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The balance between clinical and non-clinical settings: Profile of Marie-José François

Marie-Jose Francois MD, MPH, CHES
Our gut feelings said that this is the right thing to do, to assist, to help another brother, another sister, no matter who they are.
The balance between clinical and non-clinical settings: Profile of Marie-José François

“I always work two jobs at a time,” laughs Marie-Jose François, the Executive Director of the Center for Multicultural Wellness and Prevention, in central Florida. She’s also the Health and Family Specialist at Community Health Centers in Orlando, Florida. But François likes how the two jobs balance each other: one clinical setting, and one educational and community setting. “I can tell you – I love both of my workplaces. It’s a balance,” she admitted. François’s busy work schedule is a testament to her personal mission to serve others: “I believe [that] in each human being, we have that sense of service.” Every step along her life’s journey in Central Florida, from arriving as a new immigrant, to establishing herself as Executive Director, embodies her dedication to serving others.

ARRIVING IN FLORIDA

In the early 80s, François and her husband immigrated to the US from Haiti in order for her husband to attend a Master’s Degree program in Civil Engineeing in Orlando, Florida – and to escape instability in Haiti. “The political situation back home – we needed to get out,” François explained, even though it meant abandoning her previous career as a physician. But François continued anew in the US as a health educator, when she began volunteering, and then working, at the Community Health Centers (CHC) in central Florida. “When they saw my background as a medical doctor, they embraced me,” and recognized the usefulness in gaining a clinician fluent in Haitian Creole to serve the Haitian migrant community, she said, adding that she was able to receive her legal residency as a professional – and eventually her citizenship – thanks to CHC’s sponsorship.

As a health educator, she worked extensively with migrant and seasonal agricultural workers. “We used to go at night in the field in the mobile van to see the migrant women, mostly the pregnant women,” she said.  Soon, she became CHC’s OB Coordinator. “It’s really important for migrants to get access to prenatal care,” she believes. She stressed the importance of “early entry into prenatal care, so we can have a healthy baby.”  She ensures her patients are well-educated on what she calls “social rounding,” in which she counsels her patients in post-partum care on “the importance of the baby coming back to the clinic to see the pediatrician,” and on family planning.  “I call it baby spacing,” she says with a laugh.  She also talks to patients about a lifelong personal plan, working with patients to map out how they will “be healthy – physically, spiritually, morally -- so they can raise that child, so they can become self-sufficient,” she explained.

While at CHC, she also worked at the Farmworker Association of Florida (FWAF) in Apopka, where she immersed herself in the HIV/AIDS community for 15 years.  François implemented FWAF’s HIV/AIDS education and outreach program, which centered on migrant and seasonal farmworkers, and other minority communities.

MISSING SERVICES

François enjoyed her two jobs, but she saw that patients were missing sufficient education and communication to understand and manage their diseases properly.  They also lacked a place to develop community.  Around 1995, one of her patients was diagnosed with HIV. He said the disease was “a death sentence,” François recalled. She counselled him, gave him more information on the virus, and provided community resources for additional assistance.  A few years later, she saw the patient again. “He said, that day, he was so depressed, he was going to kill himself,” François said, but her care and compassion encouraged him to continue fighting.  Such patient encounters proved to François that more resources were needed.

She envisioned “a place, not a clinic setting, but a place where anyone can receive one-on-one case management and education.”  In the mid-90s, she formed the Center for Multicultural Wellness and Prevention (CMWP), which has the mission “to enhance the health, wellness, and quality of life for diverse and ethnic populations in central Florida.”  She serves as the Executive Director, while maintaining her job at CHC. The patient with HIV whom she counselled years before is now one of her “consumers,” the term François uses for clients at CMWP. In 2015, CMWP is celebrating its 20th anniversary.

She credits a “compassionate, sensitive, and non-judgmental” staff at CMWP for providing top-quality care to their wide range of consumers.  Consumer encounters, she says, matter. “We don’t know who we talk to that day. Maybe we are the point of change, the milestone in that person’s life,” François maintained. She tells the CMWP staff: “Be ready to talk to somebody, because you never know if you are the last one to talk to them that day before they do something tragic. Give them hope.”

FOCUS ON HIV/AIDS

François, who says she is greatly involved with HIV/AIDS work in her community, is proud of the comprehensive programs that CMWP runs for those with HIV/AIDS.  A recipient of Ryan White HIV/AIDS Program funding from Health Resources and Services Administration (HRSA), CMWP provides direct services like case management psychosocial support and dental coordination services. CMWP also receives funding through the Housing Opportunities for People with AIDS (HOPWA) program, which François emphasizes is essential for many suffering from the virus. “With the HOPWA, [the goal] is to avoid homelessness for people with HIV/AIDS, for them to be in a stable environment, so they can keep on medication, [and] see their providers,” she explained.

COMPLEMENTARY CARE

François feels her work at CMWP complements the medical services provided at CHC.  And she finds her work at each center informs her work at the other. Compassionate, empathetic care – the backbone of her work at CMWP – is essential in a clinical setting as well, says François. She works to ensure CHC providers are equipped to give culturally-sensitive care, particularly with unauthorized agricultural workers.  “We make sure [patients] understand we are their advocate. We are the bridge,” François stated, noting that building trust with patients is essential for a patient to tell their stories.  

At CMWP, François says, consumers are empowered through education for the community, which in turn makes more informed patients who can ask questions and provide useful information to their provider, when returning to a health center like CHC for care.

GUT FEELINGS AND RESPECT

François sees her work as essential in the community. She feels driven to care for others through a “sense of ministry,” she said. “Our gut feelings said that this is the right thing to do, to assist, to help another brother, another sister, no matter who they are." Migrant workers, she says, are often mistreated in clinical settings. “Anybody doing migrant orseasonal farm work, do not treat them as second-class citizens. They are the ones feeding us, they are the ones breaking their back under the sun, rising early in the morning until late at night, to feed us healthy foods, healthy fruits, healthy vegetables,” she stated passionately. “Anybody, no matter what they do -- migrant farmworker, construction worker, housekeeping -- we need to treat them with respect and dignity, no judgement.”

30 CLINICIANS MAKING A DIFFERENCE is a project celebrating Migrant Clinicians Network's 30th anniversary through the life stories of 30 clinicians making a difference in migrant health. Learn more about Migrant Clinicians Network.

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