Talk Can Prove a Remedy at Clinic

The nine Latinas, matriarchs of immigrant families, gathered in a small Santa Ana conference room to talk about their diabetes.

Then, as they began to talk, they realized they had something else in common, and they nodded sympathetically.

Trinidad Diaz, 51, talked about her clinical depression. Maria Magdalena Gonzalez, 46, wondered how to handle a difficult boss. Blasina Rodriguez, 61, discussed her fear of injecting herself with insulin.

They realized they shared not just the experience of diabetes, but the stresses of daily life that are inherent in a working-class immigrant community: cramped housing, tight money, poor nutrition.

The classes -- with clinical discussions about illnesses and diseases and the distribution of pamphlets and other aids -- are one reason patients flock to the Casa de Salud Family Health Clinic, a nonprofit storefront health office that provides virtually free care to uninsured people. But patients also come to the clinic just to talk, empathize and gather strength from one another. Patients say it’s a refuge from their harried lives, a place where they discuss the tensions that exacerbate their diabetes, and learn from one another and a health educator how to address those stresses.

Nearly a quarter of all Mexican Americans between 45 and 74 have diabetes -- double the rate of non-Hispanic whites, according to the National Diabetes Education Program. Researchers say Latinos are more diabetes-prone because of genetics, diet, lack of exercise and greater cultural acceptance of obesity.

Casa de Salud sees about 2,300 patients annually, and about 80% have diabetes or a high risk of becoming diabetic, said health service director Kathleen Rutland.

Among them is Maria Garcia, a 47-year-old native of Mexico.

“This class became more than a lesson about diabetes. It taught me to love myself, to take care of myself, to make time for myself,” said Garcia, who works as a baby-sitter for seven children. “And I saw that there were other people with the same problem as me.”

Patients say Casa de Salud also stands out because it tracks patients’ progress and its workers know them by name.

Even with such familiarity, Casa de Salud’s patients are only vaguely aware of the problems the clinic itself has faced. This year, it almost closed after having exhausted its $600,000 annual budget, funded through donations and public and private grants.

It remained open after the Orange County Rescue Mission invested $120,000 in the clinic, took over its administration in June and helped it generate funds to double its budget.

But the clinic faces new challenges. Last month, Bristol Meyers-Squibb, which donates some diabetes medicine to the clinic, announced it would provide drugs only to those patients with Social Security cards, which is usually proof of legal residency in the United States.

Only about 10% of the patients have Social Security numbers and most can’t afford diabetes medicines, which cost about $200 monthly.

“I don’t know how I’m going to manage or what will happen to me. I’m hoping God has an answer,” said Silveria Morales, a 58-year-old grandmother whose husband earns $260 a week in a door factory.

But Morales said she benefited by the four free, two-hour workshops on how to control diabetes -- the gatherings that evolve into self-help sessions.

The workshops are led by Emma Campana, a 50-year-old diabetic who came to the United States nine years ago and who peppers her discussions with anecdotes about immigrant life.

In the workshops, she urges her students to dance to three songs a day for exercise; during a break, she leads them to Latin music laced with lyrics about good health.

Campana admonishes the group not to let family obligations, such as being baby-sitters for grandchildren, get in the way of attending the workshops.

“I can assure you that your family will find someone to take care of them when you are in the hospital,” she said. “[So] they can manage so you can make the class.”

She also tells the patients not to share their prescriptions.

“We Latinos love to self-medicate,” she said. “We’re generous. I know you want to tell your friends, ‘I have a great medicine. Try it.’ But it can only work for you.”

But Campana’s classes strike home mostly when she talks about the hardships of immigrant life and the resulting stresses that can exacerbate illnesses.

She tells the story of Lupita, a diabetic who came to the United States to live with her son in Santa Ana.

Lupita found herself sleeping in the living room with other family members. Her daughter-in-law didn’t let her cook. She couldn’t go for walks as she did in Mexico, because she feared she would get lost or fall victim to crime. Her son worked on Sundays and couldn’t take her to church.

Her blood sugar levels rose until she passed out one day. Finally, she explained to doctors, “All I want to do is go home to Mexico, but I don’t want to tell my son. He paid $2,200 to a smuggler to get me here,” Campana recounted, quoting Lupita. “Once she was offered the opportunity to return [which she accepted], her blood sugar returned to normal levels.”

The women around the table related to the story.

“Many of us here are suffering in this country,” one patient said. “It’s very hard on women, [to work] in and out of the house.”

Gonzalez tells how she comes home with terrible headaches from her job as a caretaker for an older and demanding woman.

“I try to do what she wants, but it never seems right,” Gonzalez said. “I feel like there are marbles banging against the back of my head every day.”

“You need to consider how much you are getting from this job and how much it’s getting to you,” Campana said.

Gonzalez looks up as if a light suddenly shot through a dark alley. As other women have done during this session, Gonzalez realizes she has options. She can pick a new job. She can alter her diet and lifestyle.

Referring to the job, Gonzalez says, “I did feel like I had no choice. I guess I do.”