The St. Andrew's Children's Clinic in Nogales, Ariz. brings hope and smiles to children from Mexico that seek medical treatment. But a different emotion runs through some of the dedicated individuals who help deliver that happiness.

Bob Phillips, executive director at the clinic, started his job just under a year ago, and like any new director, began implementing changes and ideas. Some volunteers who have been with the clinic for many years, some even since its establishment, are looking unfavorably towards Philips’s new direction of the clinic, and some have even been volunteering less than usual.

Phillips says that the SACC could never run without its many dedicated volunteers, but has a vision for the clinic’s future.

He is focusing on six different areas to change about the clinic’s makeup: to build a stronger financial base to support the Clinic’s budget, to move the clinic to a new location, to create a volunteer coordinator position to organize volunteers from the United States and from Mexico, to support the volunteer doctors with malpractice insurance, and to transfer more operations to Mexico and provide health care skills to individuals from Mexico in order for them to care more for disabled children.

“Making the transition from an organization that has been completely volunteer, with no policies or procedures consistent with a non-profit, to an organization that is acting more like a non-profit but is more professional has been tough,” Phillips said. “There has been resistance – the organization doesn’t always welcome change. It is a process for both myself and the board to learn – I need to learn more about the operation and the sensitive relationships that really sustain the clinic.”

The way the clinic operates today may appear hectic to those looking in on the operation from the outside. Kim Krueger, a volunteer and former member of the SACC Board of Directors, describes this method as "volunteers flying by the seat of their pants."

“My first impression was that the clinic looked like a beehive,” Phillips said. “I was overwhelmed – people were receiving care in a very unlikely setting.”

The organization of the clinic is complicated.

“There is a board of directors and they meet about six times a year,” Phillips said. “I’m employed by them. As executive director, it is my job to hire staff members and to coordinate volunteers. We have a bookkeeper, business manager … we have a little over 200 volunteers who take care of food and clothes distribution, meals for the patients, families and staff, and then we have the medical staff.”

The effect of change

Long-time volunteers like Krueger disagree that it’s an overwhelming environment. Krueger served on the Board of Directors of the SACC for 15 years as the treasurer, and also helped Father Ed Gustafson reorganize the clinic when it became a 501(c)(3) non-profit organization. Now that Phillips is director and is implementing changes, Krueger is opting to stay away.

“I haven’t been coming just because I don’t know exactly what all he’s doing, and certainly it’s easy to stand around and say ‘I don’t think that they ought to do it that way,’” Krueger said. “I don’t think that the new director needs that.”

Krueger says the feeling that used to resonate throughout the clinic is different.

“We helped to start this clinic and we thought we were doing a great job and we feel that we did do a great job,” Krueger said. “And we were a family. Everybody loved everybody else, we all worked together.”

“Nowadays, it’s becoming much more commercial or corporate and it’s a completely new idea for me, and personally it’s hard for me to understand it,” Krueger said. “We thought that we were doing a good job that way, but I’m not against this, I think this is a fine idea and you cannot hire a new director and tell (Bob) how to do his job. So that’s why I’m staying away."

Clinic founder and orthopedic surgeon Mark Frankel recognizes the importance of volunteers and of change.

“I think that change is always hard for everybody,” Frankel said. “But change is good because this clinic was founded in 1972 and we worked in the nun’s bedroom at the orphanage across the line, so our problems and our operations are very different now.”

Although the St. Andrew’s Children’s Clinic is currently undergoing changes, the organization’s goal remains to provide free medical care to disabled children from Mexico.