Dead on Arrival

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While school health clinics in Baton Rouge, La., managed to overcome local opposition and even to expand, clinics elsewhere in the state have been derailed before they could even get started.

Natchitoches and the smaller, neighboring town of Many are located in marshy northwestern Louisiana, a four-hour drive from Baton Rouge. The towns are surrounded by forests and sustained by the timber companies that harvest them. Toledo Bend Reservoir, which snakes 76 miles along the Texas border to the west of the towns, is a popular fishing spot that teems with tourists in the summer.

Most residents who don't work in the timber mill work in the paper mill or the chicken-processing plant on the outskirts of Natchitoches. Some young people commute hours to their jobs on the offshore oil rigs that dot the Gulf of Mexico. Still more have come to this quaint old town to retire. Natchitoches is where the movie "Steel Magnolias'' was filmed, and the place exudes a peaceful, Southern charm.

But young people there, like their peers in more urban communities, have more than their share of problems. Reported cases of substance abuse, sexually transmitted diseases, tuberculosis, and child abuse all exceed the national averages.

In the fall of 1992, a health organization, a few teachers, and a consultant drafted plans to bring school-based health services to the community's neediest residents.

Willie E. Valerie, the director of the Natchitoches Outpatient Medical Center, a private concern, proposed setting up a school-based health center at the town's junior high school using state money earmarked for such purposes. The school's principal called the possibility of such a clinic "very exciting.'' Last winter, the school board adopted a resolution supporting the establishment of a clinic at the school, citing a "definite need for this type of health service and counseling for this high 'at risk' population.''

In March 1993, Superintendent Mike Whitford of the Natchitoches schools wrote a letter of support to accompany the application.

But some local residents were less than enthusiastic.

Danny K. Wells, a forester, felt so strongly about the proposal that he formed the Coalition of Concerned Citizens to defeat it. Over the next month, Wells and his coalition gathered more than 600 signatures on a petition asking the board to rescind the application for state funding.

"It's a parental-consent issue,'' says Wells, who has two boys in the public schools. "We want to be in control of our children, not a clinic or another arm of government.''

Opponents questioned who would be liable in the case of malpractice, and denied that the students lacked access to services since there already was a hospital and a medical center in town. They held sway at town meetings and informal gatherings, and pursued their case with missionary zeal.

The pressure from the coalition apparently was too strong for the school and community leaders to bear. Last spring, the medical center withdrew its application, citing a lack of legislative and community support.

Whitford, who regrets the loss of a clinic, stresses that if there is another effort to establish one in the future, there will have to be more community backing.

"The opponents weren't a bunch of rabble-rousers or rednecks, but it all got blown out of proportion that we would be advocating abortions and distributing condoms,'' he says.

"It really caught me totally by surprise, all the controversy,'' says Whitford, seeming somewhat stunned by it all. "Our intentions were honorable.''

As the Natchitoches plan was collapsing last spring, the town of Many was just about to face a battle of its own.

Margaret A. Basco, the director of the local Head Start program, lobbied to set up a clinic at the junior high school, with the principal's blessing.

Sabine Parish, which includes Many's three schools, has no designated health curriculum other than the basic requirement of six weeks in a physical-education class. More than 60 percent of the students in the junior high live in poverty. Many students also have limited access to local health services.

But, as soon as the school board announced a public hearing on the issue, the community virtually erupted, Basco recalls.

When a few local ministers learned of the plan, they became incensed and began circulating literature claiming the school system had been duped by government agencies that wanted to establish abortion clinics in the schools.

"A school-based clinic is a legal term for Planned Parenthood, and their objective is to make birth control available,'' says the Rev. Robert Spear of the First Baptist Church in Many, who preached the danger of clinics in his Sunday sermons.

"I just have a fear of government stepping in and running things,'' Spear says.

One parent and retired teacher wrote a column in the local newspaper questioning the services and the cost of the enterprise.

"When the grant runs out, the school district and the local community must assume the cost,'' Judy Slippick wrote.

Some parents also charged that the clinic would duplicate existing health services in the community.

Many Junior High Principal James Mitchell defended the proposed clinic, noting that all three Many schools shared one school nurse.

Mitchell implored community residents at a school board meeting to recognize that students needed psychological counseling, good nutritional advice, and a nurse to take care of minor injuries and illnesses at school.

But although state public-health officials had already told the school that its application had been approved, the school board felt it lacked the support necessary to continue. One month after the Natchitoches plan failed, the Sabine school board rescinded its application.

"I feel reluctant to do this,'' the school board president, Warren Founds, was quoted as saying after the vote. "By dropping the application I feel like we, as a board, are remiss in our duties. We are pretty much sticking our heads in the sand and avoiding the problem.''

Cecile Guin, a consultant to the state's office of alcohol and drug abuse who wrote the clinic proposal, was not especially surprised by the resistance she found in the two communities.

"The health department has been trying to get in North Louisiana for years because it has so many problems,'' she says. "But we just can't get it through the Bible Belt mentality.''

"You can't convince [clinic opponents] that you're not going to pass out condoms and promote abortion, even though it's against Louisiana law,'' Basco adds.--JESSICA PORTNER

Vol. 13, Issue 19

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