One day two years ago, Consuelo Barrego’s nose wouldn’t stop bleeding. So she went where she had never been before: to San Francisco General Hospital. She left the hospital with a $3,600 bill and no explanation.
“They didn’t do anything to me,” said the 27-year-old Barrego. “They didn’t even give me a glass of water.”
With that experience in mind, Barrego — one of 46,000 employed San Franciscans who lack health insurance — turned to La Clinica Martin-Baro, an all-volunteer, free pop-up clinic.
Once a week on Saturdays at the Mission Girls building on 24th Street, La Clinica provides ongoing care for people in the Mission’s immigrant communities, relying entirely on donated supplies. Through a partnership with medics from the University of California at San Francisco and students from San Francisco State University, the clinic helps close the gaps in the medical system.
Barrego’s two-year-old son, for example, has a pediatrician. But even though doctors agree that the health of the mother is just as important as and an integral part of a child’s health, Barrego’s job as a housekeeper doesn’t provide health insurance.
Obamacare will not close the gap for those who are undocumented, said Felix Kury, the clinic’s director and one of its founders.
“This health reform is not going to make a difference to [La Clinica’s patients],” Kury said. “We treat our patients, who are the most vulnerable, with the best services. Even though this is not a fancy clinic, they are treated with the best care.”
Through its guiding philosophy of care with cultural competency, the clinic is an oasis for immigrants. Most volunteers and patients speak Spanish, which makes patients feel comfortable, said Yvette Rico, an SF State student and longtime volunteer.
When a reporter began speaking English, she suggested that the conversation be in Spanish, as other people were in the room.
“We don’t want to alienate anyone,” she said. “Everyone here is equal.”
Being able to speak the language and understand the culture helps with treatment, said Nicole Betenia.
“As a physician it is easy to say, ‘Exercise or avoid these things.’ But we know that sometimes they don’t have access to better food, or are not the ones cooking,” she said. “So we try to be more realistic.”
Doctors have to keep in mind that many of the patients have gone through a traumatic journey to get to the United States and are here without their family — their health support system.
Post-traumatic stress can affect mental health, Kury said. While La Clinica sees mostly cases of diabetes, high blood pressure and asthma, they also see depression, alcoholism and issues related to homelessness.
“These issues that affect them don’t come from their internal psyche, but rather from the external factors,” said Kury, who is a psychotherapist. “I also know that there are people who have conditions that need medication, but many of the problems that affect our community comes from the environment.”
Cristina, for example, endured injuries and witnessed sexual abuse during her journey here. She couldn’t speak to her family about her experiences.
“It affected my whole life,” she said.
Other factors, like poverty, can also affect immigrants once they are in the United States.
“Health should be considered as more than the absence of disease,” Kury said. “Creating a space and working around issues that are not just medical but are social — the lack of housing, unemployment … the violence … happening in the neighborhood — those are the things that we address with people.”
As for Barrego, she is still trying to pay off her hospital bill. She was at the clinic recently, but only to accompany her brother-in-law, who was there to get a physical.
“They’ve always helped me without charging me a cent,” she said. “They help poor people.”