Rising to the call
April 30, 2020
Since the outset of the coronavirus pandemic, the CHRISTUS St. Mary's Clinic, located in Houston's economically depressed East End, has remained open but has focused entirely on patients who do not have COVID-19. In this way, the outpatient clinic helps ensure that the ongoing medical and socioeconomic needs of the vulnerable East End population do not go unmet as the pandemic continues.
The clinic's patients are primarily people who make a working-class income. Many are immigrants who hold low-wage jobs. In 2018 about 22% of the people in Harris County, where the East End is located, were uninsured. That number now is rising along with widespread unemployment.
Sr. Rosanne Popp, CCVI, is a physician and the medical director of the clinic. She spoke to Catholic Health World April 22 about how vulnerable this community is to the health impacts of delaying care — and to the economic impacts of the nation's shutdown.
Our clinic serves the people who fall between the cracks in the health care system. They either are uninsured, underinsured or they do not make enough money to pay the out-of-pocket costs of their health care. We charge a (flat) $35 fee for each visit.
Sr. Rosanne Popp, CCVI, M.D., examines a patient at the CHRISTUS St. Mary's Clinic in Houston in January. The clinic has remained in operation offering routine health care and some financial assistance during the COVID-19 pandemic. It does not treat patients who have symptoms of COVID-19.
Myke Toman/Toman Imagery.
We decided early on to keep the clinic open because of the great need. We are advising patients not to come in if they have COVID symptoms; we're doing a vigorous screening for COVID for those coming into the clinic; we're enforcing social distancing, including in our waiting rooms; we're adhering to hand-washing, mask use and other protocols advised by CHRISTUS Health; and we're sanitizing the clinic much more often than we were before the pandemic.
Because many people are scared to come into the clinic (due to generalized fears of contagion) we are proactively calling our patients to determine what their needs are. We are doing some telephone medical visits, but not many visits over the computer, because the videoconferencing can be difficult for our patients to do, and many of them do not have the needed technology.
Many people are at home and worried, and they are under a lot of stress. We are blessed to have just started a partnership with Catholic Charities before the pandemic hit, on mental health care. So when our patients express a need for mental health care, we can refer them to our Catholic Charities contact, who will assess their situation and determine how they can be helped.
The main part we're playing in the current crisis — our main goal — is to keep the community healthy. We've taken a stance — we don't want to be on the frontline testing and treating COVID because we might spread the virus among our patients. Instead, we're helping people pick up the pieces. We're seeing a lot of local people — and especially those who worked in the service industry — out of work. They live paycheck to paycheck and have no safety net. So, one of the biggest concerns for our population is the economic impact.
To me, the most striking thing in this pandemic is the financial devastation people are facing. They are no longer working, and they were fragile economically before the pandemic even hit. They will prioritize food and shelter above health care. We are seeing so many people who are now desperate or just hanging on; so, to me, that is the big picture of what this virus is doing to the economy that trickles down and hurts those who don't have any reserves.
The other issue is that the shutdown is affecting every sector of the economy. When restaurants are closed, people aren't paying the taxes, and without the tax revenues, the city can't offer as many services at the free clinic, and then people can't go there to get the care they need.
When you're at the bottom, all of these problems fall upon you. I believe this trickle-down effect of the economic impact of the shutdown could do people in, perhaps more so than the virus itself.
People are in need of medical care, and their usual care locations are closed, or they no longer have insurance so they can't go where they used to go. So, we are allowing them to come even if they cannot pay the per-visit fee. We're helping them find food distribution sites near them. We also give out gift cards, such as for groceries and gas. We used to just give out one or two gift cards per week, but now the need is so great we are giving out three or four each day. People are having to make the choice between buying their groceries and paying for their medications.
It's important for people to remember that health care is much bigger than COVID. We need to be keeping our communities healthy, including from an economic standpoint, or there will be consequences later.
What we're doing at the clinic is not glamorous. We're not going to be on ABC News. We're not saving people who are on ventilators. We're not administering thousands of COVID tests. But maybe we're making things in our little part of the world better.
There's a prayer attributed to Archbishop Oscar Romero that says in part:
'We cannot do everything, and there is a sense of liberation in realizing that. This enables us to do something, and to do it very well. It may be incomplete, but it is a beginning, a step along the way, an opportunity for the Lord's grace to enter and do the rest. We may never see the end results, but that is the difference between the master builder and the worker.'
And this speaks to how we're part of something bigger in the work we're doing at the clinic.