Healthcare - the deeply Catholic physician argues - cannot be based on a building. Healthcare must be based on a community.
Dr. Ramon Tallaj is the founder and chairman of the board of SOMOS, a network of physicians serving low-income people in New York.
His role in the fight against the coronavirus pandemic has been critical to the city’s 8.5 million residents, particularly the Hispanic, Asian and African American communities.
Dr. Tallaj led the fight against COVID-19 from the start
His work has focused on health care, but he has gone beyond that to provide human and economic resources to a population that was at high risk of sickness and death.
This physician, originally from the Dominican Republic, has had the lives of millions of people in his hands and has chosen to devote himself to an almost impossible mission: to unite everyone’s efforts in the battle against the coronavirus.
Searching intensely for resources
“We knew as early as February 2020 that what was coming was no ordinary epidemic,” he says. “We worked together with our Chinese brothers who are part of SOMOS, Dr. Chen and his group, and we looked for all the data on what was happening in Wuhan and all of Asia. We realized that this situation clearly was going to get out of hand and we started looking for PPE [FFP2 masks or similar protection], but not only that. In early March we even ordered antibody testing material from China because we knew that, at some undetermined point in time, knowing if we had immunity was going to be important.”
“We made thousands of educational pamphlets. We gave the order to set up telemedicine in each of our offices. We held a big meeting on March 5, 2020, where we gave instructions to all of our physicians. Even Governor Cuomo spoke to us that day, asking us to help him.”
March 11, 2020: WHO declares COVID-19 a pandemic.
March 13, 2020: President Donald Trump declares a national emergency.
These are important dates in the history of the pandemic in the United States and the world.
The only ones on the street
“SOMOS has been on the street since March 14, 2020. It’s possibly the only health entity that was on the streets from the beginning, without any permission, saying how things should be done, dealing with a virus like SARS which we understood was being transmitted through the air.”
“We put the first testing center downtown, at the Stock Exchange, but then we put it in Queens, and what did we realize? Seventy percent of the people were positive. So we said, ‘We have to quarantine our [sick] people,’ and we realized that many of our authorities were not prepared to deal with an outbreak of that magnitude.”
“It was a deadly virus,” he continues. “Nobody wanted to be on the street, not even the relevant authorities who had to do tracking and tracing. We said from the beginning that we had hot spots where there were very many cases, as was the case in Queens, and obviously 5-6 days later we saw how those hospitals in Queens were overcrowded and many people died. Why? Because our people were positive and there was no place to quarantine them. There was no tracking and tracing, even though I was crying out for it. I asked them to give me schools, to give me gyms, to give me hotels to put our people in and quarantine them at that time.”
“Our people,” explains Dr. Tallaj, “were affected the most, because they are the ones who have to be in the midst of things. They’re essential workers, those who have to go drive the buses, who have to serve food, drive the train, and transport food. Those people were going to get infected more often, because if they didn’t go to work, they couldn’t eat and they couldn’t pay the rent.”
Tallaj recalls some of the means that were put in place to curb the pandemic: “We opened a 1-833-SOMOS-NY line to provide information to our patients. We bought millions of masks, hundreds of thousands of PPE; we tried to find anywhere we could to do testing.” “We set up telemedicine so our physicians could continue to provide services to our patients,” he adds.
Twelve SOMOS doctors died on the front lines.
For SOMOS, the battle against the coronavirus involved actual patient care. That, unfortunately, led to the deaths of several physicians in the network. “Twelve of them,” he says, “died on the front line, on the real front line, where they were diagnosing patients, and seeing patients in their office. That was very difficult for us. That part [of what happened]—although not much is being said yet—sticks in our minds and bothers us, that so many of our physicians perished on the front line.”
Why did such a worrying situation arise? Dr. Tallaj explains that the immigrant population with which SOMOS primarily works “is a poor population who have to work to eat and pay the rent. Our buildings where we live have small apartments. When an authority tells them to stay six feet apart, one would have to be outside the window and another outside the door. Typically, a person would get infected while working on the street. They’d go home, we’d see them test positive, and we’d ask for them to be quarantined, and it didn’t happen. Nobody was keeping track. Everyone was hiding. Those authorities who had to do the work to isolate the patients didn’t understand that they had to quarantine them at that moment. That’s why so many of our people died.”
Testing sites without official permission
In that situation, Dr. Ramon Tallaj made another significantly audacious gesture. “At SOMOS,” he recalls, “we not only set up testing sites in several places in the city without anyone’s permission, without anyone’s order. We also realized what a great tragedy that this health problem was bringing to the community.”
“Already by April, people were out of work, and many lost their health insurance. How were they going to buy food? In a survey we did, most of our people had 300 to 500 pesos for emergencies, and there was no more food. That’s why SOMOS gave millions of food items, food rations. We could see something we hadn’t seen since the Great Depression: thousands of people in line, from different parts of the city.”
Others joined the food distribution efforts. “SOMOS started giving food. I thank the people who came from Marc Anthony’s Maestro Cares Foundation and the people from World Central Kitchen [founded by chef José Andrés], because they really were partners in this work to get that food to all our people.”
