BY: GEORGE B. AVILA, MURP, MAHCM
Writing on the topics of health disparities and racism is not an easy task, as I feel no amount of words can really speak to the depth of these issues in our society, especially at this moment. Over the past few months our nation has been confronted with two pandemics that have shaken us to our core. COVID-19 infections have significantly impacted communities of color throughout our country, highlighting the fact that the most vulnerable among us are the "essential" backbone that hold together our economy and have the least access to care. The cries of racial injustice from our African American brothers and sisters have made it clear that we can no longer be silent or complacent. Our world is yearning for justice, and we are each called to examine our own conscience, stand in solidarity and, most importantly, act.
I, like many of you, have felt helpless at times and unsure of what I can do to address these critical issues. Although I don't have a solution, as a servant leader in Catholic health care I can share my own experiences, which have helped shape me as a person and the ministry I share in today at CHRISTUS Health.
Catholic health has a long tradition of responding to the most pressing needs of the community. This spirit existed since the beginnings of many congregations of women and men religious who acted and responded to the signs of the times. Whether it was a mass epidemic or a program to help vulnerable people reach their fullest potential, Catholic health care was there. While the model has transitioned from religious congregations to lay women and men, the same spark that moved them into action permeates our ministries today. In the midst of divisive headlines and movements that aim to have us regard people as different and reduce access to care, we must stand firm in our commitment to honor the dignity of each person. Recognizing the sacredness within each human being, we respond with open hearts and minds to serve our brothers and sisters in need.
CHRISTUS Health's formation program prepares leaders to use the power of story to share important information and help transform perspectives. In this spirit, I would like to share two stories that are examples of how Catholic health care ministries continue to be advocates for social justice and serve as a bright light in the communities we serve. I invite you to pause and take time to reflect on your own stories of grace that have helped transform you and the communities you serve — stories that are examples of our mission in action addressing health disparities and structures of racism.
In the words of Sophia Petrillo (the best Golden Girl ever): "Picture it!" Orange County, California, around 2007. Early in my career, I was asked to serve as the community benefit lead at Mission Hospital, now a member of the Providence family. I was so excited about this opportunity and even more excited to lead the community health needs assessment (CHNA) process. I had so many plans and ideas for what the process could be, and I could hardly wait for our first community meeting where we would gather resident feedback. The excitement quickly turned to anguish as a local anti-immigrant group decided that the destruction of the community health needs assessment was their top initiative. They began to intimidate local residents. To our surprise, they picketed the elementary school where our focus groups were going to be held. We had to cancel the focus group meetings and find creative avenues to gather community feedback in ways that our community was not put at risk. Although they were a vulnerable group of people, they wanted to make sure their voices were heard and proceeded to engage their neighbors about health disparities in the neighborhood.
Unfortunately, this was just the beginning of our interactions with the anti-immigrant group. After the CHNA process concluded, the group decided that their next priority was to close our family resource center. Centrally located within the community, the resource center provided parenting classes, resource referral and health insurance enrollment, among other services. Members of the disrupter group began to visit the center unannounced and follow people leaving the center to prove that not all of them were part of the defined community. They demanded that we ask everyone for proof of legal status before we served them.
As was our tradition, we sought to live out our charism of unity and reconciliation, so we organized a meeting with the group and some key partner stakeholders. Not knowing what to expect, I felt this was an opportunity to share with them who we were as a ministry. How it was important that we serve everyone and that hopefully in some way we could serve them too. I had picked the perfect reflection to start the meeting, but there was no time for reflection. The complaints about the "others" in the community we were serving began immediately.
"These moms with strollers keep walking down our street."
"Why are their kids so loud? The children in our neighborhood never make so much noise."
"Why are your materials in Spanish? They should speak English!"
"These people are lowering our housing values."
"Can't they go somewhere else?"
Comments like these continued for what seemed like an eternity. At some point one of the members of the group brought out a picture of a young mom holding her baby in the shade of a tree, obviously needing a rest after the walk from the bus stop to the center. The group got all worked up into a frenzy spelling out every possible stereotype they could apply to the young mother – a woman they didn't know – except the most logical conclusion that she was just trying to get the best possible care for her baby.
