"It's not perfect, but 80 percent of the time it's okay," said Steven M. Galen, executive director of the nonprofit Primary Care Coalition, the organizational hub, fundraiser and advocate for the new pan-African facility and the nine other clinics in Montgomery. Some have served poor and homeless people for decades.
The objective, said Alvina Long, executive director of Mercy Health Clinic, a church-based nonprofit run out of the county's Germantown regional service center, is "health care for those who can't get it in any other place."
Alvina Long is director of Mercy Health Clinic, which has more than 1,100 patients a year and two full-time staff members.
(Lucian Perkins -- The Washington Post)
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Multilingual Medicine
Losing weight, feeling weak and suffering from digestive troubles, Ignatius De Costa took himself to the basement of Our Lady of Vietnam.
In the polyglot world of Montgomery, it turns out that the pan-African clinic caters to some Asians as well: Bangladeshis and Vietnamese. The latter is because the clinic functions out of a Catholic church with a mainly Vietnamese congregation; the former because Bangladeshi nurse Cecilia Rozario volunteers with Mobile Medical Care Inc., a 38-year-old Montgomery nonprofit group that provides the clinic with medical facilities and staff.
Rozario's presence draws fellow Bangladeshis, such as De Costa. "They feel comfortable," she said. "I can speak our [Bengali] language." She introduced De Costa to Joanne King, a nurse practitioner who helps staff one of the group's two mobile units.
King quickly figured out what was wrong: diabetes. De Costa's blood sugar level was about four times higher than normal. She gave him medication, taught him how to manage his condition and sent him to Suburban Hospital for more tests. Suburban provides such services for free to Mobile Medical patients.
The drugs worked, cutting the glucose in his blood by half. At their second meeting a week later, King provided more medication and a device he could use to test his blood sugar levels.
Untreated, King said, De Costa would surely have ended up in an emergency room, possibly in a diabetic coma. His case would have added to the costs hospitals incur for treating the uninsured.
"I think at the right time I got to the right person," said De Costa, who earns about $1,400 a month in an auto parts store and has no insurance. He paid Mobile Medical's suggested donation of $20, which has been his total payment for care so far.
'Culturally Competent'
Health care advocates emphasize that the clinics are open to all uninsured residents who meet the income requirement. But because Montgomery has become a magnet for immigrants -- one-fourth of its population was born outside the United States -- more attention has been paid to delivering services in settings that make people feel comfortable.
The pan-African clinic was founded by parishioners of St. Camillus Church, a Catholic congregation in Silver Spring. Formally known as L'Acceuil Marie-de-l'Incarnation Family Health Clinic, it is the newest in a line of "culturally competent" facilities in the county. Others include Proyecto Salud and the Spanish Catholic Center, which primarily serve Latino patients; the Pan Asian Volunteer Health Clinic, run in part by the Chinese Culture and Community Service Center; and the People's Community Wellness Center, which targets African Americans in the eastern part of the county.
"Some people might say, 'Why have you Balkanized the clinics?' " said Carol Garvey, former county health officer. "But it's so very crucial to the delivery of care that's accessible to people if you understand the cultural implications."
The immigrant-friendly approach is a signal feature of Montgomery's effort. No matter their income, undocumented immigrants are shut out of many medical insurance systems and other programs. The county's commitment to their health care comes from advocates and political leaders alike.
Duncan, at the opening of the pan-African clinic, told the story of his father's immigration to the United States from France in the middle of the last century. "We celebrate diversity," Duncan told his audience. "We celebrate the diversity we see in the county because we know it makes us stronger."
