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TCD Summer 2015 - Mobile Medical Healthcare for the Underserved

by John R. Crouch, Jr., MD
Today's Christian Doctor - Summer 2015

I walked into the exam room in our mobile medical van and greeted W.J., a patient whose name looked familiar but I only vaguely recognized him. Then I saw my note from two months ago. He presented then as an early 30s African American male who recently moved to Tulsa, very disheveled, and his train of thought was hard to follow. We gradually ascertained a diagnosis of schizophrenia, diabetes and hypertension. Since his initial visit, he had run out of all his medicines and all his problems were uncontrolled, so we started him back on his meds. Since then, our driver Tommy, along with volunteers from the church partner, have met with him several times and have been counseling and praying with him. He is now going to church regularly, and, with his medical problems better controlled, he shared with me his testimony of how his life has changed as a result of our mobile medical ministry.

W.J. is just one patient served by one of our 13 clinic sites where we partner with churches to take whole person care to the underserved right into our communities of need. It’s a ministry we started because caring for the poor is a biblical mandate (Deuteronomy 15:7-11, Luke 3:11-14, 2 Corinthians 9:6-13, Matthew 19:16-24, Matthew 25:31-46), and that includes healthcare.

The Growth of a Mobile Ministry

Caring for the healthcare needs of the poor involves a variety of different methods. Some give financially to support healthcare missions in developing countries. Others give their time and skills to a mission clinic or a church-based clinic for the poor in the U.S. And some have designated appointment times in their practices when they give services without remuneration. Still others run clinics for the poor as a full-time ministry in underserved neighborhoods. Another method is what we do through Good
Samaritan Health Services (GSHS) in Tulsa, Oklahoma, as we use mobile medical vans to serve the poor in partnership with multiple churches.

GSHS grew out of the In His Image Family Medicine Residency. When the Oral Roberts University School of Medicine and the City of Faith Hospital closed in 1989, we formed In His Image to continue a Christian family medicine residency, support worldwide healthcare missions and do something about healthcare for the underserved in our own community.

In partnership with Cornerstone Assistance Network of Tulsa, Oklahoma, an organization dedicated to equipping churches for their outreach to the underserved, we started a monthly clinic in 1997 in a low income housing area. We offered a compassionate ministry in a quality and caring way, and the community response was great. It quickly grew into a weekly clinic, and it wasn’t long before we started getting requests from all over Tulsa asking for similar free clinics in areas of need. We reasoned that we must somehow become mobile in order to accommodate the other areas, so we considered a van or minivan to transport our supplies.  Then we heard from a CMDA member in Chicago who was doing a church-based clinic for the underserved, and he said that a benefactor was willing to give a mobile medical van to someone who was doing healthcare for the poor in the U.S. as a Christian ministry.

Well, that was certainly us, so we immediately applied for a van and a representative of what is now the Foster Friess Family Foundation drove our first vehicle to Tulsa and handed us the keys and title in November 1999. It was a 35-foot truck/van with two exam and treatment rooms, a mini-pharmacy and a nurses’ station, plus it was heated and air conditioned. By early 2000, we were in three different clinic sites partnering with a number of churches. Throughout the years, the ministry continued to grow. By 2007, we were seeing thousands of patients each year at seven different sites, but the van was starting to show some wear and tear.

So we went to visit our benefactor, Foster Friess, and asked if he would consider giving us another van. He quickly agreed to give us a matching grant for half of the purchase price and suggested we raise the other half in Tulsa. We did so and purchased and refurbished a 63-foot semi-trailer truck with heating and air conditioning, three spacious exam and treatment rooms, mini pharmacy, nurses’ station and a mini lab.

Since then, we have grown to 13 clinic sites, partnering with more than 30 churches. More than 200 volunteers provide over 13,000 volunteer hours, we hold more than 50 clinics per month and we provide over $1 million worth of medications and supplies donated by other partners. We estimate that we easily saved more than 486 ER acute care visits in 2014. And it continues to grow, as we just received our third mobile unit.

But it doesn’t stop there. A “Well Woman” clinic is also held each month in multiple sites, and we have now started men’s health clinics, where we are discovering untreated hypertension, diabetes and other problems in men who ordinarily won’t go to the physician. In addition, we are in Phase 1 of a project in which we are screening the underserved, particularly diabetics, for retinopathy, one of the great causes of blindness in the middle aged and just beyond. The underserved population simply doesn’t have access to this type of screening, so we are excited to see this project come to fruition.

The Benefits of a Mobile Ministry

So what are the advantages of this particular method of taking God’s healing love to the poor? Most importantly, using mobile medical vans allows us to take whole person quality care right into the community of need! Whether that need is due to  geographical isolation with no transportation or social isolation because of a fear of government clinics or feeling dehumanized in other clinics, our church partners respond to those patients by reaching out with Christian love, care and prayer. Additionally,
our church partners provide many compassion ministries to bless our patients and form a groundwork of trust for prayer and sharing of faith.

