
Photography by Kevin A. Roberts
Imagine being in a foreign country when a global pandemic breaks out. Travel is restricted. You have no insurance coverage there, nor do you speak the language or understand the healthcare system. Maybe you need a doctor, or just basic guidance. What’s your move? Recent immigrants to the St. Louis area may be facing just this quandary right now. One place willing to help them, regardless of their citizenship status, is Casa de Salud. Located at Chouteau and Compton, the clinic aims to ensure that new arrivals to the area—particularly those facing cultural, linguistic or financial barriers—have access to primary care, mental health services, and assistance navigating the system. The COVID-19 crisis, however, has forced Casa to adapt on the fly, says its new executive director, Diego Abente.
In late March, Casa canceled in-person visits and pivoted to telehealth and teletherapy. How’s that going? We didn’t miss a beat. The number of people seeking our services has increased, so we’re ramping up the supply curve to meet the demand curve. Our biggest challenge has been the tech: we didn’t own the HIPAA-compliant version of [the videoconferencing app] Zoom; that’s quite costly. We also didn’t have the tech to send faxes through cell phones, so that was a big hurdle. So we’ve sought support and funders to help us purchase those licenses so that we can do more in-depth clinical appointments.
What are you hearing from your patients and clients? In the first couple weeks after the recommendations to stay at home and limit human contact, folks were really, really on edge. A lot was done in English only, and I understand the limitations, but it’s a lesson to be learned. We did a lot of translating and transmitting information. We also called our client and patient base. Folks are coming to us saying, “I feel anxious about calling the hotline, can you help walk me through it?” That’s great, because that person wouldn’t have called otherwise. The symptoms for COVID are the same as the cold or normal flu, so it’s critical for people to know whether they have [COVID] so that they can keep others safe.
How is Casa’s staff holding up? Especially for the folks in the high-touch roles, it’s really hard to not have some transferred feelings [from clients and patients]. They’re anxious to get them service, but eager to be a part of the mitigation effort, too. We’re utilizing Zoom to be there for each other, too: connecting on a human level to talk about our day, about what we have done and haven’t done. And our volunteer interpreters have really demonstrated an incredible commitment. The human connection isn’t the same, but we haven’t seen a drop in volunteer interest.
Given that Casa relies entirely on private donations, has the economic crisis affected your funding? We had planned our annual gala for May 9; it is one of our bigger fundraising events, so the timing of COVID was extremely challenging. We’ve pivoted that in-person celebration to a fundraising campaign, and we’ve seen a really good response to that. I’m saying to funders that today’s need is important but tomorrow’s need may be different. Our response to COVID as a community needs to be agile, so keeping your mind open is going to be really important.
How has COVID changed your life? My wife and I have set up our home offices; we have a 6-year-old and a 5-year-old, so we’re trying to work, parent and homeschool….I grew up greeting people by giving them two kisses. It’s a reflex for many of us and changing that behavior takes a conversation about what the consequences are. Hispanics from Paraguay are folks that really like to find the fun in life, so what I’ve tried to do is make it enjoyable and temporarily funny, so maybe we’ll do an air kiss or a funny dance so that you can still feel like there’s a close interaction.
So your family has roots in Paraguay? My parents came as asylees in 1979. When my dad was in college he was in a group of young folks who were advocating for a democratic regime, and because of his involvement, he was tortured and imprisoned and released. At one point, he and my mom were threatened, so it became clear we couldn’t stay in Paraguay. The U.S. opened its arms to my family and it’s really changed our trajectory. I’ve been able to shape my life in a way that feels like I’m giving back.
What do you most want people to know? In as much as people feel like they’re in our target population, I would highly recommend they call Casa and get themselves set up to receive teletherapy and telehealth. All of us will be dealing with these issues. Some of us have the means, some don’t. I don’t want anybody in our community to feel like they don’t have the means.