By John Kelly
Tuesday, November 28, 2006
Sick kids go to Children's Hospital, but Children's Hospital also goes to sick kids. My assistant, Julia Feldmeier, visited a special vehicle that takes a healthy message out to the streets.
Space inside the blue mobile care unit is tight. The kind of tight where, when two people cross paths, stomachs are sucked in and shoulders are jostled.
But where the quarters are close, so too are the relationships between doctors and patients. "We know our families very well," said Dr. Rhonique Harris, medical director of the 14-year-old program. That's the point: To provide consistent medical support for those who are neediest.
The mobile health clinic accepts all forms of Medicaid and provides free care to families who do not have insurance. Patients select a doctor to serve as their primary care physician, offering a continuity seldom found in the emergency rooms where many of Harris's patients previously sought primary care.
The two mobile care units -- one medical and one dental -- travel in tandem, making weekly visits to eight sites across Southeast and Northeast Washington.
On a recent afternoon, Tykisha Eleby, 20, brought 10-month-old son Demontay to the clinic parked on Third Street SE. He'd been coughing lately, and Tykisha was concerned. Dr. Consuela Hunt, the doctor on board, asked a series of questions, checked Demontay's breathing, determined the coughing was no cause for worry, addressed a budding diaper rash and handed Demontay off to the registered nurse to get his next set of baby shots.
For Tykisha, who only recently discovered the mobile care unit, the experience was sweet and simple. The units, after all, are parked in her neighborhood. She walked there.
"This is nice because getting on the bus and all that stuff, that's too much for me," Tykisha said.
The mobile units average about 10 patients a day, Dr. Harris said, and have an open access policy: If a child is sick, bring him in.
Next door to Tykisha, in a closet-sized treatment room, Dalianeiss Yant, 19, a college sophomore, waited for a checkup. Dalianeiss has been a mobile care patient since she was a child. The doctors here "go beyond just being your physician," she said. "They're your mentor and your counselor. I call them about personal stuff; they advise me. They're like 24-7."
The wounds that need healing at the mobile care units are manifold. There are fevers and flus and rashes, of course. But there's also substance abuse -- a big issue with some parents, Dr. Harris said. And there are problems of teen pregnancy and rape. Gang violence. Domestic abuse. Inadequate nutrition.
"Sometimes a 15- or 20-minute visit will turn into an hour," Dr. Harris said. "But we can't let them leave because we see a crisis in the making. They may come in for a cold, but there's some ulterior motive."
So she and her co-workers help line up social workers, arrange for a psychologist to provide educational testing, assist in procuring insurance and help obtain legal aid.
Despite the successes of the mobile care units, Dr. Harris knows her work is never done.
"Poverty, crime and drug abuse has not escaped our families," she said. "The mobile unit puts a bandage on a bigger problem."You Can Help
"As long as there's poverty, there will always be a need for mobile health care," Dr. Harris said. And as long as kids get sick, there will be a need for Children's Hospital. To support our annual campaign to pay the hospital bills of poor children:
Make a check or money order payable to Children's Hospital and mail it to Washington Post Campaign, PO Box 17390, Baltimore, Md. 21297-1390.
To contribute by phone using Visa or MasterCard, call 202-334-5100 and follow the instructions on the recording.