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Public health is critical to addressing the needs of homeless and indigent individuals, and to tackling the root causes of homelessness. Through an undergraduate course they teach and partnerships they have forged with students across campus, FSPH students are delivering for a population too often ignored.
ON A WARM WEDNESDAY evening in April, the two populations interacting along the West Hollywood sidewalk present a stark contrast: the young and vibrant public health, medical and undergraduate students who have made the drive from UCLA’s Westwood campus, most of them clad in gray Mobile Clinic Project t-shirts, and about two-dozen men and women looking disheveled and less exuberant than the UCLA group, for good reason - they spend a substantial portion of their time living on the streets.
But Jenna Arzinger, a Fielding School MPH student and one of three public health student coordinators for the Mobile Clinic Project at UCLA, has learned that appearances can be deceiving. “Coming here has been eye-opening and humbling,” she says. “Talking with the clients and hearing their stories, I realize there’s not a big difference between someone who is homeless and myself. So many of them have just fallen on hard times, circumstances that could happen to any of us.”
Ever since it was conceived and implemented by FSPH students in 1999, the Mobile Clinic Project has been a consistent source of support for the area’s homeless and indigent population. Every Wednesday night, student volunteers show up at the same spot on Sycamore Avenue south of Romaine Street as part of an effort to address the public health needs of the homeless and indigent population, as well as the public health issues at the core of homelessness. Working in tandem with the Greater West Hollywood Food Coalition, which passes out warm meals to the population, the Mobile Clinic Project is currently co-led by UCLA students from the Fielding School and the David Geffen School of Medicine, as well as undergraduates who are prepped for the experience through their enrollment in a required two-quarter course taught by FSPH student instructors.
Operating out of a box truck, the medical students offer basic health care (under the supervision of an attending physician) while accompanied by undergraduate caseworkers, who assist with the social history. Fielding School students fill a variety of roles to ensure the continued success of the Mobile Clinic Project. They survey clients to monitor their changing needs and assess their satisfaction with the services. They collect data on the clients’ insurance - identifying and addressing barriers to their use of health care resources for which they are eligible, particularly with implementation of the Affordable Care Act. Much of their work occurs off-site. This includes managing the patient assistance program that in some cases provides clients with free prescription medications through pharmaceutical companies; handling logistics involving medical and social service referral sites for the clinic; managing a partnership with the AIDS Healthcare Foundation to provide free HIV testing on site; and working with L.A. County’s Immediate Needs Transportation Program to provide taxi vouchers and bus tokens for clients who need them to get to shelter or medical appointments. Fielding School students also help to secure funding for the Mobile Clinic Project’s continued operation through extramural grants and private donations. In weekly meetings of the project’s leadership, the public health coordinators work with the medical school and undergraduate coordinators to improve on the services, including pushing for comprehensive care that addresses issues such as social support, legal aid, and housing in addition to attending to the clients’ immediate health needs.
“Our students continue to be key in the over-all leadership of the clinic,” says Dr. Michael Prelip, professor and associate dean for practice across the life course at the Fielding School, who has served as a faculty adviser for the program since its inception. “Much of what they do is so common to public health - operating behind the scenes to allow the work to occur.”
“We teach [students] about homelessness from a public health perspective, discuss the population’s health and social needs, and provide the students with skills so they can be effective in their interactions.” – May Bhetraratana
In CHS 187A and 187B, the two-quarter course required of all undergraduates volunteering at the Mobile Clinic Project, FSPH students provide undergraduates with what is often their first exposure to public health principles. “A lot of them haven’t had any experience working with homeless clients,” says May Bhetraratana, a Fielding School student in the interdepartmental Molecular Toxicology PhD program and a Mobile Clinic Project public health coordinator who was the CHS 187B instructor this spring. “We teach them about homelessness from a public health perspective, discuss the population’s health and social needs, and provide the students with skills so they can be effective in their interactions.” As part of the course, the undergraduates break into small groups and stage client interviews with each other. They learn the importance of being good listeners, not coming across as condescending or judgmental, and determining whether clients are motivated to change before working with them to overcome obstacles and identify solutions for themselves. Guest lecturers are brought in from UCLA and the community to share their expertise on issues related to homelessness and public health.
The Mobile Clinic Project at UCLA was born in 1999 when directors of the Greater West Hollywood Food Coalition (GWHFC), aware that their clients had needs that went well beyond hunger, approached Prelip about getting students involved in meeting some of the health concerns of the area’s homeless and hungry population. With Prelip serving as the initial faculty adviser, two of his students - one of whom, Koy Parada (MPH ’98), continues to serve as an adviser for the project - forged a partnership with GWHFC to pair the food offerings with a much larger effort. Six months into the process, the public health students recruited participation from the medical school and began to develop an interdisciplinary effort that also included undergraduates as caseworkers and law students providing legal advocacy.
Then and now, the Mobile Clinic Project volunteers become accustomed to seeing many of the same faces week after week. It’s a reminder that addressing some of the clients’ most common health concerns - skin and respiratory conditions, joint pain, hypertension, diabetes, sexually transmitted infections - is in many cases easier than breaking them out of the cycle of homelessness. Yet, the surveys conducted by Fielding School students consistently show high rates of satisfaction with the clinic’s services. Stephanie Wong, a graduating MPH student who serves as one of the public health coordinators and was the instructor for CHS 187A last winter, required her undergraduate students to submit weekly journals on their experiences as caseworkers. “So many of them reported the same thing,” says Wong. “The homeless clients are used to people walking past them as if they don’t exist. Having someone who cares about them, listens to them and treats them respectfully makes them feel better.” Wong, who plans to go to medical school, says the experience has deepened her own understanding of, and compassion for, society’s most needy members.
Jenna Arzinger won’t soon forget the regular clients she’s gotten to know through the Mobile Clinic Project - clients like the middle-aged blind man who is always accompanied by his female companion. “They’re both homeless, and yet they are two of the most positive people I’ve ever met,” Arzinger says. “She takes such good care of him, but what really got to me was when she told me that she prays for all of us and our families all the time.”
The experience of working with a homeless population as an undergraduate is what convinced Arzinger to pursue her MPH. “This is public health at the most basic level,” says Arzinger, who plans to work in correctional health after graduating this spring. “To be out on the street, working with a vulnerable population at the community level and seeing the effects of what we do...as a public health graduate student, that’s pretty ideal.”