April 9 - Visit to Berea

Above: The team paused to enjoy the sunshine outside St. Joseph Hospital - Berea. L-r: Fr. Gerry, Flora, Mark and Cordell.

The team was looking at a shorter jaunt - only about 40 miles - for the last day of fact-finding, so we took a little time in the morning to spread out the map once again, recap some of the information we’d collected, and assign some action items for the next steps, including:

*Compile a list of attendees from the kick off meeting and also a list of people we met at health care locations while we were on the road.

*Prepare an information sheet for the MMDM’s to use to generate interest and enthusiasm for a medical mission in the Diocese of Lexington.

*Continue to contact potential collaborators

*Check out possible funding strategies, including grants and sponsorships

*Set mid-November as the date for the MMDM's next visit to Lexington, with an eye for setting a date for the medical mission!

Clearly, there is a LOT of work to do. But the immediate task at hand was to head south to visit St. Joseph -Berea.

Flora Washburn, Mission Leader and Chaplain for St. Joseph Hospital in Berea (as well as Mt. Sterling), met us at the door. On the way to the conference room, she pointed out the local artwork throughout the building, part of St. Joseph's initiative to spotlight the unique heritage and culture of the Berea community. In fact, the hospital was holding a dedication ceremony that evening, with Fr. Frank Brawner of St. Clare Parish in Berea coming to bless the new art installations. Sitting down for our meeting, Flora introduced us to Gerg Gerard, President-CEO along with Elena Baker, Education Coordinator, and Katie Heckman, Community Relations.

St. Joseph Berea serves roughly a six-county area, with much of their service area in the beautiful but rugged Daniel Boone National Forest. Again, chronic illnesses, such as diabetes, hyerptenson, COPD, etc. are very prominent througout the service area. Like the other hospitals we had visited, St. Joseph Berea carries a high percentage of charity cases. Berea Health Ministries now operates on the hospital campus and offers access to primary health care services on a sliding scale. Unfortunately, there is a long, long waiting list for an appointment, and many people essentially use the emergency room as their basic health care service.

The MMDM's reviewed prior medical mission experience and discussed what kind of sites might be set up in this area. The hospital team felt the model could work in the area, and offered some ideas for working with community health centers in the area.

Flora took us to lunch, and we talked some more about some of the special challenges of providing a spectrum of health care, including wellness care. Flora also noted the significance of having a strong Catholic identity melded into the medical mission's activities. St. Joseph Hospital is a fairly new entity in Berea (previously, the building had housed Berea Community Hospital), and this medical mission offers another opportunity to demonstrate the Catholic model of care for not just the body, but the spirit and mind as well.

After lunch, we had time for a quick stroll around Berea College, which was founded in 1855 on the principle of equal opportunity for all. Berea College admitted students of all races as well as both male and female students - very radical at the time! Today, the college offers all students a full tuition scholarship in exchange for their participation in the college's extensive work program. It's a very beautiful place, and we were fortunate to be out and about on such a lovely day, with the redbuds in full bloom all around us.

Then it was time for the fact-finders to head back to the great state of Texas. It was a great visit, and we all learned a lot. Best wishes to the Medical Missionaries of Divine Mercy as they prepare for their return to Laredo in the fall of 2010 for a medical mission. We look forward to seeing the team in mid-November for another round of planning this great effort to serve as Christ would have us serve!

April 8-The MMDM team visits Grayson & Morehead

Above: View of St. Claire Regional Medical Center, Morehead, KY.

On Thursday, April 8, the fact-finding team traveled due east on I-64 for a full day of talking, listening and learning at two health care providing sites.

We stopped first at Bellefonte Primary Care (BPC) in Grayson, KY. Diana Williams, Director of Healthy Communities for Our Lady of Bellefonte Hospital (OLBH) - that's her on the right - served as our liaison with the medical staff there. The clinic in Grayson is one of seven Primary Care Centers operated by Our Lady of Bellefonte, including the Main Hospital in Ashland. See the map above left - Grayson is number 4 on the map and about the southernmost of the locations.

At the clinic, we had the chance to speak with Dr. Kari Shields (seen below left) and Dr. Segun Okudoya about the kinds of medical issues in their area and how our proposed medical mission might fill in some gaps. Dr. Shields also provides geriatric care services at a local nursing home, and talked once again about the challenge of providing dental care - in this case, to many of her elderly patients who cannot get adequate dental care through their Medicare coverage. Another challenging area is providing dermatological care for elderly patients. Dr. Okudoya, who also works out of the South Shore BPC facility, talked a little bit about his work with helping patients manage chronic health problems, including diabetes, COPD, hypertension, etc. Our team also learned that at one time OLBH had operated a mobile unit to provide basic screening procedures for women, including Pap Smears and mammograms. The hospital has not done this for a few years, but our team may want to check on the possibility of utilizing this unit and/or its equipment for a medical mission.