I was in a state of shock. Although I was at the table representing our ministry, I too was from a family of immigrants. My parents worked hard to ensure we could thrive and that we would contribute to our community, just like these parents were trying to do. I had never to my knowledge experienced racism until that point. A huge knot began to form in my stomach and my ears were ringing. No matter what I said about our service to the community, they came back with more negative things about who we were serving. The relentless chatter finally ended, but the hurt inside me remained, and it was difficult to process what had occurred. I was so upset with them, and all I wanted to do was indulge my righteous anger. Although they had violated every aspect of the dignity of the community we were serving, I had to pause and remember that each of them also was created in the image and likeness of God. They also were vulnerable in some way and in need of healing. I have to admit that this realization did not come to me immediately, but God's grace comes at the moment you need it.
As I shared this experience with my boss the next day, I could not contain my emotions. I felt hurt to the core of my being. My eyes had been opened to something that changed my entire perspective. However, I soon realized that I was not alone. God's love is abundant! Our executive team quickly jumped into action and took all this hurt and hate and transformed it into love for our community. Our ministry proclaimed publicly that we serve everyone and would always be here for our community no matter who they were or where they came from. The words of our congregational founder were repeated over and over again, "We serve the dear neighbor without distinction." Everyone has dignity, every person deserves the opportunity to reach their fullest potential, and everyone deserves the right to experience God's healing through our care.
The situation with the anti-immigrant group continued for several years. Our chief executive officer and vice president of mission integration were attacked in the media on a regular basis. The question of whether to continue to have the resource center in the community came before the city council multiple times, and public testimonies were shared for both perspectives. The donors to our foundation were approached and urged to suspend their contributions to our ministry. We remained firm, however, and our community rallied over and over to ensure that families would continue to receive care. We eventually had to change the location of our resource center. We had to get creative with the way we provided services. This was nothing new as the Sisters of St. Joseph of Orange before us had done the same for over a hundred years, and we were fortunate to carry on their rich legacy, which time and again brought light to the dark corners of society and ensured all were loved and cared for.
Fast forward to my current ministry at CHRISTUS Health. We are a unique ministry in that we serve communities throughout the United States, Mexico, Chile and Colombia. Of our 46,000 associates, 15,000 of us reside in Latin America. The reality of our ministry has made creating a culture of health equity, diversity and inclusion a key strategic priority throughout our organization.
The sponsoring congregations of our ministry — the Sisters of Charity of the Incarnate Word of Houston and of San Antonio, and the Sisters of the Holy Family of Nazareth — were very clear that we would always serve everyone who needed care. All physicians and caregivers would be welcome to practice and all patients would be welcome to our hospitals. What applied in the Texas frontier of the 19th century still rings true today throughout CHRISTUS Health.
A wonderful example of this spirit occurred within our health system at Red de Salud UC CHRISTUS (Red de Salud) in Santiago, Chile. Around 2016, groups of Haitian immigrants began to arrive in Santiago, Chile, due to the level of poverty and natural disasters they had experienced in Haiti. Many who took the long journey were promised great things by traffickers only to be abandoned when they arrived, left with nothing in a strange land. The arrival of the new Haitian community was surprising. Chile had remained largely isolated due to its geographical location and its people were made up of a relatively homogeneous society. These new "neighbors" entering their community were very different. They looked different; they spoke a different language; they came from a different culture and suffered from different health problems.
The team at Red de Salud knew they could not just offer the new and vulnerable people the services they usually provide. They had to honor the newcomers' dignity, understand where they were coming from and what they saw as their health care needs. A group of physicians and nurses quickly mobilized to set up a pop-up clinic to learn about their needs and provide care. They identified the community leaders among the Haitian group to help relay information back and forth, and then they jumped into action. The team worked to enroll them in the national health care system so they could access care at our ministry and at other health care agencies. They were also able to develop unique interventions to meet their specific health needs, rather than implementing a one-size-fits-all approach. Instead of running from this new reality in their community, the ministry responded with open arms, welcoming the strangers and transforming them into neighbors, ensuring all could experience God's healing presence and love through appropriate care. Several of those who received care initially are now working alongside us in different capacities throughout our ministry in Chile. They are slowly integrating into this new community, and we are a better organization because of this. As we learned from the story of Abraham in the scriptures, you have to welcome the stranger for God often comes to us in the person in need.
When I began this reflection, I invited you to reflect on your own experiences of health disparities and racism in your community. I hope you have been able to reconnect with an aspect of yourself and feel empowered to continue to bring light to wherever it is needed. It is good for us to share these stories and learn from what others have to share. In the midst of division and misinformation, let us recommit ourselves to educate and act, to bring a message of hope and invite others to join us in our mission of healing. In the words of the prophet Amos, "let justice surge like waters, and righteousness like an unfailing stream."
GEORGE B. AVILA is system vice president, mission integration, CHRISTUS Health, Irving, Texas.