Migrant Health Clinics Caught In Crossfire Of Immigration Debate

THE CHILDREN OF MIGRANT WORKERS PLAY MARBLES WHILE THEIR PARENTS WORK IN FIELDS – NARA – 543855 (Photo credit: Wikipedia)

From a 6 June 2012 article at Kaiser Health

..clinics [which are] part of a 50-year-old federally funded program to treat migrant and seasonal farmworkers, have become the latest flash points in the national immigration debate. Health center officials across the country describe how local, state and national law enforcement authorities have staked out migrant clinics, detained staff members transporting patients to medical appointments and set up roadblocks near their facilities and health fairs as part of immigration crackdowns…

…

“We are looking at a growing climate of fear where folks really think long and hard about accessing basic services,” says Milton Butterworth, who oversees outreach migrant health services for Blue Ridge Community Health Services in Hendersonville, N.C.

Even many legal workers do not seek care at the health centers because they are fearful of exposing family members who are not legal residents, says Tara Plese, a spokeswoman for the Arizona Association of Community Health Centers. “There is a big fear factor and it’s a big concern from a public health perspective.”

Those concerns include making sure farmworkers’ children are vaccinated, stopping the spread of infectious diseases like AIDS and treating those with chronic problems such as diabetes, officials say. Many farmworkers avoid seeking care except in emergencies.

Federal Aid Opposed

Supporters of the nation’s 156 migrant clinics, which are typically part of community health centers, say caring for all farmworkers helps protect them as well as the public — and is a humane way to treat three million people toiling at the heart of the nation’s food supply. About half of those are illegal immigrants, according to the latest federal survey of agricultural workers conducted in 2009.

“Migrant health centers continue to help ensure the safety of the nation’s food supply by keeping those who harvest it healthy,” …

Related articles

• Fear keeps migrant workers from getting health care (usatoday.com)
• Alessandro Penso, Migrant Workers (mastersofphotography.wordpress.com)

Book Note – Where there is no Doctor

 

 

When I was in the Peace Corps (Liberia) many volunteers had and used this book, despite strongly worded caveats from the Peace Corps Office

Where there is no doctor (free download)

This book is the most widely used health education book in tropical developing countries. Based on David Werner’s experiences at his Project Piaxtla in western Mexico, it was originally written in Spanish as Donde No Hay Doctor. It has since been revised and has sold over one million copies and been translated into over 100 languages.

It covers all aspects of people’s health ranging from diarrhea to malaria and bone fractures and ringworm. The book explains to you what you can do yourself and how to prevent, recognise and treat many common sicknesses. There is also a large section on giving first aid.

Calorie-restricted diet keeps heart young

From the EurkAlert of 5 June 2012

People who restrict their caloric intake in an effort to live longer have hearts that function more like those in people who are 20 years younger.

Researchers at Washington University School of Medicine in St. Louis have found that a key measure of the heart’s ability to adapt to physical activity, stress, sleep and other factors that influence the rate at which the heart pumps blood, doesn’t decline nearly as rapidly in people who have significantly restricted their caloric intake for an average of seven years.

The study is available online in the journal Aging Cell.

“This is really striking because in studying changes in heart rate variability, we are looking at a measurement that tells us a lot about the way the autonomic nervous system affects the heart,” says Luigi Fontana, MD, PhD, the study’s senior author. “And that system is involved not only in heart function, but in digestion, breathing rate and many other involuntary actions. We would hypothesize that better heart rate variability may be a sign that all these other functions are working better, too.”…

Related articles

• You: Calorie-restricted diet keeps heart young (labspaces.net)

Improving Access to Mental Health Care and Psychosocial Support within a Fragile Context: A Case Study from Afghanistan

While American service men and women are being treated for war related traumas, let us not forget the effects of war on civilians…

From the PLos Absract 

• After the fall of the Taliban, the rebuilding of the Afghan health care system, from scratch, provided opportunities to integrate mental health into basic health services through the use of funds that became available during this complex humanitarian emergency.
• Practice-oriented mental health trainings for general health workers and ongoing clinical supervision in the basic health care system led to substantially increased demand for and access to basic mental health care services.
• Treatment of mental disorders within the health care system needs to be accompanied by a community-based approach that focuses on psychosocial problems.
• Addressing service delivery needs in a fragile state has to be accompanied by capacity building and policy development in order to foster structural changes within the health care system.

….

Looking to the Future

The experience in Nangarhar shows that, even within a fragile and resource poor context, it is possible to develop integrated services for mental health and psychosocial support, to rapidly cover an area of more than a million people. It is important to use funds available during a humanitarian emergency to pursue lasting improvements in the health care system [28]. There is an urgent need to develop a system of routine outcome measuring tools that includes both symptom reduction and improvement of social functioning. It is challenging to develop context-specific and low-cost outcome measures, but recent evidence for child psychosocial programmes in post conflict areas demonstrates that it can be done [29]. People with a limited background in mental health care can deliver integrated services, once their tasks are integrated within a system of care that includes focused, competency-based trainings, regular supervision, and refresher training [30]. It is important to strengthen the psychosocial elements of treatment within the health care system, and to ensure that the social context in which the symptoms occur and are maintained, are considered in the treatment plans of health care providers. The most recent version of the BPHS includes the addition of psychosocial counsellors at the district hospitals and comprehensive health centres. Preliminary evidence on the effectiveness of adding psychosocial counselling in primary health care settings in Afghanistan is encouraging [31] Apart from health system–based interventions, the authors have learned the importance of addressing psychosocial problems through activities outside the formal health care sector to strengthen self-help and foster resilience.

Related articles

• Community and health system approaches improves mental health in Afghanistan (eurekalert.org)
• Community and health system approaches improves mental health in Afghanistan (medicalxpress.com)
• Providing psychosocial assessment and support for migrants: A critical urge (icmhd.wordpress.com)
• Combatting Mental Illness Stigma in Society (psychcentral.com)
• Adolescent Suicide Prompts Look at Mental Health System: Ontario, Canada (jeanettebartha.wordpress.com)

• PTSD outcomes improve as US Army adds behavioral health screening to primary care (EurekAlert)

14 Ways Social Media May Soon Change Your Doctor’s Visit

Although this article has a good deal of advertising and most links are to commercial sites, the content seems to be a good summary of possible futures of doctor visits. Overall it seems that social media can improve the doctor-patient relationship.

From 14 Ways Social Media May Soon Change Your Doctor’s Visits  (May 15, 2012 article at The Sociable Blog)

In 2006, Pew Research Forum discovered that 80% of American adults used the Internet to research medical information. By 2011, data (separately) compiled by Frost and Sullivan and QuantiaMD showed between 87% to 90% of physicians used at least one social media site for personal reasons, with a further 67% to 75% opting for more professional postings. LinkedIn, Facebook, YouTube, Twitter, blogging, and the like stand poised to change the face of healthcare in the exact same manner it pretty much did for most other industries.

 

Medical professionals — not just doctors — have discovered some creative (and not-so-creative) ways to apply the technology to many different aspects of their field, meaning savvy, Internet-literate patients should stay on the lookout for what might lay ahead.

1. Better Information and Support……

Related articles

• QUOTE: patient-doctor relationship and social media (scienceintelligence.wordpress.com)
• The Social Health Correction (33charts.com)
• How Healthcare Professionals Can Improve Patient Relationships (scrubnotes.com)