Service to the Poor and Sick

I sat in the spartan waiting room with a handful of patients.  One was laying out over four chairs.  Another set of people were huddled in a corner, speaking softly.  In the hallway I could see two women and a man alternately enter and exit through several doors.  Their movements were hurried but purposeful.  Over the next 45 minutes, the people in the room with me were ushered in through these doors, and then later exited.

Twenty minutes after my interview was scheduled to start, the man I first saw in the hallway entered the waiting room.  He apologized for the delay but had only in that moment finished with the last patient for the day. He introduced himself as Hanno, an internal medicine physician who volunteers at the Malteser Migrant Medicine (MMM) clinic in Berlin.

MMM helps people who do not have valid residency status in Germany.  They work anonymously in cooperation with other medical providers, churches, and charitable organizations to provide assistance.  The clinic is part of a much larger operation that evolved from the Order of Malta, one of the oldest institutions of the Christian West, and acts according to the principle which is manifest in the motto Tuitio Fidei et Obsequium Pauperum: "Witness to the faith, and service to the poor and sick."

They could not have found a better exemplar of this motto than Hanno.

                                                    Dr. Hanno Klemm with a clinic nurse

Dr. Hanno Klemm volunteers at the clinic three days per week.  He sees "just enough" patients in a private practice to make enough to live on.  "Money is not very important to me," Hanno said.  He speaks four languages and has enrolled in a romance languages class so he can learn Spanish, French, and Portuguese.  Knowing many languages is very helpful since Hanno never knows who he is going to encounter in the clinic and there is no budget for interpreters.  Last year Hanno estimates the clinic saw over 10,000 patients, a number which he expects to increase substantially this year with the levels of migration that are occurring.  The clinic depends on Hanno and the other 11 doctors who staff the clinic because the entire budget for the organization is 35,000 euros (about $48,000) per year.  All services to patients are delivered free of charge, and lab work is done at a substantial discount arranged with a local company.

Like Casa de Salud, the clinic encounters many patients who need additional treatment.  The clinic has access to a social worker, but she is only available twice a week and her caseload is packed, so Hanno is often doctor, social worker, and referral coordinator all wrapped into one.  For every patient he sees who needs a hospital, for example, Hanno must arrange for a hospital to take the patient and then negotiate costs.  On the day I visited, Hanno spent most of the morning in between seeing patients calling a neurologist to try to secure an appointment for a patient seen the previous day.

Despite how hard the work is for the doctors, Hanno and his colleagues are able to keep the slots filled during the three days per week the clinic operates.  "We just keep on being creative," Hanno said.


I came away from my visit with Hanno deeply impressed, and very humbled.  MMM sees more patients than Casa does with one-fifth of the volunteer providers and 5% of the budget that my organization is privileged to have, not to mention having to rely mostly on the doctors themselves for referrals (at Casa I have a full time person working referrals and a team of five that manages the entire external operation).  It is a reminder to me that persistence and passion on behalf of a worthy cause can surmount all obstacles.