Welcome to Café y Chisme, where we provide the café, and you provide the chisme. This is a casual event every other Friday with me, Planet Detroit reporter Isabelle Tavares. I aim to  speak with Southwest community members about the environmental and public health challenges (and wins!) in our communities. These 45-minute conversations take place at cafes across Southwest Detroit. Whether you’re a community health worker, a truck driver, a school teacher, a newly arrived immigrant, lo que sea, I want to learn from you!  

To participate, please sign up here for a 45 minute time between 9 am to 5 pm. 

Past conversations

Café y Chisme # 2: Miguel Caudillo & Ismael Ledesma on the need for medical transportation and healthy food options in Southwest

For our second iteration of Café y Chisme, Planet Detroit Southwest reporter Isabelle Tavares spoke with Miguel Caudillo, back, and Ismael Ledesma, front.

Southwest Detroit residents face significant barriers to accessing healthcare, including dialysis treatment, as evidenced by the experiences of Miguel Caudillo and his childhood baseball coach, Ismael Ledesma. 

With no dialysis facilities in the neighborhood, residents must travel miles for treatment, a challenge compounded by high rates of diabetes—affecting 12% of Wayne County’s population—and limited transportation options. 

Caudillo’s vision for a comprehensive health and wellness center, complete with a dialysis facility, transportation services, nutrition programs, and job training, aims to address these systemic gaps. Rooted in his personal experiences and supported by community mentors, his project could transform Southwest Detroit’s health infrastructure and provide much-needed resources for residents like Ledesma, who continue to struggle with limited access to care.

Growing up, Caudillo drove his grandmother to dialysis appointments at a distant facility every Saturday. The trip consumed most of his day. “I thought, there has to be a closer facility, so that way I could go play with my friends. And still, to this day, there isn’t one,” Caudillo said. 

The closest dialysis treatment facilities are in Midtown, approximately 2.5 miles from Southwest, which is not walking distance for someone seeking treatment, Caudillo said. 

The mortality rate for kidney disease in 2022 was 29.1 per 100,000 people, substantially higher than the statewide rate of 20.8, according to state health data. Access and transportation to dialysis is a critical community need, he said.

His experience is commonplace in his neighborhood, and it led to his interest in establishing a comprehensive health and wellness center in Southwest Detroit. 

“Living in Southwest, there are very few medical places that you can go to,” Ledesma said. “Family members have health issues, and unfortunately, we don’t have nobody to take them. People have to call off work.” 

CHASS Clinic, a community health and social services center in Southwest, does not offer dialysis treatment. However, it does provide a range of services for people with diabetes, including screenings, check-ups and personalized care plans. 

Ledesma receives treatment for his diabetes at Henry Ford Hospital and does not require dialysis. He said his diabetes is “under control,” and he hasn’t sought help from CHASS. 

But, he noted when he wants to learn more about his disease, there are few options. 

“You have to go somewhere else. CHASS clinic is close, but they’re always so busy, lots full every day, they’re overwhelmed,” Ledesma said. “You get to a certain point that you start depending on the [internet] to give you information.” 

Ledesma would like to see a stipend to incentivize restaurants in Southwest to provide a “healthy menu” approved by the American Diabetes Association. 

Although he has no currently has no funding, Caudillo is working with mentors to develop the idea. He  participates in a mentor program at the Michigan Small Business Development Center, where he meets with a mentor once a month. The program offers financial planning, partnership and real estate development advice. He also attended Detroit Means Business, a summit that provides tools and workshops to assist small business owners and entrepreneurs, for the past two years. 

The building he’s looking to buy, on Vernor Highway, formerly housed a taxi service, Detroit Cab, whose primary customers were dialysis patients. “I almost cried because that’s affirmation, right there,” Caudillo said.  

The property has an acre of land where Caudillo hopes to build a greenhouse. The facility would be called D.E.G Dialysis, in honor of his late mother, Dora Elliot Garza. 

“People like Miguel, they show a great interest and a great ambition to get things started,” Ledesma said.

Café y Chisme # 1: Gloria Palmisano on community-based health in Southwest

Gloria Palmisano is a Southwest Detroit resident and retired community health worker. Photo by Isabelle Tavares.

For our first iteration of Café y Chisme, I spoke with Gloria Palmisano. She served as the program manager at CHASS Clinic for Chronic Care Management since 2014 and before at REACH Detroit Partnership, a community project of CHASS Center. 

She spoke to me about the community based participatory research model and the importance of cultural integration in Southwest Detroit. The work aims to address social determinants of health, which are the non-medical factors that influence health outcomes. That can include race, income, diet, exposure to pollutants and more.

A community based participatory research model is an approach where researchers from the university work to establish relationships with community leaders. 

“In partnership, they determine what that community believes are the top health issues that they want to address,” Palmisano told me.

She said the REACH program had a large staff in 2010. “We had someone from the Dominican Republic, Mexico, Puerto Rico. They use different terminology, different words. So the community health workers would get together and say, ‘What was the most common word for this particular thing?’”

Those staff were instrumental in helping to translate a lot of health materials, she said. CHASS has continued to hire community health workers. “So that’s been really, really awesome to see,” she said. 

Palmisano said she looks for people who truly care about the community and understand its health challenges.

“When I’m hiring, I’m waiting for them to say, ‘I like helping people.’ Some of them have gone through a lot of the things that the patients have gone through. So there’s some understanding there about how difficult it is to survive with the different social determinants of health.”

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Isabelle Tavares covers environmental and public health impacts in Southwest Detroit for Planet Detroit with Report for America. Working in text, film and audio, she is a Dominican-American storyteller who is concerned with identity, generational time, and ecology.