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Feb 13, 2015 | Carol E. Barnwell

Hope Continues to Grow in East Texas

We learn what we need to know by the time we are in kindergarten, some contend. Jean Diebolt picked up some additional pointers as a combat nurse in Vietnam that have served her, and her East Texas neighbors, very well. 

 

In 1969, Diebolt (who was 28 years old at the time) had 23 critically burned soldiers air-evac’ed to Japan, too concerned for their survival to wait for permission from her commanding officer to finish a long surgery. “It was so dirty [there], the air conditioning was off and you could watch an infection grow,” she remembers. “They all survived the trip to Japan at least.”

 

Decades later, Diebolt watched the physician she worked for in Nacogdoches turn away a young mother whose infant had nephrotic syndrome because the woman didn’t have insurance. “When he said I couldn’t take care of the child I was mad for a week and told a doctor friend at church, ‘We could start our own clinic!’ She said she would back me with the Board of Medicine and that’s how we started,” Diebolt remembers.

 

Today the Hope Project has 5000 patient encounters annually and their state-of-the-art dental clinic across the street has another 2000. This spring, Diebolt, along with community partners, plans to open another clinic in San Augustine, one of the poorest counties in Texas. 

 

After college at Carnegie Mellon, Diebolt attended nursing school in Houston. In 1969 she signed up to serve in Vietnam where she met her husband, Mark, a fighter pilot. They were married in 1971 and later stationed in Germany and Iran, where one of her two children was baptized in a small Episcopal church. 

 

When her husband was stationed at Bergstrom Air Force Base in Austin, Diebolt worked in children’s oncology before returning to school, earning a master’s in nursing administration and a second master’s as a family nurse practitioner. In 2000 Diebolt and her husband moved to Shelbyville, 30 miles east of Nacogdoches, and Diebolt took up her career in rural health care. 

 

With Dr. Jane Todd’s support, Diebolt and Melba Gillis, a then-fellow parishioner at St. John’s, Center, learned to write grants and shared the groundwork that helped found the Hope Project in 2003. With an initial $10,000 Mission Funding Grant from the Diocese of Texas they bought a fax machine, an exam table “and the minimum that we needed to start,” Diebolt said. Grants from Episcopal Health Charities followed. 

 

The Hope Clinic’s first location was “200 feet from the drug-dealing center of Shelby.” One day Diebolt noticed a man outside the clinic door and asked if she could help him. “He said he was just making sure no one bothered us. The drug dealers were guarding our clinic to make sure no one broke in for any drugs we might have because we were taking care of their families,” she said. The clinic moved to Tenaha a year later and became a Federally Qualified Health Center in 2008. 

 

In a large and very poor area with little to no accessible health care, the Hope Project sees patients who are very often critical by the time they arrive. “It really is a third world,” Diebolt said, where many people’s solution to their ailments—whether it’s rashes, earaches or a sore knee—is “sweet oil,” which Diebolt later determined to be olive oil. Today, the nearest medical facility to the Hope Project is an imaging center 17 miles north in Carthage. The hospital in Nacogdoches is 45 miles away. 

 

Obesity, diabetes and cancer are runaway diseases in this East Texas community. “I can’t tell you how many people have died because they were never screened,” Diebolt said. The area has a large population with diabetes for which the clinic has a nurse educator. With support from the Epilepsy Foundation of Texas, a new telemedicine unit for pediatric epilepsy will be fully operational by March 1, linked to physicians in Dallas and Houston to help any child who has seizures. Hope Project  also has a licensed clinical social worker available for mental health issues, and veterans are treated free of charge. 

 

“We’ve had everything walk through that door,” Diebolt said. A very anxious woman came in one day and insisted something was wrong with her. “When I did an exam, I couldn’t hear any lung sounds! She had massive pulmonary embolisms and we got her to the hospital that day. Someone had told her she was just ‘hysterical.’”

 

Another patient had been borrowing his neighbor’s nitroglycerin tablets for some time and they were no longer working. “We put him in a car and drove him to the hospital in Center. Next thing I knew he was in Nacogdoches having a quadruple bypass that saved his life.”

 

Diebolt admits her ability to network and find what she needs to serve her patients comes in part from her military experience. “In Vietnam we called it scrounging—you had to figure out where you could get what you needed,” she said. “We had a story to tell here and when I told people what we were doing, everyone got on board.” 

 

Tenaha’s mayor has been supportive, providing a building for the growing clinic at a nominal cost. Hope’s dental clinic moved across the street and expanded to a state-of-the-art facility with two dentists recently. Funding came from Episcopal Health Charities and a $20,000 gift from Christ Church, San Augustine, one of the Diocese of Texas’ first worshipping communities. Diebolt bartered concrete work, framing and other construction costs for dentures and root canals to complete the $1 million facility for only $250,000. 

 

State Sen. Robert Nichols is a big supporter of Hope Project and Diebolt. “She is an unusually dedicated person, who has an amazing ability to help those in need,” Nichols said. 

 

San Augustine holds last place on a list of Texas counties in health care, and is 40 miles south of Tenaha. 

 

“San Augustine is also one of the poorest counties in Texas,” Diebolt said. County officials are renovating a 30,000-square-foot facility to offer a full range of social services. “We will have part of the facility to open a health center, beginning with one day a week,” Diebolt said, adding, “Eventually we want to offer women’s health, pediatrics, dentistry …” Christ Church gave an additional $25,000 to help this new venture. 

 

Sometimes needs have been met with a bit of help from the Holy Spirit. When Diebolt was short the $500 she needed to get their 501(c)(3), she ran into a neighbor at the grocery store who asked about the clinic. “Oh, it’s coming,” she had said, and he wrote her a $500 check on the spot. The day the paperwork was due for the FQHC, the clinic still didn’t have the needed transportation to qualify them. An official from the Brazos District called that same day and asked Diebolt, “You still want that van?” 

 

“So there it was,” she said. “We were able to put the van into our application, and we got the FQHC.” 

 

“If it doesn’t work out or things start going rotten, I have an argument with Him, and we talk, and it’s a project. ‘Step in and help us now, because I’m tired, and I’m not getting anywhere!’ and I’ll leave it like that.”  

 

Diebolt has built a dedicated staff and has encouraged them to continue their educations, preparing the next generation of rural health care administrators. “Everybody on the team has passion,” she said. “The nurses working over in the clinic will tell you the same thing—it’s not about them. It’s not about an issue. It’s about hope, and it’s about making this continue to happen. I don’t think I ever remember a group as dedicated or that works as well together as these young women do.”

 

The Hope Project still needs doctors who are willing to mentor new physicians in rural medicine. It’s a hard sell in an area with few amenities beyond bass fishing and barbecue. “We want people who will become part of the community, not just take a job that is here,” Diebolt said. 

 

The larger 20-county area still needs a birthing center and with the help of local leaders, Diebolt is committed to staffing and running it if the city will take care of the licensing and liabilities. “There is always something down the road,” she said. 

 

To learn more about The Hope Project see their Facebook page or go to: thehopeprojecttexas.org.

 

Jean Diebolt received the Bishop’s Award for Ministry at the recent Diocesan Council in The Woodlands. Bishop C. Andrew Doyle praised her dedication and continuing efforts to improve access to health care for her East Texas community.  “Jean’s ability to bring people together for the benefit of her patients has set an example for all of us,” he said.  “She and her team do exemplary ministry and we are grateful for the transformation of lives that all their efforts have brought about.”

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