Ventanillas de Salud

Take a trip to the Mexican Consulate in Fresno, where a health outreach program run by the Mexican government serves Spanish-speaking immigrants in this country.

NARR: When you walk past the metal detectors at the Mexican Consulate in Fresno, you find yourself in an open courtyard of sorts, with a wooden floor and a roof that lets in lots of light. Here is where most people who come to the Consulate to process passports or consular I.D.'s come to wait. That's when Alex Arellano might approach them.

ALEX: We start talking about novelas, we start talking about futbol, we start talking about the weather. And as we start getting their confidence, we start talking about, Tell me, how's your health? When was the last time you saw your doctor? Do you know your cholesterol level?

NARR: Arellano is the coordinator of the Ventanilla de Salud, or Health Window, program at the consulate in Fresno. Although officials are reluctant to say the program specifically targets those in the country illegally, the undocumented do constitute a large portion of their population. Xochitl Castañeda is a medical anthropologist who directs the Health Initiative of the Americas at UC Berkeley. She says health researchers estimate that around 65% of Mexican immigrants are undocumented. Dr. Castañeda says Latino immigrants do not use the health benefits they are entitled to under California law, such as emergency care, as much as native born Americans or other immigrants. She says the obstacles to care affect all members of immigrant families.

CASTANEDA: 86 % of children of immigrants are born in the U.S., which means they are citizens, but they do not access services because of the documentation status of their parents, who are afraid and do not know how to navigate the system, or do not have the information about the rights of their citizen children. So access is an issue that is really related to the undocumented factor.

NARR: Those obstacles to access to health care is what the Ventanillas de Salud are trying to counteract. In Fresno, there are two buses that travel to small rural towns around the Central Valley to disseminate information on health. The program also tries to reach out to immigrants through public service announcements, such as this one aired on Radio Bilingue about the H1N1 flu. It's produced in Mixteco, an indigenous language from Oaxaca.

NARR: Here at the Consulate, Arellano and his colleague Ana Camps give talks on diabetes, nutrition, breast cancer, and other health topics, to the 2 to 300 people who pass through the building every day. They also refer them to community clinics, where they can receive low cost medical care. Today, Camps is blowing up helium balloons for a health fair.

NARR: Out in the courtyard, the Consulate's community partners have set up tables to give out information on how to get a low-cost pap smear or mammogram, how to set up health insurance for children, and how to prevent the transmission of the H1N1 flu. At one table, there are glucose tests being performed.

GUERRERO: My name is Melinda Guerrero and I'm with Camarena Health Centers in Madera.  I'm going to be checking her glucose, her blood sugar. And she's had soething to eat in the last half hour, so we'll see what her results are. (sound of gloves).

NARR: Guerrero slides on rubber gloves and then pricks the woman's finger.

GUERRERO: Deme su dedito. ... sound of prick... Lo trae a 152. Uyyyy es mucho, verdad que si?

NARR: The woman's glucose level is 152. Guerrero explains to her that after having eaten, it should be below 140. Because the woman's mother has diabetes, Guerrero tells her she should make sure to get enough exercise and eat healthy. Diabetes is one of the chronic diseases most prevalent among Latinos. But for immigrants like Maria, who said she's undocumented, it's a rare thing to be able to test her blood sugar, much less get other health care.

MARIA. Como que no tenemos ese privilegio de enfermarnos. Pues tengo que estar muy grave para ir de emergencia, solamente. No tengo esa dicha de tener doctor de cabecera, como dicen. Tengo que estar ya muriendome para ir de emergencia. Hasta tengo miedo de ir a parar alli en la sala de emergencia.

TRANSLATION: We don't have the privilege of being able to get sick. I have to be really sick to go into the emergency room. I don't have the blessing of having a primary doctor, as they say. I have to be dying to go to the emergency room.

NARR: Maria is a 37 year old mother of five, who has been in the United States for more than half her life, for 22 years. That means she arrived in 1987, right after the amnesty that gave undocumented immigrants at the time a path to permanent residency and then citizenship. Maria used to work in the fields, and she says once she did go to the hospital when her back was hurting her terribly.

MARIA: Estuve como 6, 7 horas de espera. Estuve mucho mas tiempo en la sala de espera que en el cuartito. Nomas me voltearon, me chequearon la espalda y me dieron Tylenol y me llego un bill de 1800 dolares, y me quede asustada, yo creo que con eso tuve para curarme. No tengo dinero, no tengo MediCal ni aseguranza ni nada.

TRANSLATION: I was in the waiting room for 6 or 7 hours. I spent much longer in the waiting room than in the consult. When I did see the doctor, they just turned me over, checked my back, gave me Tylenol, and I got a bill for 1800 dollars. I was so surprised I think that was enough to cure me. I don't have that kind of money, I don't have MediCal or insurance or anything.

NARR: Although Maria doesn't have insurance, her children, who were all born in the United States, do. As she approaches the HealthNet table, a worker asks her about her kids ...

and tells her if she ever has any kind of problem or gets a bill, she can call her. Maria says she's grateful she was able to get information today on diabetes, cervical cancer, and the H1N1 flu.

For Health Dialogues, I'm Zaidee Stavely in Fresno.