By Laurie Davis
A medical exam is provided for a young child traveling with migrant family members who work on area farms. The program serving the migrant farm workers, is another extension of Dr. Richard Paat’s global medical missions.
University of Toledo medical students can get clinical training throughout their degree program as part of the Students for Medical Missions program led by Dr. Richard Paat (Med ’86). Students working toward degrees in all areas of the College of Medicine and Life Sciences, as well as the colleges of Nursing and Pharmacy, can travel to remote villages in such countries as Puerto Rico, Haiti, Guatemala, Honduras and the Philippines. There, they assess patients as a team and devise a care plan for them with the advice of an attending physician.
Paat, who started the program at UT, knows that poverty and homelessness are not exclusive to developing countries, but exist in the United States and right here in Toledo. “After the Haiti earthquake, we decided to start a medical mission here in our own backyard,” says Paat. “So, I started up a free clinic in Perrysburg, in a Latino area with 80 percent poverty.”
After the clinical program, called the CommunityCare Free Medical Clinic, was established, Paat moved the location to Cedar Creek Church on South Byrne Rd. “Every Thursday night, we see about 50 to 60 patients. It’s one of the largest free clinics in Ohio. We take care of 4,000 patients now,” says Paat.
A physician and students gather around a patient to hear what is ailing her and to determine how they can help to alleviate her pain. The team approach is used for all of the medical care programs that Dr. Richard Paat has helped to establish, allowing for interdisciplinary solutions.
Students volunteer their time to assist in the clinic even when they might have exams the next day, and they help fundraise, says Paat. A call goes out to all of the different programs in the College, asking if anyone wants to volunteer. Those who do, attend a meeting at which Paat and other physicians and nurses help train student volunteers about basic skills. They learn how to check blood pressure, take temperatures and about the clinic’s processes for seeing patients. “Almost the entire medical school shows up,” says Paat.
Paat says the CommunityCare Free Clinic uses the same interdisciplinary team approach to care as the global medical missions do. The free clinic offers patients social services, nutrition education, phlebotomy draws, and HIV and women’s health clinics. Medical and nursing students, and students from respiratory therapy, physical therapy, occupational therapy, social work and pharmacy are all part of the local team. “And, not just students,” says Paat, “but also practicing physicians.”
The church set up a hot meal service and as many as 60 people show up for the food and health exams. “This thing’s just morphed. It was never planned; it just kind of happened,” says Paat.
Dr. Richard Paat and his team of volunteer medical staff set up tables and chairs on the street in Toledo to reach out to the homeless and others living in poverty.
And at the end of an evening, which can go until midnight or later, students can talk about their interactions with the patients. “We sit down with the students each night and discuss cases and experiences. For a lot of the first and second years, it’s the first time they’ve interacted with a patient, so we teach them how to talk to them properly,” says Paat. “We want to provide healthcare with dignity. Nobody wants to come to a free clinic.”
Some social services are available and some medical tests can be free of charge through different hospitals that have charity programs. For surgeries, Paat might contact the CEO of a hospital to coordinate an operation for a patient, or he will call on a friend and physician who will offer to do the surgery for free.
For Paat, who likes to expand health care for the needy as well as student opportunities for service learning, the global missions and the community clinic are but two of the programs he’s helped to launch. Once these two programs were established and operating regularly, he helped start a street mission for homeless people in Toledo through St. John’s Jesuit High School and St. Ursula’s Academy. “It’s called the Labre Program,” says Paat. “I’m a graduate of the high school, and I said ‘well, I’ve got nothing else to do on Monday nights.’ So, we set up tables and chairs that we pop into a van and a minivan. We intermingle with the poor, find out stories about them, walk with them through their journeys.”
At the CommunityCare Free Clinic, additional services are listed for patients who need these resources.
The volunteers treat diabetes, hypertension, infections and provide food for the homeless patients who come by. “They’re there for the food,” initially, says Paat. “And they know we’re out there every Monday, whether it’s rain or shine, or holidays or winter time. One of the churches donated a big tent to us,” he adds. They take the medical care to the streets because these individuals have no transportation to go to a facility. “You can’t sit in your office and think, ‘come to me.’ This has been a real eye opener for the students and for me,” says Paat. “I’ve been living in Toledo since I was in first grade, and you go into some of these communities and say, ‘my gosh, they have nothing.’”
In the winter time, they pass out hats and coats, and the high school student volunteers from St. John’s and St. Ursula’s pass out food and hot chocolate. “We have lights and we do procedures, we have a pharmacy, and we have a social worker there and respiratory therapy. A social worker can do some things for people to help get them out of their homeless situation, but, we also know this is reality,” says Paat. Sometimes that reality can mean offering a tent to sleep in for protection from the weather.
At the CommunityCare Free Clinic, patients can pick up medications at a temporary pharmacy.
In some instances, the team of medical volunteers are able to intervene and do more, like they currently are for a four-generation family of 11 who is living in a condemnable house with a hole in its roof and no running water. “The youngest child is 3 years old, and the matriarch is 78. One of the great-grandchildren is pregnant,” says Paat. “Last year, we were treating them and we found out they hadn’t had a working furnace in two weeks in the winter time. We fundraised to get them help with a furnace and a hot water tank. Now, we’re trying to get them moved to a different house.”
Paat and his team are working with an organization called Historic South to fundraise and then acquire matching grants. They also have acquired a house on the City of Toledo’s destroy list that will be donated and renovated for this family.
Nutrition education is another part of the CommunityCare Free Clinic.
Because of the condition of the home the family is now living in, Paat and his care team members reached out to the Lucas County Metropolitan Housing Authority to find a temporary house they can stay in through the winter months, until the house being renovated will be ready in the spring.
“We can’t do that for everybody, but we can do it for a family that really needs it, and has been stuck in poverty for four generations.”
Doing this work has helped first-year students understand the kind of immediate impact they can have in the community. “You don’t have to be a full-fledged MD now, you just have to care,” says Paat. “This is our back yard. I’m going to a place in Puerto Rico where they haven’t had running water in seven weeks, but every single Monday, I’m at a house that hasn’t had running water in seven weeks.”
