Trusted Leader - February 2007
By Erin Prather Stafford
Traveling 60,000 miles along the Texas border, a mobile health
clinic operated by The University of Texas Health Science Center at
Houston has provided health care services for more than 30,000
patients since its inception in 1989.
L. Maximilian Buja, MD, the health science center's executive
vice president for academic affairs, says a new van, unveiled last
March, is the third vehicle model to provide health care services
and education to large, rural indigent populations along the
"Dr. Margaret McNeese, medical director of the mobile health
clinic program, originally came up with the idea of using an old
hearing/speech clinic that was no longer being used," Dr. Buja
"She suggested the van be refurbished for primary health care
and used along the border. State officials allocated funds for
border health, which were applied to the program. Since then, we've
relied on both state dollars and grant money. It took this
public/private partnership to purchase the current version."
Colorful and high-tech, the van is painted UT burnt orange with
"Clinica de Salud Movil" on one side and "Mobile Health Clinic" on
the other. It's equipped with three examining rooms, an education
room with medical and nutritional information, and the latest
laboratory equipment and technology, including telemedicine
capability. In 2005, the clinic provided primary health care and
education to more than 3,000 patients and immunized more than 2,000
Kathleen Becan-McBride, EdD, coordinator of UT-Houston's
Texas-Mexico Border Health Service Project, says the van serves
border residents living in areas that typically don't have
electricity, running water, paved roads, or medical care.
"Often, mothers will walk with their children to the mobile
clinic for treatment. We try to ensure the van is in an area within
walking distance of the population needing to be served. Because
the border is an expanded community within UT-Houston's outreach,
we believe it's mandatory that health care access exists for these
communities," she said.
Dr. Buja says the van has been a fantastic teaching site for
both medical students and nurses interested in primary care.
Houston, We're Connected
Today, UT-Houston physicians are continuously in contact with
staff aboard the mobile health clinic, as well as nurses at rural
school-based clinics. Telemedicine allows physicians to communicate
with border patients, even when hundreds of miles apart.
"A nurse can evaluate a patient, then call a UT physician
in Houston for an examination. With the nurse using the
telemedicine equipment, either at the school-based clinic or on the
mobile health clinic, the physician can also see the examination
and give a diagnosis and recommendation. If medications are needed,
they are called in to a local pharmacy. Should additional treatment
be needed, a referral will be made to the closest doctor in the
patient's community," Dr. Becan-McBride said.
The first school-based telemedicine clinic was established in
2005 through funding from the Cullen Foundation. There are now two
school-based clinics in Cameron County and two in Hidalgo County
where UT-Houston has provided telemedicine equipment. Each county
is designated as a medically underserved area and a health
professional shortage area.
The most common complaints seen by clinic staff are headaches,
stomachaches, coughing, ear and throat pain, and psychiatric
issues. Patients are required to sign a consent form saying the
nurse has their permission to use a telemedicine consultation for
UT physicians also provide interactive educational programs to
elementary schools on topics including hygiene, avoiding skin
cancer, and diet to avoid diabetes. Educational videos about
diabetes prevention have been used in the van for 13 years and are
being updated for the mobile and other clinics to use for health
education and disease prevention.
"Clinic staff can do glucose and cholesterol screenings," Dr.
Becan-McBride said. "An important goal of the program is to prevent
diabetes and other diseases by identifying and educating those
prone to the disease."
Added Dr. Buja, "Health and education are keys to a successful
and vibrant society. Prevention is essential, and diabetes is a
prime example of what can happen if things remain unchecked."
While there have occasionally been technological glitches, Dr.
Buja says the program's benefits far outweigh any headaches caused
by a downed server. For him, the mobile health clinic, its school
counterparts, and telemedicine are essential parts to improving
border health care.
"I personally feel as a physician I need to deliver care to all
people in all levels of society.
Texas physicians need to look beyond the big city to the rural
areas of our state. Patients there are counting on us too."