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Immigrants find a health-care home
The area's newest clinic has become the medical home for many of the region's immigrants

At the clinic, Dr. Bley works with Spanish interpreter Carmen Serrano to talk with parents Irvin Arguerta and Marisol Carraunza about their son, Kelvin.
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Date published: 5/13/2008


Dr. Donald Bley has pushed pins into the map of the world in his office to mark the homes of his patients.

Five continents and 21 countries have pins in them, including Peru, Pakistan and Puerto Rico.

His clinic has become the medical home for many of the region's immigrants and evidence of the changing face of Fredericksburg.

"Half of the people that I see in any day, I deal with them in a language other than English," Bley said.

The Community Health Center of the Rappahannock Region is at the Bragg Hill Family Life Center off Fall Hill Avenue in Fredericksburg. It is adjacent to the Bragg Hill neighborhood, where the Catholic Diocese of Arlington has resettled about 200 refugees.

Because of this, the clinic sees a different mix of patients than the other clinics operated by Central Virginia Health Services, a nonprofit agency with 13 health centers in Virginia.

"The refugee population in Fredericksburg has been high," said Rod Manifold, executive director. "They are an underserved part of the population."

For Bley, the challenge has been to communicate with these new residents about their medical problems.

"I dealt with people today in Spanish, French and an Ethiopian dialect," he said one day last week.

The clinic opened in December and offers medical care to children and adults. It serves all, but is aimed at those who otherwise can't afford medical care or can't find a doctor who'll take their insurance.

In April, for example, the clinic treated 275 patients, three-fourths of whom did not have any kind of health insurance.

"We're doing what we're supposed to be doing," Manifold said.

One of the clinic's employees translates for those who speak Spanish, the largest group other than English speakers. For others, such as those who speak Tagalog, the language of the Philippines, Bley can use a phone translation service. The result is often a "triangulated" conversation, he said, involving him, the patient and the translator on speaker phone.

Sometimes Bley's attempt to bridge the cultural difference can be comical. Once he was treating a Spanish-speaking patient and, in imperfect Spanish, wished her a happy new year.

The translator in the room practically fell on the floor, Bley said.

"What I had wished her was a happy new terminus of the [digestive] tract," he said.

The patient was shocked, Bley said, with a look that seemed to say, "I came in here for bronchitis. What's this all about?"

Jim Hall: 540/374-5433
Email: jhall@freelancestar.com

The Community Health Center of the Rappahannock Region will move across town in August to larger quarters.

The clinic has signed a five-year lease for space in the General Washington Executive Center on Princess Anne Street. The new location will be more than twice as big as its current location.

The move means that the clinic will pay rent at two places for more than a year. It signed a two-year lease and paid $250,000 for renovations when it opened in December in the Bragg Hill Family Life Center, off Fall Hill Avenue.

Officials knew from the start that the Bragg Hill location would not be large enough. But they had to open quickly with expanded services because of the requirements of the federal grant they received, said Rod Manifold, executive director of Central Virginia Health Services, the nonprofit agency that runs the clinic.

"We were going to have to add a lot more facility than there was room to add right there where we were," Manifold said.

The expanded space will allow the clinic to add another medical provider, as well as a full-time dentist and a full-time psychologist or licensed social worker.

"Of course we like it being on the hill, but the reality is that it's outgrown its location," said the Rev. Joseph Henderson, founder of the Bragg Hill Family Life Center. "We're happy that there's still going to be medical service close by."

The clinic has been busy and now has a three-week wait for appointments.

"We're very pleased with the growth there," Manifold said.

--Jim Hall


Of all the patients at the Community Health Center of the Rappahannock Region, Roberta Rollins may be the luckiest.

Rollins went to the clinic in January because she was having trouble seeing out of one of her eyes. She is 59, a resident of King George County and does not have health insurance.

"Her right eye was very abnormal," said Dr. Donald Bley, clinic physician. "Her lid was drooped and turned out to the side, and the pupil was dilated."

Bley called Dr. Richard Erwin, a Fredericksburg neurologist, and described Rollins' symptoms.

"That sounds like an aneurysm," Erwin said.

Bley sent Rollins to the emergency room at Mary Washington Hospital, where an MRI confirmed Erwin's diagnosis. Rollins had an aneurysm, or swollen blood vessel, in her brain. Her condition was critical. If the vessel broke, it could result in death, paralysis or blindness.

Soon, Rollins was on a helicopter, headed to the University of Virginia Medical Center in Charlottesville. There she had surgery to relieve the aneurysm.

"The point of the story is that this center was here when this woman needed it to be," Bley said.

Rollins agreed. She said last week that she is fine, and that her vision has been restored.

Asked what she would have done without the clinic, she replied, "Oh, Lord, I don't know. I might not be here to tell you about it."

--Jim Hall