It's a Sunday with the scent of spring in Los Angeles, and as we walk along the Oaxacan Corridor on Pico Boulevard, the fear is palpable, but so is the resilience. Looking at the street, it's easy to admire how rich and vibrant the culture is, amidst the smell of carne asada from the food stalls and the murmur of people eating on a beautiful afternoon. If you listen carefully, you can hear some people speaking one of the many languages ??of Oaxacan origin spoken in the city. As you approach some stalls and businesses, many declined to be interviewed, citing fear of the immigration raids that have been seen in the city since last June. Those who speak little Spanish say “No, thank you” when asked if they can have their picture taken, while others, like a young man tending a grill on the sidewalk, reply that “things are too difficult right now to take any risks.” In the end, he smiles and jokes about how handsome he is and that, if it were a different time, he would have agreed. “I know I’m handsome, but no, it’s better when things calm down, you can come back,” he says in a friendly tone.

For many Indigenous people, speaking Zapotec, Mixtec, or K'iche' means being triply invisible: to a healthcare system created in English, administered in Spanish, and never designed with them in mind.

These barriers existed before the Trump administration, but the increase in immigration raids and the Supreme Court's decision to greenlight racial discrimination based on appearance and language have worsened the situation.

'They were going to circumcise their son'

The nonprofit organization Indigenous Communities in Leadership (CIELO), led by Indigenous women, is a human rights group dedicated to linguistic access, cultural preservation, and social justice. They recall the numerous times they have had to be the voice of patients who speak neither Spanish nor English.

Odilia Romero, its co-founder,She was once called in to interpret for the father of a minor patient at a local clinic; the service was supposed to be translating into Spanish, but after speaking with the father, she quickly realized he spoke an indigenous Guatemalan language. “They were going to circumcise his son without him realizing he had consented to it,” Romero recalls. “We finally got him a suitable interpreter, and once they explained the procedure to him, he immediately refused to have it done.” She explains that, in the end, the circumcision was avoided, but situations like this happen frequently, and this lack of empowerment has serious consequences, such as delays in treatment, distrust in the medical system, and patients taking incorrect doses of medications prescribed by their doctors. Romero, who came to Los Angeles from Oaxaca at the age of 10, says that to ensure everyone has adequate access to healthcare and opportunities, it is crucial that clinics and other institutions not only have a wide range of interpreters but also understand how language remains a barrier for many Indigenous communities in Los Angeles seeking medical care. “I wouldn’t define it as a challenge, but as a human rights violation, because your rights are tied to language,” she explains. “For you to make an informed and reasoned decision, the information must be in your language. When it isn’t, a violation occurs because you don’t know what decision you’re making; instead, you’re making guesses based on what you can understand.” According to a map based on data compiled by CIELO and developed with researchers from UCLA, the city's migrant communities speak at least 36 distinct Indigenous languages, representing at least 25 different Indigenous communities, primarily from Mexico and Central America. It is also estimated that between 180,000 and 200,000 Indigenous people from Oaxaca reside in the city, with the largest groups concentrated, though not exclusively, in areas such as Westlake and Pico Union. Most speak Zapotec, Mixtec, and Triqui, and in other parts of the city, there are Indigenous people from Guatemala who speak languages ??such as Maya, K'iche', and Mam. “As interpreters, we are the bridge of communication,” Romero points out. “Prejudices against Indigenous people already exist, and now, with what is happening, people are afraid to set foot in a clinic and say they speak another language. And they simply accept anything.”

In general, indigenous populations in the US have very low access to doctors, due to factors such as their immigration status, discrimination, language,Cultural differences and a lack of familiarity with American medical processes and terminology make it difficult for Indigenous migrants to access health services, resulting in a lack of access to preventative care and treatment for chronic conditions.

Discrimination against Indigenous communities

Angel Cruz, an Indigenous artist from Oaxaca living in Los Angeles, agrees that there is a lot of discrimination against Indigenous people. He recalls being called “Indian” or “paisa” when he was younger because he only spoke Zapotec, not Spanish, and says that many other members of the community also face this as adults.

“People know they will be treated differently as soon as they speak, and there is also a lack of education and outreach; people don’t know where to go,” he says. “This prevents many from going to the doctor and, instead, they resort to home remedies to cure their illnesses, which sometimes only worsens their condition.” A study of Indigenous farmworkers revealed that only 9% of Indigenous Mexican immigrants have health insurance; 60% of Indigenous migrant women have never been to a doctor in the U.S. And what about people from Oaxaca in Los Angeles? For this group, there isn't even accurate data, as they are grouped under the “Latino” category, which makes their needs invisible. “There is no current official count of the languages ??that are actually present; the numbers vary, and many are excluded from those counts when their only options on a form are Latino or Hispanic,” explains Teresa Morales, health coordinator at the Binational Center for Indigenous Development of Oaxaca (CBDIO). “We’ve seen cases where they finally get their interpretation, but the interpreter isn’t the right one, so they have to wait until they get a suitable one, which only delays treatment and the patient’s health worsens day by day.”

“We’ve also seen people who go to the ER and, usually, hospitals give them a tablet to contact an interpreter, but sometimes it can take a long time, and in an emergency, that can be life-threatening,” she added.

CBDIO is a California-based nonprofit organization that focuses on language justice, cultural rights, health equity, and advocacy for Indigenous peoples.

