Dissolving Barriers: New Orleans Latino Health Outreach Project

The sun is still below the horizon when we arrive: three cars, many boxes of supplies, and five to ten people wearing scrubs, most of us women. Hazily, as the coffee is still kicking in, we begin to set up treatment stations on the hoods of cars and the beds of pickups. The parking lot we’re in and the one across the street are sparking with activity as about one hundred people, mostly male Latino day laborers, look for work in the still-devastated city of New Orleans.

The men gather, ask each other what vaccines they should get, share information about employers who don’t pay, and tell us about their families back in Texas, Veracruz, or Bahia. The wind picks up, sending gravel dust swirling around us, and people chase after Band-Aids and alcohol swabs that took flight in the gust. A regular comes by to show us how much better his leg is doing and to ask for some more vitamins. Someone else drops by to invite us to his daughter’s quinceañera, her fifteenth birthday party. Several people come for their final dose of hepatitis B vaccine; we’ve seen them off and on for six months.

These Latino Health Outreach Project (LHOP) clinics are always busy, as is every functional health care provider in this city, from the first aid stations to the ERs. The terrifying reality in New Orleans these days is that there is virtually no public health infrastructure, and so our scrappy little clinic in the parking lot is, for some of our patients, the option they feel is safest. Never mind the fact that we can’t dispense medication, rarely have a doctor on-site, and can’t do lab work or even full physical exams. We’re here every Wednesday, we speak our patients’ languages, we don’t ask about immigration status (or even last names), and we do our best to respect the dignity of each of them.

Healthcare needs

In the second week after Katrina hit, the Common Ground Free Clinic opened in Algiers, an unflooded neighborhood on the west bank of the Mississippi River. At the time, it was one of only two places offering healthcare in the region. A few weeks later, some of us began assessing health care needs in the flood zones. We quickly realized that among the many gaps in the city’s public healthcare infrastructure there was a source of culturally competent, bilingual healthcare for pre-Katrina Latino residents as well as the vast numbers of recently arrived workers.

We began setting up clinics on sidewalks and parking lots in areas where Latino workers were staying. Initially, the clinics consisted of two people giving tetanus shots and over-the-counter medications. Within a few weeks, more providers were added, including MDs, nurse practitioners, acupuncturists, and herbalists. We now do one clinic a week in the early morning at a day labor pick-up site in downtown New Orleans, one in a church out in suburban Kenner where we do limited primary care and family medicine, and we occasionally hold clinics at other sites.

In addition to providing healthcare, we are committed to improving our patients’ access to healthcare across the city, supporting struggles for justice for immigrants and working people, and building relationships with organizations who have a history of working in New Orleans’ Latino community as well as with post-storm initiatives dedicated to supporting residents’ right of return. At every step we charge ourselves to remain accountable to and take leadership from local people and organizations of color.

Before the storm, there were few Latinos in the city. As one national day laborer organizer points out, “New Orleans and Pittsburgh were the only two cities of their size in the country where race was almost entirely a Black and white issue. Both had remarkably small Latino populations.” New Orleans and its outlying areas were seven percent Latino, but the city proper had only three percent prior to the storm.

New context

Meanwhile, nine months after Hurricane Katrina, almost sixty percent of New Orleans’ original residents have yet to return, as much of the city still lacks basic services. The planning and reconstruction continue to move forward without their input. This diaspora of New Orleanians still scattered across the US tends to be overwhelmingly African-American and lower income than those who have made it back. They have no assurance there will be housing, schools, hospitals, or utilities—not to mention childcare, employment, and protection from future flooding—if they are to be able to return.

With such a large sector of the local labor force unable to contribute to (and benefit from) the reconstruction of the city, it is no surprise that workers are arriving in droves from other states and countries to seek employment. They are Black, Asian, white, and Latino; they come from places as diverse as California, Texas, Colorado, Georgia, Guatemala, Honduras, Peru, Brazil, and Mexico. These new workers have arrived in a city with few Spanish speakers, little awareness of immigrants’ needs and issues, and with five times as many agents from Immigration and Customs Enforcement (ICE—formerly the INS) as agents from the Department of Labor who, in theory, enforce labor laws.

In this new context, organizers see this situation as a historic opportunity to build a multiracial workers’ justice movement uniting (mostly local) African-Americans and (mostly newly arrived) Latinos. Soon after the storm, the New Orleans Worker Justice Coalition, a diverse group of organizers, advocates, residents, and service providers based in New Orleans’ Latino and African-American communities, started planning a multiracial workers’ center to use organizing as a way to build bridges across racial lines in a city where people of color are beginning to be pitted against one another.

