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Culture vital in Guadalupe health care

Sylvia Mori greets her first client by happily rubbing the woman's swollen, pregnant tummy.

Although it's been a tough day for Mona Tavena, she returns Mori's smile. Tavena, 21, is due in three days. The previous night, she slept, at least tried to sleep, on a mattress on the ground. Neither her home's swamp cooler nor ceiling fans work, and a box fan couldn't take the edge off the 110-degree heat.

As a promoter a for Guadalupe's Centro de Amistad, Mori's job is to check on women like Tavena and promote physical and mental health through the one-square-mile town. Centro de Amistad has served the town's Indian-Hispanic population for 25 years.

As the next house on her route, Mori runs into living proof of the promoter as success: 18-month-old Karen Garcia, who sparkles as she sits in her father's arms. Mori advised Garcia's mother and now she visits with Karen's aunt, Elisa Hernandez, due in November, as Hernandez and her sister scrape the seed off freshly roasted chilies.

Mori has conducted such kitchen-table counseling sessions for Centro's clients for 10 years. Usually, she celebrates their babies' births; at times, she is there for them in sorrow. When one of her clients delivered a stillborn baby, Centro offered her counseling but the stigma of mental illness was so great that the client when to a hospital more than 10 miles away to remain anonymous.

It's a tough battle to have people recognize mental health as an important piece of their overall health, said Santos Bernasconi, Centro's CEO.

As public-health supporter in one of the Valley's poorest communities, Centro has done everything from organizing marches to honor a woman killed by her husband to fighting against a liquor license for a topless bar. Next on the agenda: getting the town's oldest restaurant to offer food not cooked in lard.

Domestic violence, alcoholism, nutrition, mental health-Bernasconi sees them all as interlocking puzzle parts.Without mental health services, Guadalupe will continue to suffer from high levels of alcoholism and inhalant abuse, he fears.

"I see a lot of people self-medicate out there with drugs and alcohol," Bernasconi said.

Across the Valley, there are a small number of non-profit agencies like Centro that focus on human services and mental health care for Hispanics.

They face serious challenges such as nitty-gritty financial issues and more abstract ideas about how much culture can influence a person's mental health.

The largest, minority-focused agencies also include:

  • Centro de la Familia in Phoenix, a program of the larger Chicanos por la Causa non-profit organization.
  • Valle del Sol in Phoenix and Tempe.
  • Friendly House in Phoenix, the oldest Hispanic organization.

"Cultural competency is not about numbers," like how many Spanish speakers are on the staff, said Dr. Elizabeth Valdez, executive director of Concilio de Latino Salud,a non-profit health care group. "It is about respecting each person who walks through the door."

And for promoter as like Mori, it can mean going to the clients, realizing that many of them, especially the women, won't come to them.

"These women are very bashful, very shy," said Mori, who replaced a man on the job. "He had it difficult because they wouldn't open upto him. They have to feel comfortable."

Copyright 2002, Used with permission from The Arizona Republic.

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