The young woman had come into the clinic for a routine women's wellness visit, but a few questions revealed that her mother had died the previous year, suffering from diabetes and high blood pressure. She also was at risk, but confessed to public health nurse Amy Popovich that she was afraid to go to “a real doctor.”
Fear and mistrust are big reasons many low-income Richmonders don't go to the doctor, says Dr. Danny Avula, deputy director of the Richmond City Health District. The idea of having a primary care provider is foreign. Health care means going to the emergency room when you're in pain and can't put it off any longer.
The solution? Give health care a friendly face, and move it next door to the people who need it most.
Almost one year ago, in November 2009, the Richmond Health District opened a health-resource center in a one-bedroom apartment in the Fairfield Court housing project. A similar resource center opened in May in Whitcomb Court.
The old public-housing health care model, Avula says, was a nurse who did blood-pressure screenings and handed out condoms. The new centers have become busy community hubs that officials hope will serve as residents' entrance to the larger health care system.
Marked by a bright banner and a little vegetable garden planted outside the door, the Whitcomb Resource Center is easy to spot. Inside, blue, green and yellow paint brightens the cinder-block walls.
The bedroom has become an exam room, and the lab used to be the kitchen. The pharmacy is a single black cabinet. In the bathroom, a shower curtain conceals stacked boxes of medical supplies. “My office is really in my car,” Popovich says.
With an annual budget of $120,000, the centers can't fill the role of full-time doctors' offices. What they can do, Popovich says, is give patients “a medical home” and connect them to the services they need.
Nurse practitioners see patients one day a week. Every other day the waiting room is packed with 20 to 25 people seeking other services, such as prenatal advice, blood-sugar monitoring and sexually-transmitted-disease screening.
Originally intended to focus on family planning, both centers offer services far beyond health care. Staff work with other organizations to provide everything residents ask for: homeownership and budgeting classes, a walking group, employment counseling.
Administrative coordinator Sandra Bosher, who grew up in Mosby Court, has found herself typing rAcsumAcs for people out of work, helping a mother get $5-a-month subsidized day care, and even finding a mechanic willing to fix a resident's car for almost nothing.
When the health center first opened, Bosher says, “everybody thought we were affiliated with the rental office and we were going to run back and tell stuff.” Since then, suspicion has given way to trust, she says: “Now they see us, they speak.”