BestCare Pharmacy brings health literacy, affordable care to Akron's immigrant population

Ganga R. Kalikotay was doing homework on a bench in front of his family’s home when he heard the screaming.

It was his mother, 50, who was on her way to visit a nearby friend. Kalikotay found her around the corner leaning on the wall of their small bamboo hut. He brought her inside, where she described the intense chest pain that provoked her outburst. They hopped on a bike and headed to the nearest clinic.

The clinic was in Beldangi-1, a crowded refugee camp in Nepal that housed Kalikotay’s family, as well as thousands of other Nepalese individuals who were being "ethnically cleansed," forced out of Bhutan. Looking back, Kalikotay hesitates to call the squat concrete building a clinic as the provider could only be compared to a medical assistant at a doctor’s office.

Regardless, the family visited the facility, which informed them that Kalikotay’s mother would need to be transported to a better-equipped facility in a nearby city. So, they sat down in the waiting room and waited.

And waited.

And waited.

Five hours later, an ambulance pulled up – lights ablaze – to transport the family matriarch.

Sometime amid the waiting she’d died. It wasn’t until over two decades later that the family learned it was from a heart attack.

That day, Kalikotay lost his mother but gained a lesson that would shape his entire life.

You can have all the health care and money in the world, but a lack of health literacy can remain your most deadly adversary. It is simply the most important part of how a patient receives care.

If anyone in the family had known, or even suspected, it was a heart attack his mother was suffering from, they would have sold all their belongings and exhausted their savings to purchase a taxi to the hospital, Kalikotay said upon reflection.

Transforming a hard lesson into a dream

But no one knew. Not Kalikotay, not his father, not his sisters or older brothers. Low health literacy means a lower capacity to obtain, read, understand and use health care information to make appropriate health decisions. So, those who have a low health literacy rate are less likely to seek care in an appropriate amount of time.

It’s been 16 years since that day, and Kalikotay, now 33, and his family live a world away in America. They arrived in Tucson, Arizona, in October 2009. Kalikotay’s father and siblings moved to Kansas 4½ years later for better job opportunities, while he continued his higher education in The Grand Canyon State.

The lesson stuck, though. It held him in a vice-like grip during his vocational training through Jobs Corps to become a certified nursing assistant. It didn’t let go during undergrad at a community college and the back-to-back 16-hour shifts he’d pull at a local nursing home and rehabilitation center each week. It even gripped him while studying at the University of Arizona College of Pharmacy and the medication therapy management center where he worked at the time.

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At the center, Kalikotay counseled patients on their medications day in and day out. During one of his shifts, he realized that he’d been having these exact conversations before – but with his family. That’s when it hit him that by doing similar counseling in his own community, he could make an even greater impact.

Kalikotay decided Akron was the place to have that impact due to its growing Nepali population. The fact that 80% of Kalikotay’s extended family already lives in Akron, along with his father and siblings’ plan to move here in the future, helped the decision.

After opening BestCare Pharmacy in Akron’s Chapel Hill neighborhood in January 2022, he has finally been able to realize his mission to improve health literacy in former Bhutanese refugees.

Low health literacy is associated with patients who are older, have limited education, lower income, chronic conditions and those who are non-native English speakers, according to a journal in The National Institutes of Health. And although several studies have explored health literacy in the general U.S. population, very little is known about the state of health literacy in minority populations.

“We are from a community or a cultural background that really did not take any medication or seek any health care before, in Nepal or in Bhutan when my parents were young adults,” Kalikotay explained. “So, taking medication every day for blood pressure, diabetes or any other chronic condition is a new thing for us – our community is skeptical.”

The first of many

BestCare Pharmacy did not have to wait long to become a hub of activity.

In its second week, Kalikotay saw a surge in Afghan clients who had recently been displaced by the humanitarian crisis in their country. ASIA's International Community Health Center (ICHC) began sending them Kalikotay’s way since many of the Afghans spoke Hindi – one of three languages the pharmacist can communicate in.

“(Akron’s immigrant population) need more personalized care and being a pharmacist from their background, I understand, and I am willing to take the responsibility,” Kalikotay said. “Specifically, because I always think about how I would feel if my dad was living by himself, had to go to a pharmacist, and not being able to communicate with the pharmacist."

Since BestCare Pharmacy is independently owned, Kalikotay can provide that personalized care, which is essential to clients obtaining, keeping and administering the correct medications at the proper time.

The pharmacist does whatever he can to establish at least one line of communication with patients. He makes some home deliveries personally, and, if he doesn’t speak a patient’s language, will utilize an interpreter or translating app to speak with them. Kalikotay also gives them his personal phone number in case they have questions after hours or need a tutorial on how to administer a medication.

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Being an independent pharmacy also means he can make his medications more affordable. In the past he has sold medications at wholesale price or given them away for free altogether. He also has a special packaging system using blister packs to lower the language barrier between non-English speaking patients and their medication’s instructions. Practices like these put somewhat of a strain on his resources and workforce, but the payoff is worth it.

In the future, Kalikotay plans to offer medication therapy management, but has already begun administering vaccinations and building up his workforce.

“The best thing we can do is have patients feel comfortable with the pharmacy, receive their medication on time (and) make sure when they call us we are able to answer their question,” Kalikotay said.

Contact Beacon Journal reporter Tawney Beans at tbeans@gannett.com and on Twitter @TawneyBeans.

This article originally appeared on Akron Beacon Journal: BestCare Pharmacy brings health literacy to immigrants in Akron