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This episode was produced by Anne Nguyen, Eujung Park, and Ashley Tam, hosted by Anne Nguyen, and graphic by Callista Wu and Claire Sun.

Time Stamps:

00:00 Introduction to Women in Medicine Conversations: Abbey Zhu from KAN-WIN
00:55 Introduction to Abbey Zhu and KAN-WIN
02:21 Unique Challenges for AANHPI Survivors of Violence When Seeking Support
06:11 How to Start Conversations with the Community
11:32 Creating a Safe Space for Patients
15:18 Recommended Trainings to Learn Trauma-Informed Care
17:55 Misconceptions About Trauma and Its Impact On Patients’ Health
21:19 Policies to Improve Trauma-Informed Care
24:42 How to Connect with KAN-WIN
25:47 Wrap Up 

 

Full Transcript:

00:00 Introduction to Women in Medicine Conversations: Abbey Zhu from KAN-WIN

Anne: Welcome everyone to a new episode of the Asian Pacific American Medical Student Association Podcast. From roundtable discussions of current health topics to recaps of our panels with distinguished leaders in the healthcare field, to even meeting current student leaders within the organization, this is White Coats and Rice. My name is Anne Nguyen and I am the Women in Medicine Director at APAMSA. I’ll be your host for today. Today we’ll be meeting with Abbey Zhu from KAN-WIN as part of our Women in Medicine Series in the APAMSA Podcast. In this podcast, we dive into topics ranging from experiences as an Asian American Native Hawaiian Pacific Islander (AANHPI) woman in medicine, to broader topics like women’s health advocacy. Abby will be sharing with us today about KAN-WIN’s mission and their work in working with domestic violence survivors and other survivors of violence within the AANHPI community. 

 

00:55 Introduction to Abbey Zhu and KAN-WIN

Anne: Hey everyone. So we’re here today with Abbey from KAN-WIN. Abby, could you go ahead and introduce yourself first and a little bit about KAN-WIN?

Abbey: Yes. Hello, my name is Abbey. My pronouns are she/they and I’m the community engagement team lead at KAN-WIN. And KAN-WIN is a culturally specific nonprofit organization based in the Chicagoland area, serving Asian immigrant and Asian American survivors of gender-based violence. So what that looks like is we serve survivors of domestic violence, dating violence, sexual violence, and we have direct services available for them. So that includes legal advocacy, counseling, general wraparound case management, but we also have a super robust community engagement and outreach and education team. So we’re doing both the immediate crisis intervention work, but also trying to lay the foundations for a lot of community and social change so that hopefully we can equip all community members,

regardless of whether or not they’re working for a domestic violence agency with the skills, knowledge, and confidence to be able to support and advocate with survivors of domestic violence.

Anne: Thank you for sharing about KAN-WIN’s mission. It sounds like you all do a lot of great work within the community, especially with different multifaceted approaches, like you were saying.

 

02:21 Unique Challenges for AANHPI Survivors of Violence When Seeking Support

Anne: I was wondering if you could share with us some unique challenges that Asian American, Native Hawaiian Pacific Islander survivors of trauma and violence face when seeking medical or psychological support, especially because KAN-WIN has such a strong, culturally responsive focus.

