Clinician-to-Clinician: A Forum for Health Justice

Authentic Voices

Edward Zuroweste, MD — Thu, 17 Apr 2008 19:59:18 +0000

MCN is pleased to offer these five audio slideshows featuring farmworkers and health care providers. We want to hear your thoughts. What did these slideshows make you think about that you may not have previously considered?

Don’t Snort Pig Brains

Edward Zuroweste, MD — Mon, 25 Feb 2008 21:31:54 +0000

I have been following this story and feel that I have to share it with you all. There are now at least 13 pork processing workers being diagnosed with a new disease, Progressive Inflammatory Neuropathy. What makes it so interesting is that it came to light because a medical INTERPRETER working with Spanish speaking meat packers noticed that two patients she interpreted for had similar, serious health problems. This is a fascinating case both from a cultural competency perspective/interpreting services and an occupational medicine/health and safety perspective. What a great pick up by an interpreter!

Long time health and safety activist, Jordan Barab, wrote the following:

Don’t Snort Pig Brains

Oh, and it turns out that inhaling vaporized pig brains is probably bad for workers – not that anyone thought to figure this out before requiring workers to remove the pigs’ brains with compressed air forced into the skull through the hole where the spinal cord enters

Was this problem discovered by the company, or occupational health experts? No. An interpreter working with Spanish-speaking patients at a medical clinic in southern Minnesota heard the same story about strange health problems from two Minnesota pig processing workers doing the same job.

Here are some news articles on this topic:

The Washington Post

Story in the NYT

Make a Commitment to Healthcare Justice in 2008!

Edward Zuroweste, MD — Mon, 28 Jan 2008 19:41:16 +0000

Join a gathering of clinicians from across the country and show your unity with the uninsured, underinsured, and marginalized people across our nation. We are very excited to be a part of the National Summit of Clinicians for Healthcare Justice, a one of a kind event sponsored by many of the major safety-net clinician organizations across the United States. The 2 ½ day event is expected to attract at least 500 clinicians and advocates who will come together to celebrate, acknowledge and highlight the work frontline clinicians do to serve disenfranchised populations in need of basic healthcare in our country. To find out more go to www.allclinicians.org

Misplaced Compassion?

Karen Mountain, RN, MSN, MBA — Thu, 20 Dec 2007 16:56:45 +0000

I have the great privilege of visiting over 20 migrant and community health centers every year. I am consistently impressed with the quality and dedication I see among health center clinicians. As a rule, clinicians working in federally funded health centers are individuals who highly value compassionate primary care. There are times however, when I see misconceptions among clinicians about what best serves the clinic and in turn, the patients. A common problem I see is clinicians undercoding a patient visit because he or she thinks that this will help the uninsured patient to pay less for that service. While this is very well intentioned, the trouble is that undercoding undermines the ability for health centers to document the true extent of their populations’ need . Without that documentation health centers have a much harder time raising funds that in turn help those patients most destitute. Is this an issue you see in your health center? If so, have you done anything to address it?

Mercury injections?

Edward Zuroweste, MD — Thu, 13 Dec 2007 21:55:28 +0000

I recently read an article about the ritual use of mercury in immigrant populations. It jumped out at me because this is an issue that Venkat Prasad, MD, the medical director at Tri-County Community Health Center, has seen in his health center. A couple of years ago, Dr. Prasad wrote about a case of two recently arrived immigrants from Honduras who used mercury injections to ward off evil as they made their journey across the border ( Env. Health Persp. Vol 112, Num 13, Sept 2004 or MCN’s reprint in Streamline). The use of mercury to bring good luck is not uncommon for practitioners of Santeria. When used for good luck, small amounts of mercury are sprinkled in and around homes and cars. Mercury injections are a less common phenomenon. The extent of the ritual use of mercury is not well documented, but a few cases of injected mercury have come to the attention of clinicians. Exposure to mercury (regardless of the route) is problematic, but the injections are far more serious. Most recently a Mexican women required surgery and suffered a severe infection from a mercury injection to help lift her luck as undocumented immigrant. (see the article in the Trentonian) The Santatarian priest who gave her the injection has been jailed. This is one more example of the unique issues we face as migrant health clinicians and how important it is to keep an open mind about patient symptoms.

Speaking up for access to care

Edward Zuroweste, MD — Thu, 06 Dec 2007 17:17:11 +0000

It has been a rough year for immigrants in number of areas, especially in terms of legislative proposals. Migrant Clinicians Network has just signed on to a letter to Congress asking them to treat immigrants with dignity and fairness. The letter addresses numerous health care policies dealing with immigrants. While I fear that such a letter will have limited impact, I feel strongly that the health care community, so often silent, must speak up to protect the vulnerable. Accessing health care is a human right and if clinicians remain silent on this topic, who is going to speak up? If you’re interested in having your organization sign on to this letter send an email to pat.reuss@now.org at the National Immigrant Rights Center in Washington DC.

Expanding Definitions of Emergency Preparedness

Candace Kugel, CRNP, CNM, MS — Mon, 03 Dec 2007 16:15:04 +0000

Increasing numbers of worksite raids across the country exemplify the intensity of stepped up immigration enforcement activities. It is especially heart wrenching to hear the stories of citizen children who are left behind in precarious situations when their undocumented parents are detained or deported (see NCLR’s website). In light of these actions, advocates and service providers are attempting to prepare immigrants and their family members should they endure a raid. In these efforts, we might do well to think about how preparing for raids overlaps with our efforts in planning for emergency and/or disaster preparedness. (more…)

Are Social Security Numbers Required for Health Care?

Jennie McLaurin, MD, MPH — Mon, 19 Nov 2007 22:15:07 +0000

We’ve all heard that immigrants may fear giving out personal information to authorities, especially if they, or their loved ones, are here without documentation. But just how widespread is the problem of requiring Social Security numbers (SSNs) as American residents seek health care? I recently had a first-hand taste of what patients deal with every day.

After waiting two months for an appointment, I had my first visit with my new doctor. She came highly recommended as both technically competent and personally compassionate.

I came to the small office and was greeted in the usual manner, given a clipboard of forms to fill out. When I saw they wanted my SSN, I put a line through it. I did give my date of birth, full name, address, employment. The receptionist looked over my forms and said she needed my SSN. I responded that I had been advised by my bank to never give that to a doctor’s office, as identity theft was now hitting medical offices.

I was then told that I simply couldn’t be seen! (more…)