A desperate phone call interrupted the sleep of Shafqat and Naheed Chughtai recently.

Long-term residents might have called an ambulance if a loved one was having a heart attack, but for this family, the most logical contact was the couple who run the Pakistani Community Center in Midwood, Brooklyn.

Difficulty with English and fear or ignorance of the American system has had an impact on immigrants’ health, from heart attacks to birth to the flu.

Women are particularly affected because they often have less education – and therefore lower English skills – than their male counterparts. Women "can’t go anywhere," says Naheed Chughtai, 48. "They’re immobile. If they have to go to the hospital, someone has to go with them, so they need a constant chaperone."

In addition to providing English classes, the Chughtais help address the need for individual mobility in a literal way as well. Shafqat Chughtai (also known as Sunny) owns Sunny's Driving School, which often serves as an alternate site for meetings and classes that are too big to fit in the community center.

Cultural and language clashes also affect the birth process, as many Muslim women do not want to see male doctors. This is especially relevant when it comes to prenatal care.

"In our Muslim community, we prefer that women doctors should treat the women," says Naz, who works in the community center but refused to allow her last name to be published because she says she did not want to be in the public eye. "We don’t want to be naked I front of the men," she says. "Women of our culture hesitate to go to the men doctors, especially in pregnancy or in delivery."

There is one female doctor who speaks Urdu at Coney Island Hospital, but she is not always available. One woman volunteers as a translator in the hospital, often going into the examination room with the patients.

Sometimes the problem is less about culture clash and more about the bottom line.

Misinformation about their rights can sometimes affect immigrants’ physical health, says Nestor Vasquez, who works for Catholic Charities, a non-profit organization. "Many have no health insurance," he says. "They don’t apply for social services because they are fearful of being deported."

Mohammad Akbar, 52, came to New York four years ago to make money. He left a wife, three sons and two daughters in Pakistan. Akbar works in construction, sometimes 12- or 13-hour days. "You do it because you have to," he says. The construction job offers Akbar no health insurance. When he had to be hospitalized for three to four days – he says he had the flu – he had to pay for the medicine out of his pocket.

Under the 1996 Welfare Reform Act, some immigrants can be deported for being a burden on the state. As a result, many immigrants — both documented and undocumented — might fear that if they apply for welfare and other social services they will fall victim to the system, says Vasquez. But that fear is often unfounded. "That is very unlikely to happen," he says.