Position: Family Health Worker/Community Health Interpreter,
Central Seattle Community Health Centers
I am repeatedly astounded at the difficulties Ly-Sieng has overcome in her transition from being a survivor for four years under Pol Pot's regime in Cambodia to being a functioning individual in a totally alien culture. She is truly an inspiration of compassion and the ability of the human spirit to triumph in the face of extreme adversity.—Family Nurse Practitioner, Country Doctor Clinic
Nobody knows the suffering of the Cambodian people, nor recognizes the complex, long-term needs of the community, better than she. She has achieved a remarkable balance between translator, social worker, and advocate. She has always been exquisitely effective as a cross-cultural broker, and is extraordinarily respected by providers and patients alike. She is clearly qualified for many higher-paying jobs, but has made a commitment and stuck to it. She inspires all of us who are lucky enough to have worked with her.—Medical Director, Country Doctor Health Centers
People don't appreciate what they have until they've lost it.—Ly-Sieng Ngo
Growing up in Cambodia in the 1950s and 60s, Ly-Sieng Ngo led a peaceful and privileged life. She was the daughter of a large, wealthy merchant family of Chinese background. The family was attended by more than 50 servants, all belonging to the Khmer majority ethnic group. Ly-Sieng went to expensive private schools, and learned several languages (Khmer, Cantonese, Mandarin, French, and English). In 1968 she earned a degree from the Fashion Design School in Phnom Penh, the country's capital. Her future looked bright, expansive. The possibilities were exciting. And then, the Khmer Rouge came.
They entered Phnom Penh on April 17, 1975. Ly-Sieng Ngo's life—and that of virtually every other Cambodian—was turned upside-down. For the next four years, the people of Cambodia lived a nightmare; a holocaust that would result in the deaths of more than a million, perhaps as many as 2 million people, out of a population of 5 million. No one came out unscathed; but the educated and professional classes, the elite, the rich, city folk, and the Chinese minority, were all singled out for extermination. Ly-Sieng Ngo and her family qualified on all counts.
One of the Khmer Rouge's first acts in power was to completely evacuate Cambodia's cities, sending urban residents to the countryside for "re-education" via hard labor. Ly-Sieng Ngo and her sisters tried to take the family's 10 puppies with them. "When we left home, we did not know what war meant to us. We were just very naïve, very protected by the family. We did not know what living meant, what life meant, what survival meant." In a scene reminiscent of Schindler's List, the family joined the rest of Cambodia's urban elite on a long death march into the jungle. "You only think it happens in books and movies, not in real life," she recalls. "I saw people crying, carrying things, elderly family members on hospital beds with the I.V. pole on the side. I said to myself, 'I have to go on. I have to go on.' And from that moment, I blocked myself out from the reality. For four years of war, with all the family members I lost, I never cried."
From that day she left the town, Ly-Sieng Ngo endured a living nightmare: Her days consisted of slave labor from 4 a.m. to 11 p.m., starvation rations, ditch-digging, rice planting, and water carrying. "Fifteen pound buckets on either side of the pole, back and forth from the river, 120 times a day," she remembers. "You didn't know how you could do it, but I think when you have to do it, you have to do it." There were beatings or worse for those who tried to escape, broke down, or tried to get around the rules. "Some people were killed because they stole one sweet potato. They poured gasoline on these people and burned them in front of us, to show us," she remembers. "They buried some of them alive. This happened almost every day." Three times that she knows of, she herself was targeted for execution because of her family background. She was spared only by capricious good fortune, and by her own reputation as a reliable hard worker.
Pol Pot's rule ended in 1979 with the victory of invading Vietnamese troops who set up a new, less fanatical Communist regime. Nearly 50 members of Ms. Ngo's own family did not survive the four-year ordeal. Ly-Sieng Ngo finally was released from her work camp, and headed back to her village on foot. "In my village, we started with 500 people, and ended up with 34. She found one of her sisters waiting for her outside the house that had been theirs. The sister had been waiting for five months. Soon, two more sisters appeared. But the house was padlocked, and it never occurred to any of them to try to break the locks. "We didn't think of it," she admits, "and didn't have the courage to do it. You know? I was a student my entire life before I became a slave. We did not know what to do at all!" The four girls headed out of town to their grandparents' house, where they had spent much of their youth. The Vietnamese and their Cambodian allies were using the house, center of a substantial estate, as a hospital for wounded soldiers.
