A Healing Hand : Clinic Provides Free Health Services to County’s ‘Worst Slum’

Teresa Hernandez gave birth to six children in a dusty little town in the Mexican state of Sonora, beginning when she was but age 14.

Now 32, Hernandez is alone in the United States and about to bear her seventh child. The difference now, however, is that she is receiving adequate medical care for the first time in her life.

Hernandez is one of about 6,000 residents of Garden Grove’s Buena Clinton neighborhood. Although other poor, isolated pockets could be considered as unfavorable, Buena Clinton is generally acknowledged as the worst slum in Orange County.

Most Illegal Immigrants

Most of the residents in Buena Clinton are illegal immigrants and poor, and few have a history of good medical care. But for the last 18 months, many have had access to health care and other services at La Amistad de San Jose, a neighborhood clinic completely funded by St. Joseph Hospital and the Sisters of St. Joseph of Orange and the only free, private clinic in Orange County.

St. Joseph, a 505-bed, private, profit-making hospital with a staff of 850, was established in 1929 and is operated by the Sisters of St. Joseph, a Catholic order more than 335 years old.

Each year, St. Joseph allocates a portion of its profits to help the poor. In late 1985, it decided to open the clinic and provide Buena Clinton residents free medical services “because the needs were so great in this neighborhood,” said Faith Hagerty, the clinic’s administrative manager.

“We are here for people who have no insurance. Most of them are also in very low-paying jobs,” she said.

Hagerty said 1,800 residents have made 5,200 visits to the clinic since it opened. The staff, which includes a family physician and one registered nurse, treats minor ailments and provides obstetric services for pregnant women. Initially, it operated on a $250,000 yearly budget that has now been increased to $330,000.

Tom Uram, director of the county Health Care Agency, praised the clinic for understanding the medical problems of the poor and finding a suitable method to treat them.

The clinic has “established a correct method,” Uram said. “They researched the problem and properly trained their people to work there before opening the clinic. I think the clinic fills a great need in the community.”

Uram was a member of the Health Care Task Force that diagnosed the problem as severe indeed. The 28-member panel reported that despite Orange County’s affluence, there are still about 360,000 people--16% of the population--who are “health-care deprived.”

The task force--commissioned by United Way of Orange County to conduct the one-year study--reported that those are the people who, during illnesses or after minor accidents, go without treatment generally available to others.

Other Services Provided

Located on the second floor of a small industrial building on Clinton Street, La Amistad de San Jose (The Friendship of St. Joseph) also provides services such as English classes four days a week, prenatal care, nutritional courses for housewives and legal aid counseling.

A full-time social worker, Anne Rivera, helps the residents with “a gamut of problems and concerns, from housing to personal matters.”

Although his Spanish language skills are still at the struggling stage, Dr. John Millane treats about 20 patients a day with cheerfulness and compassion.

“You worry me a bit, but I guess you’re OK if you say you’re feeling fine,” Millane told Hernandez in Spanish during a recent examination.

The 31-year-old doctor was concerned that Hernandez--whose common-law husband abandoned her several months ago--had gained only one pound during her pregnancy and later scheduled another examination for the woman at St. Joseph Hospital “just to make sure” there were no complications.

“The people here are very nice,” Hernandez said. “I like the doctor. He always treats me very well. But it feels different to come here . . . since I had three of my children alone and the other three with a midwife.” Millane, who has worked at La Amistad de San Jose for the past year, completed his residency requirements at a Long Beach hospital in 1986. But he decided to forsake what he calls “the Mercedes Benz scene” of private practice to care for the poor Latino residents of Buena Clinton.

“I spent a lot of time working as an intern in East L.A. and I grew to like working with poor Hispanic patients,” he said. “Here, I can work with obstetrics and have a diverse family practice.

“Besides, there is something distasteful for me to make a bunch of money by charging top dollar for medical services.”

More Experience

Professionally, Millane said, he can gain more experience at the family clinic. He currently cares for about 30 pregnant women. He oversees their progress and delivers the babies at St. Joseph Hospital.

“One of the big impacts that I feel we have made is in prenatal care,” he said. “But we need to do so much more because we turn down a lot of pregnant women. A lot.”

Millane said that since he is the only staff physician, he can only care for about 30 pregnant women at one time and is the reason he can only take in three new patients a month.

Although care is free, the patients are allowed to donate small stipends if they desire. Medication is also dispensed free at the clinic.

Millane also said he tries to keep appointments to no more than 20 a day to allow him more treatment time and to help develop solid doctor-patient relationships with the residents.

“It’s important for me to know that here they have somewhere to go for their ailments. And it’s important that I get to know them . . . that they can trust me,” the doctor said.

Children are particularly susceptible to illness in Buena Clinton because of the overcrowded and unsanitary conditions. Millane said at least half of his patients are children, whose illnesses most often include parasitic and skin infections and viral problems.

Also, since most of the residents live in the United States illegally, they do not qualify for Medi-Cal benefits and in the past have relied on sporadic care at public health clinics.

“If the clinic wasn’t here, some of these people would wait until things got critical,” Hagerty said. “Here we can also provide preventive medicine.”

Now Rely on Staff

Although many residents initially were reluctant to visit the clinic, Hagerty said they have adjusted to the routine and have learned to rely on the staff for help.

David Munguia appeared at the clinic one day last week because a throat infection was not improving with home treatment. The 27-year-old laborer said he had been reluctant to visit the clinic until he saw how well his father-in-law had been treated last year.

“The people here are kind. And I know that if I couldn’t come here, I wouldn’t be able to afford the care,” he said.

Because the clinic is not equipped to treat major illnesses or injuries, La Amistad de San Jose has developed a “sponsored-care program.” Under this program, the 240 staff doctors at St. Joseph Hospital have agreed to give free, specialized care to patients referred to them by the clinic.

Hagerty also said St. Joseph Hospital donates hospital services to patients from Buena Clinton when they cannot afford to pay themselves.

“This is just the hospital’s policy of helping the poor,” she said.