Three young Latino patients wait in the Siloam waiting room. Above their heads reads "Come to Me, all who are weary and burdened, and I will give you rest. Matt 11:28"

Siloam Health Care Center's mission is "to share the love of Christ by serving those in need through health care."

"As a primary care center, Siloam provides affordable, high-quality health care to the uninsured and those who slip through the health care system because of time, money and language barriers."
      

A Day in the Life of Siloam: a Physician's Perspective

By Morgan Wills, Staff Physician

8:02 - Walked in a couple minutes late to staff meeting. Nancy is leading us in prayer for the day's clinic. Get teased by Beth and Alissa for being late. Coffee needs a little more sugar. Mark and Nancy lead us through a sea of issues that are confronting us this week. Thank God for administrators!

8:58 - Our faithful Tuesday morning volunteer nurse, Laura Denison, arrives and as usual patiently waits for us to end staff meeting and open the front door.

9:05 - Looking over lab results from yesterday's patients. Called the caseworker for a Sudanese refugee with an artificial heart valve to let him know that his blood was now appropriately thin. They thank us profusely!

9:15 - Screaming of young children fills the waiting area - probably anticipating shots... Ellen (staff nurse) will have her hands full!

9:20 - A recently arrived refugee from the Middle East arrives for a scheduled follow-up appointment. I quickly review pertinent questions for patients with post-traumatic stress disorder while the rest of the staff prays for what they know will be an intense patient encounter.

9:25 - Squeals of laughter from the waiting area; our office coordinator, Alissa, wacky puppet on hand, is entertaining some of the Bosnian and Congolese children in the waiting room. We wonder who's enjoying it more - her or the kids?

Meanwhile, my patient is a Muslim father of four who was shot multiple times, taken hostage and tortured by the Iraqis during the Gulf War. In addition to chronic musculoskeletal and stomach problems (half of it was surgically removed), he struggles with poor sleep, flashbacks, explosive anger, and a fear of being alone. He claims not to be able to work to support his family, and the relief agency has already way overspent their budget on him. He is frustrated, and his proud demeanor soon melts into tears. He is incredulous at the offer of prayer and receives it eagerly!

10:00 - After an extensive workup and counseling, the patient is started on antidepressant and antacid medicines. The search is on for a psychiatrist to see him in follow-up as well as for some benevolent sources of alternative income or housing while his complicated medical and emotional problems can be sorted through and treated. Spent ten minutes explaining the experience with our Vanderbilt volunteer medical student of the day.

10:30 - Next, some refugee school physicals for a healthy 17-year old Sudanese girl and two Somali boys. Time to ditch the white coat. The first one speaks great English but the latter needs a family friend to interpret so it takes a little longer. They giggle when I examine their abdomens. Some things are universal, I guess.

12:45 - After a quick bite to eat and some paper work, a 24-year-pld Ethiopian young man presents with follow-up for his abdominal pain. Discounted lab work from Baptist Lab confirms that he has an infectious cause, and we piece together an appropriate drug regimen from our donated pharmaceutical supplies. Meanwhile, he tells me about his loneliness. Wait a second! Our volunteer nurse, Laura, has a friend involved with ministry to international students. A few minutes and a phone call later, this patient, an orthodox Christian, is excited at the prospect of joining a Sunday night Bible study with other young Africans in the area.

1:30 - A 40-year old man recently released from prison drops in because of indigestion, prostate and scalp problems. These problems are diagnosed and treated but the visit suddenly takes a longer twist when a urinalysis and a quick blood test confirm that he also has diabetes. There are a few no-shows, so we go through some diabetic education and make a strong case for abstaining from alcohol. The offer of prayer is a welcome surprise again.

2:30 - Review a few cases with Clay, staff nurse practitioner. When in doubt, I cal an orthopedist friend with a question about knee injuries. Feels more reassuring than just reading it in a book.

3:30 - A Vietnamese family here for school physicals - one boy has strep throat. No allergies, well.... Penicillin on the way!

4:00 - The patient flow slows down to a trickle. There is time to make follow-up phone calls to patients and I still haven't gotten in touch with that psychiatrist. I review a few cases with Beth, staff nurse practitioner. It's been an equally interesting and challenging day for her, but we both agree there isn't anyplace else we would rather be serving than at Siloam.

5:00 - The day ends and we all look forward to tomorrow - it's Dr.Leroy Barden's day off and and his wife, Eva, spend it with Siloam - treating patients and blessing volunteers and staff with their presence.

