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Published in CenterView on August 22, 2011

MDE project delivers primary, oral health services to Delta schoolchildren

By Matt Westerfield

School-aged children in the Mississippi Delta are battling many of the same health problems as those in the Jackson area. But because they are located in one of the poorest regions of the country with few physicians to go around, kids in the Delta have less access to the care they need.

A $450,000 grant project led by the School of Nursing at the University of Mississippi Medical Center is one step toward addressing that need in the Sharkey/Issaquena-County area. Beginning with this school year, the Mercy Delta Express Project will provide primary and oral health care for students in the South Delta School District and Ripley Blackwell Head Start through a multidisciplinary mobile clinic run by the SON.

"Their health issues mirror what we're seeing in Jackson," said Dr. Lisa Haynie, professor of nursing and director of the MDE project, who listed high blood pressure, obesity and asthma as being widespread among children in the Delta. "Just us being present at the Head Start in Mayersville, which has a hundred kids, in itself is going to be huge. Mayersville is 16 miles from the nearest town, and there is no health-care provider at all."

Ten years ago, the Sisters of Mercy in Vicksburg donated the bus to the nursing school, which refurbished it into a mobile clinic. Since 2001, the Mercy Delta Express has offered limited services and health fairs around the Delta.

The grant, awarded by the W.K. Kellogg Foundation, will allow the bus to be used as a fourth school-based clinic. The nursing school currently manages three health clinics at Johnson and Brown Elementary schools and Rowan Middle School in Jackson.

The grant money will pay for supplies and staff for the clinic. Apart from Haynie, who will spend at least one day a week in the Delta, the mobile clinic will be staffed by a part-time nurse practitioner, a registered nurse, a health educator and an outreach liaison.

But more importantly, Haynie says, the project will provide an invaluable training ground for nursing students, as well as medical students, residents and dentistry students in a medically underserved area of Mississippi.

"All accelerated nursing students and nurse practitioner students will rotate through the Delta clinic," she said. "We hope to have at least 30 percent of the traditional students rotate there as well."

Dr. Robin Howard, an instructor in the School of Dentistry, says plans are in the works for dental students to share rotations on the bus, where they can provide sealants and basic oral exams. Howard will coordinate the dentistry rotations. Haynie said students also will have an opportunity to see patients at a dental clinic at Cary Christian Center in Sharkey County.

Dr. Claude Brunson, senior advisor to the vice chancellor for external affairs, said planning is under way to allow medical students and residents who are part of the Rural Health Scholars Program to work on the bus. Additionally, the bus will be linked with the Emergency Department via telemedicine to ensure physician backup. Dr. Robert Galli, executive director of Telemergency, and Kristi Henderson, director of Telehealth, are helping with that component.

Because kids are more likely to confide in a school nurse, Brunson said providing a school-based clinic will have a positive impact on a student's health and long-term outlook.

"Our responsibility is statewide," he said. "We believe that as the state's only academic medical center, we have the responsibility to find innovative ways of providing access to care to citizens in the rural areas of the state."

The clinic will begin in earnest after Labor Day, and throughout the school year the bus will begin each week at the Head Start in Mayersville.

"Then throughout the week we'll visit the elementary school and high school in Rolling Fork and the middle school in Anguilla," Brunson said. "We'll be able to follow these kids through the electronic health record from the point they enter school (Head Start) all the way through high school graduation."

One of the poorest regions in the nation, the Mississippi Delta has been named a health-professional shortage area by the Mississippi State Department of Health.

Dr. Kim Hoover, dean of the School of Nursing, said the Mercy Delta Express mobile unit provides a unique opportunity for faculty members to provide care to the underserved rural population in the Delta.

"Dr. Haynie, through the mobile unit, creates an interprofessional learning environment through which our students practice clinical skills and learn the nuances of providing culturally appropriate care," she said.

If the project is successful, Haynie said it could be sustained indefinitely beyond the 18-month grant.

"Kellogg believes in sustainability, and we do, too," she said. "That's part of the trust that you develop in the communities - that you're there for the duration. And it's worked here in the school-based clinics."

Haynie said she has envisioned the project for a long time.

"We're all coming together to meet the service mission of the Medical Center," she said. "And with the health disparities and access-to-care issues in the Delta, this is the perfect way to introduce our students to the reality of these issues and for them to find ways to resolve them."