Down in the Valley
Project Provides Health Care to Colonia Residents

For Kathleen Becan-McBride, Ed.D., providing health care to the indigent is a lifelong passion. As director of The University of Texas Health Science Center at Houston’s Office of Community Educational Outreach, she is charged with bringing health care and education to Texas’ most underserved populations. She accepts the task gladly.

“It’s my love for my job and Texas,” says Becan-McBride, native Houstonian and coordinator of UT-Houston’s Texas-Mexico Border Health Services Project since 1988. “This project gives us a wonderful opportunity to help others in our state.”

UT-Houston’s Texas-Mexico Border Health Services Project was formed to help meet the critical health care and health education needs of the hundreds of residents living in the Lower Rio Grande Valley. One way the project delivers health promotion is through telemedicine.

Four years ago, UT-Houston was awarded a federal grant for a telemedicine unit to be used at four elementary schools located in colonias, which are unregulated, unincorporated, rural subdivisions that usually lack running water and indoor plumbing. Since 2000, UT-Houston specialists, in conjunction with the Hidalgo County Health Department, have used the unit as a diagnostic tool. With the network, nurses place a camera on the patient to capture a “picture” of the patient’s condition. The image is relayed 370 miles to pediatrician Margaret McNeese, M.D., medical director of the UT-Houston Medical Mobile Clinic, and her colleagues, helping them diagnose and treat patients with ear infections, skin rashes and other disorders.

Unfortunately, the $40,000 telemedicine unit, which was housed at the medical school, was destroyed during Tropical Storm Allison last year. Becan-McBride is hopeful that a replacement unit will be obtained in the near future.

The telemedicine network also acts as an interactive, distance-learning tool. Becan-McBride and her team use the technology to give presentations in wellness education, including a presentation geared to fifth graders.

“The kids are so enthused about it,” she says. “We teach them lifestyle choices, proper hygiene and nutrition, skin care and drug- and alcohol-abuse prevention.”

The interactive distance-learning sessions are conducted with the help of UT-Houston Medical School’s joint primary care fellowship participants – doctors who have completed their medical school educations and residencies, and are pursuing additional training aimed at developing research, teaching and administrative skills.

The Texas-Mexico border is a 1,254-mile expanse of land considered one of the fastest growing and poorest regions in the United States. Health conditions are among the worst in the country. Poor sewage facilities, pollution and lack of medical services make this side of the border a haven for disease. Frequent traffic between the United States and Mexico rapidly spreads diseases from one side of the border to the other.

Diseases commonly found in Third World countries like dengue fever, parasitic diseases and leprosy continue to debilitate border residents. Cases of hepatitis A and tuberculosis occur at a rate at least twice the statewide average.

The UT-Houston Medical Mobile Clinic staff, an integral part of the project, visits the colonias to provide health care to entire families, and has treated more than 48,000 residents in a 13-year period.

Becan-McBride says Hidalgo County has the largest number of colonias, with more than 1,000 colonias comprised of households occupied by as many as a dozen family members. Her medical team, consisting of one registered nurse and two licensed vocational nurses, provides a variety of services, including glucose, cholesterol, high blood pressure, Pap smear and HIV screenings. Her team also travels to churches and schools, where they provide immunizations to children and their family members.

“In one month, our clinic staff has provided immunizations to more than 1,300 students at 20 elementary schools in Hidalgo County alone. Plus, we provided primary health care to more than 3,100 patients,” says Becan-McBride, who is also professor of family practice at UT-Houston Medical School. “This far exceeds our original goal of providing 600 immunizations a year.”

The clinic nurses live in the Lower Rio Grande Valley, which Becan-McBride says is good for the project because they are bilingual, grew up in the area and know the people in the community.

Registered nurse Elma Requenez drives 25 to 40 miles to the colonias at 7:15 a.m. daily, providing free patient services and health education.

“Elma educates them and persuades them to take care of their bodies. They appreciate Elma and the entire staff so much that sometimes they will bring them lunch,” Becan-McBride says.

Becan-McBride says her clinic staff sees three to eight new potential cases of diabetes a month, which often leads to patient referrals.

“We see glucose levels that are off the charts and we get them into a clinic for treatment,” she says.

Requenez has also helped women living in the colonias appreciate the value of Pap smear screenings. In one month alone, three out of 63 women who underwent a Pap smear tested positive, and were referred to local women’s clinics.

Becan-McBride says the project serves a dual purpose, offering quality health care and education to residents while training future health professionals to work in the community.

One of Becan-McBride’s main goals for the project is to provide clinical rotations for medical students. Fourth-year medical students from UT-Houston undergo one-month clinical rotations on the medical mobile clinic, along with medical students from The University of Texas Health Science Center at San Antonio and nursing students from The University of Texas-Pan American in Edinburg.

“We also train students from other schools who want to enhance their multicultural and communication skills,” Becan-McBride says.

An employee of UT-Houston for 25 years, Becan-McBride hopes to continue helping her fellow Texans with UT-Houston’s telemedicine unit and medical mobile clinic.

“It goes beyond employment,” Becan-McBride says. “I feel like I’m coming to their rescue.

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©2006 Texas Medical Center

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