Thank you so much for taking time to look at our blog! We are a group of edical students who are passionate about training and in underserved areas. This January and February, we are in Peru, the Dominican Republic and Costa Rica internationally as well as locally in Flint and Lansing completing volunteer service, rotating in hospitals and clinics, and learning about international medicine and local underserved health care. We appreciate any time you take to read our reflections and any donations you might offer.

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Monday, January 30

Genesee Free Clinic

        Latinos United came into existence during the Flint water crisis because all the materials regarding the crisis were in English, so the six major Latino organizations in Flint came together to distribute information to the Latino population. Myself, residents, and other medical students have been working with Latinos United for Flint since last September. Our original plan was the start health talks and health fairs for this population to raise awareness about diseases that Latinos are more susceptible to. We began this way but soon found out that there was a large subset of undocumented immigrants within this Latino population, meaning they had no access to health care. Through a team of highly committed and motivated individuals the Genesee Free Clinic wrote for and received a grant for a number free visits specifically for undocumented immigrants living within Genesee County. We have been going to events hosted by Latinos United and explaining that these undocumented individuals can receive care without fear of being exposed.  We started scheduling visits, but to our disappointment every single one ended up no showing.
            Now that I have been working at the free clinic we have actually had some of these visits used! I hope that the individuals that have been seen at the clinic will tell others that it is a safe program, simply there for their health care not for any ulterior motive. However, it is understandable this fear of being found out given the current environment in our country. Decisions for this group are often made out of fear of being exposed, which means that healthcare is often sacrificed. The programs in place to aid this population need to continue to reach out more than ever and assure them that there are resources, safe havens, and remind this group that they are not lesser than anyone else.

            I’m very proud of the work that Latinos United is doing, and I am honored to be a part of this group. While these office visits won’t solve the larger issue this country is currently experiencing, I do believe if utilized they could make an impact on the Flint population of undocumented immigrants. I hope that with a continued presence in Latinos United and repeated reminders of the grant that we can get more visits, which will hopefully equate to improved health outcomes for this group.     

Friday, January 27

Fighting Alcohol and Drug Addiction Together

The use and addiction of heroin, alcohol, opioids and other drugs are on a rise in the United States.  Specifically in Flint, Michigan there have been a large amount of addiction reported, as well as mortality from overdose.  Stopping any kind of addiction is no easy feat because the brain literally adjusts to the euphoria and makes your body crave the reward over and over again.  There are programs set in place for people who are ready to quit the majority of addictions that are known.  Programs such as Alcohol Anonymous for Alcoholics, long-term residential treatment, individualized drug counseling, 12 step programs and other self help groups.  These programs have all shown to be helpful with the aid of medical management for withdrawal symptoms, spiritual guidance and strong will from the individual.

In Flint, Michigan there is a unique approach to helping former and current addicts start and complete a road of recovery at the Genesee Community Health Center.  The Genesee Community Health Center is one of only two Federally Qualified Health Centers in Flint.  Their mission is to provide high quality healthcare services and programs in an integrated, patient-centered environment with a priority focus on homeless and public housing residents.  They offer a multitude of services from preventive health screenings, well-child visits and physicals to chronic disease management and mental health and substance abuse services.  They always leave room for walk-ins everyday and are right down the street from Hurley Hospital in case of emergencies.  They have a mobile clinic and do community outreach at a local mission every week.

I have the pleasure of working with the Genesee Community Health Center and my mission is to learn as much as possible about the clinic, how it functions and of course see patients.  The GCHC has medical management such as suboxone and vivitrol and comfort medications as part of their substance abuse services.  Their approach to the counseling and psychosocial support that is necessary for a successful recovery program is what I have found to be one of the most unique I have encountered.  They have staff who are “Recovery Leaders” who have all at some time in their lives had an addiction to a drug or substance and have chosen to give back by helping others on their road to quitting their addiction. As a recovery leader you not only show support, but you offer a ride to a recovery meeting, give advice, take clients for coffee, support the family members of the person going through the addiction, whatever is necessary to really reach out and help that person get through this hard time and successfully start or continue recovery.  During an open conversation with some of the recovery leaders, I had the honor of hearing their background stories and I learned that they love what they do. They come to work everyday with a full heart, ready to help and also feel that this helps them continue their road to recovery because they can lean on each other when they’re having a bad day.  One recovery leader mentioned that she actively seeks patients and goes into “drug homes” and “sketchy neighborhoods” because she is so passionate about stopping the cycle of addiction and showing that help is there if you need it.

There are possibly other substance abuse programs with a similar approach or maybe the same approach that I have not encountered. I have encountered this approach and I feel I would be doing a disservice if I didn’t share what they are doing in Flint to make a difference in fighting addiction.

Thursday, January 26

The Free Clinics

           If you look at the Detroit Metro area you will find a plethora of free health clinics. At first glance this seems incredible. In a place where the residents have lost so much, and lived in poverty for so long, it is inspiring to see so many clinics set up to provide at least basic healthcare for the residents of metro Detroit. However, the closer I looked the more I began to understand that an overabundance of free clinics might illustrate larger issues.
Firstly, if there are a large number of free clinics that means that we aren’t providing, or able to provide adequate healthcare (in the current system) to a large number of people that need it. There are a significant amount of social justice issues that explain this prevailing problem, which I will not delve into in this particular space. Secondly, I found another quite significant issue.  While it is beneficial if you have strategically placed free clinics to serve a population and thus eliminate the problem of a lack of transportation limiting access to healthcare, it can be counterproductive to have a random distribution of free clinics. I don’t doubt that the people who build free clinics do so with the best intentions, but I think that sometimes there is a lack of collaboration with already existing clinics. Those who start new clinics often do so, because of a perceived need that they hope to uniquely address. I argue that rather than continuously starting anew, we should invest in the already existing infrastructure. We should pool our resources and create phenomenal care in strategically placed locations.
The Gary Burnstein Clinic in Pontiac, MI exemplifies this idea. I was working there last week. It was 6 pm and we were beginning to see patients for the night. There was an excited buzz around the clinic that evening, because for the first time in a long time we were going to have a cardiologist seeing patients in the clinic. Not only that, but we also had a pulmonologist there, and we were beginning to do sleep studies on patients. It was especially thrilling because Gary Burnstein who started the clinic, in what was basically a closet, was a cardiologist himself. It is part of what led to this particular cardiologist to seek out the clinic and donate his time and expertise to care for those who needed it, but had no means to pay for it. This clinic is an example of how we should be using our resources. If we can create very strategically placed clinics where patients have access to every specialty then I believe we can improve patient care.
The clinic is an inspiring place, filled with altruistic volunteers that are trying to do a little extra good in this world. Yet, it must run to the best of its ability. This particular clinic fires on all cylinders in large part thanks to the executive director and his dedicated staff. They are constantly trying to pool resources so that people have the opportunity to come to the clinic for all of their healthcare needs. As the resources expand at Gary Burnstein I feel that the care the patients receive will continue to improve and hopefully their health will do so as well.

In closing, I think that the people who need care would better be served if free clinics spoke and collaborated a little bit more. It is similar to the problem that exists with electronic medical records in this country, where we as healthcare consumers would be better served if EMRs communicated with one another. We know the value of communication, but sometimes we falter, whether it is because we physically don’t have the means, we can’t find the time, or we are simply don’t know how to do it effectively.