient that needs interpretation, that I am a qualified interpreter, that I’ve done this type of work, and that I’m more than willing to provide that service for this patient,” she said.

Rafique sees firsthand how cultural barriers can impact care for people with diabetes. According to the National Institutes of Health, South Asian patients are three times more likely to get diabetes.

Rafique says Bangladeshis have a rice-heavy diet, which leads to diabetes.

“Diabetes runs rampant in our communities, and I think that a lot of people don’t understand the concept of rice being a carbohydrate,” she said.

Rafique says having a family advocate in the room is also another important element to health care for Bangladeshi women.

“Our cultures are very communal and very family-oriented, and it’s a little bit different from the Western idea of individualism, and I think that that makes it difficult sometimes for Bangladeshi women who want to have their family as a part of their care,” she said.

Rafique says while women rely on male family members for transportation and interpretation, they need to advocate for themselves, especially when it comes to sensitive topics like reproductive health.

She says that’s not unique to Bangladeshi culture, however, it can be a challenge.

“That balance is really difficult for a patient to navigate, how do I make sure my needs and wants are being heard by my physician, how much I want, say my husband or my brother or my father to be a part of my care, versus, those things to remain private,” she explained.

Bangladeshi-American health care workers like Noor, Chowdhury and Rafique are stepping up to provide culturally competent care and bridge the gap, by understanding the sensitivities and the lifestyles of Bangladeshi women.

However, they also say there should be more health care education for non-Bangladeshi providers to create culturally sensitive services for this population.

The non-partisan Congressional Budget Office estimates lawmakers cannot reach spending targets set in the recent budget proposal narrowly-passed by the U.S. House without cuts to the federal portion of Medicaid.

GOP members of Congress are searching for cost savings in order to pay for President Donald Trump’s tax cuts and border security agenda.

Concerns over potential cuts to the joint federal-state entitlement program, which provides medical coverage for roughly one out of every five Americans, sparked nationwide protests this week.

About 100 unionized health care workers and others who say they depend on Medicaid payments demonstrated outside the Warren office of Michigan Republican Congressman John James on Wednesday.

He wrote on X earlier this month that the GOP will always protect Medicaid.

James blamed Democrats for having spent years “burdening a system that will allow for its collapse,” while vowing to ensure Medicaid coverage for those who “rightfully paid into their benefits and our most vulnerable.”

But James’ Democratic colleague, Michigan Congresswoman Rashida Tlaib, argues the GOP is still targeting Medicaid funding.

Tlaib said the threat is so strong it compelled her to take the rare step of joining the demonstration outside James’ office, in a Congressional district miles away from her own.

Listen: Michigan Congresswoman Rashida Tlaib says Medicaid cuts would ‘devastate’ families

The following interview has been edited for clarity and length.

U.S. Rep. Rashida Tlaib: I’m here because Medicaid cuts would devastate so many of my families in my district. If John James could just join us and choose to help the families in the community he represents, the Macomb and Oakland County residents that rely on Medicaid. Especially parents with special needs kids and the huge number of mothers who depend on prenatal care through Medicaid. I’m here to urge him to choose the people that elected him, not Trump or Elon Musk. All of us will have his back if he chooses to do the right thing. We just need three to four Republicans to join us and we’re hoping that Congressman John James changes his mind and doesn’t cut Medicaid.

Quinn Klinefelter, WDET News: What do you mean specifically by needing three or four Republicans to join you?

RT: It’s the difference between Democrats and Republicans in the U.S. House and Congress. The Republican majority is very small and we know that many of our Republican colleagues have constituents who depend on Medicaid, including one in California where over 60% of his residents rely on it. So this is not about Republicans or Democrats, it’s really an issue of access to health care coverage for those that are ill or those that have special medical conditions. John James’ district is one that would be hit very hard if Medicaid cuts were to go into effect. Yet he voted to approve the House Energy and Commerce Committee cutting $880 billion in costs over the next decade. That committee oversees health care, Medicare, Medicaid, the Affordable Care Act. He did it with no hesitation. We’re here to remind him this would actually devastate his community, not just communities like mine.

QK: There had been talk for a long time that politicians should stay away from entitlements, period. That wasn’t something you touched. But now, when Republicans say they’re trying to find cost savings and that there’s not many other places to look except entitlements, what is your reaction?

