When the Bayside Community Center in Linda Vista offered free flu shots to seniors last week, Ángeles Hernandez arrived an hour early. She sank into one of the plush leather couches in the building’s reception and massaged the deformities in her hands as the room filled out around her.

She has chronic rheumatoid arthritis, but she only treats it when she can afford it. This is not one of those times. With sad eyes and a half smile, she said she had not been able to pay for a doctor’s visit in nine months, or had a good night’s sleep in almost as long. She pointed to the deep recessions under her eyes as testament.

So the chance for a free seasonal flu shot was a welcome one, and one she couldn’t pass it up, she said. She showed up early just to be sure, and she told friends.

She had just one concern when she arrived at the community center: she is not a senior.

“They told me it was OK,” Hernandez, 47, said. “They told me I am young, but I have an old person’s disease.”

Hernandez was not the only one. The seniors came from across the neighborhood, and some from across the city. Among them were Vietnamese, Mexicans, Iranians, Americans, and Filipinos. Most heard about the free vaccinations by word of mouth, and though they came for flu shots, many of their ailments — some, like Hernandez’s, untreated — were on display.

The national healthcare debate has made it clear that the challenges facing uninsured Americans seeking medical services can incite fervent emotions. Among Linda Vista’s senior population, the challenges are magnified. The community is an established immigrant enclave, and its residents are reaching old age. Many lack not only medical insurance, but also English skills and, in some cases, familiarity with Western medicine.

At the Bayside Community Center in the heart of Linda Vista, program coordinators see a growing need to address senior health in a neighborhood where the cultural and financial backgrounds of many residents may not lend themselves to prompt diagnoses and treatment.

“Our population is aging,” said Connie Curran, who coordinates the Bayside Community Center’s program promoting wellness among Linda Vista’s seniors. “There are so many more people over the age of 65 here than there ever have been.”

Linda Vista is a largely self-contained community west of State Route 163 between Friars Road to the south and Genessee Avenue to the north. The majestic towers of the University of San Diego’s campus gleam from a hilltop at its southern entrance, but north along Linda Vista Road lies a different Linda Vista. It is a largely low-income community where, according to Bayside staff members, at least 15 languages are spoken, and where older residents have little reason to venture out.

Language barriers or poverty, and often both, deter seniors from seeking physical or mental health care, Curran said. Among the community’s large Vietnamese population, residents who fled war four decades ago still struggle with post traumatic stress, and age in the shadows while developing dementia and neglecting personal health. Economic migrants from indigenous Mexican communities cannot communicate with either English or Spanish-speaking doctors, so they stay away.

“We call it White Coat Syndrome,” Curran said, and it worsens as seniors develop mental

Doing Something About It

Bayside Community Center has partnered with researchers from the University of San Diego to visit Linda Vista seniors in their homes and assess possible early signs of dementia or other mental health problems. Though the project is preliminary and not diagnostic, Bayside staff hope it will give them a better understanding of senior citizens’ living conditions, and their implications for health.

“Mental health, their living conditions, and physical health are all connected,” said Adriana Gallardo, a case manager at the community center.

By dispatching culturally sensitive volunteers to homes, the center seeks to engage seniors with basic understandings about health and doctors. Some residents, unable to afford medical care and comfortable only with the community center, have shown up there when they’ve had chest pains, Gallardo said.

Except for emergency rooms, most low-income seniors have few places to turn. The two major community clinics in Linda Vista, though operating on sliding fee scales, are still out of reach for some of the community’s poorest residents.

“They can’t afford to pay a $30 co-pay,” Gallardo said.

The staff at Bayside has tried to pick up some of the slack, but it is not a health facility, and aside from last week’s flu shot clinic, which delivered 103 vaccinations and could not meet demand, does not provide medical services.

Not Being ‘Exclusive’ About Her Healthcare

Maria del Socorro Banda, 73, still dresses with the elegance of the stage singer she was for 41 years, but instead of performing for paying Mexican audiences now serenades Filipino, Iranian, and Vietnamese seniors during free lunch hours at the community center. She tries to promote herself as a party singer to support her struggling daughter and grandchildren.

She has no regular doctor, or as she put it, is “not exclusive about my healthcare.” Instead she has visited the St. Vincent De Paul’s mobile health clinic for pap smears, and on Monday, the community center for her free flu shot.

The mobile clinic is among the few entirely free healthcare options offered in San Diego. In El Cajon, Volunteers in Medicine, a community clinic, serves uninsured residents. St. Vincent De Paul’s downtown health center used to be open free of charge to any uninsured patient, but a year ago implemented a sliding scale fee structure, and prioritized appointments for residents of the shelter and the city’s homeless, said Teresa Simms, the center’s director.

That complicated things for Hernandez, the 47-year-old rheumatoid arthritis sufferer. She is a single mother with three teenagers and a $1,200 monthly income from food stamps and welfare. Her worsening arthritis has made even some day-to-day tasks difficult, and fulltime work impossible. She used to visit St. Vincent de Paul’s for her regular doctor’s visits and prescription renewals.

Her prescription amitriptyline, for pain, ran out months ago. Forty-five dollars was too much to pay the Logan Heights Family Health Center for a consultation with an Arthritis Foundation doctor to renew her prescription. But when she awoke Sunday morning with a hemorrhage in her right eye, she decided not to put it off.

After her vaccination, she was going to call the clinic first, then worry about how she would pay the fees. She had lapsed in her commitment to make monthly visits to the Arthritis Foundation, where she had participated in treatment experiments, and had been threatened with being dropped from the program.

“Sometimes they just don’t understand that because of my sickness I can’t work or pay,” she said, adding, “I told them they could use my body to find a cure.”

Hernandez’s 17-year-old daughter, Carmen, wants to be a doctor. Before her mother’s prescription medications ran out, she helped her stretch them.

“We treated it like gold,” Hernandez said. “I would say, ‘Hija go get me the gold.’”

Hernandez is Catholic. “We pretended it was the host,” she said. “In church, the priest holds up the host and breaks it into pieces, then puts it on the tongues of his congregation.”

Her daughter was very precise, she said. Like a priest, she would cut the pills into four pieces with a knife. “She would put one piece on my tongue and say, ‘Mama, let’s pray to God that you get better.’”

Please contact Adrian Florido directly at adrian.florido@voiceofsandiego.org and follow him on Twitter: twitter.com/adrianflorido. And set the tone of the debate with a letter to the editor.

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