Common Ground Health Clinic (CGHC) was the product of a grassroots effort to provide medical services to the many largely low-income and African American individuals who remained in the Algiers community on the west bank of the Mississippi River in New Orleans. Algiers did not flood, and, contrary to public perception, many in the community did not evacuate. The principal catalyst, a community organizer living in Algiers, saw a critical need for health services because low-income African Americans, who had been poorly served before the storm, were now largely abandoned as the citys health services collapsed.
|Key Features of Common Ground Health Clinic
The call for assistance used personal connections, e-mail, and the Internet, including a web site with a live camcorder set up within days. The call also linked the post-storm emergency with the history of racism and poor health services. The aggressive outreach generated a groundswell of response from a mix of anti-establishment youth, including street medics trained in providing medical assistance at political demonstrations; licensed physicians and nurses; and nontraditional health practitioners. An interview on a national public radio program generated further response. The mix offered a range of expertise, from primary care to psychiatric services. In the first week, Common Ground had two or three trained emergency medical technicians, one physician, two herbalists, a physicians assistant, and an acupuncturist. To date, about 1,000 trained and licensed medical volunteers, plus about 150 others, have provided services.
The first volunteers spray-painted a scrap of plywood as a first aid sign and set up a street-corner clinic in a donated neighborhood mosque. They also conducted a door-to-door campaign with the help of local women to learn who remained and needed assistance. Early clinic organizers expected to find a high level of trauma resulting from the storm, but instead found a range of other maladies, including hypertension, old gunshot wounds that had never been treated, and a population that had used emergency rooms for basic primary care and now had none. Chronic health issues such as hypertension and diabetes required vigilant monitoring and medication. The nearest pharmacy was reportedly in Jefferson Parish, and those who had not evacuated, overwhelmingly people of color, were reportedly not allowed through police checkpoints. In the first month and a half after the storm, the street medics visited about 200 households and took phone calls from caretakers followed by home visits to evaluate patients. FEMA and the Red Cross reimbursed pharmacies for patients who were deemed shelter eligible. By the end of October 2005, CGHC had seen about 4,000 at the clinic100 to 200 a week at its peak.
Organizers also learned that immigrant laborers brought in to the city to do much of the de-mucking were housed in hotels with no access to health care and inadequate protections from health hazards (e.g., no gloves or vaccinations, one gallon of water for two workers working 10- to 12-hour shifts). They went to hotels to vaccinate laborers for hepatitis A and B and tetanus. Emblematic of the magnitude of the response to Katrina, the clinic, like several other sites, was inundated with donations, sometimes creating major challenges for storage, use, or redistribution. They used the door-to-door effort to distribute donations as well (e.g., two tons of clothing, food that would otherwise spoil).
By November 2005, the clinic organized formally as a 501(c)(3), with a governing board and bylaws, and created relationships with several providers in the larger public health system to procure specialized medical services. By early 2006, about five months after the storm, a landlord from the mosque offered a storefront facility across the street at a nominal rent, and the clinic was able to create a more standard clinic space and regularize and expand services. The facility observed in 2008 was a modest but attractive storefront on the exterior, and a spotless and orderly waiting room and examining rooms on the interior.
CGHC maintains a pronounced allegiance to its philosophic roots of independence, eschewing subservience to the medical establishment and attempting to controvert the underlying racism that it believes has limited access to health care for low-income blacks. But it has reorganized several times and matured over three years, to increase professionalization and quality of care, reportedly earning the respect of members of the medical establishment with whom it partners for providing high-quality services.
While committed to governing through open participation, CGHC has created internal organizing structures to address financial management, clinical services, community outreach, and management of volunteers. It administers nearly $1 million from public and foundation sources and serves 100 patients during a three-day clinic week. It still provides alternative medicine services, including herbal remedies and acupuncture, remaining close to the culture of the community it serves.