"Everyone deserves health care. No one should be suffering. No one should be in pain,” Ghazal says.

PROVIDENCE, R.I. — Months after moving to Cranston from her native Greece, Maria developed severe pain and stiffness in her right shoulder.

"I was scared. I was nervous," Maria recalls in broken English. The 55-year-old, who chose not to share her last name, has no health insurance. She knew she couldn't afford to see a doctor. "I don't know what I am going to do. My arm was very bad."

Maria was desperate for a diagnosis, but was unsure of where to turn. Her fortunes changed when friends told her about the Rhode Island Free Clinic. Located on Broad Street in South Providence, the clinic has provided medical attention free of charge to thousands of uninsured residents since it opened its doors in 1999.

At the Free Clinic, Maria was able to see a primary-care physician, who diagnosed her with "frozen shoulder," a condition in which the connective tissue around the joint thickens, making it difficult to move the arm.

After eight months of physical therapy at the clinic, Maria regained the use of her right arm and was pain free.

"The clinic helps us very much," she manages to say before breaking down in tears.

The anxiety of having a health scare and the relief of finding help at the medical "safety net" is an emotional roller coaster that many of the clinic's patients feel.

"We treat everybody with dignity and the people are very grateful," says Marie Ghazal, chief executive officer of the Rhode Island Free Clinic. "Everyone deserves health care. No one should be suffering. No one should be in pain."

That’s a daunting task when you consider that an estimated 50,000 of Rhode Island’s low-income residents have no health coverage.

But Ghazal, 63, has proven to be a powerhouse.

She may describe her leadership style as slow and steady, but in her eight years at the helm, the clinic has expanded exponentially.

"We built capacity," she says matter-of-factly. "We built more volunteers and doctors and sessions so we could take more people."

Twice the number of patients — 2,400 people from across the state — are now treated at the clinic. That’s 7,000 visits a year. All for free.

That’s an incredible feat when you consider that the free clinic's annual operating budget is only $1 million — and all that money is donated. Not a cent comes from federal or state coffers.

They’re able to keep costs at a minimum by having a skeleton staff of just seven. The bulk of the work is carried out by an army of 700 volunteers who manage and care for the patients. One hundred and fifty of them are medical professionals.

Critical back-office operations, like volunteer outreach, scheduling of personnel, data analysis and marketing, are done by nine VISTA volunteers, who rotate out every twelve months.

It’s a lot of juggling. A lot of pressure. And, the stakes are high.

"Marie is a miracle worker [who] has taken the clinic from ordinary to exceptional," writes Stephanie Chafee in an email from overseas. Strong words of praise from Chafee, a registered nurse and former first lady of Rhode Island, who founded the Rhode Island Free Clinic 19 years ago. She couldn't be prouder of what the nonprofit has become under Ghazal's leadership.

"Prior to Marie, the clinic was serving basic health-care needs. Now the clinic has expanded into every specialty," Chafee wrote.

From cardiology to ophthalmology, gastroenterology, psychiatry … there are 25 specialties in all.

"There’s a tremendous amount of challenge working here," admits Ghazal. "We have to raise money. We have to build a constant volunteer program. We have a very lean staff."

Yet, she is completely committed to the mission. It's her passion.

"I always wanted to make things better for people," she says.

Ghazal, whose parents were Lebanese, was born and raised in Central Falls.

"I wasn’t brought up in wealth," she says. "Both of my parents were immigrants. We didn't have health care. We didn't have dental care. My father was a storekeeper. We worked hard."

Ghazal studied nursing at the University of Rhode Island. During the summers she worked with kids in parks around Central Falls. She still keeps a black and white newspaper photo from 1976 in her office; it shows Ghazal in a nurse's uniform and surrounded by children in Jenks Park.

When she graduated, Ghazal became the director of the first health center in Central Falls, now known as Blackstone Valley Community Health Care. She then moved to the Providence Community Health Center, where she worked for 20 years, before taking the reins of the Free Clinic.

"My roots made me appreciate so much about giving back and being grateful and thankful," she says.

That commitment to community service is shared by volunteers like Dr. Audrey Kupchan.

"The reason we all went into medicine was to help people," says Kupchan. "This is almost a more pure form of that."

Kupchan, 63, who lives in Barrington and is an internist at Coastal Medical, has been volunteering at the clinic since 2012.

"Marie is endless energy and very dedicated," says Kupchan. "She's always thinking about improvements and expansions. She never says no."

Kupchan has also recruited several colleagues to donate their time and expertise.

"I usually tell them how rewarding it is. And that if the patients didn't come here and didn't get this help, their lives could really be in jeopardy."

Retired social worker Maxine Goldin feels the same way. Despite her 83 years, she continues counseling patients each week.

"I like the energy that people are getting services that they never thought they'd get to have. Because they're grateful. Even with all the problems that they have, they're grateful for being able to get services," she says.

Ghazal has been able to expand those services over the years thanks to major donors and community partners. She closes her office door to reveal a large posterboard full of hand-written names. They are all heavy-hitters in Rhode Island, her strategic partners in making the clinic successful.

There's CVS, which offers patients free medications and after-hours care at its MinuteClinics. Lifespan, which provides specialty services. Insurers Blue Cross & Blue Shield of Rhode Island and Amica. The Rhode Island Foundation. Local colleges and universities. The list is long.

"I’ve never met such wonderful people that I’ve met working at this clinic," says Ghazal. "The doctors, the volunteers, my board. People believe in the mission. They care."

Because of their contributions, and the help of so many volunteers, Ghazal estimates that the Free Clinic has kept hundreds of patients from going to emergency rooms — offsetting nearly $4 million in care that would have gone unpaid.

Her latest achievement is a dental clinic set to open at the end of the month.

"Patients have never seen a dentist in their life!" she exclaims. "They’ve never sat in a dental chair." Thanks to Delta Dental and the Champlin Foundation, two dental suites have been set up and are ready to go.

This top-quality primary, preventive and specialty care is what makes the clinic's patients, like Belkys Suarez, eternally grateful.

The 52-year-old from the Dominican Republic says she thanks God every day for the Free Clinic.

"Without the clinic," Suarez says in Spanish, "I would never be able to see a doctor. I don’t know what I would do."

That stark reality is what keeps Ghazal focused and fighting for the uninsured.

— Patricia Andreu, a freelance journalist living in Providence, writes Women in Action, a periodic column. Reach her at WomenInActionRI@outlook.com.