Abbey: Yeah, I forgot to mention this during the intro, but at KAN-WIN, our staff speak Korean, Mongolian, and Mandarin Chinese, and we were actually founded by Korean Advocates in 1990. So this is our 35th year anniversary of serving clients in the Chicagoland area. But related to that, right, because we’re doing both the direct service work and doing the community outreach and education work, just getting a general pulse on how the community’s doing, kind of what victim-blaming attitudes they might be internalizing, and then also just the fears that survivors themselves might face in like coming forward, asking us for help, even identifying as a survivor. I think especially in a lot of immigrant communities, a lot of our communities are very tight-knit, right? We depend a lot on each other because obviously the United States is not an incredibly welcoming space for immigrants, an incredibly welcoming space for people of color. It’s so beautiful, the ways that we’re able to build these strong communities, but at the same time, because of how tight-knit they might be, there’s a really strong fear of gossip, or there might be a really strong fear of folks stepping, “stepping out of line,” and so there might be a lot of silencing or shame in identifying as a survivor of domestic violence. I think one of the most prominent issues that KAN-WIN has been addressing since our founding is even identifying or naming something as violence. When people immigrate to the US, after they get to the US, there’s so much structural, systemic, and also interpersonal violence that people might feel like they have to normalize or be okay with to literally just survive. So I think the biggest challenge is what someone might perceive as normal, actually naming it as violence and being like, “This isn’t okay.” And I think for a lot of people, too, they might have grown up in families where there wasn’t mutual respect between parents or there might have been power dynamics between parents or power dynamic between parents and children. And when there is a power dynamic, then violence might be seen as justified, right? So I think our biggest challenge has been going out into communities, doing a lot of education around healthy relationships, not just like, “How do you identify domestic violence?” but like, “How do you actually build a healthy relationship with the person you’re dating, the person you’re married to, parents and children?” And how do we talk about things like consent not just in the terms of like sex and dating, but also between family members and trying to change the norms around how we are in relationship with each other, especially while dating or within the family, and really, really pushing for that like, norms change at the community level, not only so that we build those healthy communities and families and relationships that we want to see everywhere, but also so if someone does experience violence, that they’re able to identify it, name it, and not have any fear around disclosing to people.

Anne: Yeah. Yeah, I think that because this is such a sensitive topic, a lot of the time you want to make sure that you cultivate a safe space for that person to come forward themselves and be willing to put themselves forward in a way that, like at their own pace, everything like that.

So I think like you were saying big issues are like just starting the conversation in the first place and then getting a sense of what that person even thinks is normal or what they’re like potentially minimizing in their lives.

 

06:11 How to Start Conversations with the Community 

Anne: I was wondering for KAN-WIN, because you were talking about education and community outreach for y’all, how do you guys get people to be receptive to your efforts, or how do you start these conversations in the first place?

Abbey: Yeah, that’s such a good question. And I think it’s something we continue to try to figure out. I mean, at KAN-WIN, we have a multilingual advocacy team as well as community engagement team. So we work together, but we’re also separate departments. You can think of us as separate but partner departments. And for our multilingual advocacy program, they are people who are bilingual, so fluent in an Asian language and also fluent in English. And they explicitly do education and outreach to immigrant communities where people might not be speaking English as their first language. So we have a Mandarin Chinese speaking advocate, a Korean speaking advocate who also does a lot of targeted outreach to Korean faith communities, so Korean Christian communities, and then we also have a Mongolian advocate.

And I think it helps so much, obviously to be able to do things in language, so much of our values are also embodied in our language and that– being able to have someone who can translate and interpret so skillfully is really important. And then also I think, depending on like what generation immigrant you might be, that also is going to change your lived experience, your values, and the way that you move through the world. So I think having that team is so, so helpful because they’re generally targeting older folks, first generation folks, people who don’t speak English as their first language, and really just laying the groundwork for, okay, like, hey, like a lot of the things that you’ve experienced in life are really, really messed up. Like, a lot of them can change and can be different, especially for future generations. And on the community engagement team, we’re mostly English speaking, we have a youth and young adult organizer who explicitly does education and outreach to Asian American high school students. We focus on college students, and then also like professional to professional training, like certification training, sexual harassment training, bystander intervention, etc. But what we’ve been trying to do is try to also do more, just like intergenerational dialogue. So actually, this past February, our youth and young adult organizer, our faith advocate, our Korean speaking faith advocate, and then also members of our direct service team did a whole month of workshops and programming with Korean churches. So they did workshops on teen dating violence because February is teen dating violence awareness month. And they did workshops just for the parents specifically, just like what they should know about teen dating violence, how to support their children, how to maybe identify as well. And then for the teens themselves, our youth and young adult organizer and an art therapist on staff did workshops around boundaries, consent, basically how to maintain healthy relationships. Think about healthy relationships, both within the context of family but also dating. And an art therapy workshop that kind of also helps facilitate, ‘How do I want to set up boundaries? What kind of boundaries do I want to enforce’, etc, etc. And they also created a brochure so that parents and children could have a dialogue with each other. And so this very targeted intergenerational outreach I think was super well received. I mean it’s something that parents will always be worried about. They don’t want their children to be facing violence right. Then for children, empowering them to be able to keep themselves safe and then also set the foundations for the types of relationships that they want to have was so, so helpful. And I think like we want to keep being able to do that into the future because I think parenting workshops have been super helpful, especially among first gen immigrants, people who don’t speak English as their first language and our multilingual advocates have done consent and parenting workshops so often. And we want to be able to keep developing that and keep creating conversations between generations, just that we can like really clearly emphasize that there are folks in the community who are thinking about this who recognize that mental health is a really big issue, that creating healthy relationships is really difficult within immigrant families. And how do we start doing that, start saying like, some of these things that might have been seen as normal are actually not okay. And how do I know that other people also have my back and are going to support me and trying to create a different or better future for all of us.