RT: Have they looked at the Pentagon budget, the Pentagon budget that hasn’t passed seven audits in a row? You’re talking about almost 15% of the federal budget coming from the Pentagon budget. The defense contractors, the military defense complex, has been draining our public tax dollars. If they can’t pass an audit, why didn’t you start there if you’re talking about efficiency? Why would you go to Medicaid and the Department of Education and so many of these vital, important services for our families? Without the food assistance, without Medicaid, without special education programs through our public education system, their lives would be devastated. You have folks that are gaslighting the public and saying that this is supposed to be some sort of cost-saving. It’s not. It’s them wanting to deteriorate any sort of public programs that help our families so they can privatize. And if you listen to the public, they would have told you, “Don’t touch Medicaid.” You promised not to touch it and you did. You voted for an almost $1 trillion cut to health coverage.

QK: You mentioned during your speech here that your phones have been blowing up with calls from people. After the recent stopgap funding measure was passed by Congress, there were some people who said they didn’t think Democrats were “standing up” enough against President Trump and the Republican majority. That Democrats should take other actions beyond what they’re doing right now. Again, what’s your reaction those kind of comments?

RT: I mean, I’m here. I’m doing everything I can, even if it means me having to join John James’ residents here or pushing back against billions of dollars in cuts for veterans’ health care in that so-called temporary budget, the Continuing Resolution. There’s health care coverage, there’s veterans care, there’s vital services that are literally on the chopping board within weeks of Trump becoming president. And this is not a choice that we should be giving Americans. We should be listening to them and understanding that if we really want to care for them, let’s figure out other ways. Let’s fix our health care system, if that’s really your true intention to find efficiency and waste. When we can organize our residents, transformative change comes from them. They can move the institution. We can put our organizing hats on, join our residents and try to give them a bullhorn. And that’s what we can do with the power of our letterhead, the power of our vote and the power to organize.

Editor’s Note: This story is part one of a new four-part series from WDET’s Nargis Rahman called, “Shustho: Mind, Body, and Spirit,” exploring health care and health care access for Bangladeshi women.

Michigan is home to the third largest population of Bangladeshis in the U.S., with a significant number living in the metro Detroit area.

Bangladeshi immigrants struggle with a number of challenges when trying to access health care, including language, cultural competency and adequate insurance.

Community organizations like the Detroit Friendship House in Hamtramck are working to bridge the language gap many Bangladeshi women in southeast Michigan face when trying to access health care.

The nonprofit provides health education workshops to help them understand and navigate the health care system.

Khurshida Hossain is the executive director. She says women are the lifeline to their families. 

“It’s the mothers that come to pick up food, and we need to understand that women, even though if they don’t have access to education or transportation, they’re the ones putting the meals together, they are the ones that have more autonomy over the nutrition and the well-being of their children, and that’s important to us,” she shared.

The organization holds workshops on topics like women’s health, nutrition, and chronic illnesses. But information alone isn’t enough to educate women about their health. Hossain says making health care more approachable is essential.

Workshops are paired with direct enrollment into health care services to help women navigate complex systems. 

“Having them enroll on the spot and explaining those medical terminologies, or having someone that can translate that on the spot makes it more accessible, rather than having just a workshop and saying, ‘Okay, now you have to go here, downtown somewhere, to enroll and speak to a certain person that’s very disconnected and very intimidating,’” she said.

In 2018, Detroit Friendship House partnered with Eastern Michigan University’s Racial Ethnic Approaches to Community Health program (REACH), to create more targeted workshops.

Hossain says a key goal was to help Bangladeshi women learn English so they could better advocate for themselves at the doctor’s office, instead of relying on a translator or their child to provide interpretation services. 

“Instead of taking the registration form and handing it to a translator or their child to fill out this sensitive information, they are empowered to answer those questions and fill out those forms themselves,” she said.

The organization also encourages women to sign up for free mammograms and pap smears to educate them about breast and cervical cancer.

Volunteers like Mst Begum, a student at Hamtramck High School, play an essential role. She serves as a translator.

“I was chosen because I’m also Bengali, and I had an easier time connecting with the patients,” she said.

She says part of her job is breaking down stigma.

“That is so necessary to have people who are Bangladeshi trying to get people who are Bangladeshi to sign up for these programs because they feel more comfortable and confident,” she explained.

The growing need for health care workshops for Bangladeshi women

A decade ago, providing culturally specific health education for Bangladeshi women was rare. Dr. Subha Hanif, a cancer rehabilitation fellow at the University of Michigan, started a similar effort in the metro Detroit area in 2012 through her organization Bangladeshi Americans for Social Empowerment.

“I felt this like, this disconnect between the resources being there and then the community, nothing really bridging them together,” she said.