Morales said that in their work, they try to identify the different languages ??spoken in the region, but noted that this task shouldn’t fall on just one organization.

What’s Lost in Translation with Mental Health

The language barrier also affects people seeking mental health services,According to Mirna Martinez, a therapist from Oaxaca and co-founder of the Oaxacali Run Club, who has witnessed these challenges firsthand. Although she herself doesn't speak any Indigenous language, she has been a voice for those seeking help. She recalls an occasion when the receptionist called her over to speak with a woman she assumed spoke Spanish, but who actually spoke K'iche', a Guatemalan language. “I called CIELO, but if I hadn't been there and hadn't known about resources like CIELO's, my coworker wouldn't have known what to do, and that call wouldn't have gone anywhere,” says Martinez. “I soon realized how important it is to have representation in these spaces.” She explains that when someone is in therapy, language is of utmost importance, as it's how many express their emotions and share their story. And most clients feel comfortable sharing their life story and struggles in their native language.

“If I can make someone feel seen and comfortable, that’s where healing can begin for our patients,” says Martinez. “It all starts with how we communicate with each other. If they can’t do that, they won’t be able to take full advantage of the resources available to them.”

When Coverage Disappears

Community members also face additional obstacles due to the freeze on federal funding, including a lack of funding for ancillary services such as translation and the loss of health insurance coverage.

For her part, Dr. Seciah Aquino, executive director of the Latino Coalition for a Healthy California, says the funding freeze is one of the biggest obstacles communities are facing right now. Aquino stated that the community faces many challenges due to immigration raids, and while on the one hand there has been a decrease in the number of patients attending regular checkups out of fear, on the other hand, some patients who depend on medication and suffer from underlying illnesses are seeking medical attention more than ever. “We see that they are using their coverage more out of fear of what will happen when they lose access to it,” she indicates. “It is extremely dangerous to lose access; for some it is a matter of life or death; we are going to see an increase in health inequalities.” The Challenges of Child Interpretation Although Los Angeles County has a language access plan that offers translation and outreach services in several languages ??and collaborates with groups such as Indigenous Communities in Leadership (CIELO),While CIELO, which offers translation services for more than 30 Indigenous languages ??in 27 states, still faces gaps in the clinical sector. Even so, these deficiencies in clinical settings need to be addressed, and the current political climate is exacerbating, rather than mitigating, the situation. When asked if CIELO's medical translation services had increased since Trump took office, she replied that the opposite had occurred. Fewer people are seeking medical care, and when they do, language barriers persist. “Some people say it's increased by as much as 200 percent, but that's not true, because right now there are institutions that don't offer interpretation services to Indigenous people. I get more calls from the LAPD than from hospitals or clinics,” she says. Often, the responsibility for translation falls on the shoulders of the children of immigrant parents, who have long relied on them to translate complex medical and legal terminology. “As a child interpreter, I have to tell you that you're placing a great responsibility on a child's shoulders, because interpreting is an art and a skill that requires training,” Romero states. “There are legal and medical terms specific to the profession that we don't use in everyday life.” One example she gave was the use of the word “cholesterol” in English; in Spanish, it's “colesterol,” but in the numerous indigenous languages ??spoken in Oaxaca, that word doesn't exist. However, she said that's where interpreting services come in: a term like high cholesterol isn't translated with a single word, but rather its full definition is explained. Romero indicates that, although there has been a decrease, that doesn't mean there's no longer a need. Therefore, CIELO, in an effort to identify and address shortcomings in order to provide services more quickly, has been working on an application that aims to streamline services for providers. They have been working on the application for the past three years and will launch it approximately next month, allowing institutions to request interpretation services more quickly and on the go.

“We know the need is there. There are violations of language rights everywhere,” she stated. “There needs to be a shift in people’s mindsets so they understand that language is a fundamental human right.”

Legislative Policy in Preparation

In the state of California, some steps have been taken to improve access to interpretation services and identify the languages ??spoken in the state, such as the introduction of SB 1016,The Reducing Disparities Between Latinos and Indigenous Peoples Act, which requires detailed, specific, and anonymous tracking of ancestry, language, and medical outcomes to address disparities in specific communities.

Dr. Aquino said they have also been working closely with Senator Maria Elena Durazo and have introduced SB 1422, which seeks to reverse the freeze on enrollments for undocumented immigrants.

“The Medi-Cal freeze is one of the biggest obstacles. It directly impacts access, so we are asking for that freeze to be lifted so that people can continue to have access to health care,” Aquino explains.

When asked how easy it is for a patient to consent to a procedure they don't understand, Romero responds that it all begins with the initial patient review. She indicates that when they are asked to raise the arm or leg that hurts, they may only understand that they should raise something and often raise the wrong arm or leg. Without proper communication, this could lead to a misdiagnosis. “This leads to what we call linguistic violence: if you end up having surgery you didn’t know you had agreed to or where you don’t understand what they are going to do to you,” she explains. “The process of human rights violations begins with the person at reception, because they assume that anyone who comes from Mexico speaks Spanish.” As we walked away with a burnt milk ice cream bought at one of the markets along the Oaxacan Corridor, the sweetness couldn’t mask what remained: the fear, the uncertainty, and the silent resistance of a community that knows it has always had to fight to be seen.

This article was produced in collaboration with the Healing California Ethnic Media Health Reporting Collaboration of the USC Annenberg Center for Health Journalism