The first time the young man showed up at the traveling medical clinic in Cadet, Missouri, Mary Vatterott Hastings knew something was very wrong.
Though only in his early 30s, the man could barely walk without becoming winded.
“He had worked in a rock quarry in Mexico since he was young,” said Vatterott Hastings, a retired family physician. “It turns out he had silicosis from quarry dust,” a condition in which tiny crystals severely damage the lungs.
As an undocumented immigrant, the man had been afraid to seek medical care — and although he was working full time, he didn’t have insurance.
He’s among the dozens of patients Hastings has treated at the Rural Parish Clinic, a Catholic nonprofit associated with the Archdiocese of St. Louis that offers free medical care to low-income, uninsured adults out of a 40-foot converted van. The clinic, which travels to rural areas south of St. Louis, is set to open its fourth treatment location in Jefferson County in early June.
The need for health care in rural areas is “tremendous,” said Sister Marie Paul Lockerd, a physician and the clinic’s medical director. Many of their patients haven’t visited the doctor in more than a decade, she explained, because they can’t afford the cost.
“One of the very first gentlemen I saw had a blood pressure of 240 over 110,” Lockerd said, an off-the-charts condition that damages blood vessels and can lead to stroke. “And he just laughed and said, ‘Well, my doctors told me I’d die in my 40s. I’m 52, so I’ve already outlived it.’”
By some estimates, uninsured people in the U.S. are three times as likely to postpone medical care due to cost than people with insurance, and they also die at higher rates.
The percentage of uninsured residents in any given state largely depends on whether legislators have opted to expand Medicaid. Missouri voters approved Medicaid expansion last year, but the GOP-led legislature declined to fund it — likely setting the stage for a legal battle.
In Washington County, where the Rural Parish Clinic got its start, 1 in 8 people under age 65 don’t have health insurance, according to 2020 county health rankings data.
“These are your neighbors who are waiting for Medicare,” Lockerd said. “They’re in their 40s and 50s and starting to get sick, but they think, ‘Well, I’ll just wait until I’m 65 to go to the doctor.’”
To qualify for care, clinic patients must be uninsured, between the ages of 18 to 64 and living below the 200% poverty guidelines, or roughly $52,400 per year for a family of four.
Lockerd, along with four other volunteer physicians and a team of nurses, diagnose and treats patients for a variety of ailments, including thyroid conditions and arthritis. A separate mobile clinic will begin offering free dental care in Cadet, Missouri, in June.
For complicated illnesses like cancer or leukemia, staff refer patients to specialists at one of three partner health care organizations that have agreed to provide financial aid: Mercy, SSM Health or Ascension.
But the work goes beyond prescribing medication, said Hastings, who began volunteering with the nonprofit in 2019, shortly after retiring from her position as medical director of the St. Louis County Jail.
“The white [doctor’s] coat is like the passport to the soul; they start telling you all of their problems,” Hastings said. “Pretty soon, you find out they need counseling or they were the victim of sexual abuse or some other form of trauma. I can’t treat one part of the person and say this is going to be fine.”
One patient had recently gone through a divorce and was sleeping in her car, so clinic staff helped connect her with housing resources. Another was experiencing back pain from his job as an assembly line worker and looking for online training in computer programming.
Hastings often talks with patients who are hesitant about getting vaccinated against COVID-19 and tries to dispel misinformation. “You have to try to figure out what their particular resistance is,” she said. “You don’t judge them; you just try to see things from their standpoint.”
Though the clinic has run into its fair share of challenges in its first two years of operation, including a high cancellation rate and a global pandemic, staff members are heartened by the progress their patients have made — including the former quarry worker diagnosed with silicosis.
As he grew more comfortable with the doctors and nurses at the clinic, he started coming to his appointments early so he could eat a potluck lunch with them.
The damage to his lungs is irreversible, Hastings said, but he’s now on medication and able to live a more comfortable life.
“The people I work with, they’re all there with a sense of higher purpose,” she said. “And when you work with people like that, it’s a win for you and a win for the patients.”
Rural Parish Clinic hours and locations
- Sonrise Baptist Church, 454 Berry Road, Bonne Terre, Mo. (first Monday of each month)
- St. Joachim Parish, 10120 Crest Road, Cadet, Mo. (second, third and fourth Monday of each month)
- Good Shepherd Parish, 703 3rd St., Hillsboro, Mo. (first Thursday of each month)
- St. Clare Catholic School, 165 E Springfield Road, St. Clair, Mo. (second, third and fourth Thursday of each month)
To schedule an appointment or for more information, call 888-870-9610.
Follow Shahla on Twitter: @shahlafarzan
Copyright 2021 St. Louis Public Radio. To see more, visit St. Louis Public Radio.