What I remember when testing African diaspora immigrant communities for COVID-19

I found it impossible to celebrate Black History Month in February 2022 without reflecting on how the pandemics of our time, like COVID-19, affect the health and human rights of African diaspora immigrant communities—my communities.

As a pulmonologist, I treated people infected with tuberculosis, cancer, and other respiratory diseases at Fann University Hospital in my home country of Senegal years before I responded to the COVID-19 pandemic in New York. For 10 years, I practiced pulmonology and infectious disease on the wards at Fann, a renowned institution that sits at the top of the Senegalese Ministry of Health’s hierarchical and tiered system of hospitals. Little did I know that this clinical practice in Dakar would prepare me for the frontlines of a battle against a novel coronavirus in New York at African Services Committee (ASC), a multi-service human rights agency in Harlem that provides health, housing, legal, social welfare, education, nutrition, and advocacy services to immigrants, refugees, and asylees from across the African diaspora.

However, I must urge the public health community to pause and reflect on how this virus shaped the health and human rights of populations close to my heart and home: African diaspora immigrant communities in New York. These communities have been at greater risk of exposure to COVID-19: more than 54% of essential workers in New York are immigrants. As essential workers in New York during the COVID-19 pandemic, African diaspora immigrant communities have cared for the sick and elderly, cleaned public spaces, and delivered meals throughout all five boroughs. Greater exposure to COVID-19 led to a greater number of COVID-related infections and deaths in New York.

When they became infected with COVID-19, many of these uninsured and undocumented immigrants avoided care for fear of cost: of the more than 8,200 New Yorkers who died from COVID-19 due to lack of health insurance coverage, at least 2,700 were undocumented.

I remember the stories of these 2,700 undocumented immigrants. I will never forget one of these stories. Newcomers to New York from Africa, an ASC client’s husband became symptomatic of COVID-19. Uninsured and undocumented, a fear of costs delayed their accessing care. When his symptoms worsened, this client brought her husband to an emergency room. He then died from complications related to COVID-19. Admitting him to the emergency room was the last time she saw him before he was buried in New Jersey, which prevented her from preparing his body for burial, as is customary in her family’s Islamic traditions.
Clients began calling ASC, asking for COVID-19 testing because our agency, they said, was the only provider trusted by African diaspora immigrant communities in New York. Many other providers often required insurance and identification for services.

Countless stories like this compelled me and my colleagues at ASC to build—from the ground up—a culturally-conscious testing program for COVID-19. We sourced supplies from the New York State Department of Health, contracted a lab to process PCR tests, and submitted provider reimbursements through the Health Resources and Services Administration. We built an outdoor testing center to engage clients on the streets of Harlem. The New York City and New York State departments of health did not certify all community-based organizations as a COVID-19 testing center, so ASC had to prove to these departments that we could do it.

And we did. Supported by ​​staff representing more than 20 countries and speaking more than 27 languages, ASC administered over 780 PCR tests and distributed over 400 at-home testing kits between August 2020 and February 2022. The agency integrated COVID-19 testing into its suite of testing services for HIV, tuberculosis, hepatitis, diabetes, hypertension, pregnancy, chlamydia, gonorrhea, and syphilis. ASC also rolled out a COVID-19 Helpline and secured additional funding and support from the Health Resources and Services Administration, New York City Vaccine Referral Bonus Program, Test and Trace Corps, and the New York City Department of Health and Mental Hygiene. Community health workers, peer vaccine ambassadors, outreach specialists, and youth workers distributed personal protective equipment; navigated community members to testing and vaccination; and broadcasted multilingual messages to dispel misinformation. Since November 2020, they have delivered more than 300,000 masks to communities disproportionately infected and affected by the virus.

I am proud of the work we did and continue to do in the spirit of improving the health of the public. And here’s what I remember when testing African diaspora immigrant communities for COVID-19 in New York: nio far. Translated from Wolof, my maternal language, it means we are one. We are one community—together, but separate—navigating complex health and legal systems during an unprecedented pandemic in the United States.

Halimatou Konte is a pulmonologist and the health program director at African Services Committee, a multi-service human rights agency in Harlem dedicated to assisting immigrants, refugees, and asylees from across the African diaspora.