L.A. Skid Row Residents Distrustful of Clinics : Health Care Hits the Road to Help Poor

If you can’t bring the poor and the homeless to clinics for health care, bring the clinics to them.

That’s the idea behind Los Angeles County’s new medical outreach program on Skid Row, where two part-time workers make “house calls” to five homeless shelters.

The team conducts preliminary examinations, administers simple first aid and sets up appointments with doctors and dentists at area clinics.

Survival on Streets

An estimated 15,000 homeless people survive Skid Row’s mean streets, walking around with an array of untreated ailments, including crippling sores on the legs and feet, high blood pressure and even knife and gunshot wounds.

“There are people in the shelters who need health care but aren’t getting it,” project coordinator Marie Brown said.

The program was created after health officials found that many homeless people were reluctant to go to clinics, even though special funding efforts had been made to beef up staffing and facilities, said Tony Rodgers, who oversees the program, which is paid for with county and state taxes.

“There’s a fear of institutional settings,” Rodgers said. “The problem has been one of trust. . . . The county (health) system can be intimidating. We’re trying to engage them (through the outreach team) so they trust us.”

Outreach workers Toni Young, a registered nurse, and Pedro Martinni, a foreign-trained doctor seeking licensing in the United States, are on the front lines of that trust-building mission.

Lapse in Care for Years

Young and Martinni are the first health care workers some of the homeless have seen in years.

“Some of them haven’t been to a doctor in 15, 16 years,” said Young, 23, during a recent visit to the Fred Jordan Mission in the heart of Skid Row.

As on previous Wednesdays, Young and Martinni had set up shop for office visits in a small meeting room on the mission’s third floor. A gray first-aid kit similar to a fishing tackle box, plastic medical record cases and a portable telephone sat on a folding table.

In one corner, a man was getting a haircut from a mission volunteer. Other men walked in and out of the room as Young, wearing a white lab coat, attended to a man complaining of a sore throat. She felt the man’s neck for signs of swelling as he sat quietly in front of her.

“I feel very comfortable with these people,” she said, occasionally glancing out a window to make sure her car was OK. “They’re very happy that someone is caring for them, and I’m meeting them on their home ground.”

She had seen a steady stream of about 20 people during this visit, but no emergencies. Most of the cases had been minor ailments such as bunions, sore throats and various aches and pains. One man who was trying to kick a rock cocaine habit came in seeking information on dealing with withdrawal symptoms.

It wasn’t necessarily a typical day. Young and Martinni have seen their share of serious health problems since first going into Skid Row on Feb. 22.

One week earlier, a 26-year-old man came to them with open sores on his leg and foot that were so severe he could hardly walk, Young said. “He just hopped (on his good foot) wherever he went,” she said.

Project director Brown drove the man to a nearby clinic for treatment.

Because Young and Martinni conduct only basic examinations, provide simple first aid and distribute non-prescription items such as aspirin, cough syrup, bandages and condoms, a large part of their job is setting up appointments at nearby clinics for those with more serious health problems.

Making sure that the patients actually get from the shelters.