The sisters wound up at their town's city hall, which had been converted into a shelter. But Ly-Sieng Ngo could see that there was no future for her in this new Cambodia. "My neighbors, my friends, they keep walking to Thailand," she relates. Soon, she herself joined the tide of refugees. There were family members scattered throughout the world—Ly-Sieng Ngo had a brother in America, who had been on his way to study in Paris when the Khmer Rouge took over, stranding him in mid-journey. He wound up in Seattle, although he spoke no English, only French. Still, he was a connection, a lifeline to a fresh start, a hopeful future. He co-sponsored Ly-Sieng Neo together with a local church. Eventually, the rest of their family came over to join them.
When she arrived in Seattle, Ly-Sieng Ngo was sent to ESL (English as a Second Language) courses to improve her skills. But her English was already good enough for her to serve as a volunteer interpreter and educator for the Cambodian Association. Church volunteers had set up public assistance for her, but Ms. Ngo was uncomfortable having to account for every dollar she spent, and pleaded for help getting a paying job. Soon, she was earning her own keep as a bilingual family health worker for the Indochinese Language Bank (now called Community Health Interpretation Service) of Central Seattle Community Health Centers. It is a position she holds to this day.
Ms. Ngo's job was to interpret for Cambodian and Chinese-speaking patients at several community clinics. In actuality, she did much, much more. At the office, she wrote translations of health education materials, assisted patients in completing forms, and worked with providers to identify and arrange referrals for specialty and social service care. She coached refugees in US health care practices and how to use its health care system, and she counseled health care workers about their patients' culture, beliefs, and practices.
As if all this weren't enough, in her spare time Ms. Ngo began to do volunteer work. "When I translated for people, other things popped out," she explains. "You know, this family didn't have food, that family's children were sick, families were separated, had no clothes, no place to live. There were so many of them, it was overwhelming. I did a lot of home visits on weekends, because these people came, and they were mostly country people, farmers—not like my family—and they cried a lot, but we did not have time to talk at the clinic. I was curious, though, and I wanted to help. So I went to their houses on weekends, to find out how they lived their lives, who they had around them, what kind of troubles they had, what kind of help they needed. And then, to see how much I could do on my own." If they had no food, she found food for them, or showed them how to get to the food bank. She showed them how to take the bus. If, like many women with children who had lost their husbands, they were unable to take the bus, she did their errands for them. If their child was sick, and they'd come in for medication, she'd visit to make sure the child was okay, and help the family decide whether to go to the emergency room. She would attend pregnant women when they went into labor, interpreting for them with the hospital staff.
Two years after coming to the United States, Ms. Ngo herself began to have problems. Night after night, she was awakened by nightmares—scenes of horror that returned whenever she closed her eyes. She would awake in terror, not knowing whether she was in Cambodia or the United States. She suffered in silence for over a year, without realizing what was happening. Finally, she confided in her supervisor at work, who referred her to therapy. There, she was diagnosed with depression and post-traumatic stress disorder (PTSD). Although at first she didn't feel they were helping her—"They didn't even know about Cambodia at all," she recalls—Ms. Ngo continued to visit her therapists for over a year. The chance to tell her story, and have someone listen, kept her coming back. Even more therapeutic, she feels, were her contacts with friends she'd made on her job, a doctor and a nurse practitioner whose support and companionship proved crucial in her lowest moments. They listened, but more importantly, they made her get out of the house, go to the park, take the bus, go to the beach, or go hiking with them in the mountains.
After a while, Ms. Ngo felt herself capable of taking camping trips on her own. On one these jaunts, Ms. Ngo spent a particularly painful time alone in a cabin in the woods. "I was so depressed, I couldn't do anything," she remembers. "But I'd been trained as a fashion designer, remember. And there was this baby quilt I was making for my sister's grandchild, and it needed to be finished, so I sewed and sewed, and it felt good. I asked my friends if there was anything magical about sewing quilts, and they told me the American Pioneer women did it to help themselves through depression. And then I thought, maybe I can try that with the Cambodian women...." It was the beginning of Ly-Sieng Ngo's most ambitious project yet—a quilting circle. "The next week, I got permission from my manager to bring the women in to sew. The first week, I brought six women, and they were fighting to tell their stories. When they'd come to the clinic, they never shared one word. I thought my experience quite bad, but their stories were way more than what I could even imagine!"
Within a year, the group had grown to 46 women. Ms. Ngo was the only facilitator. But the results soon proved to be dramatic—the women were using health facilities much less often, and some no longer required anti-depression medication. The women were sharing stories, food, friendship; they were healing each other's psychological wounds, and re-awakening each other's interest in life. Ly-Sieng could feel herself healing as well.
Then a unique opportunity presented itself. Inside Group Health Hospital was a small retail space designated to support minority and women's businesses. The space was becoming available, and needed a tenant. "Everything just happened at the right time," Ms. Ngo says. "The store was available with very little rent, and my women had enough quilts to sell. So we open the store, and we sold quilts, and then we were on the front page of The Seattle Times! And we sold our quilts like hot cookies!" she finishes with a laugh. "It was like a miracle."
