Ailing Homeless Find Medical Care Parked at the Curb

The 36-year-old woman winced in pain with each step. A gash on a little toe had been infected for days. Now the dirty foot was swelling--and she was worried.

“My safety is in my walking,” said Pamela, who did not want to give her full name because her son does not know she lives on the streets of South-Central Los Angeles. “If my foot goes bad I’m in trouble.”

It was Pamela’s painful walk that led her into a makeshift doctor’s office for treatment.

Parked along Western Avenue, the Watts Health Foundation’s new mobile health care trailer was beginning its mission to seek out and offer free care to the bruised and aching bodies of homeless people in South-Central Los Angeles.

‘I Can’t Believe This’

“I can’t believe this good luck,” Pamela said, dropping her plastic bags and taking a seat next to a nurse. “I don’t have a medical card or nothing like that. . . . I didn’t know how to get to a doctor. I sure couldn’t walk to county,” she said, referring to County-USC Medical Center.

The homeless health care van is a one-of-a kind operation in Los Angeles County, putting medical services within steps of a population that would rather spend the time trying to find a safe spot for sleep than go to a doctor for medical help, county and city homeless authorities said.

“You have to go out and find these people if you want to help them,” said Deputy Mayor Grace Davis, who heads a city task force on homelessness.

In its first month of curb-side care, about 300 patients have passed through the trailer, where doctors and nurses are equipped to handle such basic health care needs as immunizations, obstetric care, treating wounds and prescribing drugs for minor ailments.

Today, the trailer will begin full-time service as a one-stop doctor’s office--complete with an examination room and a mini-pharmacy. The traveling doctors and nurses will pull up to homeless shelters, food pantries, soup kitchens and parks where the homeless congregate, said Harold Hambrick, a foundation official.

“All we need is a curb or a vacant lot to park and help,” said Leonard Westmoreland, the director of the mobile medical project. “We’re kind of like an urban ‘MASH’ team.”

In the next 11 months the doctors hope to see about 5,000 patients. The Watts Health Foundation received $600,000 in federal financing for a one-year period to run the van.

The federal grant was awarded under the Stewart B. McKinney Homeless Assistance Act, which was approved by Congress in 1987. The act provided $50 million nationally for health care, substance abuse treatment and mental health services to the homeless.

Dr. Chierry Poyotte, medical director of the Watts foundation, said that homeless people usually seek out medical help only when they are acutely ill or in pain.

“When you are fighting for the basics to survive, health care is not a major priority,” Poyotte said.

Typical Cases

During the first few weeks of trial operations, Poyotte and his staff have cleaned and bandaged numerous wounds, sores and skin infections. Lice-killing shampoo is commonly distributed. As part of the general physical examination, cases of tuberculosis, diabetes and venereal disease have been detected.

A frequent injury, Poyotte said, are hand and arm burns from trash barrel fires.

One man stepped out of a food pantry with a sack of cheese and bread to ask for a clean bandage for his burned, infected finger that was taking weeks to heal--an indication that the man might be diabetic, the doctor said.

But he walked away with a new bandage without information for future treatment, typifying what stands as a problem of extending homeless health care beyond a quick bandage.

Helping in Small Ways

“Even if we just change the dressing and give them an antibiotic for infection, we’re helping,” Poyotte said.

Program officials hope that by returning to the same locations about twice a month they will be able to push for follow-up care. Those with the most serious ailments are driven to health clinics.

“The homeless travel in the same circles. They gather in the same places in South-Central,” Westmoreland said. “We think we are going to keep running into them.”

Waiting Time Cut

The medical trailer cuts through the weeks or months of waiting for an appointment at a county health clinic and is welcomed to park in front of the Community Connection Shelter on Western Avenue near Exposition Boulevard anytime, said shelter director Ray Conway.

“Most of the people who come to our shelter have not had medical care in years,” Conway said. “We can make a doctor’s appointment and give them referrals, but we never know if they make it. They disappear on the streets.”