This doctor stepped up to bridge the gap as the pandemic ravaged this small city

The experience provided Nelken with a close-up view of the physical, mental, and economic toll that the virus taken here in a compact, impoverished city where many people are uninsured, undocumented, and unsure where their next meal will come from.

“There is quiet suffering,” Nelken said at her office this week. “Hungry kids don’t make big noises.”

Nelken will be honored at Central Falls City Hall on March 11 as part of International Women’s Day 2021.

“We would like to award you in acknowledgement of your hard work, especially during the COVID-19 pandemic,” Mayor Maria Rivera wrote in a letter to Nelken. “You have been the hero of our city and your work is immensely appreciated.”

Dr. Michael Fine, the former state Department of Health director now serving as the chief health strategist for Central Falls, said Nelken has filled a void, providing COVID-19 testing at a crucial point and then becoming a significant source of vaccines in the city.

“She is our beacon,” Fine said. “She is the real thing.”

He said Nelken has been listening to and caring for families who often have nowhere else to turn, no one else they trust.

“She was an ear to a community that had no other ear,” Fine said. “She was providing the major access for the undocumented community.”

She and others helped protect public health by providing consistent daily information about the spread of the disease, he said, and she offered an early warning that the virus was infecting whole families in Central Falls.

Fine said the true meaning of medicine involves putting the needs of patients and the community ahead of self-interest. “And Dr. Nelken exemplifies that un-self-interested advocacy,” he said.

Nelken, 49, was born in California, where her grandmother had immigrated from Mexico. She graduated from Wesleyan University and the University of Connecticut School of Medicine. She taught for a year in Nicaragua. She did her medical residency at Brown University, training at Hasbro Children’s Hospital. And she took part in medical brigades in Honduras, Guatemala, and Mexico.

She worked at the Thundermist Health Center for 10 years and at the Blackstone Valley Community Health Center for four years before forming her own pediatric practice last year.

Nelken said she was motivated by working in Central Falls High School and seeing families who lacked insurance – recent immigrants who were unable to afford prescription medications and in some cases relying on “bodega remedies.” She launched the pediatric practice, providing free care to uninsured children.

But then, just weeks after she opened her doors, the pandemic hit.

With just two staff members, Nelken was unsure if she could help address the crisis. “I was ready to close my doors,” she said. “There was a little panic. But Dr. Fine talked me down. He said, ‘The community needs you – what are you willing to do?’”

In April, Nelken reached out to the state Department of Health, which provided her with one Abbott rapid-test machine, and she ended up buying a second Abbott machine and a one-hour PCR machine.

At first, she and her staff were standing on the curbside, clipboards in hand, offering people free COVID-19 tests.

“It was like a lemonade stand,” Nelken said.

Early on, the state was conducting tests at the Twin River casino in Lincoln, but some Central Falls residents didn’t know about that location, or couldn’t get there, or felt uncomfortable going to a site staffed by National Guard members in uniform, she said. Others lacked referrals from primary care doctors, or they ran into language barriers, she said.

So her office emerged as a trusted, convenient source of testing. About a year later, her staff has grown to 15, they all speak Spanish, and they have conducted hundreds of tests over the past year, swabbing noses on the front porch, she said.

Along the way, Nelken has seen the scope of the devastation wrought by the virus. “It is economic and health misery, layer upon layer,” she said.

She saw the Central Falls residents who worked in restaurants, grocery stores, warehouses, and factories where they were called “essential workers” but treated as expendable. She saw the janitors and landscapers, often paid under the table and provided with poor or nonexistent medical care or sick pay.

She saw families struggle when a breadwinner would lose a job or get deported. She saw extended family members move in with one another, creating crowded conditions. And she saw families begin to go hungry.

“These are families that are living a delicate balance of survival to begin with,” Nelken said. “It doesn’t take more than a single blow to knock them down.”

While schools provided food programs, she saw the need in the long lines that form whenever the Elisha Project provides meals.

She saw that young people, amid the isolation and desperation, were grappling with depression, with some wondering whether life was worth living.

Nelken said she went through waves of exhaustion but she has felt a “call to duty to respond to the dire need of the situation.”

“There is nothing I would rather be doing,” Nelken said. “And there is nowhere I’d rather do it.”

She said she has been amazed by how the tiny city has rallied to respond to this enormous crisis. “I have never seen a community like this that is so powerful in its compassion and commitment to each other,” she said.

Nelken noted that Central Falls has been vaccinating 500 to 1,000 people each weekend now that it has been prioritized as a hard-hit community. “We could be a model for the United States for a high-density population making a turnaround,” Nelken said.

But that won’t happen if Central Falls doesn’t remain a priority and does not receive the vaccine supply it needs, she said.

According to the most recent Department of Health data, 33.1 percent of the Central Falls population has received one dose of the vaccine, while 17.1 percent has been fully vaccinated. But the city received just half of the supply it expected for a vaccine clinic on Saturday.

“Don’t withhold support now,” Nelken said, “because we are on the second lap of the 4 by 800 relay.”

She hopes that a year from now, Central Falls will have returned to a “manageable cautious way of life,” with schools and restaurants open and businesses thriving.

And she hopes the front porch of her office will be used for barbecue parties rather than COVID-19 tests. “We will turn the swabs into barbecue skewers,” she joked.

Edward Fitzpatrick can be reached at edward.fitzpatrick@globe.com. Follow him @FitzProv.