Anne: I think that you brought up really great points about like the very targeted interventions because you know, this is– these are like issues that affect many people of like many different backgrounds within the same community. I like the work that you did with the Korean communities and things like that because it’s just you’re really utilizing something that is like a sense of a support system for people who are going through things and then by partnering with them, you know, you can create a much stronger and safe space for people to talk about things.

 

11:32 Creating a Safe Space for Patients 

Anne: I think for us as future health care providers that learning how to build and create the safe supportive space is something that we’re always keeping in mind when we talk to patients. I’m just wondering if you had any tips for how clinicians or health care providers can navigate these conversations about difficult topics like violence, especially maybe in terms of language so we can approach care without actually traumatizing or just kind of like accessing the situation when we meet patients who we think might be going through something.

Abbey: Oh, that’s such a good question. And like my first instinct to answer that question is just like to be curious about your patients to ask questions that might not just be directly related to their symptoms of where they’re coming in to seek care for, but genuinely being curious about

patients’ lives and getting the context for why this person came in, in the first place. And I think just having longer conversations with someone reveals so much, especially for domestic violence survivors or really anyone who is a survivor of like racialized violence or economic violence etc. Right? What, beyond like the medical care that can be provided, maybe I can refer someone to a social service organization that could provide economic financial assistance or housing assistance rental assistance, if someone’s worried about insurance or like paying for their health care, and giving them information about Medicaid or other affordable health care options in your city or in your state. I think with domestic violence. I’m sure I’m quite sure almost every state has their own version of what might be called “40 hour training”. And that’s basically just a really intensive training where you get trained on how to identify domestic violence, identify dynamics of domestic violence, how to support survivors, and basically also how to treat survivors in a– as much as possible trauma informed way. And I know the word trauma informed is such like an amorphous like bubbly word, like what does that actually mean? But to me it really just means recognizing and acknowledging that no one ever faces violence, whether it be domestic violence whether it be medical violence again like economic violence, racial violence etc. None of that happens in a vacuum, and like understanding on a deep level that the world that we live in is so unjust and so many different ways. And so when someone comes to me because they’ve experienced violence in some way or another, recognizing that it’s never just on the interpersonal level but there are so many reasons why that person experienced violence and why they’re here today, and like trying my best to be able to be able to understand the context in which the violence happened and not just like the manifest– maybe the physical manifestations of violence in the current moment. So I think just being curious, asking questions, and trying to get as much context as possible and then if you have the time, and you can get your workplace to pay for it because it’s usually so expensive, getting 40-hour-trained is super super helpful in just getting a deeper understanding of what domestic violence looks like and how to specifically support survivors.

Anne: Yeah, I think that, what you were saying about the training and figuring out the context it’s all so important and something that we need to keep in our minds constantly. Someone might not be coming to you to tell you their whole backstory but then if you kind of like make a space, elicit information, you can, you know, then gather that context and really help them to the fullest.

