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Muslim health clinics work to close gap in medical care for uninsured, underinsured

By M. Kay Siblani - Editor
Friday, 04.25.2008, 02:07pm

At three clinics, Muslims constitute less than five percent of the patients

Just as Catholic and Jewish communities founded hospitals in the middle of the last century where their faith communities as well as the general population could receive quality healthcare, Muslim community based health organizations (MCBHOs) across the country today are helping tremendously to close the gap in service to uninsured and underinsured populations in large urban areas. That was the result of an extensive study done by the Institute for Social Policy and Understanding (ISPU), a Muslim think tank based in Michigan. The group released the results of the study in a national telephone news conference in conjunction with the Association of Muslim Health Professionals (AMHP) Foundation, based in California.

The pilot study was based on 43 interviews with individuals representing 10 Muslim community-based health organizations in four cities identified as having American Muslim populations above 50,000: Chicago, Detroit, Los Angeles and Houston. The study also included a review of relevant literature and on-site visits of the health facilities. The research was approved by the Institutional Review Board at the Boston University School of Medicine.

The report said Muslim community-based health organizations have a history that spans at least two decades in the United States. This was the first study to closely examine how they have developed and how they are providing free or low-cost primary care services.

"This analysis of 10 prominent MCBHOs in these cities opens a window into the state of American Muslim public health service. With these health organizations, American Muslims are following in the tradition of other religious minorities, including Catholics and Jews, in initiating a new wave of institution building that had in decades past concentrated on mosques and schools. The rise of MCBHOs in recent years can be seen as an indication of the American Muslim community's growing civic and public service role in the cultural mainstream and the emergence of a new American-born generation of Muslims dedicated to serving the only country they have ever known," says the study's Executive Summary.

One of the study's co-authors is Lance D. Laird, a Fellow at ISPU and a comparative religion and Islamic studies scholar. He is an adjunct assistant professor and post-doctoral fellow in general pediatrics at Boston University School of Medicine. He conducts medical anthropology research and cultural competency training as a senior consultant to the Boston Healing Landscape Project, an institute for the study of religions, medicines and cultures of healing.

Wendy Cadge, the other author, is also a fellow at the ISPU. She is an assistant professor of sociology at Brandeis University and the author of "Heartwood: the First Generation of Theravada Buddhism in America," published by the University of Chicago Press in 2005. Professor Cadge was a Robert Wood Johnson Foundation Scholar in Health Policy Research at Harvard University.

Of the Muslim community-based health organizations in this study, the earliest to emerge were NISWA (Arabic for "women"), which formed in 1990 to assist with the mental health, domestic violence and social service needs of Muslim families in Los Angeles; University Muslim Medical Association (UMMA) Community Clinic, the most well-known Muslim organization to offer medical services, which emerged in South Central Los Angeles in 1996; Shifa Clinic Houston, which began providing primary health services in the region in 1997; Muslim Family Services (MFS) of Detroit, originally founded by the Islamic Circle of North America (ICNA) in New York, which began providing marital counseling and psychotherapy for Muslims in 1998.

Several other Muslim community-based health organizations have emerged steadily since the turn of the century, including Al-Shifa Clinic in San Bernardino (2000), the Ibn Sina Foundation Clinic in Houston (2001), Inner-city Muslim Action Network (IMAN) Health Clinic in Chicago (2002), the Compassionate Care Network (CCN) in Chicago (2004) and the Health Unit on Davison Avenue (HUDA) Clinic in Detroit (2004). Organizations like Zaman International in Detroit, dedicated to providing humanitarian relief as well as culturally competent end-of-life care and women's shelters, are slowly emerging. Other Muslim-initiated community health programs are developing in Chicago, Baltimore, Northern Virginia, Las Vegas, Buffalo and elsewhere, building on the models established by these pioneering organizations.

Indeed, last weekend, U.S. Congressman Keith Ellison, the first Muslim elected to Congress, assisted with the grand opening of the Muslim Clinic of Ohio in Cincinnati, with Muslim Public Affairs Council (MPAC) Director Salam al-Marayati, a group unrelated to ISPU or the AMHP or its foundation.

Just over half of the MCBHOs were initially started by American Muslims to serve particular ethnic and immigrant communities. This included providing Muslim patients with culturally and often linguistically appropriate care. But other MCBHOs, such as Los Angeles' UMMA Community Clinic, from the beginning, emerged in response to a universal commitment to serve urban populations that lacked access to insurance and health care. Today, the majority of MCBHOs serve the broader community, both Muslim and non-Muslim. Notably, at three major institutions, Muslim patients represented less than five percent of the population served.

Most of the organizations in the study were founded by first-generation American Muslim physicians who were motivated by a desire to "give back" to society, in keeping with the Islamic tenets of serving those in need. The emergence of MCBHOs also represents the emergence of a new American-born generation of Muslims that has successfully established roots and financial stability and is seeking to provide public service to underserved communities. Many of the MCBHOs were providing community-based health care well before 9/11, yet most leaders acknowledged that the current climate has strengthened their sense of urgency, purpose and commitment to providing — through these health initiatives — a highly visible manifestation of "what Islam is all about."

Many who provide health care services in MCBHOs do not distinguish themselves from other free clinics or networks and describe their organization's Muslim identity as mostly derived from the nominal identification of the majority of providers. Although the organization may have been founded and/or run by Muslims or affiliated with an Islamic center, all medical services are "open to everyone."

The study also says MCBHOs provide a critical, cost-savings safety net. Because they rely largely on volunteers (and, in some cases, private donations), MCBHOs likely provide better health care at less cost than many other forms of primary health care providers. These clinics are likely to be particularly good at locating and providing health care to the underserved, especially low-income communities who live in urban areas who might not otherwise access health care services. Funding for MCBHOs mirrors those of other community-based health organizations and clinics. Nearly all clinics studied receive grants from city, county, state or federal government sources and rely on non-Muslim charitable foundations, in addition to donations from local and national American Muslim groups, the study says.

Many interviewees in the study explained the rise of MCBHOs in the past few years as a sign that the American Muslim community is coming of age. Several interpreted the emergence of UMMA, for instance, as indicating the emergence of a new American-born generation of Muslims dedicated to serving the only country they have ever known. The story of the UMMA Community Clinic, organized by second-generation American Muslim activist medical students, represents one trajectory in the emergence of these MCBHOs, one shared in significant ways with HUDA and IMAN. For instance, Dr. Faisal Qazi, who served as a young resident in Detroit, is frequently mentioned as the driving force behind the creation of HUDA, which followed the UMMA model. Nevertheless, the Muslim Physicians of Greater Detroit, an organization composed largely of older, first-generation American clinicians, also played a role in organizing and funding the initiative. African American Muslim social workers and community organizers like Mitchell Shamsuddin also partnered with these immigrant Muslims in the creation of HUDA, and the Muslim Center of Detroit now provides the space for the clinic. The IMAN Health Clinic is the brainchild of Sherene Fakhran, then a Northwestern University medical student, who enlisted two young South Asian-American physicians, Drs. Rima and Ahsan Arozullah. The latter also cite UMMA as part of their inspiration. The larger IMAN organization itself is the product of collaboration between second-generation Arab American and African American Muslims.

Says Rodwan Saleh, president of the Islamic Society of Greater Houston, who addressed the Shifa Clinic Houston fundraiser "I see us as Americans. This is our home, not a home away from home. We chose to come here; we chose this country as our country. America is our country. We were given chances here for education, business; we were allowed to be who we are. Now it's time for us to pay back the country that accepted us with open arms."


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