Hajra Lakhani (second from right), Mahmood Marfani (third from right) along with another volunteer and a patient at the Shifa Clinic in Houston, TX. Photo by Sahar Habib Ghazi.

HOUSTON Nestled behind a grand copper-domed mosque in a suburb just outside of Houston, Texas, dozens of patients fill up a waiting room. The buzz in the room is a mix of Spanish, English, Arabic and Urdu.

A nurse in scrubs escorts an elderly patient in a burqa out into the waiting room, as a tall, blonde lady in a floral sundress makes her way into the exam room along with her toddler and worried husband.

The two women may seem to be from opposite ends of the world. But one thing has forced them to cross paths - the broken health-care system in the US.

“Regardless of race, colour, economic or immigration status, we treat whoever walks through the door,” said sixty-year-old Rafique Jangda, the executive director of Shifa Clinic in Sugarland, Texas.

Every Saturday, the clinic offers “no questions-asked medical services,” which include free check-ups from a pool of sixteen licensed doctors and specialists. The clinic is run by a group of two-dozen volunteers, most of whom are of Pakistani-origin.

Jangda himself emigrated from Pakistan when he was just a student in the '70s. Clean-shaven in a pink polo shirt, he tells me every week the clinic treats 40 patients.

This week, many diabetes patients fill up the Shifa waiting room to see Dr Shahid Muhammad, an endocrinologist and a graduate of the Dow Medical College in Karachi. He has been volunteering at the Shifa Clinic for a few years now.

“Patients have to face physician fees, lab costs and prescription costs,” said Dr Shahid, “once I started coming here, I realised a lot of people could not afford treating their condition because they were not insured.”

It can be financially crippling to be ill in America. Doctors, medicine and lab tests are very expensive. And people with chronic conditions like asthma and diabetes get the worst of it.

In a survey sponsored by the Kaiser Family Foundation in 2005, 43 per cent of all asthma patients in the US said that they did not have the money to pay for their treatment.

And according to the American Diabetes Association, 23.6 million in the US—that's 7.8 per cent of the total population—have diabetes that costs a staggering $174 billion every year. That comes up to about $7,500 per diabetes patient.

Most of that expense should be covered by the patient's insurance plan. But often time's insurance companies in the US discriminate against clients with “pre-existing conditions” like diabetes. So the patient has to dip into their pockets to manage their expensive condition.

And that's if they have insurance. According to the most recent US census statistics, 15 per cent  in the US are uninsuredTexas tops that list, with every fourth person in the state falling outside the insurance net.

At the Shifa Clinic they try to fill that gap. Since all doctors are volunteers, there are no doctors' fees.

After Jangda, an engineer by profession, joined the clinic, he soon realised that expensive prescriptions and lab fees were another hurdle for patients. So he started a rigorous outreach programme, connecting with other clinics and building relationships in the health care community.

And his lobbying efforts paid off. Now, Shifa Clinic has contracts for low-cost lab work, prescription assistance programmes from pharmaceutical companies and a reciprocal relationship with other free clinics for services it cannot offer-like advanced eye screening for diabetes patients. Now, Dr Shahid can treat some of his patients, practically free of cost.

Patients do have the option of paying a non-mandatory $20 fee, which 60 per cent of the people that walk through the door, choose to pay. This money, along with Zakat for the community, helps pay for the operating cost of running this clinic, and its three sister clinics in the Houston metro area.  All together, the four clinics, under the Houston Shifa Services Foundation, a registered non-profit, offers free medical services from a pool of 50 doctors and over a 100 volunteers. According to their website, since 1998, the Shifa Clinics have provided services worth $3 million to the people of Houston.

The clinics were made possible through the cooperation of the City of Houston and the Islamic Society of Greater Houston (ISGH). The city administration funded the buildings, while the ISGH donated their property for the clinics and continue to pay all their utility bills.

Jangda manages the Sugarland Shifa Clinic, which has six exam rooms, including two fully equipped for their resident dentist and their eye doctor. He has recruited 25 youth volunteers from the area to assist doctors and help run the clinic. Some volunteers go on to join medical school and for some young professionals like Hajra Lakhani, who works in the energy industry, it gives her the opportunity “to give back to the community.”

The clinic also provides a chance for newly immigrated Pakistani doctors to volunteer at the clinic and become familiar with the health care environment in the US, while they apply for their licenses and jobs. They aren't allowed to treat patients or write prescriptions though.

Ten of the current pool of licensed doctors, are of Pakistani origin and most of the rest have Middle Eastern roots.

Although the buzz in the waiting room was a mix of Hispanic, African-American and Middle-Eastern patients, Jangda estimates seven out of 10 patients at the clinic are of South Asian origin.

One of the things that surprised Jangda when he started volunteering was the number of Pakistani immigrants that had been living in the US for years without seeing a doctor.

“When people complain about a 30-minute wait, I know they've never been to a clinic in the US,” said Jangda throwing up his hands in the air.

That's where Mahmood Marfani, the clinic's Manager of Social Services, comes in.

“I had trouble when I first came to America from Pakistan. Because of unawareness, shyness, language and cultural issues, I discovered a lot of Pakistani families also suffering,” said Marfani.

Now retired, he helps educate patients who come into the clinic about the options available for them within the health care system in the US.

Holding what he called a million dollar paper, Marfani shows a list of over a dozen federal programmes, including CHIP, available for low-income un-insured Americans.

“Some families don't send their children to school because they cannot afford immunisation. They don't know that the CHIP programme can take care of their expenses.”

Marfani added, “We are so blessed in America, people just don't know there are people and resources out there to help you.”

Sahar Habib Ghazi blogs at www.outsideislamabad.com and has been selected as a 2010-2011 Journalism Knight Fellow at Stanford University.



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