 

15:18 Recommended Trainings to Learn Trauma-Informed Care

Anne: I’m really interested in the 40-hour-training that you were talking about I was wondering if you could tell us more about that or other resources and training that you would recommend medical students and other clinicians within this– working with this community who want to improve their ability to provide trauma informed care.

Abbey: Yeah, so the 40 hour training is specific to Illinois. In Illinois, if you want to work with domestic violence survivors in a one-on-one setting so work at a domestic violence agency, volunteer for a hotline, volunteer for a shelter etc. So if you’re looking to get 40 hours of training first before you can start working with those survivors. Basically it’s just a law that’s like we want to make sure that folks working with survivors are not going to retraumatize survivors. In New York or in other states, yeah, quite confident that there are probably other training requirements for y’all, but generally domestic violence agencies or organizations will host 40-hour-trainings throughout the year, you can register for them. So some of them are all online some of them might be 20 hours of self paced learning 20 hours of in person training, but it is a really really great way to get really really in the weeds of just dynamics of domestic violence, legal options for survivors, medical options for survivors, and also like history of the anti-violence movement as well. So it’s really like kind of like foundational training for you to be able to expand your knowledge of how to support survivors of gender based violence, intimate partner violence.

In terms of other trainings I think really just any professional trainings that you can register for that deepen your knowledge of anti bias work, just anti racism, just any trainings where you can learn more deeply about the structures and systems of our world and how they impact people on the individual level and how that’s going to impact the way they show up when they come to a hospital or when they come to a clinic or when they come to the doctors. I think there are so many really amazing organizations who provide and do trainings on that, because, again, like we grow up in a world learning so many narratives about so many different people. And so there’s a lot of stuff for all of us to unlearn, because our brains are wired to think in very specific ways and we might not even be noticing, that we’re thinking or behaving and therefore acting in a way that is actually really harmful towards other people. So yeah, those are my recommendations. 

 

17:55 Misconceptions About Trauma and Its Impact On Patients’ Health

Anne: On that topic, then, what do you think are some common misconceptions about trauma and how it can impact patients health and well being just so we will know to look out for what we want to unlearn and things like that.

Abbey: Yeah, I think, in the context of domestic violence, the biggest misconception is that the only thing that counts as domestic violence is physical violence, so people might only be looking for physical signs of injury, whether that be bruises like choke marks around the neck broken

or whatever. But what we know as folks working in the anti-violence movement as people serving survivors of domestic violence is that domestic violence is so much more than that. It could look like sexual violence, including sexual assault, it could look like tampering with someone’s birth control forcing someone to have a child if they don’t want to have a child, it could look like emotional abuse, psychological abuse, financial abuse, not letting someone get a job, not letting someone have their own bank account, and like that doesn’t manifest physically

right but all of that trauma, even if it is like “psychological” is going to show up in the body in different ways. So a lot of our survivors might be like, “Oh, like, I’ve had chronic stomach pain for months”, and like that’s stomach pain obviously is a manifestation of like the abuse and violence that they’ve been enduring, but it shows up as this like body problem that might feel like, “where did this come from?” and also like, oh, at the same time like “that’s just a stomach ache”, right. But as y’all know, as medical professionals, as medical students, all of the violence, even if it isn’t physical, is going to show up in our bodies in different ways, whether that’s mental health difficulties or issues, whether it’s chronic pain, chronic stress, high blood pressure, headaches right? Thinking about that and then also thinking about how you never really, “completely heal” from trauma. It’s always going to stay in the body in some way or another might show up as PTSD again, might show up as chronic pain, but just like getting rid of the idea that like, things can be “fixable”, but rather empowering survivors giving them the tools, the empathy and the space to decide for themselves what they want their healing journeys to look like. And also being really honest with survivors. I think that’s something that we repeat over and over again is that we’re never going to over promise to survivors when we do legal advocacy right? Applying for a restraining order or order of protection– when we help clients apply, we’re not going to say like, “you will be able to get this for sure” right? We’re going to be like “hey we’re going to help you get this, it’s ultimately up to a judge”. And I feel like in medical context, it’s a similar thing of like “we’re going to do our best to address this and work through this together”. But again, right like there’s no guarantee that it’s going to be over or gone completely.