By Kristin Ehst, VMSII

My experience at Siloam was priceless. I appreciated the chance this elective provided for me to see into the heart of community-based healthcare. It is evident to me that God has called dedicated, compassionate servants to work at this clinic and has blessed the ministry and outreach into the community. I really appreciated working with doctors and nurses who were sensitive to the unique needs and perspectives of refugee populations as well as low-income families. There were several wonderful experiences that I hope to carry with me as I continue to practice medicine.

One of the first days I was at Siloam I entered the room and met a woman who was physically overtaken with grief. Her eyes were downcast and swollen from tears and her posture was hunched over. She appeared forlorn but immediately engaged with me. As I began talking with her, she began to share her story. She explained that her daughter had been killed a year ago and she was unable to do anything but mourn the loss of her child. She was unable to sleep, eat, or communicate with anyone who loved her, and it was obvious she was in deep depression. I listened patiently and encouraged her to seek out a therapist or counselor. My heart yearned for her to have peace and healing. With tears in my eyes I asked her if I could pray with her and she lit up. She said she had read that some doctors were willing to pray with their patients and that there were ppeople at this clinic who would do this. We prayed together and as I left the room to get the physician I was encouraged to see that God was working at this clinic and people were responding to his healing hand.

I enjoyed being able to work alongside physicians who demonstrated effective and caring ways of treating patients of different cultures. There was one experience where I worked with a resident who was able to break down cultural barriers of language by simple touch. Throughout the exam he would rest his hand on her shoulder or arm to show he was intensely interested in her comfort and well being. In addition, throughout the exam he explained everything he was going to do to the husband who was the translator. Her unsettled eyes slowly relaxed and by the end she was smiling at the physician as she vigorously shook his hand. He showed unique interest in her cultural background by asking her husband about their background, which helped to instill trust to this Vietnamese family.

I feel blessed to have been able to work at Siloam and I would love to volunteer here in the future after I have a few more years of clinical experience. The rewards of working with underserved populations are rich and life-changing. I am thankful for the time and personal interest that Dr. Gregory and the volunteer physicians gave to the students in this elective.
  

By: Alissa Dyer, Volunteer Coordinator

   The mid-South heat scorches down on a group of teenage boys as they walk into the cool haven of the Siloam Family Health Center waiting room, accompanied by a representative of one of the local refugee resettlement agencies.  This heat is nothing to these young men, known as the "Lost  Boys."  They have survived far hotter days in the deserts of the Sudan, a country in Africa, where they walked thousands of miles, collectively, under a much brighter blinding sun.

   In 1983, war broke out in the Sudan, which borders eight neighboring nations.  This war originated primarily between the Islamic government and those who refused to adopt and/or practice this religion.  Christians became the largest targeted population for oppression.  Many lived in the southern region of Sudan.  When overt violence became the norm, thousands fled for their lives to bordering nations, such as Ethiopia and Kenya.

   Adults were murdered and girls were taken as slaves during government- sanctioned attacks, leaving mostly young men (between the ages of 4 and 18) to journey across the desert in pursuit of food, shelter and education in pursuit of freedom.

  Today, after years surviving in refugee camps following their trek, many of these young men are finding freedom in the United States.  Siloam has been touched in a personal way by the stories of these Sudanese refugees.  Here, staff members share some of their impressions and recollections.

   Ellen Bishop, nurse, recalls, "The first group of 'Lost Boys' that came to Siloam, I remember well.  Several of the boys cried when I gave them their immunizations.  I began to cry with them because I knew they had survived far worse experiences in their short lives. It grieved me to cause them additional pain."

   Morgan Wills, physician, was particularly impacted by one19 year-old. Dr. Wills shares, "This young man recounted the day that he returned to his village from the nearby fields to find it burning from a government-sponsored attack.  His parents sent him in the care of a teenage 'uncle' to flee on foot toward the East.  They were to head for Ethiopia. Neither had any idea how far away it was or the ordeal it would be to make it to this destination.  He remembers joining other youth in flight (eventually hundreds of displaced youth traveled together).  He witnessed other boys being eaten alive by lions and crocodiles, drowning in a flooding river, and falling by the wayside from hunger and exhaustion; left behind to starve to death.  This boy was 11 years old at that time."

