COVID-19's Impact on Nonprofit Health Clinics & Promotoras

Story by Cynthia Maduka, Communications Intern (Summer 2020)

At the border of Mexico and Texas, Access Esperanza has been serving greater Hidalgo County since 1964. Their mission is to provide the community with access to family planning resources, including an extensive range of contraceptives options and STI testing and treatment. Access Esperanza is able to provide low-cost health services in an area where 30% of its residents live in poverty (according to the US Census).  They believe in advocacy and education through community outreach in order to help those who are not only low-income, but lack access to conventional health clinics due to geographic isolation.

Dora Proa, an Outreach Coordinator of 28 years, is accustomed to presenting information on Access Esperanza Clinics services at the crowded flea markets of Hidalgo, in the midst of shoppers looking for fresh produce, clothes, or jewelry while the sound of Spanish music echoes in the background. However, during the stay at home initiative, Proa and other Promotoras (community health educators) went from pounding the pavement to dialing numbers.

Claudia, an Access Esperenza Promotora adjusts to the new normal of COVID-19 as in-person outreach slowly returns to the Hidalgo flea market in June 2020.

Typically, the Promotoras are monolingual workers who travel around the community attending events from flea markets to community health fairs, while the campus educator attends University health fairs and holds student workshops, all to educate the public on family planning and the available clinic services. The seven Promotoras currently working with Access Esperanza form the backbone of their outreach efforts, and they are able to reach 1,000-1,200 people through outreach each month.

During this time, they play an instrumental role in notifying past patients by calling and informing them that the clinic services are still up and running amidst the pandemic. And yet, for Proa, the community engagement part of her role is what she enjoys the most.

“My favorite part of my job is being out in the field and presenting about health topics at schools and, community centers, and when I wasn’t able to do so during the lock down it was difficult,” said Proa through an interpreter.

In efforts to flatten the curve of Covid-19, several states, including Texas, employed emergency safer-at-home orders. Hidalgo County enforced even stricter travel regulations such as implementing checkpoints to ensure that travels were for essential purposes only. Those found to be traveling for non-essential reasons would be subject to potential jail time or fines.

“My favorite part of my job is being out in the field and presenting about health topics at schools and, community centers, and when I wasn’t able to do so during the lock down it was difficult."

Despite remaining open as an essential business, an underlying barrier made patients reluctant to visit clinics. Access Esperanza serves a large immigrant population, and many feared that they would be stopped by the police and asked about their immigration status.

According to Martha Leos, Supervisor of the Entre Nosotros project, Access Esperanza drafted a letter for patients to bring with them while traveling to a clinic, in hopes of reassuring patients that it was safe to receive care. The letter stated that the patient is traveling for essential purposes and is receiving services at the clinic.

“Even with the letter, our clients were still apprehensive about the possibility of being pulled over and asked about their immigration status,” said Leos. “They opted to wait until things settled before making an appointment.”

Regardless of the stay-at-home orders, the Promotoras still managed to spread the word about the clinic remaining open, which eventually led to an increase in patients visiting the clinic.

The type of hands-on Promotora outreach common in the community before the pandemic hit.

As with other nonprofits, Access Esperanza sustained financial losses during the COVID-19 pandemic. However, as a result of an emergency support grant from the Argosy Foundation, Access Esperanza was still able to fund the salaries of the essential workers who in turn were able to continue their work in the community.

As Texas struggles to get back to some sort of normalcy, Proa and the other Promotoras are back in the field, geared with their masks and hand sanitizer in tow, maintaining a safe 6-foot distance, as they continue to educate their community about the low to free cost services that Access Esperanza provides. You can visit their website to learn more about these services and the rest of Access Esperanza's work.