Posted on January 1, 2006

Katrina, the hurricane, illustrates in graphic detail what I have seen as a family physician working for the past ten years in some of the poorest neighborhoods of Buffalo. Katrina blew into New Orleans and wreaked devastation and ruin to this great city. In doing so it exposed a nation that had not invested the time and resources to strengthen the levees to prevent a catastrophe, that was ill prepared to protect its own in time of crisis. This storm showed in ways we could not ignore that when a catastrophe occurs the most vulnerable among us will suffer the most. Who can argue that in New Orleans the poor, the elderly and people of color suffered the brunt of the storm?

Just as Katrina exposed the vulnerabilities of the poor, elderly and people of color to a natural disaster, so too, I have seen first hand the way this nation’s health care crisis is affecting the lives of the people we serve here in Buffalo.

America is the richest country in the world. We have amazing technology, more doctors and more medicines than any other country in the world. Yet there are over 45 million people in this country who have no medical insurance and who can little afford our health-care system. It is a generalization, but we basically have a three-tiered system of care. Folks with private insurance can usually access and afford the very best this country can offer. Medicaid covers the bill for the poorest of us in most cases, but often that means they see a whole different set of doctors, often students or interns, and they often receive a different quality and level of care. The uninsured basically get no medical care unless they are emergently sick and often this care is given in an emergency room instead of a doctor’s office.

Like the poor of New Orleans, who could not flee because they had no car or airplane ticket or credit card, the sick poor may not be able to access medical care they need when they need it and so they suffer. Silently, without fanfare, everyday our most vulnerable citizens are marginalized and die because the health-care system of this country has failed them in their hour of greatest need. Who will rescue them? Where are God‘s people? Radical change is needed in our current health care system to insure that all people have access to quality basic health care.

Race mattered in New Orleans and it matters in medicine. African-Americans are more likely than white people to have diabetes, high blood pressure and heart disease, and when they do show up in the ER with a heart attack they are less likely to receive needed interventions such as heart catheterizations. African-Americans have a lower life expectancy by five years than white folks. Recent studies show disparities in health care across the board. Only 30% of eligible African-Americans receive a yearly flu shot (compared to 60% of whites). Almost every day I see examples of these disparities in real people. This week I saw a 63-year-old African-American woman who had not seen a doctor in years because “she does not trust doctors” and her blood pressure was stroke level high. Yesterday I saw a young African-American man who at 29 is uninsured, overweight and has poorly controlled diabetes and a heart condition. He will be dead by the time he is 40. He was on no medications. Just like in New Orleans, the racial health disparities are obvious. Researchers tell us that these differences persist even if taking into account one's income, education and access to health insurance.

Trust is an important barrier to care for some people of color. They remember the Tuskegee syphilis experiments and wonder if they can trust the doctor this time. Centuries of oppression have carried over into the present time in both obvious and hidden ways. It is time to confront this with renewed vigor and diligently work to ensure all people are truly treated as equals. Those of us who minister and work in communities of color need to establish trust with the people we serve. Trust is earned over time as people see that they are treated with respect and dignity, as people see commitment to long-term mission. People are moved most by our actions.

Mr. Orendick came to see me for the first time six months ago. He is a big, burly elderly white man and his gray-haired wisp of a wife is always with him. I remember they made quite an appearance in our waiting room. Neither had seen a medical doctor in many years. They have an herb and natural food stand at the local market in the heart of Buffalo's African-American community. Somehow they heard about us and decided to come in. That first day he had some chest pain. I quickly realized this overweight man with high blood pressure was having a heart attack. However it took me 45 minutes to
persuade him to go to the hospital. He finally did and he ended up having life-saving heart surgery and now he loves me. Now every week at his herb stand at the market he is dispensing his herbs and remedies but also is telling his customers about this doc who saved his life. As a result I am seeing African-Americans who have not seen a doc in years because they did not “trust” doctors. All because of the witness of a person they trust...Mr. Orendick.

It is time we address issues of race and poverty in our country, our churches, our neighborhoods and our ministries. Katrina did provide opportunity for a discussion. This discussion must continue. Katrina also provided a chance for the church to reach out in a time of need and Christians of all colors have responded by donating volunteer time, money and prayer to the people and churches affected by the storm. This must continue.

Is this country willing to invest the energy and resources needed to rebuild New Orleans again into a vibrant city, diverse and alive once more? Will we choose to redesign the levee system to prepare it to better withstand a storm in the future? We have the resources to do this; it is a matter of priority and leadership. So too, we as a country can design a fair and just health-care system which would ensure access to excellent health care to all who live in this country. By investing in such a system we would be better prepared to face a medical catastrophe such as a flu pandemic. Such a system could begin to address some of the root causes of poverty and racial health disparities. Our nation would be better for it.

As a passionate follower of Jesus, I am most interested in applying to the best of my ability the principles of his life to my actions here in this world. I can almost see Jesus cry in anguish with the poor who have suffered so much in a country that is so rich. How would Jesus challenge the current system that seems to codify poverty and that leaves so many vulnerable? Katrina did provide opportunity for followers of Jesus to provide acts of charity and, yes, the church has responded. So too have many people responded to the health-care crisis and have served faithfully, some for most of their lives. Witness the many ministries and people associated with CCHF. But our acts of compassion in Jesus’ name should only be the beginning. The Bible is clear that God cares deeply about the plight of the poor and marginalized and that ultimately he will judge us by our care for the poor.

Old Testament prophets such as Isaiah, Jeremiah and Amos were courageous in their ability to challenge the leaders of their day to seek a just land. In Isaiah chapter 58 the prophet calls for a fast that would “loose the bonds of injustice, let the oppressed go free and bring shelter to the homeless”. In the gospel according to Matthew, Jesus reminds the disciples that the “righteous” have clothed the naked, given food to the hungry and visited the poor in prison. In the gospel according to Luke, Jesus tells his disciples to report to John that “the blind see, the lame walk, the lepers are cleansed, the deaf hear, the dead are raised AND the poor have good news brought to them”. The Old Testament story of Nehemiah gives us a vivid example of how the people of God can dedicate themselves to rebuilding a ruined city - a prophetic encouragement for the city of New Orleans. The prophet Micah challenges us to “do justice, love mercy and walk humbly before God”.

As the people of God, may we act with compassion and charity to those in need natural disasters such as Katrina and to those in need of health care. May we also passionately advocate for justice on behalf of the most vulnerable among us. We must work to change the system that has created poverty, racism and health disparities. May God compel us to act.

May God Help us all!

Tags: H&D, Healthcare System


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