At the same time, Ms. Ngo was moving ahead on other fronts as well. She trained and evaluated new interpreters. She organized a volunteer network to assist people in need of preventive health care. In the face of the AIDS epidemic, she developed and conducted AIDS education workshops for Cambodian men and their wives. At one point, she visited China to study herbal medicine with the express purpose of providing extra care to patients with AIDS. Ms. Ngo's combination of caring and expertise allowed her to promote appropriate western health care practices among Asian patients without undermining their own health beliefs or cultural practices.
In 1984, Ms. Ngo returned to school for training as a community health advocate. in a year she earned her certificate of completion, and began advocating for the rights of individual patients and for quality patient care. She addressed conferences and meetings of American medical providers, speaking about Cambodian culture and appropriate use of interpreters. She provided individual and family health education activities in areas such as nutrition, family planning, and prenatal care. She assisted with workshops: a typical workshop, taught by health providers from a clinic, helped parents to provide home care for their children's minor problems, and to recognize when their children needed further medical attention. These activities helped sensitize the two communities—providers and patients—to cultural differences, and built an atmosphere of trust between them.
In 1988, Ms. Ngo went back to school again, obtaining a childbirth educator training certificate. She began childbirth education classes for refugee mothers-to-be, and eventually coached hundreds of women in labor over a 10-year period. In 1989, she took on an additional part-time job as a mental health interpreter, helping prepare state evaluations for a local Seattle psychiatrist.
For all these efforts, in 1994 Ly-Sieng Ngo was nominated for, and received, the Robert Wood Johnson Community Health Leadership Award. "It changed my life entirely," Ms. Ngo says of the award and the $100,000 stipend that came with it. She used the money to pay the salary of a co-worker to do with Cambodian men what she herself had done with the women—create a support group that would provide not just healing, but a livelihood. Their first project was a furniture manufacturing co-op. But after a short while, the men themselves, most of them farmers in Cambodia, asked Ms. Ngo if she could help them set up a landscaping business. She turned to the staff of the Community Health Leadership Program (CHLP) for help. "They were very supportive and well-organized," Ms. Ngo says. "They had expertise in setting up a business, and could connect us with people who could help us." The men began by mowing the lawns of Ms. Ngo's clinic co-workers, and from there, by word of mouth, their client list grew. The business is now booming, providing the men with increased self-esteem as they can now take pride in supporting their families, and come to feel secure in their financial futures.
Another result of the award was that Ms. Ngo found herself the object of media attention. "When I came back from the award ceremony in Washington, D.C., reporters came to the clinic to interview me, and they put me on the front page the next day!" she remembers. "After that, people kept calling to find out about what I do, ask for advice, ask about my experiences—and it still continues." She also appreciated the opportunity to exchange ideas with other CHLP award winners at the program's annual retreats. "Each time I come back from the retreats," she says, "it boosts me up to another level of recovery."
Since winning the award, Ms. Ngo has continued her efforts on behalf of the Asian refugee community in Seattle. Due to welfare reform, most of her quilting women sought full-time jobs, and last year, the group disbanded, closing up their little shop. Ms. Ngo would now like to find funding to start a plant nursery staffed by some of these women, which would build on the successful landscaping business she created for the men. "I want to use my energy to help these people recover from their depression, and show them that they can be productive, can live a life. Right now, we are just surviving in this country." She feels financial independence is crucial to these refugees' recovery. "If you are financially in such bad shape," she says, "the mental health recovery part is not possible. You have to have food on the table for the family, and live in a decent neighborhood, where you don't have to witness drugs and killing and car wrecking every day." Ms. Ngo is also concerned about the fate of the children of Cambodian refugees growing up in the United States. "Nine out of ten Cambodian families have children who are in gangs or in jail," she says sadly.
Ms. Ngo also plans to finish writing her memoirs. "I want to write the story of my war experience and share it with the younger generation of my family members, because they didn't go through the war. Because in the Western world here, people don't appreciate what they have. They just want more, and I would like my nieces and nephews to know it's not necessary, because if you've had the kind of experiences I've had, you'd see that the things around here are just extra."
To Ly-Sieng Ngo, leadership is all about caring. "If I don't do what seems right, I can't sleep well at night," she admits. She has found her happiness serving the same population that were her servants as a child back in Cambodia. "You know," she says, "people don't need a special skill, or to go to a special school, to learn how to lead. You can do a lot of things by just being who you are. When you care about other people, what goes around comes around. When you help other people recover, other people help you recover, too—and then we can be productive members of society, and contribute to make society better for the next generation."