Doctor Who Makes House Calls to the Down, Out and Homeless : Twice a week, Dr. Pedro Jose Greer visits the encampments of Miami to persuade ailing residents to get free treatment.

The Mud Flats is where poverty comes home to roost in a cardboard box. Here, under a freeway overpass in the shadows of downtown, about 200 people live hour to hour in a Third World squalor of raw sewage, rats and mosquitoes, and an HIV and hepatitis infection rate that has reached near-epidemic proportions.

Even before Hurricane Andrew destroyed or severely damaged 85,000 homes in the region, Miami’s chronic homeless population was estimated at 10,000. Now it seems to be growing.

State health officials have declared this area a major health hazard. Andy Menendez Jr., Dade County’s director of homeless programs, calls the make-shift shanty town “as disgusting and disgraceful as you can get.” After a recent visit, Archbishop Edward A. McCarthy of Miami described the encampment as an insult to humanity.

This week, in a ruling that could set a national precedent, a federal judge declared that the homeless had a right to sleep, eat and bathe on public property, and ordered the city not to bother them. U.S. District Judge C. Clyde Atkins also told Miami officials to set up two “safe zones” for the homeless.

For now, the Mud Flats is one.

Outside of the residents themselves, perhaps no one knows about life in Miami’s Mud Flats as well as Dr. Pedro Jose Greer, a gastroenterologist who for nine years has been on a self-directed volunteer mission to help the down and out. He’s a street doctor who makes house calls to the homeless.

“The Mud Flats,” says Greer, “is the last stop before severe illness and death. You expect to see a sign here: ‘End of the World, half a block.’ ”

At least twice a week, Greer, 36, hops into his red car and drives into a nether world of urban encampments scattered throughout Miami--in parks, under bridges, in lean-to shelters put up right next to the bay along famed Biscayne Boulevard. His mission: to persuade a wary population afflicted with everything from AIDS and drug addiction to respiratory problems and skin lesions to come into a free clinic for treatment.

Eight years ago Greer founded a downtown clinic, the Camillus Health Concern, to treat the homeless. Since then, he has been widely recognized and honored for his work. Newsweek hailed him as one of “America’s Unsung Heroes.” He’s been featured on two television networks and has been named Doctor of the Year by the Dade County Medical Assn. Last February, Los Angeles comedian Paul Rodriguez stopped by to hand Greer a check for $410,000, a gift from Comic Relief.

On a recent Tuesday afternoon, Greer pulls his car up onto the sidewalk under the freeway, climbs out and wades into the Mud Flats through a rip in the chain-link fence. He is trailed by the flapping tails of his white lab coat, two students from the University of Miami Medical School and a social worker who is trying to organize a trash cleanup.

As they make their way through the Mud Flats, Greer and his entourage step over fetid pools of waste and rainwater. They walk around mounds of beer cans, bottles and hypodermic needles. They walk up to people sitting on milk crates, holding their heads, staring into the dirt.

Suddenly, a man with blood pouring from his nose walks up to Greer. His name is Shorty, and he is holding a filthy shirt to his face, but the blood is still dripping onto his chest. “Some dude hit me,” explains Shorty.

Greer is not wearing protective gloves. He gingerly tips the man’s head back to have a look. “You better come to the clinic,” the doctor says.

Shorty’s nose was one of the least severe problems Greer and his staff would see that week. Crack-addicted women about to give birth, a growing rate of hepatitis B and tuberculosis, open sores and persistent skin infections--all of these are common in the Mud Flats.

“We have had many years of misplaced priorities in this country,” says Dade County’s Menendez. “But you have to wonder: How did we let things get this bad?”

Recently, Mud Flats residents were provided with running water, portable toilets and regular trash pickup. The county has also received a $2.3-million federal grant to work with an estimated 1,100 homeless people with AIDS, and after the tent cities in hurricane-stricken Homestead were closed last month, the Federal Emergency Management Agency gave Dade $360,000 to resettle chronic homeless people who had migrated there simply for food and a cot.

Menendez says he will propose to a special session of the Florida Legislature a 2% restaurant tax to fund homeless programs. In the meantime, he is searching for more permanent shelters and fighting what he calls widespread “not in my back yard” neighborhood resistance.

Greer welcomes improvements in the Mud Flats. But he also is wary of temporary fixes that offer no real solution to homelessness.

“Very simply, I would start by giving everybody a good physical, including a urine test for drugs, and then put people into programs,” says Greer. “We have to offer long-term therapeutic intervention, which means three to six months in house, and then intensive after care. The answer to homelessness is dealing with urban poverty and providing employment.”

Greer, the son of Cuban immigrants, practices medicine with his father, also a gastroenterologist, and is on the faculty at the University of Miami, the first medical school in the United States to require its students to spend time at a homeless clinic. Although Greer provides a comfortable living for his wife and two young children, he makes far less, he says, than he could if he didn’t volunteer 20 hours a week on homeless issues.

Greer does have critics, those who say that as the clinic’s volunteer medical director he has become more interested in starring in news media sound bites than in treating patients. But Menendez calls Greer “a catalyst for change, a man who has been in the trenches since Day 1. I admire him tremendously. We need more people like him.”

Greer himself is not sure what compels him to go into places which most people--even the residents--find foul and frightening. He has discovered bodies in homeless encampments, and once had a gun aimed at him.

“You know, society lets you suffer but it doesn’t let you die,” says Greer. “If you show up in the emergency room, we’ll catheterize you, bypass you, do whatever it takes to save you. And then we’ll send you back under the bridge. There’s something wrong there.”