A wealth of experience in disaster situations
In retrospect, it could seem surprising that SOMOS knew how to organize itself so quickly in the coronavirus crisis. The explanation is that it wasn’t the first emergency situation that SOMOS and Dr. Tallaj had experienced.
“When there was the earthquake in Haiti, we went. But not only to Port-au-Prince; we went to Jackmel, in little rickety planes that were at least 60 years old, to go and bring aid. When the Nicaragua earthquake happened, we were there. When Hurricane Maria hit, everybody was taking aid to the big cities. We went to the mountains. For diabetics, we took solar power plants, so they could put their insulin in refrigerators run by solar cells. We had already done the work to know what crises are and how to handle them immediately. That’s why SOMOS was prepared.”
Why did Tallaj become a doctor?
Actually, Dr. Ramon Tallaj’s preparation for difficult situations came to him at a very young age.
While still living in the Dominican Republic, Dr. Tallaj was vice minister of health, but the Catholic Church asked him to go to the United States to care for Hispanics.
“I was raised by my uncle, a pediatrician who was very well known in my country, a hero of the anti-Trujillo struggle. A hero because he was also from the Cursillos de Cristiandad and a hero because he saved so many children and so many lives. I saw so much suffering in children with diarrhea in such a poor country, with so many infectious diseases… And I also saw a cousin who died of cancer. All that forged in me a clear idea: to become a doctor.”
Dr. Tallaj is deeply grateful to God for what he has received in life: “Doing something you love, creating a family and raising four children who also work in healthcare is important. But greater than everything is the fact that the Almighty has given me the resources, in these days of my life, in these past five years, so that what I was doing with patients at a local level before, I can now do in a global way, with a more humanitarian feeling and more aligned with the needs of a large group of people who have few services, in areas with few resources. Poor people—not just poor in money; people who are poor because they really don’t have the ability to move around the country if they don’t have the help of people like us.”
Ramon Tallaj launched SOMOS, the network of doctors serving under-resourced people in New York City, in 2015.
Serving nearly one million Medicaid patients
With the pandemic, Dr. Tallaj quickly learned that his area of action went far beyond medical care, and that the job entailed significant risk to his life and the lives of his loved ones.
Sometimes I think I put a lot of people at risk.
Dr. Tallaj admits that he’s well aware he put himself at risk. “There is a risk. I’m 65 years old. Sometimes I think that I put at risk a lot of people who followed me without hesitation. Some of them died. Twelve of our doctors died in that battle. Incidentally, SOMOS is the only institution with so many dead, because they were actually on the front lines of the real battle, where we were diagnosing people and sending them to the hospital. I was in the middle with my family and my wife, and I suffered the consequences.”
He recalls what he and his family went through on a personal level: “We have three sons who are doctors. One son, who is not a doctor and who was with me from the beginning, caught the virus. He and his whole family. Another one was infected while working at a hospital. He was alone and it was frightening, with a fever for more than ten days, not knowing, leaving his food at the door of his apartment, with us not being able to enter because we had the possibility of catching the virus.”
In addition, his daughter also got sick. “My daughter was in the hospital for twenty days with a fever, and thank God we were able at the last moment to save her life.”
In the middle of these situations, the doctor assures, he has always worked with faith. “Just as the Holy Spirit had the Hebrews mark their houses with a red cross on the door in Egypt, so we felt protected, that the Almighty was going to protect us. Obviously we also took precautions. We used vitamin C, vitamin D, we used hydroxychloroquine… But we were afraid, very afraid—but we were more afraid of not saving lives. Someone had to do the job.”
In memory of Dr. Decoo
Dr. Tallaj again mentions the SOMOS physicians who passed away. Among them, he cites Dr. Decoo, “who caught the virus while seeing patients in his office. He was 69 years old and couldn’t resist the virus, and he died after an arduous battle.”
He also talks about “one of our dentists, who went to a hospital and they intubated him and he didn’t make it through. It was difficult to find his body inside a truck, very difficult.”
Tallaj mentions that in this tragedy there were also undocumented patients. “We were called by family members who were scared because they didn’t know what to do. And those patients died alone in the hospital. Or many of them at home. Maybe some of them are still unburied today.”
For Dr. Tallaj, this two-year history of the pandemic in the United States, full of light and shadows, teaches us a lesson we must not forget.
Injustice and social inequality
Regarding the management of the pandemic, in Dr. Tallaj’s opinion, “The most difficult point of all for me is to see how there was a dual quality of services. For the elite like the professional athletes, you could get isolation in hotels and every 3 days they were tested and played without fans. And I said, ‘But I don’t have a room to quarantine my people, a bed in a school; how is it possible that they’re asking to separate the athletes in hotels and test them every 3 days? Why test them every 3 days, if they’re quarantined and there are no fans? Do you know why? Because the rabble, because the lepers, who are essential, the Hispanics, the African-Americans—we had to serve them food, drive their bus, make the bed for those elite. How shameful.”
