It was just 10 in the morning and already the crowd was restless. In spite of intense congestion and long waits the complaints were few. Around the waiting area there were sounds from many corners of the world. Vietnamese, Chinese, and Laotian voices were intermingled with soft whispers in Spanish. Many of the crowd were starting to look apprehensively at the entry to the main offices. How much longer? Will there be enough time for all?

Inside the main door two tables were engulfed by nervous family members. Young professionals were talking in expectant idioms in an effort to ascertain the reason for today’s visit. The language skills necessary were solved by utilizing everyone around and sometimes by pointing and using signs to establish a reliable line of communication. During one stretch, six languages were required to maintain open lines. Frequent smiles indicated that personal contact had been established.

At two tables a medical student checked blood pressures and entered the main reason for today’s visit. Nurses checked blood sugars or cholesterols by fingerstick for those people who were worried about lipids. Blood pressure cuffs were changed often to meet the wide variation in arm size. In case of high levels, the pressure was checked again after a few minutes of rest. Charts were pulled from a central filing cabinet in preparation for the doctor’s consultation.

Further into the room there was a line that was very slow. Pharmacists and their assistants were explaining to the people in line that they should take this with food or once a day or when they had appropriate symptoms. The line for medications seemed the slowest, because the pills had to be correct and the orders understood. Orders were written in Vietnamese, Spanish, Arabic, and English. The need to use sign language was a constant companion. The need to modify the original physician request was common because of the lack of many medications. Substitutions were checked with the original ordering physician.

Still further into the front room were three doors each leading to an examining room that was surprisingly well equipped. Each room had an examining table and a desk. There were adequate chairs for the family members who were together. In most instances, the people were each evaluated and given prescriptions to be taken to the medication room. Diabetes and hypertension were the commonest illnesses treated. Translators scurried among the exam rooms, because language skills were of paramount import. At times, there was no one who really understood, so contingency plans were developed. Sometimes the waiting room would produce a person who could help. In rare instances the management had to be postponed until help could be located. Usually there was someone who could be called for language assistance.

What is this that is being described? Well, the answer is in the Manos Juntas mission statement. The clinic is held at Epworth Methodist Church and is held in place by Jeni Markham-Clewell. Every Saturday morning (except major holidays) since February 1995 there are a group of health care professionals who join hands to serve those who need service. The clinic is free. Currently about 50 people are treated each Saturday. The demographic makeup is truly diverse. Men, women, and children are bought here for care. The youngest child was 10 days old. The most difficult language match was for a woman from Kosovo who required transfer to another hospital clinic for care. The stories heard in this clinic are incredible.

The key to the success of this clinic is a group of students of many persuasions and levels of training. Supervision and management of the students is always done by fully licensed physicians. Some students have now completed their course of study and have moved to other areas. Premedical students are now in Medical School. Pharmacy students are now in graduate schools or at work in pharmacies. Some pharmacists with full time commitments break loose to help us as the need arises. Nurse students and graduates volunteer their time and skills to help. Doctors volunteer their free time to pitch in and serve the needy. Teachers have been most generous to assist with reception and clerical duties. Volunteers from Epworth and Open Arms churches give of their time and pitch in money to buy medications. The contribution of so many has made this "hands together" effort a reality.

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