We are excited to be a part of this coalition because it allows our work to concretely support organizing for workers’ and immigrants’ rights in New Orleans, even as we maintain our role as healthcare providers, not organizers.

In a way, we envision our clinics as a tool to help dissolve the barrier between service provision and organizing that commonly exists. In the absence of a functioning workers’ center where service provision, advocacy, and organizing would take place, our clinics are a potential focal point for just such a hybrid of activity, support, and leadership development. For now, the day laborer clinics serve as an excellent connection point between our patients and the organizers from the Worker Justice Coalition. At times, organizers have come to our clinics to hand out know-your-rights materials or talk with workers about upcoming events. We’d love to see our clinics serve as a steady point of contact between workers and organizers as the work of the Coalition grows.

Significant questions

Like most organizations that began in New Orleans after Katrina, we are struggling with our own transition from a stopgap emergency response crew to a rooted, long-term community organization. We are facing significant questions as we try to determine the future of our work and how it fits into the service-versus-organizing paradigm. Do we see our clinics ultimately as an organizing tool or as a valid source of primary healthcare? Can we legitimately be both? How does our vision for our clinics coincide with our patients’ needs and their understanding of our work? How does our limited capacity affect what we can provide?

We also find ourselves challenged by our relationship to the Common Ground Clinic, the free clinic out of which LHOP began, which is now one part of a much larger organization of primarily white volunteers, mostly from outside New Orleans. In the months after the hurricane, Common Ground has received significant feedback from local, people of color-led organizations concerning accountability to the larger struggle in New Orleans, as well as a need to examine racism within the organization.

In recent months some Common Ground volunteers, with enormous support from local African-American organizers from the People’s Institute for Survival and Beyond and white allies from San Francisco’s Catalyst Project, formed an anti-racist working group, which has begun to do an incredible amount of work shifting the organization to a more accountable focus. LHOP coordinators work closely with the anti-racist working group, and although the Common Ground Clinic and others hold us up as a model within the organization of accountability and local leadership, we recognize how far we still have to grow.

In addition to these challenges, over the last few months workers near our day laborer clinic have been targeted by increasing police and ICE harassment and arrest. Partially because of this, workers are fanning out to other neighborhoods. This dispersal means that a single mobile clinic can’t serve the majority of day laborers in New Orleans, and that day laborer organizing itself will become more challenging.
Organizing tool

Meanwhile, we continue to face challenges finding reliable healthcare providers for our primary care clinic in the church, which still lacks lab services and other elements that could greatly increase continuity of care for our patients. Finally, neither of these clinics are ultimately the best options for patients who need more in-depth services, such as acute care, women’s gynecological and prenatal care, specialty care, or long-term monitoring.

We’re realizing that these realities are forcing us to make decisions about where to direct our limited resources. At first, we thought we’d have to do one of two things: invest more time and resources into our church clinic, making it a viable source of bilingual healthcare for Latinos in the Greater New Orleans area; or shore up the mobile clinics and focus on using them as support for worker-led organizing. Now we’re realizing that our ultimate path probably won’t fit firmly into either category.

It’s been important for us to make these decisions in light of our strengths and limitations, the relationships we have with patients and other providers, and an awareness of the larger picture of healthcare and community organizing, especially among Latinos and low-income working people in New Orleans. Right now a feasible option for us is to continue to build up our mobile clinics while maintaining a presence in Kenner. In addition, since we know that many of our patients have medical needs that stretch beyond the capacity of primary care, we are beginning to build up a base of translators and patient advocates who can accompany our patients to emergency rooms, prenatal care appointments, and specialists.

Focusing more on the mobile outreach clinics also means that we can begin to more concretely use these clinics as an organizing tool. Most likely, this will begin happening in our health and safety trainings. We have seen the interest among our patients when we have done safety and environmental health trainings while we distribute protective gear for workers involved in mold remediation, demolition, and house gutting. We see this as a concrete capacity-building tool, a necessary service, and a bridge to connect health issues with labor organizing. We’re excited to expand that to include consistent legal trainings, wage-claim support, and more.

Ultimately, we see our work as one component of a large, vibrant, multifaceted movement for racial and economic justice in the Gulf Coast and beyond.

ABOUT THE AUTHORS

Catherine Jones and Jennifer Whitney are Louisianans who coordinate the Latino Health Outreach Project. Catherine is a third-year medical student, and Jennifer is a Wilderness EMT and a massage therapist. We would like to thank our volunteers, advisors, and mentors, and everyone who has given us their time, money, resources, support, or advice. Most of all we thank our patients, whose dedication and generosity continue to humble and inspire us.

To volunteer, donate, or get more information, please go to http://www.cghc.org/lhop.html or write us at lhopla [at] lycos [dot] com