Breaking Medical and Racial Barriers : For more than a quarter-century, the Watts Health Foundation has defied doomsayers’ predictions to deliver health care to a diverse Southern California community.

For the last 26 years, the Watts Health Foundation has cared for people who are considered too difficult to serve, according to conventional wisdom. Because of language, age or economic status, many people are overlooked by most health care plans.

Our history has shown that we are strong because we have served where conventional wisdom said you really couldn’t survive. The organization started in a group of trailers in the front yard of the Jordan Downs housing project two years after the 1965 Watts rebellion.

A lack of community health services, high unemployment and an irrelevant educational system caused that civil unrest. The health center was founded to provide community, grass-roots health care. But the trailers were temporary, as was the government’s commitment to fund us.

The organization needed to be self-sufficient, and our patients needed more than just physicians. They needed health care workers, social workers and classes, not just prescriptions. They needed to have services provided in a social context, not just a medical context. Aware of Kaiser’s prepaid health service, we designed our first prepaid program in 1971.

People thought we were crazy. Critics said it was inappropriate for a neighborhood health center serving poor populations to model itself after Kaiser. After all, Kaiser was large and it serviced middle-class populations.

Today, the federal support that brought us into being represents less than 10% of our total operation. The rest of our revenue is generated by our health maintenance organization, United Health Plan. We see about 40,000 patients a year at our Watts Health Center at Compton Avenue and 103rd Street, but there are about 120 other facilities, including private physicians’ offices, where UHP members are covered.

We’ve grown substantially both in terms of revenue and in terms of how we define ourselves. We no longer see our community as Watts, but instead as Southern California. We’re concerned with populations at risk: poor people, illegal immigrants, people with the HIV infection, seniors, babies born drug-addicted, people who are addicted to drugs and people who don’t speak English.

We have knitted together a health delivery quilt that has both a mainstream component that serves those people who have the ability to make decisions about where they get health care, as well as a component to serve those who really have few options.

Getting the technology of managed care to people of various cultures took a commitment on my part, as leader of the company. Years ago, I reached out to Koreans and made friends. They helped me to understand their culture, history and language. When the foundation decided to welcome Koreans and Korean Americans, our board held an orientation with the help of Koreans.

We wanted our staff to understand our new patients and staff members. We showed films on Korean history and culture and served Korean food. I started holding meetings with senior managers in Koreatown, and I visited Korea.

People outside the foundation said that the Koreans wouldn’t accept us. Community members were suspicious. There were rumors that we were being bought by Korean interests, and rumors that I had lost my mind.

But when we were able to identify unmet health needs, such as small Korean businesses where people had no health coverage, people took note of our sincerity.

We found Korean doctors who wanted to serve their community. When addressing communities that are in some way insular, you have to plug into that environment rather than try to pull the people out of it.

In some cultures, it is better for a woman than a man to examine a woman. We can’t say, “Wait a minute, that’s sexist!” That perspective comes from our Western orientation. We have adjusted our services so that people who would feel their privacy was invaded by being seen by a male physician can feel comfortable in our facilities.

Our goal is essentially to hang a sign at every facility and business we’re involved with that says this is a safe place to come, irrespective of whether you’re heterosexual or homosexual, African American or Latino, Korean or a new immigrant, legal or illegal.

What we don’t want is to have the kind of arrogance that you see in some practices where patients are told if they don’t speak English, they should bring an interpreter. In many instances that means that children are in the exam room translating for the mother and doctor, who is asking personal questions. Those situations destroy the dignity of people who don’t speak English.

Now we’re reaching out to our Chinese community. We’ve established wonderful relationships, and the pattern of acceptance and learning is playing itself out again.

We don’t see ourselves as just medicine people. We see ourselves as promoting health--and health is more than just the absence of disease; it is being able to feel good about one’s circumstances, safe, secure and comfortable about one’s surroundings.