Hidalgo County Health Department

Cameron CO Health Dept Yvette Salinas 1122 Morgan Blvd

Harlingen

Hidalgo CO Health Dept Eduardo Olivarez 1304 South 25th Street Edinburg 78539 956-383-6221 956-383-3229 Hidalgo County

Hidalgo County Health Department (Edinburg Clinic)
3105 E Richardson
Edinburg, Texas 78540
(956) 318-2040
http://www.hchd.org/clinics/edinburg.htm

Hidalgo County Health Department (Edinburg STD Clinic)
1425 S Ninth Street
Edinburg, Texas 78539
http://www.hchd.org/clinics/edinburg.htm

Hidalgo County Health Department (Elsa Clinic)
708 E Edinburg Street
Elsa, Texas 78577
(956) 262-7842
http://www.hchd.org/clinics/elsa.htm

Hidalgo County Health Department (Hidalgo Clinic)
702 E Texano Drive
Hidalgo, Texas 78557
(956) 843-7463
http://www.hchd.org/clinics/hidalgo.htm

Hidalgo County Health Department (McAllen Clinic)
300 E Hackberry Avenue
McAllen, Texas 78501
(956) 682-6155
http://www.hchd.org/clinics/mcallen.htm

Hidalgo County Health Department (Mission Clinic)
211 S. Shurbach Road
PO Box 2369
Mission, Texas 78572
(956) 585-2461
http://www.hchd.org/clinics/mission.htm

Hidalgo County Health Department (Pharr Clinic)
1903 N Fir
Pharr, Texas 78577
(956) 787-1531
http://www.hchd.org/clinics/pharr.htm

Hidalgo County Health Department (Weslaco Clinic)
1901 N Bridge Avenue
Weslaco, Texas 78596
(956) 968-7542
http://www.hchd.org/clinics/weslaco.htm

http://www.co.cameron.tx.us/health/Environmental.htm

http://www.co.cameron.tx.us/sheriff's/sheriffsoffice.html

http://www.tachc.org/About/Membership/Member_Directory/Brownsville.asp

Starr County Services Project

This Project has provided, at no cost, intensive physical exams and follow ups (involving screenings for glucose, cholesterol, and triglycerides and hypertension; specialized eye exams; and ultrasound evaluations) to Mexican Americans along the border for the past 18 years. more information

A joint project between UTHSCH and UT Pan American led to the development of low-literacy, culturally sensitive health promotion brochures in Spanish and English on the topics of anemia and menopause. more information

Doctors , Doctor MD and Health Dept. finder and how to for Clinics in and near the RGV, McAllen , Edinburg, Cameron county, co, Harlingen, Weslaco, Brownsville, Mission, Pharr, Edinburg, Mercedes, Donna, Texas, TX.

For Kathleen Becan-McBride, Ed.D., providing health care to the indigent is a lifelong passion. As director of The University of Texas Health Science Center at Houston’s Office of Community Educational Outreach, she is charged with bringing health care and education to Texas’ most underserved populations. She accepts the task gladly.

“It’s my love for my job and Texas,” says Becan-McBride, native Houstonian and coordinator of UT-Houston’s Texas-Mexico Border Health Services Project since 1988. “This project gives us a wonderful opportunity to help others in our state.”

UT-Houston’s Texas-Mexico Border Health Services Project was formed to help meet the critical health care and health education needs of the hundreds of residents living in the Lower Rio Grande Valley. One way the project delivers health promotion is through telemedicine.

Four years ago, UT-Houston was awarded a federal grant for a telemedicine unit to be used at four elementary schools located in colonias, which are unregulated, unincorporated, rural subdivisions that usually lack running water and indoor plumbing. Since 2000, UT-Houston specialists, in conjunction with the Hidalgo County Health Department, have used the unit as a diagnostic tool. With the network, nurses place a camera on the patient to capture a “picture” of the patient’s condition. The image is relayed 370 miles to pediatrician Margaret McNeese, M.D., medical director of the UT-Houston Medical Mobile Clinic, and her colleagues, helping them diagnose and treat patients with ear infections, skin rashes and other disorders.

Unfortunately, the $40,000 telemedicine unit, which was housed at the medical school, was destroyed during Tropical Storm Allison last year. Becan-McBride is hopeful that a replacement unit will be obtained in the near future.

The telemedicine network also acts as an interactive, distance-learning tool. Becan-McBride and her team use the technology to give presentations in wellness education, including a presentation geared to fifth graders.

“The kids are so enthused about it,” she says. “We teach them lifestyle choices, proper hygiene and nutrition, skin care and drug- and alcohol-abuse prevention.”

The interactive distance-learning sessions are conducted with the help of UT-Houston Medical School’s joint primary care fellowship participants – doctors who have completed their medical school educations and residencies, and are pursuing additional training aimed at developing research, teaching and administrative skills.

The Texas-Mexico border is a 1,254-mile expanse of land considered one of the fastest growing and poorest regions in the United States. Health conditions are among the worst in the country. Poor sewage facilities, pollution and lack of medical services make this side of the border a haven for disease. Frequent traffic between the United States and Mexico rapidly spreads diseases from one side of the border to the other.

