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In Houston’s Most Diverse Neighborhoods, Clinics See More Patients Than Ever After Harvey


Hurricane Harvey

HOPE Clinic keeps its headquarters in Alief, Houston's most diverse neighborhood. (Photo by Felipe Luna for Direct Relief)

Yen Ly first came to the HOPE Clinic in the Alief neighborhood of West Houston in 2011. By then, she and her husband had been living in the U.S. for two years, having moved to New York from Ho Chi Minh City. Uncomfortable with the small size of the Vietnamese community in New York, they decided to move to Houston, home to one of the country’s largest Vietnamese populations, making a quick trip home to visit family first. “We came back from my country and my husband had a really bad allergy, but we had no work and no income,” Ly said on a chilly January morning recently. “That’s when we first saw the name HOPE Clinic.” 

Yen Ly, like many staff members at HOPE Clinic, first came as a patient. She now does outreach to the large number Vietnamese of residents in the Alief neighborhood of Houston, Texas. (Photo by Felipe Luna for Direct Relief)

HOPE opened in Alief in 2002 as the Asian American Health Center, operating once-per-week out of the Chinese Community Center, a United Way affiliate in Houston’s Chinatown. In the summer of 2005, Hurricane Katrina swept through the Gulf, transforming the region’s cultural and physical topography. The clinic was forever changed, too.

Of the 15,000 people of Vietnamese origin who were resettled in Houston after leaving New Orleans, some 3,000 found their way to HOPE Clinic, which, by then, had a staff of 20 people working four days per week.

Health information in multiple languages is displayed in the clinic’s lobby. Staff members at HOPE Clinic speak a total of 29 languages. In 2017, they saw patients who spoke a total of 45. (Photo by Felipe Luna for Direct Relief)

“At the time, we were one of the only clinics that could accommodate the Vietnamese population coming in,” said Cathy Phan, the clinic’s business development coordinator. Today, HOPE employs 150 people at three locations who speak a combined 29 languages. Many of those staff members, including Yen Ly, who coordinates outreach within the Vietnamese community, come from the same communities they serve.

Though relatively few of the clinic’s patients suffered damage in Hurricane Harvey, said Dr. Andrea Caracostis, the clinic’s CEO, “they had the heart to go out and help,” exposing themselves to flu and tetanus. “Thanks to Direct Relief, they had access to the shots they needed.”

Lara Hamilton, Christ Clinic’s executive director, has worked both in private practice and in cash-only medical practices, which tend to serve the wealthy. She describes her patients at Christ Clinic as “the most resilient people you’ve ever met.” (Photo by Felipe Luna for Direct Relief)

Other communities were not so lucky. Just 17 miles to the west, the Christ Clinic in Katy, Texas, serves a community that, according to Executive Director Lara Hamilton, is generally viewed as one of Houston’s more affluent suburbs. “Hurricane Harvey came and it hit Katy pretty hard,” Hamilton said on a recent afternoon the day after a winter storm that had brought Houston, still understandably weather-sensitive, to a complete stand-still. Several of the surrounding communities, she said, had been inundated by water released from the Addicks Reservoir in the heart of the area.

Julio César, who works in construction, is rebuilding homes in the Bear Creek neighborhood at little more than the cost of materials. Others, he said, are exploiting the situation, charging astronomical rates to get houses back in working order. The neighborhood was one of many that flooded in the Houston area. (Photo by Felipe Luna for Direct Relief)

“What we found is there were a lot of people living at the top of their means and they had no safety net,” Hamilton said, adding that, before the storm, the Katy school system had 900 homeless students on their rolls. That number has since climbed to 3,000.

Like the HOPE Clinic following Hurricane Katrina, the Christ Clinic has seen a substantial increase in patients coming through its doors in the wake of Hurricane Harvey. Prior to the storm, the clinic saw an average of 750 patient visits per month. In September, there were 2,300 patient visits. A month later, that number had gone up to 2,800 visits for 2,300 unique patients. “We really have no idea what our patient volume will be this year,” Hamilton said. “We have no idea.”

Following the hurricane, Christ Clinic set up in several local shelters to distribute tetanus and flu shots donated by Direct Relief. “People who didn’t know who we were — and the first time they encountered us was through our services after the hurricane —they will always be supporters,” said Hamilton. “People always remember what you do to help in a crisis.”

In Bear Creek, debris from the floods sits at the end of driveways even months after the disaster. (Photo by Felipe Luna for Direct Relief)

The disaster has raised awareness not just of the clinic, but of the fragility of security faced by even the most affluent people. “Before there were a lot of wealthy people who didn’t recognize the need for a charity clinic here who now recognize that ‘oh, this could happen to me.’ People are now acutely aware that poverty can be out of your control,” Hamilton said. Having worked as a nurse practitioner in both private practice and in a cash-only practice for the “super wealthy,” Hamilton described her patients at Christ Clinic as “the most resilient people you’ve ever met. For many of them, if it’s not one disaster, it’s another.”

The waiting room at the main branch of HOPE Clinic is an astonishing cross-section of the communities that have made Houston the most diverse metro area in America. (Photo by Felipe Luna for Direct Relief)

Though they come from different communities and, in many cases, very different backgrounds, the same could be said of many people who seek help at HOPE. Though overall patient visits have remained consistent for HOPE after the storm, Dr. Caracostis, like Hamilton, said that it’s impossible to tell just yet what may come in the future. “Going through Katrina, we recognize that the real need is long-term,” she said, which is why the clinic is currently in the process of beefing up its behavioral health services.

“When your world is so shaken up, you’re not thinking about having your vaccines up to date, so to have someone to do that for you, that makes a huge difference,” said Yen Ly on that January morning from behind her desk, where she uses social media to track medical needs in the Vietnamese community in real time. As HOPE continues to expand in the coming years, the clinic will build a new campus in the heart of Alief that will include offices, healthcare facilities, and also a health food café that will employ people from the community while raising awareness about healthy cooking techniques derived from the virtually infinite variety of cuisines available in the surrounding area. “We want to be more of a community center,” Phan said. “We don’t want people coming in just because they’re sick.”

The waiting room at the main branch of HOPE Clinic is a cross-section of the communities that have made Houston one of the most diverse metro areas in America. (Photo by Felipe Luna for Direct Relief)

Walking through the waiting room at HOPE’s clinic headquarters that morning, Dr. Caracostis gestured across a room filled with people from every corner of the globe, chatting happily with each other whenever language wasn’t an insurmountable barrier, and sometimes even when it was.

“Health,” she said, “is the great equalizer.”

Crisis is another.

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