   Clay Satterfield, family nurse practitioner,  reflects, "These young men are such an inspiration to us all.  Whenever I ponder their stories, I feel conviction.  I had a great home.  My family was never more than a few minutes away, much less thousands of miles or indefinitely lost.  Murder was not a word in my vocabulary.  Bombs never fell from the sky.  But, no matter the struggles of our Sudanese friends, they have joy.  They smile.  They laugh.  They love to meet people.  They are instantly your friends.  They rest in what the future can be, not what the past has been for them.  Who am I to complain in the face of such men?"

   Beth Bancroft, family nurse practitioner, offers, "Their stories are staggering.  I once spoke with one who had arrived just the previous afternoon.  It is likely that until a mere three days prior, he had never seen electricity, running water, or the endless supply of fruits and vegetables at any local grocery.  His eyes were glazed.  I could not imagine the sights those eyes have seen friends starving, brothers drowning, family members dying.  And, now, he is here, ready to begin a brand-new life.  How does one go about putting such things behind?  All they've known is hunger, loss, fear, separation, and tragedy.  But, they are here.  And they have each other.  Many of them know Christ.  And, in Him lies their hope. In Christ is true newness of life."

   At Siloam Family Health Center, our mission is "to share the love of Christ with those in need through health care."  We believe that through this mission, we will see our Sudanese friends gain the healing and hope, both physically and spiritually, that they need and deserve to begin their new life here.  They have much to learn as they integrate into this foreign culture and we have much to learn from them.  We have witnessed their initiation into the small technologies and so-called luxuries present in our clinic and in their homes that many Americans take for granted-toilets that flush, door handles that lock, even the delicacy of home-made chocolate chip cookies! We at Siloam are honored to assist the "Lost Boys" (and every refugee patient) and hope to be a resource to buffer and teach as they navigate this strange and wondrous New World.  We welcome them with open arms.
  

 
Catholic charities Refugee and Immigration Services in Nashville, under funding by a series of federal grants, has been servicing the refugee population in Nashville since 1975, resettling approximately 350 persons per year. People served come from Bosnia, Iraq, Kurdistan (Northern Iraq), Somalia, Vietnam and Cuba.

The goal for each refugee unit, whether individual or family, is self-sufficiency within 90 days (requiring no monetary assistance from either government sources or Catholic Charities). During the first 90 days, Refugee Resettlement provides core services including: apartment set-up prior to arrival (all furnishings donated), airport reception, initial food and clothing, application for food stamps, TennCare, SSI (only for disabled persons or those over 65), social security card, child school enrollment, referral to health centers for health screening, referral to employment services and ESL (English as a Second Language) classes.

Basic resettlement: provide with food, clothing and safe, clean housing. Teach about American culture and life in Middle Tennessee. Assist in complying with laws, completing forms, meeting friends and securing employment. Teach English , place children in school, ensure access to basic medical care, . Goal is to get families to the point of self-sufficiency as quickly as possible.

Immigration services: Provide assistance with green card and citizenship applications as well as processing sponsorship applications to allow immigration of immediate family members from their home countries.

Welcome to America Baskets

Kitchen supplies
Bowls
Coffee mugs
Colanders
Cooking utensils (ladles, spoons, etc.
Glasses, plates
Dishwashing liquid
Knives (sharp), large cooking pots
Silverware, tea pots, pots and pans
Manual can openers, place mats, dish towels

Household Cleaning Supplies
Brooms, dust pan
Laundry detergent
Commode brush, mops, 409, Lysol, Comet, etc.
Sponges, scrub pads
Trash cans, trash bags

Baby Items
Diapers
Receiving blankets, bibs
Baby shampoo, powder
Rompers
Layette

Personal Hygiene
Bars of soap
Bath and hand towels, washcloths
Deodorant
Mouthwash
Razors, sanitary napkins
Shampoo, shaving cream
Toilet paper
Toothbrushes, toothpaste

Miscellaneous Items
Alarm clock, light bulbs
Envelopes, pens
Insect spray (roach)
Shower curtain and liners
Bed linens
Radios
Bedspread
Writing tablet
Furniture Items
Lamps
Chairs
Mattress and box springs (single or double only)
Tables (kitchen, end, coffee)
Kitchen chairs

Items can be new or slightly used but must be in good condition. Place items in a laundry basket, bucket, or trash container (all usable by refugees). Hotel soaps and shampoos are also appreciated. For more information, contact Catholic Charities Refugee and Immigration Services at 259-3567.