Monday, March 24, 2008

Career, part 2

The second day of taking students into the refugee community I was sitting on the back of my blue Toyota pick-up truck behind some apartments when a student came running up, “Mr. Kemp, a lady is having a baby in those apartments!” By the time we got there the other student had caught the baby and everything was under control. We called for an ambulance and they came and took the woman and baby to Parkland. A while later I saw the ambulance was back. We went over to see what they were doing and learned that the hospital had sent them back to get the placenta so they could count the lobes. But in the meantime another woman had put it in a paper sack and into the dumpster and when the EMT reached into the dumpster to take it out the bottom of the sack broke open and the placenta slithered out and down deep into the dumpster. In Texas. In the first week of September. In a refugee neighborhood. Have a good time in the dumpster. Photo: Student with Neth Nguon

Our base of operations was mostly Lay Rith’s and Chneang Roeun’s apartment on Fitzhugh. Cozy, full of children, the transcendental Lay Rith, and the wonderful grandmother – a perfect community health operation. Leslie and I worked together 7 days a week, from family to family. What a job. In other accounts I’ve written more about Leslie. The other major player in all this was Ron C., a police officer who became (and remains) a good friend.

Things were going well at TWU until I wrote a grant proposal for some HIV outreach. Somehow that put me in the line of fire between the dean and associate dean and I was told to resign. That was a hard time, but, you know, time passes.

I started teaching at Baylor in 1989. Though I took students to Terrell State Hospital a few semesters, I was able to transfer the refugee work over to Baylor. Here is something from a website:

In our earliest work in East Dallas (1981-86) we worked only with Cambodian refugees because they presented with the greatest health needs and problems of any population in the area. At that time we were working door-to-door in the community and initially had no physician services. Students conducted in in-depth community assessment and that document was used to obtain agreement from Temple Emanu-el for them to work with us to develop medical services. That partnership led to the East Dallas Health Coalition, which later became the East Dallas Health Center, Dallas' first community-oriented primary care (COPC) center.

Leaving the medical care to medical people, we continued working in the streets. In 1991 we decided to adopt the district health model and shift our focus to the community as a whole rather than a specific population within the community. We took responsibility for providing health care to a culturally diverse (primarily Asian refugee and Mexican immigrant) inner-city low-income community with significant needs/problems. Rather than begin with another lengthy formal assessment (Is it really necessary to again show that this or any other such community has unmet needs?), we began working on one street to assist people in the community to obtain health care and social services. We went door-to-door and every time we found a person with an unmet health or related need, we stopped and figured out how to meet the need. Through the process of assisting people with the problems they felt were most pressing, we were able to develop a trusting and professional relationship with the community; identify needs and problems at all levels of care/prevention/promotion; develop a meaningful understanding of available community services, and become a part of the community of solution


In the early 1990s I began work on the book I had wanted to write since my days in hospice – a practical guide to caring for people with terminal illness. I went with Lippincott as publisher because they had also published Bernard Fall’s work (Hell in a Very Small Place, Street Without Joy, etc.). I thought the best part of the book was a series of tables and text that charted the natural history/metastatic spread of the 18 most lethal cancers. The tables spelled out what to look for as the diseases advanced so that problems could be identified early rather than late. The book, Terminal Illness was published in 1995 and the second edition in 1999.

In the mid-1990s Parkland agreed to send a physician to work with us out of the East Dallas Police storefront facility. We thus had medical services, refugee screening through the Dallas County Health Department, and outreach through Baylor students. Leslie and I were back in business together with her doing the social work and clinic management. We began working with Church Health Ministries (CHM) in the late 1990s and through that relationship, added additional medical services. We moved to a small community church in 1999 and in the spring of 2000 separated from CHM. Photo: Me, Khan Soeurt, Kara (student), and Lance at the community garden

Community Care moved to Emanuel Lutheran Church for a few months. We were in the church house next door to the church on one side and a crack house on the other. They had good-eyes in upstairs apartments across the street – a scene. Estevan G. was our doctor, a wonderful ER pediatrician and good man. One thing he taught me was how to start with a room full of patients and work steady through them.

One day I was at the clinic in Emanuel’s church house, maybe an hour before I was to leave to go to New York to get an award, kind of a crowning one, when the pastor came in to tell me they were severing our relationship. “The elders feel that our relationship is with Church Health Ministries, not this clinic, and have asked me tell you that we can no longer … blah, blah, blah” – it was surreal, unreal, devastating – the destruction of what we had worked so hard to do. It was not really about the church and was not instigated by that church – it was about power and politics, revenge. Heavy stuff. The award was sand in my mouth.

I remember what this one guy – a famous guy, perceived by many to be a spiritual leader and I guess in his own way, maybe he is – said to me as he cut us loose from his so-called faith-based ministry, “I’m a pragmatist,” he said. I thought, “Yeah, that’s exactly what you are.” I think we should be careful about what we link to “I am.”

I went to several places looking for a home for the clinic and we entered a partnership with Agape in the fall of 2000. I remember when we went over to Agape. Dale said, “I’ve suggested several times that you come over here.” I said, “I believe you – I never heard it or I just wasn’t ready.” I remember we had all our medicine in 2-3 drawers of the big brown filing cabinet and when I told Bobbie (the medical director) that we’d keep ours in there she said, “no, just put it in with ours.” They had a 100 times more than we, so it was an extraordinarily generous thing for her to say. As he had done several times before, Martin H. helped move the clinic. He’s been a rock through the years! As he says, “Grace falls on the just and the unjust,” hence the name, Common Grace Ministries. Once when Martin and I were moving some very heavy something I felt this pop in my lower abdomen. Uh oh, another hernia (see how nice I talk these days).

When we moved into Agape I felt like we’d come home.

Teaching at Baylor, like any other job or aspect of life has its good times and its bad times. The best part is that the university has come to understand and support the ways in which what we are doing is consistent with Christian action. The worst part is the judgmental narrow-mindedness of some people there. Photo: Leslie, Maria (with Luvia in lap), Roxanne, and Lupe in the waiting room at Agape

I know many people and to a greater extent that anyone I know in Texas or anywhere else, I have been committed to students as (potentially) essential parts of the community of solution. I have integrated my teaching and my community care and have expected great things from my students. And through their work, great things have happened: the East Dallas Health Center, 1,000s of patients, and good work with countless people. Here is a little something from 1995:

Strange People: In the course of outreach, one of the students made several visits to an apartment where a 60-something year old woman lived with a younger man and woman. The younger woman was very seclusive and every time we were there she had blood in her mouth (but no other evidence of trauma), and would not let us close enough to determine what the problem was. In conversations with the older woman we learned that the man (call him Jimmy) was "helping" a 10 year old girl who lived nearby. Over several weeks the story came out that the girl had a bad home life. Her mother lived with two men and was having sex with both. The girl was afraid of one of the men and so spent as much time as she could with Jimmy. She bathed at his apartment and at least once a week she spent the night with Jimmy, sleeping with him on a fold-out couch. According to the older woman, he and the girl liked to wrestle. Needless to say, when the story came out we took quick action. I remember the student on this case saying in a very serious way, "Mr. Kemp, I think there may be a problem here." We talked with a detective of my acquaintance and he went after Jimmy and brought Child Protective Services in on the case. I don’t know the final outcome, except that the girl was removed from her mother's home and Jimmy was gone, where I don't know.

1 comment:

Sanford said...

If you are interested in being a goodk teacher, see the new book on "Teaching and Helping Students Think and Do Better".