After lunch, we stopped in to visit Sts. John and Elizabeth parish just outside Grayson. Sister Marie Colette Gerry gave us a tour of this beautiful church and pointed out some of the prominent features in the spectacular stained glass windows. Above left are two of the windows in the cupola, representing fall and winter, and at right is the magnificent panel behind the altar, depicting the Baptism of Jesus.

Then it was back west on I 64 to stop in at St. Claire Regional Medical Center in Morehead. Sr. Marge Mouch, Director of Mission Integration, greeted us at the door. She had arranged a meeting with a number of hospital administrators, so we got right to work.

Looking at the map of St. Claire's 11-county service area (see map at left), the fact-finding team got a good feel for St. Claire's extensive network of clinics and programs in the region. St. Claire President Mark Neff pointed out the free clinics in the region and, as we could have guessed, told us that those clinics "are completely overwhelmed" with the need for services. Sr. Marge noted that St. Claire logs in about 500,000 patient encounters a year!

We saw that I 64 marks a dividing line between upper (north of the interstate) and lower tiers (south of the interstate). The St. Claire folks told us there are more gaps in health care in the lower tier. For instance, one of those lower tier counties does not even have a dental practice within the county. Some dental care is offered on a limited basis from mobile units, but otherwise, residents have to travel pretty far to access dental care.

Dr. William Melahn, Vice President of Medical Affairs, seen at right, talked about the most pressing health challenges in the area, and again, the usual suspects were named: dental care, diabetes, hypertension, heart disease and COPD. Dr. Melahn pointed out that controlling the chronic medical conditions in, say, 80% of cases presented, would not be all that difficult or even expensive in these days of the discount department stores' $4 formularies. As examples, Dr. M noted that health care providers can take excellent care of people with diabetes for about $12/month. Likewise, hypertension can be controlled for about $8/month and heart disease for about $20/month. The trick, of course, is to sustain the treatment and make sure people are enrolled in the programs or have the means to obtain the medications. Another big component for meeting these widespread health challneges is to get people to buy in to the wellness components of managing disease, including eating properly, exercising, not smoking, etc. Dr. M also noted that a focus on screening and intervention/wellness might actually be the mission trip activities that yield the greatest benefits. Certainly something to think about!

And there were many other items covered, such as rounding up more statistics for consideration of how to best allocate resources, recruiting volunteers of all kinds, collaborating with educational organizations such as UK and Morehead State, telemed conferencing, etc.

Many thanks to all the physicians and administrators for finding time to meet and talk with us. We look forward to working together to serve the needs of this region!

April 7 - The MMDM Team Visits Hazard

Above: The MMDM's and (mostly) trusty navigator at Mother of Good Counsel, Hazard. L-R: Cordell, Jill, Fr. Gerry, and Mark

After getting some input and information at the previous day's kick off meeting, the Medical Missionaries of Divine Mercy (MMDM) advance team and Diocese of Lexington Grant Developer Jill Heink hit the road on April 7 to visit Hazard, located about 3.5 hours southeast of Lexington. It was a beautiful day for a drive, with lots of redbuds in full bloom (our visitors were not familiar with redbuds, so they already learned something new!).

Our first stop was at Mother of Good Counsel Church, where Pastor Fr. Mike Chowning, OFM, was our gracious host. Fr. Mike gave us a quick tour of the church, which was looking especially beautiful with its Easter flowers and decorations (above, our Lady of the Mines keeps watch). Then Fr. Mike showed us the space in the lower level of the church, just off the parking lot, which used to serve as the Little Flower Clinic (LFC) some years ago. We noted that the former examining rooms are still very functional (they have sinks!), and the doctor's closet would work will as a "dispensary."

The LFC is now part of the KY Mountain Health Alliance, Inc. After lunch, we visited the current home of the LFC, located on Main St. in Hazard (and in the process of renovating a new facility, so they will be moving soon!). We talked with Bev May, a Family Nurse Practitioner who is also Clinical Director. (Bev is in the photo below left, second from the right, in the bright pink top). Bev explained that the clinic sees patients 4 days a week and has evening hours 2 days a week. "We need a fifth day for paperwork!" she told us. The LFC is primarily funded through a federal grant to provide medical care for homeless populations, and Bev estimates that about 80% of their patients are indeed homeless.

