A volunteer provides care to a patient at Clinica Amistad, which is in need of donations to sustain free health services during the COVID-19 crisis. The clinic is bracing for an increase in patients due to the rise in unemployment while simultaneously experiencing a decrease in financial contributions.

 Photo Courtesy of Clinica Amistad

Even during the pandemic, the little clinic that could has continued to treat many of Tucson’s most vulnerable patients.

“Clinica Amistad is on the front lines. We rely on volunteers — including many from the University of Arizona who have been sent home and lots of providers who are older and fall in the vulnerable age bracket and have had to step back,” said Nicole Glasner, executive director of development for the clinic.

“We have had many others who have stepped up, but we are running on a skeleton crew. We are low on lots of supplies and personal protective equipment, but we are getting through.”

A shortage of funding and supplies is nothing new for Clinica Amistad. For the past 17 years, it has offered no-cost primary and preventative health care, education and medications to low-income, uninsured people at the El Pueblo Neighborhood Center, 101 W. Irvington Road, Building 3. The clinic is open from 5 to 9 p.m. Wednesdays and Thursdays and from 10 a.m. to 2 p.m. the first Saturday of each month.

Funded completely by private donations and grants, Glasner said the effort is made possible by a small administrative staff and a volunteer force of 100-plus physicians, physician assistants, nurses, pharmacists and other health-care providers.

Among those are Dr. Raymond Graap, who has worked with the clinic for the past 10 years and serves as medical director.

Graap, 84, said he and several other colleagues who are fellow octogenarians have been gratified to take protective precautions and continue their volunteerism during the crisis in spite of falling into the “high risk” age category.

“I think most of us who do similar work have had many years of experience and have a lot to give in that regard,” Graap said. “Physicians and health-care providers who have had busy lives don’t like to not be busy.

“We want to be involved in an activity that we know contributes to the general health of people in the community and that is very gratifying. We plan to continue for as long as we can do it.”

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Graap said the volunteers are incentivized by the knowledge that Clinica Amistad works with an underserved segment of the population. The majority of the clinic’s patients are elderly and Hispanic and 91% fall below the national poverty level, which was defined by the U.S. Department of Health and Human Services in 2018 as an income of less than $16,240 for a household of two.

Clinica Amistad scheduled more than 2,800 appointments last year. In-house services include screenings, prescriptions and access to care in pulmonology; diabetes and endocrinology; gynecology; dermatology; cardiology; internal medicine; and optometry.

The clinic has arrangements with community consultants in the specialties of procedural cardiology, urology, nephrology, general surgery, gastroenterology, ophthalmology and retinal specialty procedures. It can also assist patients in obtaining surgical procedures.

The COVID-19 crisis has forced the suspension of integrative services such as acupuncture as well as counseling and diabetes education.

“These are important, but it was necessary to temporarily decrease the number of patients being seen per clinic session,” Graap said. “We hope to restore these services as soon as the regional coronavirus problem diminishes.”

Graap said the clinic has implemented other changes in response to the pandemic, including installation of floor markers for safe social distancing, checking of patients’ temperatures upon arrival, making the majority of visits available by appointment and offering telemedicine services to established patients. Some walk-ins are accepted, but patients with respiratory symptoms are encouraged not to visit the clinic. Anyone with respiratory symptoms is taken directly to an isolation room to minimize contacts with other patients. Over the past three months, one patient has tested positive for COVID-19 at the clinic.

“We are doing OK. We are seeing the patients who need to be seen. Most of them have diabetes or hypertension and they are happy to have care. They are all grateful and respectful of the situation and we have had no problems with people following the rules,” said Graap.

Among the most acute challenges the clinic faces as a result of the pandemic is the anticipated increase in patients who have lost jobs and/or insurance and the decrease in contributions from donors now facing financial uncertainty themselves, Glasner said.

She said the recent lifting of home isolation restrictions is expected to result in more patients seeking attention for primary care needs, and more funding is needed for basic clinic expenses such as medications, supplies and consumables as well as for lab work, pathology, consultations and other evaluations.

“The clinic has become a vital resource in the community, especially for many established patients who need follow-up,” Graap said. “Interestingly, we have a donation jar at the clinic. These people we see are struggling to meet just basic needs in their lives, but guess what? They go ahead and drop dollar bills in the donation jar and it tends to accumulate each month. It just reflects how grateful they are.”

He and other supporters are appealing to individuals, businesses and private foundations such as the Stonewall Foundation, which has been a generous donor to Clinica Amistad for the past two years and recently gifted emergency funding to help the clinic during the pandemic.

“The Stonewall Foundation has generously stepped forward to help us through this crisis,” Glasner said. “We have had individuals make masks and donate their time and their resources to help. We are Tucson Strong, but we need donations to help those who need it most in our community.”

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Contact freelance writer Loni Nannini at ninch2@comcast.net