Today, the doctor evaluates these two years of pandemic: “If I have to look back at everything that has happened, the first thing that strikes me is the large number of deaths, of human beings who have fallen. For some people, nuclear wars or conventional wars are more important than this one because they produce money, create controversy (…). For me, this war is one of the biggest that this country has fought and it caught us unawares.“
The doctor elaborates : “It caught us without the necessary resources, human resources, materials. It caught us divided, polarized, and this didn’t allow us to act in unison. It didn’t allow us to make decisions based on what was best for the human beings living in this country, and I think it’s something we have to look at for the future.”
“But to that end we first have to go back to talking, and look for commonalities rather than looking for the things that divide us. We shouldn’t use people’s weaknesses to gain political positions or appointments. I’m tired of having so many people with asthma in places where for 30 years we haven’t made an improvement. I’m tired of us talking about unchecked diabetes in our neighborhoods. I think there has to be a point where our leaders wake up to this reality for their children, for their grandchildren, for future generations.”
We need to bring back the role of primary care physician.
Before the pandemic, care for the underserved was a top issue. Now, with what has happened in the two years of the pandemic, Dr. Tallaj is even more convinced that SOMOS is an indispensable healthcare model.
“We created SOMOS because we wanted to change the health situation in the United States, especially in poor communities. Bringing back the role of primary care physician, paying attention to the quality of service in places where there’s social inequality and lack of resources, not only monetary resources but also human resources; where people don’t even speak your language in the health sector. Health cannot be based on a building; health has to be based on a community, on human beings and their needs, as a whole. That’s the way that SOMOS, under my leadership, sees health in our neighborhoods.”
This is why SOMOS is seen as indispensable. “Institutions like ours,” Tallaj explains, “do not exist [elsewhere] in the country. SOMOS is unique—and obviously, because it is unique, due to the many political differences in this country many times one group or another would like to look the other way. Because the interests here have always been based on hospitals.”
The current phase in the war against the coronavirus pandemic is focused on vaccination.
Dr. Tallaj continues to take advantage of every moment to teach about vaccination. “We get the vaccine to defend ourselves from the virus, but chances are that we’re all going to get the virus, that most of us are going to encounter it. How do you want that virus to find you? Vaccinated or unvaccinated? That’s the difference. We say, ‘Young people, you’re going to be more protected with this virus right off the bat. If you’re vaccinated, much better; you can maybe take the mask off in some places.’ Older people, with other diseases… or without diseases, just because of age, like me, in places where there are many people, let’s keep the masks on. If we take it off and we get the virus, I hope we’re vaccinated because it can save us. But if we’re not vaccinated, we’re going to be part of this group of 900,000 or more who have died in this country. [ed. note: 997,000 dead as of May 11, 2022]”
The key to fighting the pandemic
“There are two sayings that could be very important,” he says. “It’s when Jesus told his apostles which was the most important of the commandments. The first part is clear: to love God above all things, with all your body, all your soul, all your being. The second part is the hard part: to love others as yourself and to treat them as you would want to be treated. That has been our motto.”
“We are human,” he admits, “and we make, have made, and will make mistakes. But it’s that devotion, that faith I have in my Christian religion that gives me strength. It’s a solid foundation that has grown in these last two years. Not only because of what has happened to us and what we’ve done, because of the protection he has given us to do this work, or the resources he has given us to develop it, but also because in every moment of my life, in every action I perform, I always ask him, ‘If it is your will…’ And that’s where I believe that most of the time He answers us (…). Many times we don’t follow Him and we fall, but how nice it is to get up and believe in our faith again and attract many more people.”
Dr. Tallaj unveils something that very few people know: “A group of us have been praying every day since this pandemic started, at 8 o’clock at night.”
Tallaj mentions the date of March 26, 2021, “when I asked them to go read Isaiah 26:20, which clearly speaks of quarantine.”
“Come, my people, enter your chambers, and shut your doors behind you; hide yourselves for a little while until the wrath is past.” – Isaiah 26:20
“I have not the slightest doubt that there is something,” he assures us, “after we leave this earth. I have so much faith, and personally, a revelation happened to me during this whole journey, which my close friends know. So I felt and understood that I was walking with a banner of protection, with His mantle beside me to do my work.”
“On the first day I told everyone and anyone who was not a doctor, ‘As long as you pray, we will work on the front lines. As long as you pray, we’re going to keep educating our people and we’re going to be in the middle [of this situation] without fear. Please don’t stop praying. To this day we haven’t stopped and we keep praying, we keep working.”
The coronavirus pandemic has changed us all. Dr. Tallaj explains what this personal transformation has been like for him.
A personal change
“Before, I was a person who wanted to have material goods. They’re important for the family: food security, salary security, transportation security, education security… I have achieved that with all my children.”
“My intention now,” he continues, “is to continue, as I have told my CEO, Dr. Mario Paredes, and [to ensure] that all our resources be used with all our soul, all our heart and all our effort for our motto of helping the poor, feeding the hungry, caring for the sick, and trying to help others as we would want them to help us. And it’s difficult. Because these are things that change and, in our case, the greatest thing is that the Lord has provided us with resources of earthly riches. He has kept us from wanting to keep them for ourselves. He has made us want to have more of what is not earthly and continue to work for others.”