What are some of the medical issues seen in the clinic? Pretty much everything, Bev told us. Diabetes and its accompanying problems - poor circulation, eye problems, etc. - is a big one, along with heart problems, hypertension, and chronic obstructive pulmonary disease (COPD). The LFC works with patients to enroll them in free/low-cost drug plans to help control some chronic conditions with medication, and the clinic also participates in SKYCAP ( Southeast Kentucky Community Access Program), whose "navigators" help the unisured and underinsured utilize the resources in the community to help improve access to health care, social services, and housing.

A good number of folks have serious back pain, Bev added, but the LFC doesn't have the resources to diagnose and treat those kind of problems. Dental care is also hard to come by, but the clinic did receive federal stimulus funds this year to send a small number of patients to local dentists for treatment.

Bev also told us about participating in the Remote Area Medical (RAM) Volunteer Corps' June 2009 visit to Hindman, which is about 20 miles northeast of Hazard in Knott County. RAM is a non-profit organization based in TN that organizes a number of one or two-day "medical expeditions" to offer medical care of all kinds to areas where a lot of people have trouble accessing or affording health care [I will be calling RAM soon to find out more about their work and report on their plans to visit KY again]. Bev enjoyed her role as "just a nurse," for a Saturday, taking medical histories and some vital signs as patients arrived. A huge crowd showed up, she said, and it was quite an operation, "Like storming the beach at Normandy!"

After our informative visit at the Little Flower Clinic, Fr. Mike took us up to see the Appalachian Regional Hospital (above) and we also drove by the University of Kentucky's Center for Excellence in Rural Health (below right). The MMDM team duly noted the many resources available in Hazard and got an idea of the kinds of needs out in the wider area - lots to think about!

Back at Mother of Good Counsel, we thanked Fr. Mike for his wonderful hospitality (including lunch!) and headed back to Lexington, where we would rest up and get ready to hit the road the next day.

The Fact Finders Arrive!

Above: The MMDM Fact Finding Team and Fr. Mike Chowning, from our stop at Mother of Good Counsel in Hazard. L-R: Cordell St. Cyr of Sugarland TX, Fr. Mike Chowning, OFM, pastor of MOCG, Fr. Gerry Kelly, MM, of Houtson TX, and Mark Tomasello of Sugarland TX

On Tuesday, April 6, the Diocese of Lexington welcomed three members of the Medical Missionaries of Divine Mercy to the Catholic Center for the first day of their fact-finding visit. Cordell, Fr. Gerry and Mark drove from Houston to Lexington over two days, with an overnight just north of Nashville, and rolled into town in time for our lunch meet-and-greet.

Things got started with introductions - attendees included diocesan staff, health care professionals representing St. Joseph, St. Claire and Our Lady of Bellefonte hospitals, pastoral directors, and parish health ministry participants. We had an impressive group assembled!

Next, Cordell St. Cyr, Director of MMDM, presented a Mission Information Overview, including Power Point slide shows that showed the MMDM's in action in 2006 in the municipality of Tamasopo in the State of San Luis Potosi, Mexico. The MMDM's first visited Tamasopo on 2002 and over the years established a wonderful relationship with the people there, along with local health care providers and civic authorities. Collaborating together, the MMDM's were able to provide a wide range of medical services to over 2,000 people, young and old, during each week long mission visit. The MMDM's also brought thousands of dollars worth of equipment, prescription medicine and vitamins (which, given customs regulations, was quite a trick in itself).

With increased complications in the logistics of traveling to Mexico, the MMDM's decided to organize a stateside mission for 2009 in the Diocese of Laredo. Bishop James Tamayo enthusiasically welcomed the MMDM mission group, and as seen in the Power Point retrospective, pitched in to help unload trucks, stack boxes, move furniture, and then celebrate the opening Mass. The mission set up in an old parish hall and again saw thousands of people over the course of a week or so. Since Texas law had some twists on storing prescription medicine, the mission had runners drive to local Wal-Marts to fill prescription orders! The MMDM's return to Laredo in the fall of 2010 for more medical mission work.
Encouraged by their results in Laredo, the MMDM's are looking to help other stateside dioceses expand their health ministry efforts.

