By Bruce Nolan, The Times-Picayune
May 24, 2010, 6:00AM
Kevin Youngblood explains hearing problems he is experiencing to registered
nurse Celeste Lewis, standing, at St. Anna’s Medical Mission in New Orleans
on Wednesday. At left is Karen Batres.
Something is wrong with Kevin Youngblood’s hearing on one side. Maybe infection, maybe injury.
His right ear has felt clogged-up for weeks, the 29-year-old landscaper tells nurse Celeste Lewis in the simple clinic at St. Anna’s Episcopal Church. He’s losing his hearing on that side, he says.
Youngblood has come from the West Bank to the church at the edge of the French Quarter because he’s heard he can get free medical attention, something that is important to him because he works without insurance.
Earlier that day, the same medical clinic transported itself to the Rebuild Center behind St. Joseph’s Catholic Church on Tulane Avenue. There, Dr. Brian Copeland, a Tulane University psychiatrist, met privately with a few of the homeless men and women, some with histories of mental illness, who gather there daily for showers, food and mail.
Since the loss of Charity Hospital in Hurricane Katrina, medical care for the poor and uninsured around New Orleans is spread among more than three dozen autonomous community health centers scattered about the region, replacing the huge medical mothership that once loomed over Tulane Avenue.
Built on various economic and management models, backed by public dollars and private philanthropy, they seek to become “medical homes” for the poor — the places in charge of all their primary medical care.
St. Anna’s Medical Mission fits into the edge of that mosaic.
Private and faith-based, founded by money from the Episcopal Church USA and now financed by other grants and donations, St. Anna’s clinic is the $420,000-a-year mobile medical ministry of the little Episcopal parish that attracted attention three years ago with its “murder board,” a public roster memorializing by name every homicide victim in the area, day by day.
But unlike the Tulane University clinic at Covenant House, or the Daughters of Charities clinics around New Orleans, the St. Anna’s clinic doesn’t offer permanent primary medical care.
It’s mission is more limited, said Diana Meyers, the registered nurse who runs it.
On Monday mornings, St. Anna’s 37-foot, specially outfitted RV rumbles to a stop under the North Claiborne Avenue overpass at the edge of Treme to see the poor and uninsured arriving at the door with high blood pressure, diabetes and other chronic ailments.
Monday afternoons, it’s the Lower Ninth Ward; Tuesdays, it’s Arabi; Wednesdays it’s St. Joseph church in the mornings and St. Anna’s in the evenings.
Except for those occasions when a volunteer doctor sits in, St. Anna’s offers the over-the-counter care and advice experienced nurses like Lewis can provide, along with mental health counseling, flu shots and other basic care.
But more important to a community ravaged by hypertension and diabetes, St. Anna’s conducts thousands of medical screenings a year, more than 17,000 since it opened in 2006.
Left uncontrolled, chronic diseases like hypertension and diabetes produce extraordinary damage: strokes and kidney failure, blindness and amputation, as well as expensive medical bills when the diseases aren’t managed in their early stages.
St. Anna’s staff sometimes exhorts some of its 3,300 annual walk-ins to get a doctor’s appointment without delay. Occasionally, Lewis said she puts patients on the telephone and helps them get a doctor’s appointment at a community clinic.
Moreover, said Lewis, the mission dispenses something else its patients desperately need: medical literacy.
People with little or no experience with doctors have been conditioned to receive medical care passively, without understanding what they’re getting, or why, or how they can stay well, she said. No one has told many patients they can ask their doctors for clear explanations; that they can ask about options. Nor do many understand their own responsibility in treatment. For instance, that they should complete a prescription medicine, not discard it when symptoms disappear.
“At a restaurant, people know to ask questions. Can I have that broiled? Can I have it fried? But for many people, with doctors it’s different,” said Lewis, 34, a nurse for six years. “So I encourage patients to ask questions when they see the doctor. I suggest the questions. We role-play.”
With that knowledge comes a sense of control, Lewis said, and control is followed by a measure of dignity.
She recalled a man who stopped by the clinic, on his way to having blood drawn at another location on the clinic’s recommendation. He was dressed in his best suit. “For you and me, having blood drawn is nothing. But to him, given his background, it was special. It was an event.”
Bruce Nolan can be reached at email@example.com or 504.826.3344.