Somehow the gravity of the words was diminished when translated into a second-language. “Tienes diabetes” (You have diabetes). It wasn’t until after I had said them, and after I saw the empty stare of the words’ recipient, that I realized the weight of the information I had just relayed. The make-shift office of felt walls and PVC pipes in the underground parking garage felt like an odd place to give someone a diagnosis of a potentially chronic illness. In that moment, the reality of health inequity was made clear to me.
Though an organizer for this year’s Health Care Equality Week screening fair, I had a bit of patient interaction on the day of the event when I stepped in to interpret for Spanish speakers a few times that day. The annual event, held in downtown PDX, brought in nearly 300 patrons from the surrounding area. When I arrived for set-up at 7:30 that morning, many had already started forming a line, waiting for the gates to open an hour and a half later. As a multi-disciplinary and multi-university event, the screening fair featured a variety of services including oral exams, visual acuity screenings, diabetic foot care, immunizations, veterinary care, medical consult, blood glucose checks, and hair cuts among other things. Throughout the day, a steady stream of people seeking medical attention ventured into the damp, cold underground parking garage where the fair has traditionally taken place. Held in conjunction with Potluck in the Park, patrons could head above ground in the afternoon for a meal after the fair.
Like some of those who attended the fair, the Spanish-speaking person had come for a specific ailment and wanted to speak to a medical provider. He had been experiencing blurry vision and numbness in his feet. When his pinprick revealed an elevated blood glucose, the pieces of the puzzle began to fit. What seemed to bother him most about his newly acquired diagnosis was how we would pay for his care. He had been receiving regular check-ups until the last 1 or 2 years, and it was over this time period that his body’s resistance to insulin began. He didn’t know where to go. He didn’t have insurance and he didn’t have a job. He explained that because of an inability to find work in Portland, he thought he would have to move back to the Midwest. He asked what kind of medical care he could receive there. Explaining to him that I could not speak for that part of the country, I took him over to the referral table where he received information about being seen at the Virginia Garcia clinic. I urged him to call, giving him their number with a message to say that the OHSU health fair sent him.
I wonder today if he ever called, and if he was ever seen. So many in this country still slip through the cracks, and many preventable illnesses are left unchecked. Because he was faced with the challenges of unemployment and potential re-location, any barrier to access care would understandably be formidable. I saw that the health fair, just four hours on one day out of the whole year, was a chance to regain some that are lost. It was a chance for us as students to give back to the community. It was also a chance for us to see first hand the reality of health inequity in the United States. The office visits and routine screening that many of us take for granted are hard to come by for a large population in this country. Unfortunately, this same population also deals with a number of other stressors that come along with low socioeconomic status, further compromising their health.
The health fair was a great reminder that as future health care providers we must view community health as something intertwined with the other necessities of life–housing, employment, food, etc. To promote health, we must also promote everything that comes with it.
Editor’s note: View more photos from the student-led clinic in conjunction with Health Care Equality Week on the School of Medicine’s Facebook page.