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Stemming red tide tragedies
Health officials meet with Asian elders to devise better ways to warn about shellfish dangers
09/03/2000
Sandi Doughton; The News Tribune
South Sound
As they feasted on plates of jasmine rice, stir-fried ginger and pork soup, about three dozen Cambodian elders carried on a lively question-and-answer discussion on shellfish safety.
"What do you think about the health department's shellfish warning signs?" asked Sothea Pal, of Tacoma's Indochinese Cultural & Service Center, where the elders gather each Friday for lunch.
"They're good," said Bou Ban, speaking in Cambodian, "but some people can't read or understand them."
"How could the health department improve the way it gets the word out about red tide?" Pal asked, also in Cambodian.
Saroun Khou suggested the agency announce the warnings on TV. That way, she said, more people would hear about them.
The news that nine people in Pierce County - seven of them Cambodian - were sickened or hospitalized by red tide shellfish poisoning over the past week has the tight-knit Cambodian community buzzing, said Pal, who coordinates a shellfish education program for Asian and Pacific Islander groups.
Most of the victims have recovered, and all are expected to be fine, but several could have died if they hadn't reached the hospital in time, doctors said.
The spate of poisonings, among the worst in the state's history, shows that red tide warnings need to be communicated better - particularly to people who don't speak English, say many of those who have been grappling with the issue.
"It's pretty apparent we need to sit down and revisit what we've been doing and come up with another game plan," said Ray Hanowell, of the Tacoma-Pierce County Health Department. "I don't think we're going to be able to protect everyone completely, but I think we can do a better job."
Some are angry that information about the danger wasn't disseminated more widely.
The state health department closed many Pierce County beaches early in August because of rising levels of the red tide toxin that causes paralytic shellfish poisoning. Multilingual signs were posted in seven spots - on public beaches and access points - and the information was available on the state's shellfish hot line and Web site. But the health department didn't issue a public alert to the news media until after the first poisoning cases turned up in area hospitals, Hanowell said.
By then, toxin levels in mussels from Carr Inlet had reached the highest levels ever measured in South Puget Sound.
Darren Pen, president of the Khmer Community of Tacoma, said he's talked with all the Cambodian victims and their families, and none knew about the red tide danger.
"If they had seen a warning anywhere, they wouldn't have gone out," he said. "This is a matter of life and death. It's the health department's job to take care of that stuff and inform all of the citizens."
It was precisely because the state health department realized its messages weren't reaching many immigrants that the Asian and Pacific Islander shellfish education program was launched two years ago, said Wayne Clifford, who leads the effort.
Sponsored by several government agencies, the Indochinese Center and the Korean Women's Association, the project works to overcome cultural and language barriers.
For example, Pal said, most Cambodian people aren't familiar with red tide poisoning, because there's nothing like it in their native country. Limits on shellfish harvests are also new to them, as is the concept of government health warnings. In Cambodia, when beaches are posted with "Keep Off" signs, it's because rich people want the shellfish for themselves and want to keep the common folk away, he said.
While Americans are trained from grade school to read and obey signs, many Cambodians are not. And many of the elders don't read at all, Pal added. Even so-called "universal" symbols, such as a clam with a diagonal slash across it, aren't recognizable to people who have never seen them before.
The shellfish education project focuses on two groups: elders active in the communities and influential within their families; and young people, who often serve as a link between the old world and the new.
This summer, Pal and others conducted beach walks for Cambodian, Indonesian, Korean and Vietnamese elders, teaching them about harvest limits and conservation, as well as health risks.
Teenagers were hired to collect shellfish samples for red tide analysis and to share the knowledge with their families.
As part of the program, the Indochinese Center receives information from the state about beach closures and passes it on to those who ask.
Before this summer's poisonings, though, many didn't know they needed to check beach conditions, Pen said. Also, the mussels that sickened so many people came from private docks, where no warning signs are posted.
Kop Sar, a 45-year-old landscaper, was among those who fell ill. He started feeling bad about half an hour after eating a dozen baked mussels at a friend's house on Aug. 27. He had no idea they might not be safe to eat, he said, speaking in Cambodian interpreted by his daughter, Sara Sar.
By the time he reached St. Joseph Medical Center, Kop Sar couldn't walk and barely could breathe because the red tide neurotoxin was paralyzing his diaphragm and other muscles. He spent nearly two days in the hospital breathing with a respirator.
He said he'll never eat mussels again, but he wishes someone had warned him earlier.
In the coming weeks, Clifford said, he and his colleagues will try to figure out how they can help prevent others from going through the same misery.
"It's really important to me and my agency that we understand why this happened and how we can fix it in the future," he said.
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* Staff writer Sandi Doughton covers medicine, health and science. Reach her at 253 597-8516 or by e-mail at sandi.doughton@ mail.tribnet.com.