She worked with Beaumont Family Medicine to create women-only health workshops. But gaining support for the program wasn’t easy.

Traditionally, men in the Bangladeshi community would gather information and relay it to their families. Hanif had to convince the elders that women needed their own space to acquire health education.

“I had to do a lot of sitting down with, you know, the uncles in our community and making them understand that if you send your wife here, she’s going to be more empowered to learn about her health,” she added. “She’s going to inadvertently help your family, your children and your health, and she’s going to be more empowered to take care of herself better as well.”

Hanif says many women said they benefitted from these spaces and learned how to ask more questions about their health care.

But language barriers go beyond just medical terminology.

Sylheti-speaking interpreters, health care workers, are in demand

Zak Ahmed is an interpreter for the U.S. Department of Justice and several Michigan hospitals. He says many Bangladeshis in the state speak Sylheti, a dialect used by 11 million people in the world. However, interpreters often speak Shuddo Basha at institutions, the standardized formal Bengali language.

“When I used to do the asylum cases and immigration court, we’ve seen so many people that they are denied or deported because of the language barrier. So we found out that they don’t understand these are, these are basically Sylheti speakers,” he said.

Ahmed says the U.S. Department of Justice added Sylheti as a separate unique language in 2018.

But he says there is still a need for more Sylheti-speaking interpreters, although many patients don’t realize they can request one.

“They do feel much better actually, when they speak their own dialect. They can feel better when they see someone that they can understand their needs,” he said.

The Michigan Department of Health and Human Services says interpreters are available  at no cost for anyone who needs one, including in Bengali.

Last year the state also passed the Meaningful Language Access to State Services law to prompt government agencies to translate important documents in different languages.

However, more bilingual speakers in health care are needed.

There isn’t a formal health care language certification for Bangla or Bengali in metro Detroit, like the one offered in Arabic for health care workers at Wayne State University.

Khurshida Hossain from the Detroit Friendship House says it’s important to amplify efforts to increase the number of Bangladeshi Americans entering health care.

“Then you have doctors and nurses and pas that not only can speak and understand the language, but that look like the community, and it makes that doctor’s appointment that much less intimidating, that much more accessible,” she said.

Language access is a delicate balance between learning health care terminology, advocating for themselves, and finding resources like interpreters for Bangladeshi women in southeast Michigan.

Tonight on The Detroit Evening Report, we cover the state’s efforts to form a new advisory committee of former Medicaid recipients to share their experiences; Detroit’s 67th annual St. Patrick’s Day Parade and more.

Subscribe to the Detroit Evening Report on Apple Podcasts, Spotify, NPR.org or wherever you get your podcasts.

Former Medicaid members sought for new committee

The Michigan Department of Health and Human Services is recruiting former Medicaid recipients from across the state to join its new 15-member Beneficiary Advisory Council. The group will be tasked with identifying barriers to accessing Medicaid services, addressing the social elements that affect health for recipients and making policy recommendations to MDHHS leadership.

Those selected to serve on the committee may receive compensation for their time and reimbursement for childcare and respite services. Applications are due by 5 p.m. on April 14. Questions about the application can be emailed to MDHHS-BAC@michigan.gov.

Related: Michigan Health and Hospital Association CEO says protecting Medicaid protects Michigan

MESP College Savings Program celebrates 25 years

The Michigan Education Savings Plan’s 25th anniversary is this year and it’s offering new benefits to celebrate. The ‘5-29’ savings plan lets people put money aside for college, vocational training and some other educational expenses. Starting next month, those funds can also be used to cover apprenticeship costs and to repay up to $10,000 of student loans. The new benefits align Michigan 529 programs with many national savings programs and are made possible by state legislation passed last year.

Michigan Ukrainian refugees in limbo

Thousands of Ukrainian refugees who migrated to Michigan to escape the war are bracing for possible deportation, after recent reports that the Trump administration will revoke their legal status.

President Donald Trump announced last week that he will soon decide the fate of the roughly 240,000 Ukrainians who fled the conflict, following a Reuters report announcing his administration’s plan.

Detroit’s annual St. Patrick’s Parade returns

Corktown will host the 67th annual Detroit St. Patrick’s Parade this Sunday, March 16, beginning at 1 p.m. at 6th Street and Michigan Avenue. The parade, which features floats, marching bands, pipe and drum bands, and so much more, has brought together people to celebrate Detroit’s rich Irish heritage for over half a century!

Do you have a community story we should tell? Let us know in an email at detroiteveningreport@wdet.org.