In Santa Monica and L.A., teams of health
workers bring critical medical services to people
who are often averse to seeking treatment.
By Martha Groves
Times Staff Writer
April 3, 2007
Friends call him Thurston Howell III, for his
passing resemblance to the millionaire played by Jim
Backus in the 1960s sitcom "Gilligan's Island."
But Mike Huffman, 60, is no millionaire. The
former computer program analyst and TV technician
sleeps on a concrete slab at the beach in Santa
Monica. He sometimes goes days without eating. And
he forgoes medication for high blood pressure
because he has no money.
A break finally came Huffman's way last week
after a homeless outreach team received word that he
was exhibiting signs of pneumonia. A worker from the
Ocean Park Community Center, one of the Westside's
largest service providers, and a doctor from the
Venice Family Clinic tracked down Huffman on
Thursday at a gazebo south of the Santa Monica Pier,
checked his blood pressure, took his temperature and
whisked him to the clinic.
Street medicine, as this practice of making house
calls on the homeless is known, is fast becoming a
popular tool in Santa Monica, Los Angeles and other
cities in their attempts to help an often
disaffected population known for its aversion to
accepting help. Activists acknowledge that street
medicine can serve only a fraction of those who need
care, but successful programs in Pittsburgh and
Boston have helped spark the movement.
"We potentially have saved many lives by doing
this," said Christine Fratino, a Venice Family
Clinic doctor who helped develop the "street med"
program.
The lifesaving starts with steps that might seem
small to those who have Band-Aids, pain relievers
and hydrocortisone cream close at hand. To those
living in alleys and parks, however, the street
ministrations of Fratino and her colleague, Dr.
Susan Partovi, can mean the difference between a day
spent suffering from a wracking cough or sore rib
and a day when the body, at least, is free of pain.
Like many other homeless healthcare programs, the
Venice Family Clinic-OPCC effort, launched in
January, receives federal funding. Nationwide, such
programs serve about 650,000 homeless people a year,
according to the National Health Care for the
Homeless Council.
***
For the Santa Monica street medicine team, the
day began at 7:30 a.m. in the parking lot behind the
Ocean Park Community Center at 16th Street and
Broadway in Santa Monica.
On Thursday, Fratino and Partovi, who usually
alternate on the weekly outings, decided to team up.
With them were Susie De La Rosa, an OPCC outreach
worker who drove the van, and Bryan Sauter, a
physician assistant from the Los Angeles Mission
Community Clinic. Fratino had packed a large black
backpack with ibuprofen, asthma inhalers, ointments,
multivitamins, a temperature probe, a blood pressure
cuff and lots of disposable gloves.
The first stop was an alley between 4th and 5th
streets near Broadway. There, next to trash bins and
a bank parking lot, Amelia "Bootsie" Skinner, 68,
was using an outdoor faucet to rinse out clothing
and wash her face. Plastic trash bags stuffed with
her possessions were piled high in a grocery cart.
Skinner, who is missing many teeth, recognized
the outreach team and smiled as she greeted them. At
Fratino's request, she removed her fleece-lined
moccasins, unwrapped the plastic bags around both
ankles and pulled up the legs of her jeans to reveal
swollen legs and feet. She lifted her right foot to
show Fratino a cut on the bottom.
Fratino, 35, handed Skinner a tube of ointment.
The doctor also offered an antifungal cream, but the
older woman — who insisted she has a doctorate in
psychiatry and once practiced medicine in Tuskegee,
Ala. — rejected it.
But Fratino wasn't fazed. The fact that Skinner,
who the doctors believe is schizophrenic, accepted
any aid at all was encouraging.
"At first she couldn't walk," Fratino said. "Now
she's mobile."
The next stop was Palisades Park, where John
"Teddy Bear" Cunningham, 43, sat on a bench, his
legs splayed. Partovi took his blood pressure; at
158 over 96, it was too high.
One goal of the program is to encourage homeless
individuals with skin infections, upper-respiratory
ailments, high blood pressure, diabetes and other
conditions to visit the Venice Family Clinic.
Doctors hope that patients would then be willing to
take advantage of other services such as rehab and
counseling.
Partovi, 39, offered Cunningham, a former school
custodian who has been on the streets for seven
years, a ride in the van to the clinic. "OK," he
said.
After dispensing Tylenol, vitamins and cream to
treat the dry, cracked hands of Masako Ellis, a
soft-spoken woman wearing hot pink lipstick, the
team headed for the public showers under the Santa
Monica Pier, an early morning gathering place for
the homeless.
Just before they left, De La Rosa told Cunningham
they'd return for him. "I'm not going anywhere," he
said.
***
People who become homeless tend to have severe
personal problems, said John Lozier, the
Nashville-based executive director of the National
Health Care for the Homeless Council. "Often those
problems include illnesses that make people
resistant to receiving care," he said. "Kind,
competent professionals doing outreach becomes
critically important."
The homeless population's transiency makes it
difficult to measure results, but Lozier said
studies have shown that healthcare projects for the
homeless are as effective in helping control some
chronic medical problems as are more established
clinics. Small steps work, Lozier said, adding, "We
tend to get our gratification one person at a time."
Jean Sedillos, a Santa Monica
activist, said the city has known for years that it
needs more outreach to homeless individuals.
Nonetheless, she was concerned that a street
medicine program could make it easier for transients
to remain on the streets.
"It's hard to argue with an outreach program that
really does bring people in" to services, Sedillos
said. "But if it turns into another feeding in the
park, with no questions asked and no accountability,
then it is an enabling situation. It could go either
way."
Members of the street med team say the outreach
will encourage clients to get off the streets. The
first step, they contend, is making the homeless
comfortable with those providing the services.
And that means going to where the homeless
congregate.
At the public showers, the team members were
greeted by several regulars, including Arthur
Tarango, 56, who asked: "You guys got any pills?"
He had fallen off his bike and was in pain.
Partovi examined his left arm and identified the
problem: an inflamed tendon. He walked off happily,
toting several packets of ibuprofen.
Fresh from his shower, Dave Culver waved away the
team's offer of help, saying, "I'm fine, except for
being alcoholic, of course."
Then the team set off in search of a man named
Mike who might have pneumonia. "He's my best
friend," Culver said. "You'll find him at the
gazebo."
Indeed, there was Huffman, struggling to breathe
while suppressing a cough. He said he had injured a
rib when another street person "popped me a good one
and I hit the pavement."
Huffman said he averages a fifth of vodka a day
and has been in and out of Alcoholics Anonymous. He
hadn't eaten in two days. An exam yielded
distressing data: He had extremely high blood
pressure (170 over 124), a temperature of 100.2 and,
Partovi suspected, pneumonia or bronchitis.
He accepted a ride to the clinic and climbed into
the van. De La Rosa drove back to Palisades Park to
pick up Cunningham, and the group headed for the
clinic on Rose Avenue.
A scheduler arranged for afternoon appointments
for both men.
Later, Partovi reported that she treated Huffman for
his high blood pressure and gave him medicine for
pneumonia and rib pain.
He agreed to return for a chest X-ray. Cunningham
failed to show up for his appointment.
martha.groves@latimes.com
http://www.venicefamilyclinic.org/
