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New DAP Health initiative helps women in underserved areas succeed

When a woman’s health needs come first, there’s nothing she can’t do. Coachella resident Maria knows this firsthand.

Maria (who asked us to remove her last name for privacy reasons), 32, was homeless until she was 18, suffered food insecurity, was sexually abused and abused by a family member. During that time, she did not receive the medical care she needed, especially for her mental health issues, and she often considered suicide. Years later, whenever she went to see a doctor – especially during her pregnancies – she did not feel welcome and did not feel like she was being treated with the best care.

It wasn’t until she was enrolled in the Enhanced Care Management program through Borrego Health (before the merger with DAP Health) that things began to change for Maria. Although she was hesitant to trust at first, she slowly began to open up and participate in the program, which is available to people with certain health conditions, homelessness, and other criteria.

Maria is now one of many women sharing their stories as part of DAP Health’s new Women of Impact initiative, which addresses the systemic barriers that make it difficult for women – particularly in underserved areas – to access healthcare.

Following DAP Health’s acquisition of Borrego Health last year, which included the acquisition of 18 medical clinics in Riverside and San Diego counties and thousands of patients, the Palm Springs-based healthcare provider now serves more than 60,000 women and children.

Women’s health services have always been available at DAP, but after expanding and broadening its resource offerings, the organization wanted to fill those gaps and “bring our knowledge of what we’ve done for the HIV/AIDS population to the women’s health crisis,” says Eve Fromberg Edelstein, co-chair of Women of Impact.

“There are gaps in women’s health care in many health systems in this country, if not the world. This is demonstrated by fetal mortality rates, lack of preventive care, and overall health outcomes for women that are even worse for women of color,” Fromberg Edelstein said. “We are trying to remove these barriers to women’s health care and recognize that DAP is a specialist in providing quality health care to stigmatized groups.”

Read more: Sale of Borrego Health clinics to DAP Health completed: What patients need to know

Goals of the DAP Health Women of Impact Initiative

With Women of Impact, DAP Health is focused on closing the health gaps that currently exist in its clinics.

The first step is to expand facilities, starting with the Palm Springs Family Health Clinic at 1100 N. Palm Canyon Drive. The clinic currently serves about 30 women a day, mostly pregnant women, Fromberg Edelstein said.

However, there is a need for gynecological services, she said, including regular check-ups, Pap smears, mammography screenings and STI testing. The expansion would grow the center from about 140 square meters to nearly 420 square meters and increase the number of gynecologists, perinatal medicine specialists and medical assistants. With more space, treatment rooms and doctors, daily patient capacity is expected to increase to 90 women.

Providing expanded pediatric services is also critical. Women, especially mothers, often put the health needs of others ahead of their own, said Karyl Ketchum, co-chair of Women of Impact. By offering pediatric services in the same spaces where women can get checked, “that’s when you grab them.”

Chris Boone, DAP’s chief development officer, said the expected expansion cost is about $1.5 million.

DAP is also considering focusing on care during the fourth trimester, the first 12 weeks after birth, which involves a series of physical and emotional changes for both mother and baby. Mental health in particular is a serious concern during this period. According to the World Health Organization, about 13% of women suffer from mental health problems after giving birth, mainly depression. In addition, studies have shown that suicide is a leading cause of maternal mortality, accounting for about 20% of deaths after childbirth.

Despite this knowledge, Fromberg Edelstein says there is a lack of support for new mothers in areas such as mental health, follow-up visits, and nutrition and lactation counseling. One of Women of Impact’s goals is to recruit professional and clinical staff, such as lactation consultants and social workers, who can better meet these needs and provide appropriate help to those who need it most.

According to Fromberg Edelstein, further goals in the future could be to develop a program to care for menopausal and aging women.

Women of Impact also focuses on addressing “the whole person,” Fromberg Edelstein said. Providers check in with their patients and ask if they need food, clothing or other items to care for themselves and their loved ones.

“Every person deserves good, competent and comprehensive health care that covers their entire life,” she said. “If we don’t consider the whole person, we cannot truly improve their health.”

Giving something back to the DAP clinic that “saved” her

The holistic care literally saved Maria’s life.

Nearly two years ago, Maria received a call from Veronica Vaca, a community health worker at what was then Borrego Health, about the Enhanced Care Management program (now available at DAP Health). Patients are enrolled for two years and assigned to a care team that helps them develop a personalized care plan, connects them with food assistance or other social services, and more.

“I didn’t trust him, I didn’t even know about the program,” Maria said about the first phone call.

She had good reasons to be hesitant. She explained that an obstetrician was very rough with her during her first pregnancy and that the doctor wore a large ring on her hand that made vaginal exams very painful. Shortly after the second birth, a doctor “left me open with gauze in it and all the nurses were surprised that he did that just to go to another patient,” she said.

A week later, she had to go to the emergency room and undergo a dilation and curettage, a procedure that removes tissue from the uterus. At another appointment, she received test results that indicated the possibility of cervical cancer, but Maria said she was never given the proper treatment or medication.

She also had mental health issues throughout her life, but couldn’t talk to her family about them. Mental health is often a taboo subject in Mexican culture, she said, and if she confided in them, “they would probably just say I was crazy.” She added that she suffered from postnatal depression after giving birth, but didn’t seek help because of her previous bad medical experiences.

After speaking with Vaca, Maria decided to take a leap of faith and enroll in the program. Looking back on that decision today, she is “so happy” that she did it.

As part of the program, the two women began talking on the phone every two weeks to communicate and find out what Maria needed, Vaca explained.

“It’s like chipping away at stones. I gradually got her to come to me and really work with her,” Vaca said. “I gradually got her to go to doctors. Little by little she was able to see doctors. Eventually she was able to gradually regain her trust.”

She was put in touch with a psychiatrist, a gynecologist, a general practitioner and a hematologist who supported her through her medical journey, especially after she was diagnosed with bipolar disorder, anxiety, depression and post-traumatic stress disorder. It hasn’t always been perfect, she admits, but the care she has received has given her “a more positive attitude that I can do something, that I can slowly help myself.”

She attributes her success mainly to Vaca.

“I didn’t feel like I had a purpose before, and if it weren’t for Veronica, I’d probably be dead,” Maria said.

In October 2023, Maria was asked to share her story during Women of Impact’s information tours at Centro Medico Cathedral City, one of the main clinics treating women and children. She said those moments “gave me more courage” to open up and face her past.

She completed the Enhanced Care Management program earlier this year and, based on her previous education, work experience and life experiences, she was offered the opportunity to work at DAP Health as a Community Health Worker – a health care worker who is a member of the community and/or has an unusually good understanding of the community they serve.

“When I talk to my patients, they are very grateful. They have told me, ‘Thank God they sent someone like you,'” Maria said. “Every time I hear that, it makes me proud.”

The team behind Women of Impact hopes that more stories like Maria’s will emerge over time.

“Her story is a textbook example of what a woman can accomplish when she has her health care, her mental health care, her maternity care, her educational opportunities, her professional skills and what she can accomplish with the support and stability of her life. Maria can now even advocate in the community: ‘Do for other women what was done for me,'” Fromberg Edelstein said. “She is the dream.”

For community members interested in learning more about Women of Impact, tours of Centro Medico Cathedral City and Palm Springs Family Health are available. For more information, visit www.daphealth.org/womenofimpact.

Ema Sasic covers entertainment and health in the Coachella Valley. Reach her at [email protected] or on Twitter at @ema_sasic.

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