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Friday, Aug. 18, 2006 | After fleeing her native country of Somalia, Bisharo Aidid found herself in City Heights. It was an arduous journey, especially with three young children in tow. Sixteen of her relatives made their way to a refugee camp in Kenya, some never made it out. Because of the brutal civil war, Aidid said her family lost everything, including their property and business.

In 1992, her brother petitioned for her to come to the United States, where she began to see the challenges of learning a new culture. She remembers how the simplest of tasks, like grocery shopping, frustrated her.

“When I came here, it was kind of a culture shock,” Aidid said. “Everybody here was too busy, too independent.”

Aidid’s story of is a familiar one to City Heights. Immigrants from all over the world have gathered in this small community east of downtown San Diego. They come from Africa, Southeast Asia, Latin America and the Middle East – many are attracted by affordable housing, its central location and easy access to public transportation.

Some immigrants are refugees from countries torn by war. They end up with family members who have already staked out a home. Or they are placed there by resettlement agencies or organizations that assist refugees also look for the most affordable living situations. There are more than 80,000 refugees who have made San Diego their home since 1975, said Robert Montgomery from the International Rescue Committee.

Aidid knows first-hand how difficult it can be to America. That’s why she now works at the La Maestra Community Health Centers helping recent arrivals from Africa as a translator and health educator. Here, with the community clinic where the newer and older immigrants of City Heights mingle. Aidid’s work is just one example of how La Maestra functions – with staff members, doctors, and health educators that are as diverse as the patients.

La Maestra also offers a glimpse of a dynamic neighborhood where access to health care continues to be a pervasive problem. City Heights remains as one of the poorest neighborhoods in San Diego; the average household income was about $25,000 last year, only a fourth of what Del Mar residents earned. La Maestra serves a population where 99 percent of residents live below the federal poverty line, 98 percent first come to the clinic uninsured.

La Maestra is a maze of 13 small buildings. The facilities are refurbished modest residential units. They vary in size, shape and materials, from stucco to wooden walls, but most are painted in plain white. Signs designate each building’s function.

Here, City Heights residents can access a myriad of services including medical, mental, dental and educational programs. There is a job center and a food pantry open every Friday. Inside La Maestra, the hallways are narrow and the rooms are small, despite the fact that there are up to 350 patient visits per day.

The clinic sees a population that speaks 19 languages in all, said La Maestra’s chief executive officer Zara Marselian, from Spanish to Arabic, Laotian and Somali.

Aidid said the biggest obstacle encountered by any refugee or immigrant is learning to speak the language. She learned English in Somalia, but the accent, she knew, was British and not American. Africans like herself find it frustrating when they need to go to hospitals or clinic.

“When refugees come here, they don’t where they’re going,” Aidid said. “They need everything, job training, transportation, education, and someone to translate.”

In La Maestra, translators are always on hand and there are familiar faces who understand cultural differences. Most of the clinic’s employees are also immigrants; some also came to the country as refugees.

Because of the population she treats, Pauline Tran, the clinic’s dental director, said she sees many serious dental problems. She treats tooth infections and other serious preventable dental conditions. Many of her patients come from home countries where they lacked resources and where dental problems worsen. Patients tell her about their experiences in refugee camps where a tooth brush is just not available.

“But I’m a refugee person also and I see the need for this population,” Tran said.

Tran was 16 when she fled Vietnam by boat to a refugee camp in Thailand. She endured four harrowing months in the sea between the two countries – and even survived a pirate attack.

Tran said she was scared at the time, but optimistic. “I was thinking that someday would be a bright day for me,” she said.

Her family eventually came to live in San Diego. Almost 20 years later, Tran heads the dental clinic for La Maestra working at the main facility in City Heights and three satellite locations. Once she finished dental school, she decided to come back to the place where she first settled with her family to work with the immigrant population.

“I love to work in community clinics, to work with people who usually don’t get a chance to see doctors,” Tran said.

La Maestra began as an educational program in 1986. Its main function was to provide vocational training for immigrants and prepare them for naturalization. Medical services such as prenatal care were later added on as the need arose. Doctors who spoke Spanish and could better understand the community’s needs were also brought in.

As the community’s immigration population has grown more diverse, so too has the clinic’s clients and employees. Its programs have also expanded beyond health services.

Edgar Quiroz, La Maestra’s compliance officer, was part of the clinic even in its earliest years. He first began as a student in one educational program after moving from Mexico. He eventually stayed on. Quiroz said he wanted to keep helping the people in his community learn more about the health services available to them.

“We need to educate people,” he said. “Sometimes they have a cough and they don’t know it’s asthma or that they have diabetes or high blood pressure.”

Teaching how to manage chronic diseases to clients is one of the most challenging aspects of working at La Maestra, said Karin Capps. Capps, who is from Peru and works as a health promotion and education coordinator, said her background helps her understand the people she sees every day.

“We have the same customs and needs,” Capps said. “Working at La Maestra keeps me in touch with the population. It would be different at another hospital.”

Elena Cruz, who coordinates the jobs program, said placing recent immigrants in jobs can require creativity, as many women from African countries, for example, prefer wearing traditional clothing.

“So you would have to find work that doesn’t require uniforms,” Cruz said.

Cruz, who is from Belize, saw up to 650 clients in a one year.

After 20 years in the same facility, La Maestra is trying to raise money for a new building and double its current size. Right now, the clinic’s medical records room is stretched to capacity with shelves upon shelves of files. Patients wait in an outside area for their dental appointments. Staff members hope that will change once a new building is completed in 2008.

But even as the number of patients rises, a reflection of how immigrants continue to settle in City Heights, staff members say some San Diegans still do not even acknowledge the neighborhood.

“I think City Heights is not understood by a lot of people in San Diego because it is different,” Marselian said. “They think it’s interesting but they don’t understand it.”

Please contact Marnette Federis directly with your thoughts, ideas, personal stories or tips. Or send a letter to the editor.

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