Diseases commonly found in Third World countries like dengue fever, parasitic diseases and leprosy continue to debilitate border residents. Cases of hepatitis A and tuberculosis occur at a rate at least twice the statewide average.

The UT-Houston Medical Mobile Clinic staff, an integral part of the project, visits the colonias to provide health care to entire families, and has treated more than 48,000 residents in a 13-year period.

Becan-McBride says Hidalgo County has the largest number of colonias, with more than 1,000 colonias comprised of households occupied by as many as a dozen family members. Her medical team, consisting of one registered nurse and two licensed vocational nurses, provides a variety of services, including glucose, cholesterol, high blood pressure, Pap smear and HIV screenings. Her team also travels to churches and schools, where they provide immunizations to children and their family members.

“In one month, our clinic staff has provided immunizations to more than 1,300 students at 20 elementary schools in Hidalgo County alone. Plus, we provided primary health care to more than 3,100 patients,” says Becan-McBride, who is also professor of family practice at UT-Houston Medical School. “This far exceeds our original goal of providing 600 immunizations a year.”

The clinic nurses live in the Lower Rio Grande Valley, which Becan-McBride says is good for the project because they are bilingual, grew up in the area and know the people in the community.

Registered nurse Elma Requenez drives 25 to 40 miles to the colonias at 7:15 a.m. daily, providing free patient services and health education.

“Elma educates them and persuades them to take care of their bodies. They appreciate Elma and the entire staff so much that sometimes they will bring them lunch,” Becan-McBride says.

Becan-McBride says her clinic staff sees three to eight new potential cases of diabetes a month, which often leads to patient referrals.

“We see glucose levels that are off the charts and we get them into a clinic for treatment,” she says.

Requenez has also helped women living in the colonias appreciate the value of Pap smear screenings. In one month alone, three out of 63 women who underwent a Pap smear tested positive, and were referred to local women’s clinics.

Becan-McBride says the project serves a dual purpose, offering quality health care and education to residents while training future health professionals to work in the community.

One of Becan-McBride’s main goals for the project is to provide clinical rotations for medical students. Fourth-year medical students from UT-Houston undergo one-month clinical rotations on the medical mobile clinic, along with medical students from The University of Texas Health Science Center at San Antonio and nursing students from The University of Texas-Pan American in Edinburg.

“We also train students from other schools who want to enhance their multicultural and communication skills,” Becan-McBride says.

An employee of UT-Houston for 25 years, Becan-McBride hopes to continue helping her fellow Texans with UT-Houston’s telemedicine unit and medical mobile clinic.

“It goes beyond employment,” Becan-McBride says. “I feel like I’m coming to their rescue.

Medicine on the Move

When people mention the University of Texas and Texas A&M University in the same breath, the conversation usually drifts to their historic football rivalry. The universities can cooperate when necessary, however, as they do along the Texas-Mexico border, where both operate mobile medical clinics.

The clinics serve colonias--substandard housing developments along the border that are some of the most medically underserved communities in the nation, according to Dr. Kathleen Becan-McBride, director of Community and Education Outreach at the University of Texas Health Science Center at Houston (UTHSC-H).

"In Hidalgo County, deaths from diabetes are 55 percent more frequent than in the U.S. interior," said Becan-McBride.

She also said childhood disorders, including depression, attention deficit-hyperactivity disorder and obesity, often go undiagnosed or untreated in the area.

Medical mission
A mobile medical clinic is a van equipped with medical equipment and staff. The clinic operated by UTHSC-H for the last 15 years focuses on Hidalgo County and provides health education, diagnosis, treatment and disease prevention for a population that is isolated from services, has a lack of health care professionals, limited finances and a lack of transportation, said Becan-McBride.

She estimated there are from 850 to 1,000 colonias in Hidalgo County, and the mobile clinic can only visit about seven each year. When UTHSC-H chooses which colonias to visit, the staff tries to select ones that are near other colonias to increase the availability of health care to more residents.

The clinic has three employees: a registered nurse who is in charge of the clinic, a licensed vocational nurse and a medical clerk. The clinic sees patients four days a week, with the fifth day reserved for paper work.

"Flyers are distributed to colonias door to door, to tell residents that the clinic is coming, and patients show up," Becan-McBride said.

The mobile clinic staff sees the same patients repeatedly, and for some, the clinic is the only medical care they receive, said Becan-McBride.

"We try to visit a colonia for one month or two months because we want to follow up with patients who need additional care or who can take advantage of our telemedicine consultations with physicians at the UT Medical School," she said.

No bed meds
In 1998, with the help of state and federal grants, UTHSC-H equipped its mobile clinic with a video monitor and a link to UT Medical School physicians who can consult with clinic staff and speak with patients while they're being treated.

Telemedicine is the use of electronic audio, visual and data communications to help with health care diagnosis, consultation and treatment. It also can be used to educate patients and to transfer medical data.