Anne: And so after sharing about that I do think that, like you were saying, it’s really easy for people to get caught up with these kind of “classic or typical expectations” of what like a survivor would look like. So just being like very open minded to know how people might come in with different experiences and then being honest with them I think would definitely help a lot in terms of you know how to catch people while they’re, you know, in a place where they might need help.

 

21:19 Policies to Improve Trauma-Informed Care

Anne: So I was also wondering if you could tell us if there are any policy or changes that you think would improve trauma informed care in medical settings as well.

Abbey: Good question. I think in an ideal world, and if there were enough resources and enough time because I know y’all are also so overworked. Every medical professional if not to get 40-hour-trained but at least to get basic domestic violence or intimate partner violence training so that they’re able to identify domestic violence survivors or if someone discloses to them, like, knows what they need to do to be able to refer that survivor to the resources or services that they might need. And then I also think just increase partnerships between domestic violence organizations and hospitals, or like medical groups. I know that there are a lot of domestic violence agencies in the Chicagoland area who have partnerships with certain hospital or medical groups in the Chicagoland area where those hospitals provide

reduced cost or just like no cost care to survivors if they were to come into the hospital requiring care after experiencing domestic violence. I also know that there are really strong referral networks so if a survivor, if someone comes into the emergency room after having experienced really severe physical domestic violence, a nurse has the knowledge and knows who to call, and can know how to speak to the survivor and ask, “Hey, like, do you want me to call a hotline with you?”. And then, since they have that like referral network and those partnerships with these DV organizations, then also medical staff know who to call. And I think also, this is more like a policy level unless on like an individual medical professional level but ensuring federally like nationwide that all people have affordable health care. And so that people aren’t afraid to ask for care. I think that is one of the biggest barriers as well like “Oh, how am I going to pay for this if I were to go in to ask for testing, screening, medication, etc”. And a big part of our advocates work at KAN-WIN too, is trying to find as much as possible, state or government assistance for our survivors because a lot of our limited English speakers or might be low income or don’t have a lot of financial independence because of the abuse that they’ve been enduring so short answer to all this is just more, more just policies for all people and then also stronger partnerships and collaborations between the medical field and domestic violence field.

Anne: Yes, I totally agree with all of that like just like the stronger partnerships like I mentioned before working within the community I think it’s so powerful, because you know like, if y’all like KAN-WIN have a great network with people that you know are seeing survivors with clients, then you know, having medical groups partner with you guys really just capitalizes on that sense of trust and can really more effectively like help you all with your mission and like approach people who are survivors of violence in a way that’s familiar to them, safer for them. And then, in addition like you were saying with the policies, especially the financial aspect that you were mentioning, I think that’s huge, just removing that burden kind of opens up a whole new world, or it makes it so that people aren’t afraid to ask for help if they need it.

 

24:42 How to Connect with KAN-WIN

Anne: And then, just kind of as a last question, I was wondering if you could let listeners know where they can hear more about KAN-WIN’s work. What are ways for them to get involved and any exciting kind of new services or programs that you guys are doing.

Abbey: Yeah, so best way to stay updated on our work is to follow our Instagram. Our handle is @KANWINChicago, all one word, no spaces or underscores, and our website is KANWIN.org And you can subscribe to our newsletter there, our website also regularly updates like news and updates. So, great way to stay updated on the work we’re doing. 

 

25:47 Wrap Up 

Anne: Great, thank you so much for speaking with me today, sharing with us, you know more information about how to interact with survivors of violence, especially the tips on trauma informed care and culturally responsive methods. I think this was a great conversation, I learned a lot, I hope that the people listening learn a lot too. Yeah, thank you again so much for meeting with us and sharing today.

Abbey: Of course, thank you so much for having me and coordinating this, it was an honor.