A mobile clinic in a Mississippi Healthcare desert

In Mississippi, it is not just abortion that is difficult for women to access. The poorest, without health insurance, are unable to get basic health care, contraception and mammography, or are struggling to do so. In the past year, a free mobile clinic has crossed the Mississippi Delta region to help them. The duty visited her while in Greenville, a small town on the border with Arkansas.

The clinic’s exterior walls, decorated with colorful murals, catch the eye. Inside, Antoinette Roby smiles proudly in front of “her” patient reception room, right at the top of the detachable staircase that allows you to climb up there.

The local health worker is dedicated to those seeking medical care and medicine, donated free of charge by the non-profit organization Plan A Health.

Its clinics, including the one on wheels, provide care in rural areas that are underserved and disadvantaged at many levels – the delta is the poorest region in the poorest U.S. state – “with an emphasis on reproductive and sexual health,” its mission statement said.

That so many women in the Delta, a region of northwestern Mississippi along the river of the same name, are seeking free contraception from the mobile clinic shows a real problem at the source.

According to Plan A, nearly 45% of pregnancies are unplanned in the United States, and this rate is 20% higher in Mississippi. In this condition, the number of teenage pregnancies is 50% higher than the national average, and African American women will die of cervical cancer much more frequently than others.

Antoinette Roby states that the most frequent consultations are for screening for sexually transmitted diseases, HIV and cervical cancer, for problems with hypotension and hypoglycemia, and for contraception and prescriptions for mammography. Birth control pills are offered, as is the installation of a IUD.

The majority of the clinic’s patients are women, she explains as she opens one of the clinic’s two gynecological examination tables.

“It’s all free,” she says contentedly, adding that many of her patients have no income. In Issaquena County, in the delta, 43% of the population is below the poverty line, according to the 2020 census.

The clinic’s patients are uninsured or “underinsured”, not to mention that those who still manage to see a doctor can not always afford the prescribed medicine, she says: “Many people have to choose between buying medicine or feeding their families. »

With less than 20 square meters, the truck still has two examination rooms, a toilet and even a small “laboratory” room for the various analyzes. “Seeing how much people need the clinic breaks my heart,” says Antoinette Roby.

The people of the delta are still among the forgotten, she laments, referring to this agricultural region rich in cotton fields that experienced the atrocities of slavery.

The very existence of the clinic speaks of the shortcomings of the state medical system.

It boasts its lush vegetation around its bay, but it is a medicinal wasteland in many ways.

Six rural hospitals have closed in the delta in recent years, leaving many patients orphaned. Mississippi has the lowest rate of physicians per. per capita in any state, according to the latest report from the Association of American Medical Colleges.

Women riding

The team on board the clinic consists exclusively of women: two local doctors and a nurse. “That’s all. And we roll it,” says M.me Roby bursts out laughing.

This week, the clinic travels more than 700 kilometers to visit four locations. The size of the truck and the distance do not scare Antoinette Roby, who has to drive a car: The woman has already earned a living by driving trucks across the United States.

The number of patients they can examine per day varies enormously and depends on the size of the city visited. “We go to villages that sometimes have only 200 inhabitants. »

Those who can not afford a visit to the doctor often struggle to get to a clinic when they have no means of transport, and those who combine small jobs to survive can not afford to miss a working day – unpaid – to go for a consultation, explains Antoinette Roby, securely attach the equipment to the examination tables before starting.

The clinic car notifies the rural residents one month in advance when it will visit.

It runs on the pink-beige roads of seven delta counties – and sometimes more – thanks to donations from private foundations, individuals and businesses, plus a small portion of government grants.

What does Antoinette Roby find most difficult? “Finding resources for my patients. The clinic can not do everything. Female doctor spends a lot of time looking for doctors for surgeries. How do you get surgery when you are penniless? “Good question. There are some government programs that help, and they sometimes offer the option of monthly payments.”

A matter of money

Alyssa Woods, in her early twenties, met outside a store on Martin Luther King Jr. Boulevard in Greenville, and does not have health insurance at his job in a fast food chain. To see a doctor: “I have to pay,” she says, a baby of a few months in her arms.

On the Internet, advertisements promise a deal with a doctor “from $ 59”. It’s more than a day’s work for many workers in this state, where the minimum wage is $ 7.25 an hour.

Clarke Ware has health insurance at a cost of $ 900 per. month with a deductible of $ 6,000. When the man in his 60s had to have a double bypass a few years ago, his hospital bill showed $ 150,000. Despite his insurance, he had to pay $ 22,000 himself, he said.

“The health care system is rotten in this country,” he said. Many people go bankrupt after a hospital stay or they are in debt for the rest of their lives. »

Charles Modly of Sunflower County, Delta, regrets Mississippi’s decision to refuse to expand Medicaid – a low-income federal program for adults. This explanation is supported by several studies, but rejected by others, who rather see it as a multifactorial problem. Access to care is complex in the United States, and can vary widely depending on the many insurances, income, and government programs.

As for the colorful clinic on wheels, it will continue to roll its hump in 2022, while soon expanding its offerings with the addition of dental care, such as cleaning and extraction.

This report was funded thanks to support from the Transat International Journalism Fund.The duty.

Democratic determination

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