diabetes among Latinos

Hi all! Emily here again. I just got back from the Imlay City Migrant Clinic, where today we talked a lot about diabetes among Latinos in the United States. The director of the clinic told me that 1 in 10 Latinos in the United States has diabetes! Today I brought some bilingual literature to pass out to our migrant worker patients about this extremely serious disease.

Something I love about the Imlay clinic is that in addition to having bilingual staff and Spanish-language health literature, there are more Latino staffmembers than non-Latinos working here. Cultural understanding is so important to providing quality care to our migrant worker patients. Dr. Carter, seated in the photograph below, is the sole physician at the Imlay Clinic. She is a gringa like myself and has never lived in Latin America, but she speaks a whole lot of Spanish just having learned it from her patients. I have learned plenty of vocab from her as well!

Standing behind Dr. Carter in this photo are Esther and Kay, the office translator and one of our nurses respectively. Everybody here is so kind--I feel very lucky to work with them.

The worst part about working at a migrant clinic is not being able to afford to treat the patients as we know they should be. We had a woman tonight who needs $75 compression stockings and a sleep study and CPAP machine, and she can't afford any of those. Someone else needed physical therapy for tendinitis, but she can't afford that either. How lucky those of us are who have health insurance, and how sad and unfair for the people who do not!

homestays

A few days ago I was in the van carpooling with the Health Delivery, Inc. staff to the migrant clinic in Imlay City, and I overheard one of the WIC staffmembers talking about a patient who had 11 children and had recently gotten married. "Eleven children is a lot of children to have with no husband" I said. "Don't you know Emily, nobody gets married any more!" the staffmember told me, sounding a little annoyed at my judgmental comment. I felt ashamed of myself. The truth is, I was definitely judging this woman. "Who is paying to raise 11 children?" I had been wondering. Not really wondering--I was feeling put upon as a taxpayer, that almost certainly this single mother living in Saginaw, receiving health care at a free clinic, was not taking financial responsibility for her nearly dozen children. It is tough not to feel less than sympathetic for some of our patients. And that is sad--both for me and for them. I really try not to judge people, but I do it anyway, almost every day.

How can we, the privileged handful of MSU students who choose to come live in this extremely underserved community of Saginaw, MI, learn to relate to our patients? How can we bridge the gap between our wealthy, educated, socially high-status selves and our poor, uneducated, low-status patients?

The photos I posted are samples of what much of Saginaw looks like, especially the areas east of the river and around the hospital, where many of our patients live. We would never live there. We were in particular warned not to look for housing east of the river when we moved out here. So physically as soon as we arrive there is already a divide between "us" and "them."

When we travel abroad, we always stay with host families. The hope is that by living with people from the communities we are joining we will learn about how they live--their struggles, their language, their ideas of how life is and should be. Why don't we do that in the underserved communities back here in the United States? I do not understand how a woman who chooses to have eleven children with no income and no education and no second parent to help her...I do not understand how she thinks, but I should. How can we bridge this divide?

slathering on the sunscreen here in balmy Michigan

Hi all! Emily here. I am the only LMUVer who stayed here in Michigan, and let me tell you about all the tanning and sightseeing I am doing in this lovely weather. Um, none. But I am having a wonderful hodge-podge of a time working outpatient family medicine Mondays and Wednesdays at the Imlay City migrant clinic and Tuesdays and Fridays at the Shiawassee clinic in Owosso. Thursdays I work with a psychiatrist, Dr. Lenhart, at the Bay City county jail, the Cathedral House free clinic, and Bay Arenac Behavioral health. Dr. Lenhart seems to have the patience of Job, and I have seen so much just after one day. Almost all of his patients' mental health issues--depression, anxiety, bipolar disorder, and schizophrenia--are complicated by substance abuse, domestic abuse, emotional abuse, violent crime, or any combination of the aforementioned. On Sunday evening Dr. Lenhart invited me to the Mustard Seed, a homeless shelter run through Catholic Worker House that takes in women and children. The Catholic Worker House runs charitable offices across the country, and coincidentally my mother and sister have been volunteering as ESL tutors for years with a CWH charity out in California. Last Saturday I worked in the ER at Covenant with Dr. Wagner, and I saw a patient with toxic shock syndrome and a patient with pseudotumor cerebri. Since my patient population of interest is Latino immigrants, my favorite site so far is the Imlay Migrant clinic. And though I am not eating mangoes and touring rain forests, I bet I am learning almost as much new medical vocabulary in Spanish as my classmates abroad. For example, "comezon" means "itchy" in Mexican Spanish, and "flujo vaginal" means vaginal discharge (sorry to all the non-medical people reading this but it's handy to know how to say that). Anyway I am off to bed so I can be ready to head up to Imlay tomorrow. Les deseo muy buenas noches a todos!