Caring for the Community

Private hospitals are relatively rare in the nation's urban ghettos. Some have followed their white patients and doctors to the suburbs; others have closed because low-income blacks cannot afford their fees. Despite this pattern, which helps make black health care a scandal in many U.S. cities, two small private hospitals in Chicago's West Side ghetto have proved that such institutions can not only survive but also serve their communities as well as ever.

Bethany Brethren Hospital, a 66-bed facility run by the Church of the Brethren, went out of its way to accept poor residents as patients as early as 1960, when the area's ethnic makeup began changing rapidly from Italian to Spanish to black. By the time of the 1968 race riots, 90% of Bethany's patients were black; though nearby buildings were damaged during the disorders, the hospital sheltered community residents and escaped untouched.

Unacceptable Union. Bethany's success helped convert the 141-bed Garfield Park Hospital, whose white patients had moved to more affluent areas. Garfield's board sought a merger with Bethany, which agreed on condition that the hospital open its doors to blacks from the neighborhood. The directors then merged the two institutions and appointed a white administrator, Vernon Showalter, 42, who had run Bethany since 1952. He firmly told Garfield's medical staff: "Black patients are the ones living in this community, and it's black patients who are going to end up in this hospital." Many doctors found the union unacceptable and, over the next few months, several responded by resigning.

To replace them, Dr. Risher Watts Jr., 45, a black physician who headed the hospitals' combined medical staffs, set about recruiting young doctors who were willing to accept the risks of working in the ghetto. Those risks were considerable: Showalter has been mugged near the hospital; two doctors have had close calls. But Watts now has a staff of more than 100 doctors, including 15 blacks. Each hospital's board also includes seven black directors.

Hiring other personnel proved harder. Garfield's white nursing director quit shortly after the merger: Showalter desperately replaced her with a black male nurse who lacked the generally required bachelor's degree. Other appointments were equally unorthodox. Garfield's personnel director is a former inventory clerk at a local faucet factory; the food-service manager is a onetime hospital kitchen worker whose ability to run a kitchen more than compensates for her lack of training in dietetics.

The measure of the merger's success is that many West Side blacks now can avoid Chicago's publicly supported Cook County Hospital, which is notoriously crowded. Local residents account for 80% of Garfield's patients and 90% of Bethany's. They have also taken advantage of the Bethany Medical Center, an outpatient clinic housed in a former grocery store. The center provides non-emergency and dental care for 1,600 people a month. The average cost of treatment, including tests and Xrays, is $17.

But finances remain a problem. The two hospitals mainly rely on reimbursements from the state welfare department, which supports most of their patients. Those payments are often delayed as long as six months. As a result, both hospitals operate in the red.

No one expects these struggling little private hospitals to solve the ghetto's massive health-care problems. Even so, they aim to expand their limited facilities, not cut back on their services. Garfield is seeking a Government grant for a health-care center similar to Bethany's. Bethany also hopes to start a methadone program for drug addicts next month. It is not waiting until then to do something about the drug problem. Accompanied by an ex-addict, a hospital pharmacist is busily touring neighborhood schools to warn children and help stop addiction before it begins.

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