Anyone who doesn’t believe access to health care is a problem in our country, our state, or our city, need only look at the Alamodome Wednesday morning. The doors to Your Best Pathway to Health, a free health services event sponsored by the Seventh Day Adventist Church, opened at 7 a.m. At 8:30 a.m., the line wrapped around the Alamodome.
Tammi and Michael Schane had been there since 3 a.m., and were far from the first in line. The Schanes are Corpus Christi residents, but have family in San Antonio. They are not among the 24% of uninsured residents in Texas, but are among the many underinsured. They have private health care, but co-pays are, for them, exorbitant. Each visit to the doctor costs. A lot. This event gave Tammi the opportunity to visit a series of medical providers for a variety of ailments, for free. FREE. This is a working family who took days off work to receive health care.
An estimated 23% of people were uninsured in 2013 in Bexar County, according to a Kaiser study. The Affordable Care Act has gone a long way to improving that problem, but clearly, if the lines at the Alamodome and the expectation of 6,000 patients over three days were any indication, it has not gone far enough. The vast majority of patients seen had no insurance, but many, like the Schanes, were underinsured. The cost of basic preventive medicine was still out of their reach. It is an event like this, which offers vision care, dental care, mental health services, surgery, well checks, physicals, obstetrics, gynecology, laboratory services, and even hair cuts, physical therapy, and massages which make a “pathway to health” possible.
More than 1,700 volunteers participated in the event, from medical professionals to social services agencies. While they are driven by a spiritual desire to help, the result is that many people who may never otherwise see a physician, had an opportunity to do so. The volunteers came from across the U.S. During the Katrina Evacuation events of 2005, we learned that cross-state licensing for medical services can be problematic when nurses wanted to volunteer from other states. Licensing procedures meant turning them away. Your Best Pathway to Health made sure that would not be an issue – all licensing agencies had verified certifications to practice in the state of Texas.
Dr. Peter Nelson, a dentist, along with his wife, Suzanne, a dental hygienist, from San Luis Obispo, Calif., have spent their vacations performing volunteer dentistry in more than 25 countries, most with the Seventh Day Adventists but also with Rotary, Catholic Relief, and Amistad International. Dr. Nelson and his family have been committed to a life of service, particularly focused on health care.
Coming to San Antonio was an extension of this vocation. While his partners in San Luis Obispo keep the practice running, Dr. Nelson’s dental assistant has accompanied him on a handful of mission trips with her husband, a retired law enforcement officer, who came along on this trip to help with instrument preparation. They had seen at least five patients in the first couple of hours of operations Wednesday.
Among the many services offered was surgery. How exactly does one perform surgery in the Alamodome? Residents with potential surgical needs came to a pre-opening day pre-op session. They were evaluated, and if they could verify transportation to and from Central Texas Medical Center, the Seventh Day Adventist hospital in San Marcos, they were scheduled for surgery on Wednesday and Thursday. As of late Wednesday morning, all who were scheduled had reported for surgery. Michelle Lewis, RN from Loma Linda Hospital in California, said that surgeries which did not require general anesthetic, such as vasectomies, cyst removal, dermatology, and orthopedics were performed in the Alamodome. Banks of autoclaves assured sterile instruments, curtains assured privacy, and dedicated surgeons got to work. Think about that next time you go to the Alamodome for a Spurs Championship Celebration.
Dr. James Logan, a pediatrician from Paradise, a community in Northern California, chatted with a young patient about his ailments. In the end, all was well. Within four hours after opening, Dr. Logan had seen 15 children, most of whom had had some access to health care. Many were “in between” – they hadn’t yet registered for Medicaid or hadn’t started on a new plan. About half of his patients were there for well visits, which means making sure the child is on target for appropriate developmental milestones and vaccinations. Others were more problematic. Acute conditions could be addressed, but chronic conditions require diagnosis and follow-up. An 11-year-old patient with hydrocephaly, a buildup of cerebrospinal fluid in the brain, had a shunt but had not seen a neurologist for a few years. Fortunately, the child was doing well, but questions arose about follow-up. Dr. Logan could check the patient’s current condition, but where does the patient go next?
Having spent a great deal of time in refugee clinics around the world and serving as medical incident commander with San Antonio Metropolitan Health District during the Katrina Evacuations to San Antonio, I’ve seen my share of “pop up clinics.” This event, though it may have appeared chaotic to the casual onlooker, was indeed a well-oiled machine. The planning was impressive, the coordination of volunteers; incredible. But having seen missionaries come to a community, do great things for a few days, feel good about themselves, and then leave, I was a little skeptical. Those of us left have to figure out what’s next. Here were my questions:
What happens to the patient once they leave?
To ensure adequate follow-up, Dr. Lela Lewis, Pathway to Health President, has coordinated with local health care providers such as Faith Family Clinics, Centro Med, and other Federally Qualified Health Centers (FQHCs) for referrals. The group has been working closely with the Metropolitan Health District, who co-sponsored the event, as well as the YWCA and the Mexican Consulate to provide assistance to patients for Medicaid registration, ACA registration, and health seminars.
The health fair also involved lab tests, which may take days for results. On April 15, the patients may receive their lab results at area Seventh Day Adventist Churches, where they will also receive prevention education and health care seminars that include cooking, mental health, diabetes, and healthy lifestyles.
This is not the first such event Pathways has hosted: last year they served more than 3,000 people in Oakland and San Francisco and next year will be in Spokane, WA. The group hosts their Conference in San Antonio every four years, so our city was an obvious choice. Working closely with the Metropolitan Health District, they were granted the use of the Alamodome.
Most mission trips sponsored by religious organizations involve travel to the developing world. Dr. Logan, the pediatrician from Paradise, Calif., said this was his first ever “Mission Trip.” For Dr. Logan, this was an opportunity to do a Mission Trip stateside. As grateful as we are to these volunteers for their amazing efforts, and as important as such an event is to the health care of our community, it also begs the question – why is a major metropolitan city in the U.S, a “mission?”
In one of the wealthiest countries in the world, with access to some of the greatest medical care in the world, why do we need a developing-world style mission?
Because our residents lack access to affordable health care.
The Affordable Care Act has been a step in the right direction. More people than ever have access to care, but we’re still falling short, especially in Texas.
*Featured/top image: The Alamodome is transformed into a giant clinic for Your Best Pathway to Health. Photo by Cherise Rohr-Allegrini.