Critical Condition : Quake Damage Has Forced Clinic to Operate Out of Trailers

To the staff of the Mid-Valley Comprehensive Health Center, trailers never looked more stately and hospitable than when a caravan of them rolled into the facility’s Van Nuys parking lot last month.

The county-run facility had been operating out of tents beside its building on 7515 Van Nuys Blvd.--belatedly condemned two months after the Northridge earthquake--when the mobile units arrived, bringing a sturdy roof and running water, if nothing more, to a makeshift operation.

A month later, however, with no immediate plans for relocating to a permanent building, the trailers are finally being seen for what they are: a 6,000-square-foot campsite trying to take the place of a 50,000-square-foot medical building.

The usually steady stream of low-income clients--the clinic recorded 93,000 visits last year--now feels like a torrent. Some workers are increasingly stressed about their working conditions. The center’s medical files, extricated from the shuttered building, are lying unused in a storage trailer because there is not enough space to review them, according to associate administrator Ernest P. Espinoza. Staff members just start anew.

“We don’t have any of our public nursing records or nursing manuals,” said Bernie Nelson, the director of nursing for the facility, regarded as the hub of the 10 county health centers in the San Fernando and Santa Clarita valleys. “We’re working with (records) we’ve created since the earthquake.”

County officials are having difficulty finding a reasonably priced building in the Van Nuys area large enough to house the medical center. According to county sources, the old building is unlikely to ever be used again.

The building, which was a major medical command post after the quake, was examined and deemed safe shortly after the temblor. But a fourth inspection in March revealed that four of its support beams were cracked and the building was ordered closed, displacing the 140 employees.

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The center, which sees 4,500 to 6,000 patients a month, mostly for tuberculosis, sexually transmitted diseases and prenatal care, has been forced to relocate many of its services because there is not enough space or equipment to help everyone.

There was no room for a dentist’s chair in the trailers, so the dentist and the dental-care program were transferred to Olive View Medical Center in Sylmar. Mid-Valley used to perform about 400 X-rays a week, but since there is no X-ray machine in the trailers tuberculosis patients, for example, now have to go to the North Hollywood Health Center. And anyone who needs treatment for a sexually transmitted disease now has to travel to the Canoga Park Health Center, where some nurses and doctors have been transferred. Screening for the AIDS virus is still done at Mid-Valley.

Some of the services deemed too important to relocate have been cut back.

The prenatal care and the family planning units, which had their own spacious accommodations in the old building, now share cramped space in the middle of the main trailer, each using it on alternate days. Much of their medical equipment is kept in storage boxes.

“If you want to get things, it’s a lot of digging and looking around, which causes delays,” said Secorro Salanga, 38, a nurse in the prenatal clinic. “But I feel we’re still able to provide good service to our patients.”

Salanga said the pressure of seeing about 80 patients a day in such a small area is creating friction among workers.

“Sometimes, we get on each other’s nerves,” Salanga said. “We rub elbow to elbow.”

Privacy has also become a serious problem at the center, which provides one-on-one counseling to hundreds of patients. The counseling is now taking place in one of two remaining tents outside of the trailers. The other tent is being used to question patients about their medical history before providing them with treatment.

Yet despite the chaotic conditions, many of the center’s patients interviewed Thursday said they were satisfied with the level of services being provided.

“It took two hours to get in on Tuesday,” said Teressa Garrett, an unemployed mother of seven who was bringing in four of her children for tuberculosis testing after having them vaccinated at the center Tuesday. “We’ll see today. But in any health center, you wait a long time.

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“Here at least you get helped,” said Garrett, who lives on welfare.

Maynor Medina of North Hills comes into the center every day to receive injections for his chronic tuberculosis, as he is required to do by the county. When he was diagnosed at the center last year, nurses at the center discovered golf-ball-sized lesions in Medina’s lungs. On Wednesday, his birthday, nurses bought him deodorant and after-shave as a present, much to his surprise.

“This country has the finest medicine, and people don’t appreciate it,” said the Guatemalan immigrant. “This building is more secure anyway. Things would fall on the floor everywhere during an aftershock in the other building.”