Some of the factors the MMDM's are looking for in conducting a mission:

What are the needs of the area? - the success of the mission hinges on identifying what kind of illnesses and medical conditions need the most attention and securing the best places to deliver this attention. The MMDM's mission is to bring healing for body, mind and spirit; along with the medical team, the pastoral and spiritual teams are other important components of the mission visit.

What resources are in place for support? - The MMDM's bring "What the Good Lord sends us, " as Cordell says, and mission teams have ranged from 25 to over 50 people from the Diocese of Galveston-Houston who volunteer their time for this mission. In addition, the mission needs volunteers of all kinds from the local area - not just health care professionals, but also folks to help greet patients and keep records, help prepare meals, pack/unpack, run errands, etc. After the mission, there will need to be a plan in place for follow up care for those folks who are found to need additional care, such as continued treatment for a chronic condition or possibly surgery.

The MMDM's estimated that their missions cost betweem $50 - $80K. About half of the costs are paid by the mission volunteers - they pay a fee which pretty much covers their travel, lodging and food costs. The other half of costs are covered through donations of all kinds. The MMDM's have gotten great support from their home parish in Sugarland for their Mexico and Laredo missions and expect their parish to be generous again. They hope that we can also find financial support in this Diocese, and obviously, the more support (of all kinds) that can be rounded up, the more that can be achieved by the mission!

How can we provide for team members? - The MMDM's need a lot of support to help locate accommodations and food service, for both the mission team that travels in from Texas and for the local volunteers.

Then the general discussion began, and it was pretty lively. Here are a few observations, in no particular order:

- dental care is a huge need in Eastern KY. There is already a shortage of dentists in the area, and very few take Medicaid patients. Children are getting better coverage through KCHIP (Kentucky Children's Insurance Program), but accessibility is still a problem.

- the population is more spread out in the mountains and rural areas; transportation (or lack thereof) is a big issue in getting folks to wherever the mission is conducted. This will also be a big consideration in planning a continuum of care after the TX volunteers have left.

- Catholic hospitals and many physicians already carry millions of dollars of charity care and stay overwhemed with requests to do more. That's something to keep in mind when talking about what financial and volunteer commitment could be offered on their part

- the population in Eastern KY is about 99% NOT Catholic, which is very different from what the MMDM team encountered in Mexico and Laredo. Spirtual/pastoral program components will need a different approach than previous mission trips. Volunteers will need to learn a lot about the unique culture of Appalachian KY.

After lots of input, comments and questions, it was time to plan the trips out into the field to find out more. Attendees gathered around the KY road map and after some more discussion, the fact-finding route was set up:

Wednesday - Hazard

Thursday - Grayson and Morehead

Friday - Berea (whence the team could head southwest back to Texas)

Many thanks again to all who attended the meeting and offered such great insight and input.

The next blog posts will take a look at what the team learned in their travels .....

We're on a Mission!

Welcome to the first entry of this blog! Through a running commentary, we hope to keep everyone updated about the efforts of the Medical Missionaries of Divine Mercy (MMDM) and the Diocese of Lexington to develop a program that continues the healing ministry of Jesus in a very special place - the mountains and hollers of Eastern Kentucky.

Our ultimate goal is to promote better health in body, mind and spirit for those in need in this part of Appalachia, one of the poorest regions in the United States. To achieve this, we will bring together volunteers from the MMDM organization of the Diocese of Galveston-Houston and volunteers from the Diocese of Lexington for a week-long "Medical Mission" in Spring, 2011.

A fact-finding team from the MMDM's visited the Diocese during the week of April 6 - 9. We traveled to several different health care sites and parishes in the eastern part of the Diocese to learn about the needs of the region and how a mission team might help out. We'll look at some of our early findings in upcoming blog entries.

The Medical Missionaries of Divine Mercy is a lay organization based in Sugarland, TX, that takes its inspiration from the devotion based on the revelation about Divine Mercy received by Sister Mary Faustina in 1931. The image on this page depicts Sister Faustina's vision, in which Jesus raises a hand in blessing and with the other hand indicates two rays issuing from the depths of His Sacred Heart. Sister Faustina noted in her diary: "The pale ray stands for the Water which makes souls righteous. The red ray stands for the Blood which is the life of souls.... We are not only to receive the mercy of God, but to use it by being merciful to others through our actions, our words, and our prayers; in other words, we are to practice the Corporal and Spiritual Works (Acts) of Mercy."

In 2000, Pope John Paul II designated the Second Sunday after Easter as Divine Mercy Sunday. It was very fitting that the MMDM team was able to visit the Diocese of Lexington during the week leading up to Divine Mercy Sunday!