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Mary McGrory

Care on Wheels

By Mary McGrory
Sunday, April 21, 2002; Page B07

They had what is called locally a "shout-out" in Anacostia last week for two sleek new vans that will roll through seven neighborhoods dispensing medical and dental care to children from newborn to 21. On Savannah Street, near the Malcolm X Elementary School, the heat was literally breathtaking, but the speeches were short and fervent, the songs touching. Even the prime mover of the event, who deplored it because he thinks children should get health care at clinics with fixed addresses, enjoyed it.

Dr. Irwin Redlener is a fanatic about children's health care and always has been. As a new medical school (University of Miami) graduate in 1969, he went to an east Arkansas county, one of the six poorest in the United States. He is convinced that the problem of treating poor tots can be solved. In 1987, with singer-composer Paul Simon, he founded the New York Children's Health Fund, which has worked with the Children's Health Project of D.C. and Children's Hospital to bring the state-of-the-art mobile units to replace Anacostia's tired equipment.

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Anacostia, which has never been known for its luck, got a big break on health care. Oprah Winfrey took note of its efforts and honored Dr. Gloria WilderBrathwaite, the imposing and charismatic figure who runs the show. Dr. Gloria, as she is known to her patients, got a "Use Your Life" award from Oprah in February. There was also a $100,000 donation from Oprah, who did not stop there. Dr. Redlener proudly revealed that their benefactor had also written a check for $273,000 for the new beauty parked at curbside.

Before the program, Dr. Gloria showed visitors through the facilities, expressing her great joy at the spiffy new examining rooms, electronic record-keepers and, above all, the oxygen that comes out of the wall to help Anacostia's many asthmatics. She is accompanied on her rounds by a resident physician from Children's Hospital, a nurse and a driver who doubles as a receptionist. The dental van goes its separate way, but both units make a point of showing up at the same place at the same time every week.

"They can count on us," says Dr. Gloria, who knows that whatever else Anacostia lacks, it has had an oversupply of broken promises. It is traditionally at the end of the line for city services. She knows all about mean streets. She was born in Brooklyn's Bedford-Stuyvesant. Her mother worked three jobs, and her father was an abusive alcoholic. Her schoolteachers encouraged her, and she went to Howard and Georgetown Medical School. She has four children of her own.

Edwin K. Zechman, CEO of Children's Hospital, which is the mother ship of the mobile units, said they don't solve all the problems but they do make a difference, which is all Anacostia asks.

The District's chief medical officer, Dr. Ivan C. A. Walks, said that the sight of vans coming into their community would make children, sick or well, know that "they are important -- they will know they are valued."

A gentle 9-year-old girl named Samantha Younger, who wore a white lace dress, sang an affecting song called "Don't Give Up" -- surely an anthem for Anacostia. Every now and then, Samantha, a fourth-grader at Malcolm X, lifted her eyes shyly from her music to see how it was going over.

When it was his turn, Dr. Redlener pointed out what a shame it is that mobile units have to bring help to the "medically underserved."

He readily admits that part of the reason is that many Americans believe the problem was addressed and solved in 1997. That was the year the left-right team of two senators, Orrin Hatch, a full-throated conservative, and the unblushingly liberal Edward M. Kennedy, produced a plan to provide health insurance for America's uninsured children, who numbered 10 million at the time.

But the State Children's Health Insurance Program (SCHIP) didn't quite solve the problem. Five years later, there are still 9 million uninsured children. Employers, looking for benefits to cut, dropped children from employees' coverage. And for every child enrolled in SCHIP, another child was dropped from private coverage.

Dr. Redlener knows that his dream of universal, mandated child insurance coverage is a nonstarter in today's Congress. "We won't even provide drugs that seniors need to stay alive," he says. "And children are a much harder sell than seniors. They have no votes, no clout."

He thinks that the underlying problem is that Americans, regardless of party, feel that health insurance is a "privilege that you have to purchase, not a right." That's why children in Washington, the capital of the richest country in the world, get their health care on wheels -- and probably will for some time.

© 2002 The Washington Post Company