HOPE clinic fulfills a dream for East Texas poor

September 25, 2003

Last winter, when Jean Diebolt and Melba Gillis realized that there was no affordable health care for the working poor in their area--Shelby, Panola and San Augustine counties--the two women began a project with monumental goals.

"These are three of the poorest counties in Texas--all are designated 'Medically Underserved Areas,' but there is no United Way. They are in the lowest 25th percentile in health status and summary score distribution," says Diebolt, a family nurse practitioner.

"Forty percent of the children live in poverty, so their medical needs are often not met. Hispanic families are the engine that drives the omnipresent poultry industry, yet most of these families have been overlooked in the census. County indigent funds are not available to them, either because they are not eligible or because they fear exposure that will bring unpleasant consequences. The working poor representing diverse ethnicities must often travel a minimum of 80 miles one way to reach affordable care. For many people, this is not an option. Many people never go to a doctor because they simply cannot afford it," she added.

Diebolt and Gillis, a high school Spanish teacher, collaborated with three churches (St. John's in Center, St. John's in Carthage and Christ Church in San Augustine) to form HOPE--Health Opportunities for the People of East Texas, Inc. They started with "The HOPE Chest," a consignment and resale shop, the profits from which are used to fund x-rays and lab fees for indigent patients.

This summer, the HOPE Clinic became a reality. A corner of an unused warehouse, donated by the Shelby County Outreach Ministries, was transformed into a pristine clinic by a grateful patient, Daniel Best. Dr. Jane Todd donates her time as medical director and many others volunteer in the clinic.

HOPE, Inc.

Maria Duran, her husband, his mother and four children live on the $200/week that her husband brings home. He waits each morning to be chosen for work at Handy Andy's parking lot (the day worker pick-up location). Their son, Ruben, has asthma. It frightens Maria when her son can't breathe. She borrowed fifty dollars to take her son to the doctor only to find out that with the breathing treatment and steroid injection the cost of the visit was $100 instead of the expected $50. There was no money for the prescriptions and no money for the follow-up visit or the pulmonary function tests the doctor ordered. Grandmother needs medicine for her diabetes. The doctor will give her samples, but she can't afford the visit. The Durans are proud; they ask for nothing. Above all, they want a better life for their children. Many of HOPE Clinic's older patients live on fixed incomes averaging $500/month and have complicated health problems. They too are proud and, most of all, they want to retain their dignity. Affordable care for acute and chronic health problems is at least 80 miles away. There is no county sponsored health clinic for the poor. The HOPE Clinic answers this need.

On opening day, the clinic was double-booked. A very low-cost sliding scale fee is used to figure patient charges, but patients are cared for regardless of their ability to pay. Patients are offered assistance in receiving free medications for chronic diseases from pharmaceutical companies. As funds become available from the grants that Diebolt and Gillis are writing, laboratory and x-ray studies will be offered at minimal cost.

Their goals for this year include 2,000 patient encounters; patient education for asthma, diabetes, hypertension, diet and weight control, and parenting classes in the patients' preferred language; clinic and health fair screenings for colon cancer, hypertension, prostate and cervical cancer, anemia, thyroid function and cardiac risk; elderly home assessments; and community immunization fairs.

Future plans include classes in English as a second language, Spanish and bilingual pre-natal care, with the addition of a certified nurse midwife. Geriatric exercise classes are planned to help improve the flexibility and balance of older patients. A mobile dental service facility for children will come on a scheduled monthly visit, as well as a mammogram van.

Diebolt is a retired Air Force Reserve colonel who served as a nurse in Vietnam and helps run the family game bird ranch. Gillis is in her 30th year as a high school Spanish/English teacher.

"Jean and I have a strong calling to this ministry," says Melba, who then adds a Bartlett quote, "Feeling sorry for the needy is not the real mark of a Christian--to help them is."

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