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Taking the Initiative 

Tucked inside Chatham Hospital in Siler City is one of the most innovative health-care services for immigrants in North Carolina. The Immigrant Health Initiative was designed to reduce the barriers faced by many Latinos in finding access to decent, affordable health care.

"We're here to help provide health education to the community and also help make appointments for immigrants and take them to appointments," says Sergio Melendez, the initiative's director.

The initiative uses three lay health advisors from the community affiliated with the three largest Hispanic churches in Siler City--Hispanic United Methodist Church, Love's Creek Hispanic Baptist Church and St. Julia Catholic Church. The health advisors work directly with people in the community to educate them about the health-care system and help them find the care they need. Advisors explain employer insurance plans, public health concerns, and provide transportation and translation services for medical appointments.

The Duke Endowment funded the initiative in 1999 to extend existing cooperative efforts between the hospital, UNC Family Medicine, the Chatham County Health Department, the Hispanic Liaison, Hispanic churches and local industries.

But what really sets the initiative apart is the partnership it has developed with the poultry industry in Siler City. Each month, the initiative holds mesitas, or roundtables, during first and second shifts at the Townsends poultry plants where lay advisors educate poultry workers on a specific health care topic. Melendez says the mesitas draw anywhere from 100 to 500 workers. In the past year, the roundtables have covered a range of topics including rubella, dental health, prenatal care, first aid, back pain, fitness and weight control, and cancer prevention. Last month, the mesita focused on diabetes.

"We explained what diabetes was, what they should check for, resources on where to go and what to do," Melendez says. He adds that Townsends has allowed health advisors to set up information tables in the plant. Two management employees from Townsends also serve on the initiative's board. "Their goal is employee satisfaction," Melendez says. "They're trying to meet some of the needs of their employees and keep them healthy."

Keeping its work force healthy is clearly in the best interest of the poultry industry. In 1996, an outbreak of rubella at one of the poultry plants in Siler City touched off a massive public health outreach by the Chatham County Health Department to crack down on the disease. Rubella, otherwise known as German measles, can be dangerous to the fetuses of pregnant women. Rubella cases were soon found at both poultry plants in Siler City and vaccines were administered there and at a plant in Pittsboro. The county also conducted outreach and vaccinations at churches, dance halls and shopping centers. In all, the county administered between 5,000 and 6,000 vaccines for measles, mumps and rubella.

Industries like the poultry industry that employ large numbers of Latinos, have good reason to want to educate their work force about health issues and cut down on sick time. Last year, of the 95 cases of rubella confirmed by state health officials, 92 percent involved Latinos.

Townsends also hosts a yearly health fair that the new health initiative participates in to provide more health education to workers and their families. Melendez says the company has even provided free mammograms to employees.

The initiative is also working with Chatham Hospital to create a computer system aimed at eliminating the confusion around multiple names and aliases that vexes so many health providers when serving the Latino community.

Despite all this, there is more to be done to provide health care to Latinos. Melendez notes that even after all the education efforts launched by the new initiative, some topics are still confusing to local workers. "Even with the education we've done in Townsends they still don't know how to use their insurance," he says.

What may be most telling in how far Siler City needs to go in addressing access to care for Latinos is the fact that the hospital is still waiting for its first bilingual, bicultural doctor--a doctor who can transcend both the Latino and Anglo communities and provide care for everyone.

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