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clinic offers culturally sensitive help to Hispanics

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Funding shortfall threaten programs
Flor Santolo Sherbahn of Salud Hispana (Spanish Health) has a passion to serve people who often fall into the cracks of social service systems. Limits at the social agency, however, are often beyond her control.
“My idealism is frequently laced with cynicism,” she said. “Our income for all programs is about $190,000, and it is stretched as far as it can go. Every year, we apply to banks and foundations for essential dollars. Too often, grants are won by high-profile agencies that can’t always serve specific needs. This agency is so important to me that for a period of 14 months, I took no salary so we could endure. We get constant feedback from schools, parents, kids and other agencies indicating that what we do here works.”
In 1997, Santolo Sherbahn, a director of the health clinic at Lancaster’s Spanish American Civic Association, and Dr. John Laguna, a psychologist who has since moved to Tampa, Fla., launched Salud Hispana. It is a grass-roots social agency that provides access to health care for Lancaster County’s underserved Hispanic community.
“We were not out to duplicate services provided by others,” said Santolo Sherbahn. “We wanted to fill a void that existed in serving non-English-speaking Hispanics by offering culturally sensitive prevention, education and treatment programs. We have to renew our pleas each year, and sometimes the money dries up,” said Santolo Sherbahn.
A diabetes-management program is one service that is in danger of ending because funding will end July 1. A person who suffers from diabetes either is unable to produce insulin or can’t properly use the insulin his or her body does produce. As of March 13, the clinic had not found a new source of money for the program.
“Lancaster Health Alliance only funds new initiatives for five years, and our time is up,” said Santolo Sherbahn. “We have to find money elsewhere to continue our work with the hundreds of people we serve.”
Over the years, the amount of the grant from the Alliance has decreased, from $100,000 in the first year to $40,000 in the fifth year. Diabetes is a particularly serious problem among Hispanics, said community health worker Edwin Gonzalez.
“We conduct six session class cycles that help people understand the disease and essential management techniques,” Gonzalez said. “We have speakers from Lancaster General Hospital and Community Hospital. Family members and caretakers also participate.”
While the exact cause of diabetes is unknown, people who are over age 45 or are overweight and don’t exercise regularly may be at risk of developing diabetes. Heredity may also be a factor. In 1998, of the 30 million Hispanic Americans, about 1.2 million had been diagnosed with diabetes, according to the National Diabetes Information Clearinghouse. About 675,000 Hispanic Americans have diabetes but do not know they have it. Diabetes is particularly common among middle-age and older Hispanic Americans.
When Luz Ayala, 51, was diagnosed with diabetes, she thought she would be dead soon. “Many people in my family suffered from this disease,” she said. “My mom had both legs amputated and died at the age of 61.”
Ayala heard about the diabetes education and maintenance program at Salud Hispana last year and enrolled in the program.
“When I entered the program, my sugar level was at a dangerous 400 (milligrams); now I am down to 113. I’m on a diet, take my medication and exercise regularly.”
The normal range is between 70 and 111 milligrams per deciliter of blood.
Ayala plans to relocate to Puerto Rico. “I’ve had training as a nurse,” she said, “and I plan to start a diabetes support group as a volunteer. I want others to benefit from my experience; this program gave me back my life.”
When it was formed, Salud Hispana provided the diabetes management and a teen pregnancy-prevention program.
“When the community no longer needs a service, we shift gears and seek to fill existing voids,” said Santolo Sherbahn. “We no longer have a teen-pregnancy program because our teens all spoke English and could be served by other agencies. Now we are looking at involvement in smoking prevention programs that are funded by the
$1.1 million tobacco settlement awarded to the county.”
Lancaster County will receive a total of $3.3 million over three years, or $1.1 million a year. So far, Salud Hispana has not received any of that money, although it is still in the running with other agencies in the county.
In 1998, Salud Hispana started a parenting skills project, as well as a drug and alcohol prevention program.
The Lancaster County Children and Youth Services agency provides funding for Salud Hispana’s structured 15-week Spanish-language parenting program, focused on reducing the risk of child abuse and neglect.
In addition, its Parents Anonymous support group meets weekly to give at-risk families encouragement, hope and a better relationship with their children. “We offer child care services and meals while parents are meeting and learning,” said Santolo Sherbahn.
Paso-a-Paso (Step by Step) is a program for pre-teens who have been identified by schools as most vulnerable to substance abuse. The program is funded by the Lancaster County Drug and Alcohol Commission.
Twice weekly, Gonzalez picks up children at a local elementary school at 3:15 p.m., brings them to the agency and takes them home when activities ends. “We recruit them in fourth and fifth grades before we lose them to drugs in their early teens,” he said.

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