We have come to realize our niche of service is to utilize our mobility and the partnership with churches and church volunteers to serve the people who are falling through the cracks of the regular health system. And just like the ministry of CMDA, our purpose in mobile ministry is to see transformation in the lives of those we are serving and, in the process, see transformation in our own lives.

The results of that transformation are starting to be plentiful within the communities we serve. Take G.H., for example. She is 49 years old. She is one of eight siblings and has always felt unloved. She was molested by her father. At age 18, she got married but found herself with an abusive husband who supplied her with drugs. She was afraid to leave, so she stayed with him until he died in 2010. To support her habit, she prostituted herself and shoplifted, which landed her in prison with a couple of felony charges. It was when she was at Eddie Warrior’s Correctional Facility that she met up with Pastor Dixie and found a whole new way of life. In 2014, G.H. was released from prison and connected with Pastor Dixie’s God’s Shining Light Church. During that critical first year, her medical needs were met at both the women’s clinic and one of our regular clinics. “Good Samaritan was there when I had no one else,” she said. Now she is employed and has insurance. She met us with a smile the day of the men’s clinic earlier this year, happily cleaning up after the outreach. She was excited because God made a way for her to have some tattoos removed—past relics of a life that was no longer hers.

Pastor Jonathan Reichman of Riverside Baptist Church told us that a substantial number of new attendees/members of his church have come through the clinic. It’s a blessing to see this ministry continue to grow and make an impact in our community.

The Challenges of a Mobile Ministry

Just like with all ministries, we do face challenges in mobile ministry. One challenge is finding healthcare professionals. Busy healthcare professionals have “day jobs” that consume much of their time and energy. We do have volunteers working in our daytime and evening clinics, but we also hire a full-time physician and nurse practitioner to staff the daytime clinics. Second and third year residents in our residency program are required to “volunteer” at least once per month. Many volunteer to do more, as do many first year residents who can work with a licensed healthcare professional as back-up.

Because of the sheer volume of people needed, this entire outreach ministry does not work without faithful church volunteers. We believe the best situation is to get at least three churches to partner together so volunteers do not experience burnout. We now have a semi-annual pastors’ luncheon to recruit new church partners. We require a site coordinator from one of the churches for each site and volunteers undergo training and learn to use our medical protocols (confidentiality, disposal of biologic waste, needles, etc.). Our program is supported by a mixture of both paid and volunteer workers. \

Of course, there is the challenge of maintaining the vehicles: gas, maintenance for wear and tear and, for our large van, a Class A driver’s licensed person. Plus, there is the challenge of obtaining labs and imaging, as well as consultations for problems that can’t be managed in the van. Our St. John Health System partner for our residency has supported us with those types of services as well as financial support as part of their mission as well. Our work clearly helps to decrease the non-pay patients who go to their ERs and are admitted to the hospital.

As our reputation for providing quality and caring care has been recognized by the community, we have enjoyed increasing support from foundations and individuals in the community. We, therefore, raise support from individuals, churches, foundations and hospitals.

The hindrances for not starting a mobile medical van ministry include not having champions who really believe in this method. Vehicles do break down and have to be replaced. It might be considered expensive, but is it? The cost per patient is about $120 per visit, including doctor evaluation, labs, x-rays and most medications (we supply about 60 to 70 percent of the patients’ medications).

Conclusion

It’s easy to get bogged down by these challenges and hindrances. Laid out together, it might seem too overwhelming, too daunting to even begin considering starting such a ministry in your community. But it’s important to remember that alongside those challenges is a great host of benefits—benefits for you, your community and more. There are obviously great benefits for the patients who can be diagnosed and treated in their own community. In addition, our volunteers love this approach and find it a great opportunity for serving their own community with Christian love. Our healthcare professionals are also blessed by reaching out to the poor in Jesus’ name in this unique way. And churches are not only expressing their compassion for the underserved in our community but have also found it to be a way to partner together.

If you are interested in considering mobile medical vans to provide healthcare for the underserved in your community, I encourage you to learn more from Christian Community Health Fellowship at www.cchf.org. In partnership with CMDA, CCHF can help you learn about the mechanics of mobile medical clinics, serving the poor and more. You can also contact us at www.GoodSamaritanHealth.org. If you are giving serious consideration to mobile medical vans, we encourage you to pay us a visit so we can share even more about this important outreach ministry.

As Jesus says in Matthew 25:40, “…inasmuch as you have did it to one of the least of these My brethren, you did it to Me” (NKJV).


ABOUT THE AUTHOR

John R. Crouch, Jr., MD