Getting the Poor Into the Medical System : Jorge Fransisco Lopez: Health Coordinator

Men and women, some of them balancing babies on one hip, linger outside as they wait to go into the crowded offices.

Inside, amid the din of names being called out and ringing telephones, Jorge Francisco Lopez lectures about 20 men and women about the benefits of prenatal care and the dangers of smoking.

Lopez is a health coordinator at the Santa Ana Neighborhood Service Center, which offers health information and other community services to the poor.

Lopez, a doctor in his native Guatemala, is about to take an examination to qualify for a California doctor’s license. In the meantime, he has a front-row view of the profundity of health problems among the poor, especially Latinos, in Orange County.

“Many of those who come here are very uninformed about health problems, and this lack of knowledge about what to do, where to go, keeps this population from bettering their lot,” said Lopez, 34.

Clients come to the center every day, he said, with problems ranging from tonsillitis to breast cancer.

“We can’t do anything for their particular problems--we’re not licensed to--but we can tell them where they can go for help, and what it could be, and how to keep it from getting worse,” he said.

Since he came to Orange County in July, 1989, Lopez’s work with Orange County’s poor has shown him how inaccessible medical care is for many people because of the high cost and the language barrier.

He is part of the Consortium of Physicians From Latin America, a year-old organization that is working to persuade the California Medical Board to offer licensing exams in Spanish so that foreign doctors can practice in the state more easily. Florida has made similar changes.

Not only is there a shortage of doctors in Southern California who can speak Spanish, Lopez said, but the bedside manner of U.S. doctors differs from that of Latin American doctors.

Lopez ran his own clinic in a town of about 30,000 in northwestern Guatemala. Patients in the surrounding rural area would come by with any kind of health problem, and they were given plenty of time to explain their ailments.

In this country, Lopez said, doctors tend to be in more of a hurry.

Coming from a country with an extensive system of socialized medicine, and where visits to private doctors are much more affordable to the average working person, Lopez is amazed at the inaccessibility of medical care in this country.

“Even though our facilities might have been poor, everyone had access to them,” he said. “Here, there are no hospitals to serve all of the people. The first question they ask you at hospitals here is, ‘Do you have any money? Do you have insurance?’ If you don’t, it’s, ‘Well, then, out of here.’

“In my opinion, that is putting people’s health as a second priority.”

A typical client of the Santa Ana center, he said, earns $5.50 an hour at an unskilled job, has rent to pay, and a family to support. More often than not, their jobs offer no medical insurance.

“What can these people do?” he said. “This is the biggest problem we see.”