'They didn't see a doctor here: Number one is the language, two is the transportation and three is it's too expensive,' said Amy Lee, nurse coordinator at the Pan Asian Volunteer Health Clinic in Silver Spring.
But all that's changed for the retired couple since the October opening of the clinic, which offers primary care, including physical exams and treatment for acute and chronic illness, to low-income, uninsured county residents. the clinic is open from 4 to 8 p.m. every Tuesday at the Dennis Avenue Health Center.
Although available to all residents, the clinic targets Asian Pacific American ethnics groups through such efforts as providing bilingual staff and information forms translated into Chinese. That means people such as Shu, 72, and Yu, 69, have a place to go where they can feel comfortable, said Lee, who translated for the couple during recent clinic visit.
For Yu, the "main thing is that everybody speaks the same language. The doctors see them in a way that they can express themselves," Lee said.
Overcoming the barriers of language and cost for low-income and uninsured Asian county residents was the driving force behind the clinic's creation. said Ling Cheung, its assistant director and a longtime advocate for Asian residents at the Chinese Culture and Community Service Center in Gaithersburg.
For years, Cheung said, she and others at the culture center have worked to educate Asian residents about county services that are available to them. Established in 1982, the nonprofit center provides activities and services for county residents and promotes understanding and appreciation of Chinese and Asian cultures. According to the 2000 Census, Montgomery County has about 99,000 Asian residents; they account for 11.3 percent of the county's population.
The clinic is a partnership of the culture center, which helps recruit volunteer doctors and clinic workers; the county department of Health and Human Services, which provides space and financial support; and Mobile Medical Care Inc. in Bethesda, which provides clinic management and referral services. MobileMed is a nonprofit organization that offers primary medical care to the low-income, uninsured, working poor and homeless through a network of 10 health clinics in the county,
"It's really a testimony to the goodwill of like-minded people to make if happen," said Robert L. Spector, executive director of MobileMed.
County Health Officer Ulder J.Tillman noted that the Pan Asian clinic is the latest step in the county's efforts to reach out "in a culturally sensitive manner to ethnic populations."
'I'm very enthusiastic that we have the launching of this clinic,' she said. 'We were pleased that a group wanted to address the health concerns of the Asian population.'
Although other health services are available to low income residents through the county and from organizations such as MobileMed, many Asians don't take advantage of them because of an inability to communicate, said Cheung and others.
Annie Chen, 41, of Silver spring can relate, Her mother, Mao Hua Wu, 65, was 'very excited' to hear about the clinic. She doesn't speak English and felt uncomfortable when visiting a doctor because she couldn't understand what was said.
'I have to be with her," Chen said. "Finally, there's someone to help her. She said, 'Oh my life is getting easier,' She is very happy."
The cost of health care also is an overriding issue for many of the people who visit the Pan Asian clinic. Clinic workers are trying hard to change traditional beliefs that one doesn't visit a doctor until very sick, which often means that the cure will be more expensive and take longer.
Samnang N. Wu, 50, who works as a county community service aide at the clinic, said she has seen a number of Asian residents who tell her that they can't afford medical care.
Recently, she said, a man who came to the clinic said he hadn't had the medicine that he needed for six months. "I said, 'Why don't you go see a doctor?' He said the doctor costs $100 or more. He had to think about food for his children first," said Wu, a native Cambodian.
"The clinic does not just save money, most importantly it saves lives. If people wait until they get very sick, sometimes they can't be saved in the emergency room," she said. "Number one, I want to get the message across that if you start to get sick, don't wait too long. Then the care will take longer, and that costs more."
The culmination of two years of planning, the clinic is based on a model established by MobileMed and its other clinics, which operate at facilities or in mobile vans through the county. Patients, who must show proof of residency and income, may pay from $20 to $60 for a visit, depending on income. No patients are denied service if they can't pay.
Clients are screened and treated for possible illnesses; many suffer from a such chronic conditions as hypertension, and diabetes, If necessary, patients are referred to area hospitals for lab tests, diagnostic radiology services of inpatient care.
In its first month, the Pan Asian clinic served 28 patients who were Chinese, Cambodian or Vietnamese. Currently, about 10 new patients are seen each week by a volunteer doctor, according to Yvonne Richards, 52, nurse administrator for the country's Tuberculosis Control, Refugee and Migrant Health Program.
Cheung is hoping to recruit more bilingual doctors so the clinic can accommodate more patients each week.
'We don't have enough doctors,' she said. 'If we can recruit more doctors, we can double the patients."
Spector, however, doesn't want to move too quickly to expand the clinic.
"We've deliberately chosen to grow the clinic slowly to make sure that we have our act together," he said. "We're forging new ground here, We want to make sure everything works."