follow-up healthcare meeting

Today I went to a follow-up meeting about healthcare in Apopka, sponsored again by the Orange County Health Department. The meeting started out with about a fourth of those who were present at the last one. Attendees included a representative of a local nonprofit offering healthcare for the uninsured, a few reps from Florida Hospital, the two women from OCHD who have been working on the Apopka project in their spare time, (including Nina Cooper, summer intern who's doing a master's in public health out in California, who will be missed) and, a little later into the meeting, a few community members and Jeannie from the Farmworkers Association. Geraldean Matthew spoke eloquently on behalf of the community- she wasn't able to make the last meeting (she recently learned she needs a kidney transplant), and she has so much presence that whenever she talks people are spellbound. She's a tireless community activist, but her health issues are starting to get in the way. A few highlights:

- Nina shared with me that St. John's River Management has decided Apopka is no longer polluted, so this may mean a loss of funding. OCHD has hired some toxicologists to confirm this report.

- The problem of access to fresh produce: Nina and Michele (OCHD) have been in talks with LYNX about getting buses to go to a Publix or to cross the street to the Super WalMart-- the bus now stops on the other side of the busy stretch of 441, which would be impossible to cross in time unless you were a marathon runner.

- The Apopka community clinic director has been approached about keeping the clinic open and reserving one night each week for this particular population of farmworkers (again, many of them need MUCH more than a visit to a general practitioner-- they need specialists, endocrinologists, etc)

- Nolan & I are invited to take part in talks with Florida Hospital about setting up some health seminars... which we're working on... trying to tap into the expertise of many of our colleagues at Rollins.

- The Apopka community members voiced their frustrations about outsiders starting little programs only to disappear and never be heard from again. They reiterated that many of their community members are dying. Geraldean spoke of the difficulty in getting healthcare-- once you get ON Medicaid, you're limited in the choice of doctors-- very few doctors want to be a part of the Medicaid plans because they don't get paid much by the government to see Medicaid patients, so there are no financial incentives. In particular this is true of specialists, so sometimes the only specialist who can serve as a Medicaid provider will be in Tampa. This is a huge systemic problem. Think Michael Moore's "Sicko..."

- If you build it, they will come... but not necessarily. On the hospital side of things, representatives feel like they have a hard time getting community members to attend anything. There was a lot of talk about how to "Get the word out" about community meetings-- churches, flyers at a furniture store where people cash their social security checks, a fish market people frequent.

- Geraldean talked about the need for health education-- she seemed to like the idea of healthcare seminars, and the possibility of having someone to talk about issues such as the best way to choose a healthcare provider, manage diabetes, eat healthfully... She was tired, though, of being blamed for bad nutritional habits. All the former farmworkers said they used to eat nothing but fish from Lake Apopka and fresh vegetables from the farms, which they took home with them every day.... and look where this got them.