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Dr. Leonard Berkowitz is PATH’s
medical director and Brooklyn Hospital Center’s chief
of infectious diseases. He hired Sendzik in 1997, and shortly
thereafter, Caledonian closed its inpatient care unit. Despite
the loss of an inpatient facility in the Prospect Park neighborhood
in Brooklyn, Sendzik saw the glass half full.
“I knew that if the hospital
would give us some of their vacated space,” he says,
“we could create a system of care that responded to
patients’ many needs, all under one roof.” Sendzik’s
wish was granted, paving the way for PATH to provide access
to the array of onsite services that are available today.
Many of these services are Haitian-focused
and include the Haitian Centers Council, Diaspora Community
Services, Church Avenue Merchants Block Association, Grenada
Women’s Organization, and New World Creations Resource
Center. They offer services like job training, housing support,
information about domestic violence, counseling, instruction
in English as a second language, and computer training. One
organization works to improve the literacy level of mothers
so that they can read to their children.
Zipcode 11226 is the primary catchment
area for the PATH Center and lies in the center of Brooklyn,
a borough that geographically is much larger than Manhattan
and that reflects both the epidemic of the 1990s—new
infections among the very poor—and ironically, also,
the epidemic in its early stages. There is a large population
of Haitians, a group that early in the epidemic was classified
not as a culture or a race or an ethnic group, but as a risk
factor. They are estimated to be just over 74,000 strong in
Brooklyn, and they reflect as much unmet need today as they
did when the epidemic emerged in 1981.44
Open Doors
“Over the last 10 years, the
Center has grown in ways that make it increasingly reflective
of clients’ needs,” explains Sendzik. Of PATH’s
44-member staff, 8 are Latino, 1 is Arab, 1 is Asian, 11
are African-American, and 10 are of African Caribbean descent.
Among the latter are Dr. Roselyne Chery, a doctor from
Haiti, and Angela Campbell, a nurse from Jamaica. Dr. Chery
speaks Creole to the clinic’s 200 Creole-speaking
clients.
With PATH having approximately 900
patients at the end of the first quarter in 2006, one might
expect to find an overcrowded waiting room or clients who
have little face time with staff, but that’s not the
case. What one finds instead is an atmosphere in which patients
are helping one another, where Sendzik, Berkowitz, and the
entire staff seem to know every patient by name—and
where Yvonne Kingon, the pediatric nurse practitioner, wears
a green lizard stuffed animal around her neck. You’ll
find a mural depicting community life painted along the wall
as a thank-you from one of the Center’s clients. And
you’ll find Dr. Mahmoud Hassanein, a pediatric infectious
disease physician, whose clinic treated 96 HIV-positive or
HIV indeterminate patients under the age of 24 in 2005—over
half of them were children under 12.
Feeling at Home
While visiting the PATH Center, you’re
also likely to run into Mildred Wallace, the Center’s
first peer advocate. “I’m someone a lot of
patients can relate to,” says Mildred. “I
figure this is my life’s journey: to pass on what
I’ve learned
to help someone else.” Wallace recalls how the PATH
Center helped her overcome her own battle with addiction
and her fight for community. Clean and sober for more than
10 years now, Wallace remembers how the staff didn’t
look down on her and instead lifted her up. It was particularly
poignant for her that the staff used gloves only for internal
exams, but not for shaking hands. It was acceptance that
she, like so many of the patients she now works with, have
found hard to find.
“I’ve been where many
of our patients are now,” says Wallace. “I identify
with them in a way that many other people on staff can’t.”
She adds that she knows what it’s like to build a life
from the ravages left by addiction, and to deal with the challenges
posed by stigma and lack of acceptance.” At a holiday
dinner for my family,” she recounts, “there was
real china and silverware for everyone but me. Mine was plastic,
and while everyone else was seated according to their age—adults
at their tables, children at others—I was relegated
to the kitchen counter.”
Not surprisingly, Wallace hasn’t
been to a holiday dinner with her family for a long time,
nor has she visited an aunt she loved, who put covers on the
doorknobs before her visits. “The message was loud and
clear.” says Wallace. “This was not where I was
meant to be.” It is a message that many clients at PATH
get in response to their HIV status.
“We forget how meaningful it
is,” says Wallace “when someone finally remembers
your name or talks to you about your problems. So many of
our patients have nowhere to turn. And, as providers and advocates,
we get involved in our own day-to-day lives and fail to remember
that we are making a difference—like I had the other
day, when a patient came into the clinic, walked up and hugged
me, and said, ‘You saved my life.’”
A Light in the Window
In 10 years, the number of people
treated at the PATH Center has more than quadrupled. After
people find the Center, they keep coming back, and the next
time they bring their friends. A testament to the power of
word-of-mouth: the majority of new patients are referred by
current clients.
Sendzik and Berkowitz are the biggest
supporters of PATH and their patients but also the biggest
critics of the organization’s inability to meet some
needs. They are especially troubled about the unmet need for
mental health services among their clients.
“Our vacancy for a psychiatrist
is a hard sell,” says Berkowitz, “because TBHC
has no inpatient mental health services unit. This means that,
at least from the clinical care perspective, the person we
hire will have to go it alone. So now, while we offer counseling
onsite, more intensive mental health services are provided
offsite by other providers.”
Working with Diaspora, one of the
community-based organizations just down the hall, PATH has
found at least a stopgap solution. Diaspora is applying to
the State to become a certified mental health services provider,
and if that happens, clients will be able to walk down the
hall to receive mental health services instead of traveling
across the borough of Brooklyn.
Sendzik and Berkowitz love their work,
and they welcome PATH’s continuous flow of new patients.
Their hope is that the clinic will continue to grow with the
need that is so evident in this part of Brooklyn. “We
want to create an identity,” says Sendzik, “that
says to all of Brooklyn, ‘if you have HIV/AIDS, get
your care here.’”
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