The World Health Organization defines health as “a complete state of physical, mental, and social well-being, and not merely the absence of disease or infirmity.”
My first experience with healthcare delivery in the Rio Grande Valley occurred between 1985 and 1990 as the nurse coordinator for a state-wide Epilepsy Initiative.
The Epilepsy Clinic was based at the Santa Rosa Hospital in San Antonio, Texas, and regularly offered adult and pediatric sub-specialty Neurology services, not only in San Antonio, but also Harlingen, Del Rio and Laredo.
During this time, before HIPAA, the Health Insurance Portability & Accountability Act of 1996, our San Antonio–based team, consisting of a Neurologist, a nurse, a social worker and a clerk coordinated all care with local healthcare providers. We traveled to the outlying clinic sites with all that we needed to conduct a clinic. This included everything from medical records to a washing machine-like centrifuge that was used to separate blood samples, drawn during the clinic, for transport back to the hospital lab. Not exactly precision medicine by today’s standards, but an excellent investment in the health of a community with very limited sub-specialty services.
The next step in bringing sub-specialty care to the Rio Grande Valley was through a research project funded by a small grant from the Border Health Office at UTPA. The research project proposed to: conduct a community-wide needs assessment for sub-specialty services, specifically Epilepsy/Neurology, in the four-county area of the Rio Grande Valley; identify community resources and potential partners, and to provide educational opportunities for all interested groups. The project was initiated in the fall of 1991.
One of the first interviews conducted as part of the needs assessment was with Sandra Gaulke, RN, then the director of nurses for the McAllen ISD. Her first comment to me, spoken by way of greeting, was “If you are here just to do another study, I don’t want to talk to you. We have been studied to death.” This message from an outstanding community leader clearly was “stop with the pilots already.” From then until now, I have strived to keep my promise to her that I was not here just to do another study.
The project met all of its goals. Within three months of beginning the needs assessment and the initiation of monthly in-service programs, we received word that a clinic needed to be established to begin offering Epilepsy services in Hidalgo County. What began as an Epilepsy Clinic very quickly evolved into the UT Valley Pediatric Sub-Specialty Clinic. The clinic was located on the second floor of the Migrant Health Clinic in Pharr. Medical records were maintained on site and support services were provided by nurses, social workers and clerical staff from the community. All of the physicians were Pediatric specialists from San Antonio and the UT Health Science Center. The Pediatric sub-specialty care offered was orthopedics, rheumatology, pulmonology, and neurology.
The establishment of these clinics was the greatest achievement and finest example of community and external investments to improving the health of the Rio Grande Valley. The clinics adhered to a model of holistic health, by identifying and addressing the Biological, Psychological, Social, Linguistic and Spiritual needs of the community as identified by formal and informal leaders – all consumers as well as providers of services.
Much has happened in the last 25 years, not all of it positive, that impacts the health of the local community. In spite of the addition of many hospital beds and primary healthcare services and providers, the Valley Region continues to be identified as medically underserved. Many communities persistently lack basic amenities such as sidewalks, parks, libraries, community centers, street lights, and proper drainage.
In fact, nothing has happened in the Valley that has really improved the health of the community. Lacking is a comprehensive care plan for the community. We still have too many people doing too many studies. Unless and until all that makes this area unique is factored into a comprehensive care plan, “a complete state of physical, mental, and social well-being, and not merely the absence of disease or infirmity” cannot be achieved.
Editor’s Note: The main image accompanying this guest column shows military personnel providing dental care to a Rio Grande Valley resident during Operation Lone Star. Operation Lone Star, a program to provide free medical care, runs for one week in the year, every summer. For many Valley residents it is the only time they get to see a doctor.