“The role of navegantes is so near and dear to my heart because I think it’s the essence of what health care should be,” said Jaqueline Medrano, special projects director at Clinica Esperanza in Rhode Island. The health workers help the free clinic offer culturally competent patient care.

By Olivia Lewis
First published October 27, 2026 by Direct Relief

Seven years ago, Jaqueline Medrano received an email about a free clinic in need of Spanish-speaking volunteers.

Medrano, a first-generation undergraduate student at the time, said the email was a reminder of how she accompanied her parents on their medical visits as their Spanish-to-English interpreter.

At the age of eight, Medrano said she became the voice in the room that her parents didn’t have.

“I just remember the uncertainty, and I remember the fear,” she said. “You’re in this country, you don’t know anything about it, and you don’t speak the language. It’s scary.”

Now, Medrano is the special projects director at Clinica Esperanza, or Hope Clinic, in Rhode Island. She followed the flyer to begin volunteering and signed up for the clinic’s Advanced Navegantes Training Program, a workforce development program that certifies multilingual and multicultural community health workers. The clinic formalized the program in 2015 after shifting population and community dynamics revealed a greater need for culturally competent care.

“The Essence of What Health Care Should Be’

The navegantes, or navigators, were named after the services they provide to patients. The navegantes conduct patient intake, ask about social determinants of health, and build rapport with the patients before any other staff meets with them. When patients meet with the physician, the navegantes interpret throughout the appointment and provide resources on where to get further support throughout the community.

Following the 10-week training program, the navegantes can complete a six-month internship at the clinic or with a clinic community partner. The clinic pays for their services through a statewide workforce development initiative and Medicaid support if a patient has Medicaid.

Of the 16 full-time staff members at the clinic, 12 are or have been navegantes.

“The role of navegantes is so near and dear to my heart because I think it’s the essence of what health care should be,” Medrano said. “They work really, really hard and they work with folks in their most difficult days when receiving the most difficult news. And they do it with such love and compassion.”

Connecting Patients to Care

The program was initiated in 2015 by the Clinica Esperanza’s founder, Dr. Annie De Groot, who saw value in peer support through her work in infectious disease programs with AIDS patients. De Groot wanted to bring a similar level of compassionate and culturally competent care to the clinic.

At the time, Rhode Island’s Hispanic and Latino population had significantly increased and there was a need for community health workers who represented the communities the clinic serves. Since then, the population has continued to grow.

According to the 2026 Rhode Island Kids Count Factbook, the Hispanic child population in Rhode Island grew by 22%. In 2024, it was found that 24% of Rhode Island children spoke a language other than English at home, encouraging community-facing organizations to “adapt their practices to become more culturally competent.”

For 11 years, clinic staff have recruited people from within the community that are English and Spanish-speaking for the 10-week program.

“They are certified community health workers, medical interpreters, lifestyle educators, and we cross-train them on site as medical assistants,” said Morgan Leonard, the clinic’s executive director.

The cohort learns from clinic staff on public health topics and core competencies, while professors from a nearby university educate participants on vaccines and healthy lifestyle education on hypertension, diabetes, and how to interpret languages in medical settings.

The program has graduated 300 participants so far, and 85% have gone on to work in other health-related positions.

Using ‘Navegantes’ to Bridge Care Gaps

“The majority of people who experience health disparities in the state are overwhelmingly Latino or Black compared to white counterparts,” said Leonard.

Leonard said that the clinic acknowledges that social determinants of health affect overall health. The navegantes consider where patients live, their access to grocery stores and gyms, their places of worship, and who they can communicate with on a daily basis.

The executive director said that cultural familiarity has helped them build trust and begin to address the health disparities.

“There is an immediate understanding and a connection that is made (through navegantes), and that’s the reason culturally competent care is so important,” Leonard said. “When we’re thinking about the social determinants of health and somebody’s overall wellbeing, a patient (who is) newly diagnosed with diabetes may need to change their diet. Handing them something that may work for one person doesn’t always work for another.”

As the population continues to grow, gaps in healthcare persist. Hispanic residents continue to have higher barriers to accessing healthcare than any other racial group in the state.

In 2022, Rhode Island’s Health Department reported that for the state’s Hispanic population, over 20% are uninsured, nearly 25% have no doctor, and just under 20% said they couldn’t afford to see a physician.

Compassionate Care is a Language and a Culture

Dr. Michael Brabeck has been a physician for half a century. While a New Yorker for most of his professional career, Brabeck’s work took him to Central America for weeks or months at a time for several years. Brabeck, who speaks Spanish, provided care to the Indigenous communities of Guatemala.

In 2021, Brabeck retired and moved to Rhode Island to be closer to family. He began volunteering with the clinic and is one of two volunteer physicians who speak Spanish. Even he has trouble communicating with patients from time to time.

“When I can’t understand or get a good sense of what a person is telling me, because I’m not of that culture, I’ve got a navegante by my side.”

“Esperanza is the living example of the fact that all medical care is collaborative today,” he said. “Nobody can do it on his or her own.”

The physician said the care given to patients at the clinic is special. It would seem that the more people associate themselves with the clinic, the more they want to be involved. The physician’s grandson began volunteering at the clinic and registered himself for a class to become a medical scribe for the clinic.

Medrano assumed she would only volunteer for a few weeks, then move on for other professional aspirations. Now, she says, “They can’t get rid of me.”

Medrano says she wonders how different it could have been for her parents had they had a navegante the first time they walked into a physician’s office to say, ‘I’m not feeling well, and I don’t know what to do.’

“Imagine somebody responds and says,’ It’s okay, you’re in the right place,” Medrano said.

Since 2016, Direct Relief has provided Clinica Esperanza with more than $14.3 million in medical support to strengthen patient care.

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