With one in seven Americans without health insurance, thousands of church-based clinics across the USA have been stepping in to provide health education or direct medical services to people of all faiths. Sharmila Devi visited one such clinic in Harlem, New York City, to find out more.
At the community hall of St Mary's Episcopal Church in Harlem, Carlos Morales rapidly rattled through a description of his health problems to a medical student from Columbia University, because he had to get back to his homeless shelter before curfew at 7 pm.
Diagnosed with hepatitis and a history of alcohol abuse, Morales also has epilepsy. He came to the St Mary's free clinic, which takes place each Tuesday evening, only days after being discharged from hospital where he was treated for a seizure. “He was prescribed dilantin [to control seizures] but he has no money to get it and he heard about the clinic from a friend”, said Priya Batra, a third-year medical student, who speaks Spanish and examined him under the supervision of a qualified doctor. “We can't provide the drug but we have given his details to a social worker who can hopefully get him enrolled in Medicaid [the state-run programme for the poor].”
The case of 42-year-old Morales, who moved to the USA from Guatemala 3 years ago and was without work or near family, is typical of the patients who visit the St Mary's clinic. Often homeless and with few means of support, they resort to emergency hospital care to manage chronic conditions.
The St Mary's clinic, run by volunteers and funded by donations, is one example of a growing trend by churches to provide direct health services. A survey of more than 6000 congregations of various Christian denominations by the National Council of Churches USA (NCC) late last year found that about 70% provided direct medical care to individuals by trained professionals and 65% ran health-education programmes.
The medical services ranged from three Alabama congregations that sponsored a free health clinic to two retired lawyers in upstate New York who volunteered to assist elderly people and migrant workers to complete health-insurance forms. Thousands more churches offered screening for diabetes, hypertension, vision, hearing, and referrals to appropriate health facilities for follow-up care.
The NCC also said that it had anecdotal evidence that other institutions, including mosques and synagogues, were also providing health services.
“With our national health-care system cracked and breaking, this survey shows that churches across the country are doing their best to fill the gaps”, said a statement by Risa Lavizzo-Mourey, head of the Robert Wood Johnson Foundation—which supported the survey and is the largest philanthropic health-care organisation in the USA.
“Faith communities have a long and important tradition of providing health services to the most vulnerable in our nation. Now that one in seven Americans has no insurance, and therefore has difficulty accessing needed health care, the work of our churches has never been more important. The bottom line, however, is that they cannot shoulder this burden alone. The health-care crisis is a national problem that needs national, bipartisan solutions.”
Reverend Earl Kooperkamp, the pastor at St Mary's, has long believed in providing both material and spiritual assistance. A community activist, Kooperkamp has worked with poor people in urban New York for much of the past 30 years. “Access to health is a real issue here. Some 25% of the kids have got asthma, one in ten adults has diabetes, and many suffer from chronic conditions like heart disease and obesity”, he said. “We had nurses in our congregation who said ‘we've got to do something.’”
St Mary's biggest foray into providing health services followed the outbreak of HIV/AIDS in the 1980s. Next to the church was a wasteland where homeless people with HIV/AIDS “would literally die”, said Kooperkamp.
