After a 10 year, uphill struggle, hard workers, grassroots activists, concerned county representatives and health officials in the New Cassel/Westbury community established a new health facility.

The New Cassel/Westbury Health Center opened three years ago, and immediately went into action providing services for the community at large, as well as many of the surrounding townships. It is one of the largest centers of its kind, providing services such as breast screening, neo-natal care, pediatric care, a well-baby clinic, general family medicine, dentistry, young adult health services, and HIV/STD clinic services. Up to now, the facility has also had an ongoing relationship with Long Island Jewish/North Shore Hospital, and the Nassau County Medical Center.

The culturally diverse community promptly took advantage of the health care services offered. Employees of the center exhibited valuable experience, sincerity, and personality, while working under competent supervision. This was exactly what the community needed.

Prior to 1996, a health advisory board was formed, consisting of concerned citizens and health care professionals who wished to assist in and contribute to the efficient operation of the health center. Similar boards were also created in sister communities. The New Cassel/Westbury Health Advisory Board (NCWHAB) has been indispensable to the progress of the center through the years, and was also instrumental in the planning phases of the center's physical plant. The board has also served as a positive link between the community and the center. In our current situation, the NCWHAB appears to be one of the strongest and most active advisory boards advocating for community health rights.

The relationship between the community and the NCWHAB has been a positive one. Grassroots activism rallied for a much larger, state-of-the-art facility, and quality health care long before the management of such care was to become a private venture. We now appear to be at an impasse, and privatization has put "a foot in our grass." Is there an intention to mow down the interdependent relationship between the community and the health center? Has our position become a mythical one at this point?

Most people understand the implications that privatization can bring; it has the potential to disenfranchise the masses from having any real say over their own resources. It can prevent localities from developing, controlling and benefiting from such resources in any consistent manner. Further, privatization can act like a faceless, insensitive, avaricious beast, a total alien who is bent only on its rapacious appetite for acquisition and profit.

And at whose expense? It comes at the expense of the community. New Cassel/Westbury Health Center and its advisory board, like other boards, have worked diligently to establish community service with a face--true "care-givers." The staff of the center are known to the community they serve. Typically, it is not unusual for employees to come across clientele in their travels, and have familiar exchange with them. This builds confidence and trust.

The pale horse looming on the horizon was Nassau County's fiscal crisis. Mismanagement, and a fiscal deficit caused some deterioration of the county-run health system, and its health facilities. Control of these center facilities went up for sale to the highest bidder. An organization called Public Benefit Corporation (PBC) acquired the controlling interest in the management of the New Cassel/Westbury Health Center.

In an effort to understand what role the PBC would play in this affair and how it would affect our community, the NCWHAB met with representatives of the PBC. The PBC made many promissory statements to the board that the general structure of things would not drastically change. The employees of the center would be secure in their present positions. All-in-all, it was a bill of goods which we feel was not delivered. The community itself has worked hard and placed a great deal of faith in its ability to determine its own affairs. We are now confronted with a new challenge.

As we now perceive it, the county has opened the doors of this community to a symbolical "Trojan Horse." The PBC wasted no time in shifting around many of the employees of the center, and their supervisors, sending key resident employees from the immediate community to distant places. These moves will certainly impact the community, and may have adverse effects on dedicated workers.

The advisory board has opted for more meaningful assessment, open negotiations between the PBC and the community, and greater consideration of the role the PBC has undertaken. At a Dec. 9 meeting, PBC representatives expressed that their assessment and criteria for evaluation of such changes was done through careful observation, etc.... The advisory board, in the true interest of the community, questions the integrity of the PBC. The PBC has really only been formally active as a managerial entity of the health center for the past three months. We, the community members have struggled to establish a quality health center over the last 10 years.

The NCWHAB is a unified body, has functioned as such, is regularly consultative, people oriented, and concerned with the holistic well-being of the community. To us, the health care issue is not just a commodity through which a long-range profit can be realized. People are the most valuable commodity, and the most valuable "capital." Without healthy people, we have an unhealthy community, and without a healthy community, our quality of living is insecure, sub-standard and unproductive. Communities like New Cassel have suffered developmentally, economically, educationally and environmentally over the decades. Proper health care has been a longstanding issue.

The dialogue between the PBC and this community via the advisory board is a vital element in continuing a prosperous relationship between the center's clientele, constituents and component services. As stated in a Dec. 2, 1999 Newsday article, "What is needed is a panel to advise the Nassau Health Care Corp., which recently took over Nassau's hospital and geriatric-care facility along with the clinics. Corporation officials have resisted such a panel, presumably seeing it as a potential nuisance ... The county no longer operates the hospital directly, but it must continue to ensure that it runs well and stays true to its public mission of providing care to the elderly and the poor."

Advisory boards are an essential part of healthy operative mechanics and management of various centers throughout the county. All attempts to ignore this fact will result in a residual "Midas Effect." PBC may feel it has the golden opportunity to wield its powers, but not by grabbing the sword by the blade. It should consider what or who is the blade.

PBC must develop a balanced relationship with the communities at large, and the personnel they employ. The advisory boards, for all intents and purposes, are not centralized, except for their localities. Perhaps if they were operating more closely, PBC would move more gingerly, and with greater consideration. After all, the PBC certainly has to pay attention to the legacy it inherited from the county, and the county still has an obligation to its people to make sure this untimely transition will actually function conscientiously. Successful management of health care systems in communities is contingent upon establishing a positive, progressive, and strong rapport with the people who are providing the service.

The community's reaction to the changes in the New Cassel/Westbury Health Center is that such changes are unwarranted. What provisions can the community make that will preserve the integrity of our health center? Our supervisor is being moved to the outland of Inwood, in the Five Towns area. What is the real reason behind the move? She is one of the community's residents who has done an excellent job supervising at the New Cassel/Westbury Health Center.

We feel as though we are being deprived of our most vital assets when changes are foisted upon us, without recourse or redress of the community to voice its true sentiments. As we begin a new millennium, witness a global privatization trend. We must not be complacent ... if we stand still, we stand to lose everything.

Activism has helped to secure our center, and activism will inform the public about their responsibility to protect and preserve the integrity and quality of a true public trust ¬ our health care facilities. True public benefit is not derived from a corporation. Rather, it emerges from public will, selflessness and humanity. We have been the watchdogs over our public trusts; we are not about to be sent to the pound of ignorance, and gassed.

During the 1960s, terms like "backlash," "Power to the People," and "Seize the Time," described the socio-political climate of the times. It is no less right during this time to evoke the same revolutionary responses to the current global anti-humanitarian movement that is linked to privatization.

We are not irresponsible people, nor are we reactionary, or notoriety seekers. We are a thinking, educated, and self-motivated consortium. We feel it is time to create another venue by presenting our case to the people for public scrutiny. What do you feel?

Jamal A. Abdul-Karim

Member, New Cassel/Westbury Health Advisory Board