In addition, the clinic is linked electronically to four colonia elementary schools in Hidalgo County, which allows the professionals from UTHSC-H's Department of Family Practice to provide health education programs for the schools' students on topics such as skin cancer, fire safety and dental care. Parents are welcome to attend the presentations.

Becan-McBride said that with a federal grant, UTHSC-H soon will allow nurses in the area to come to a colonia school to get free continuing education so they can maintain their licenses.

The UTHSC-H clinic also has telemedicine diagnostic tools that enable off-site doctors to get the information they need electronically. For example, the mobile clinic nurse can place a tele-otoscope to a patient's ear canal, and the inner ear is shown on a screen 385 miles away. Or the nurse can use an electronic stethoscope to listen to a patient's heart, and a physician at the UT Medical School can hear the sound.

In fiscal 2003, the clinic served more than 3,000 patients and immunized nearly 2,300 children. The clinic also provided clinical rotations for 32 senior nursing students and 32 physician assistant students from UT-Pan American. Becan-McBride said the clinic has a plan to rotate medical students from the UT Health Science Center in San Antonio in 2004.

Becan-McBride said it's difficult to estimate the funding necessary to operate the clinic because the clinic receives in-kind donations. For example, the Rio Valley Food Bank gives over-the-counter medications to the clinic. The clinic also gets help from its joint partner, the Hidalgo County Health Department, which offers garage space for the van as well as office space and supplies.

One-on-one
The Texas A&M University System Health Science Center's School of Rural Public Health (SRPH) launched a mobile clinic for colonia residents in 1998.

The SRPH's mobile clinic does not have medical personnel on board. Instead, it has Linda Michels, a clinic coordinator, who is a health educator and lab technician. Instead of treating patients directly, she coordinates their care with local health care providers and community groups who either operate out of the clinic or in their own offices on referral from the clinic.

"We work one on one and with community organizations and partners, such as Head Start and Planned Parenthood," said Michels.

Doctors and nurses from the area use the clinic to give physicals, routine exams, immunizations and dental checkups to children participating in Head Start, and their mothers can get physicals from Holy Family Services, another local group, Michels said.

The clinic operates primarily in Hidalgo County, but also goes to nearby counties. The clinic also participates in Project Lone Star, which the U.S. armed forces and the Texas Department of Health use to bring reserve military medical staff to the area for two weeks of training at three locations. The mobile clinic provides dental care to area residents during the training.

The clinic, which served 1,646 patients in 2002, is sometimes known as the HERO Van, which stands for Health Education Research and Outreach. Mary Wolf, the HERO director, said the van always go to Progreso, Texas, on Wednesdays. The other four days a week, the van travels to different communities. Wolf said that SRPH's clinic doesn't compete with area doctors, but works with them to provide health care to those who cannot afford it.

While the van is equipped for telemedicine, it is used primarily to store patient histories, not for diagnosis.

"We thought telemedicine would be needed, but our patients didn't need direct consultations with specialists," Wolf said. "However, we can take a picture of a pap smear and help them to overcome modesty and to deal with privacy issues."

Wolf also said Michels coordinates colonia visits with the UTHSC-H mobile clinic so each can provide backup for one another in case scheduling problems arise.

"We are not competitive, and we keep in touch with one another to avoid overlap," Wolf said.

Local help
To personalize its services to the community, Michels works with promotoras, who are informal local leaders and peer educators who understand the needs of the colonia residents and how the health care system works.

Promotoras not only make thousands of home visits each year, but also hold community meetings and host local community events, said Kermit Black, associate director of Texas A&M University's Center for Housing and Urban Development's colonias program.

Black said promotoras help colonia residents overcome poor transportation, a limited understanding of the health care system, illiteracy and embarrassment.

The local help is critical, Wolf said.

"You can't just walk in with a business suit and say 'here we are' and expect to understand the patients' needs," Wolf said. "By working with someone in the community, we can build bridges," she said.

Michels said working with promotoras helps reassure patients.

"Word gets around, so people see the clinic approaching, and they automatically know free medical services are available, and they knock on the door inquiring about what services we provide," she said.

Dual doctors
"These two programs [run by Texas A&M University and the University of Texas] are augmenting the medical care given to colonias residents who lack basic transportations services," said Pedro "Pete" Lara Sr., assistant regional director for Texas A&M University's Center for Housing and Urban Development Office in Laredo.

"We partner with these programs and bring colonia residents to them in our vans when they visit the community resource centers we have set up in conjunction with the counties," Lara said. "This is a good example of partnerships, and we are trying to develop new partnerships to increase medical care for colonias."

"Health outreach programs are extremely important to the border," said State Sen. Juan Hinojosa. "Promotoras and the mobile health units are valuable tools in reaching communities that normally don't receive much needed health care services."

Doctors , Doctor MD and Health Dept. finder and how to for Clinics in and near the RGV, McAllen , Edinburg, Cameron county, co, Harlingen, Weslaco, Brownsville, Mission, Pharr, Edinburg, Mercedes, Donna, Texas, TX.