Copyright © 2019 Albuquerque Journal
On a recent weekday morning, not long after the sun had begun to creep across the sky, a small group made up of a therapist, a physician and a nurse from Albuquerque Health Care for the Homeless climbed through a hole in a fence on the corner of Central and Tramway.
Behind that fence, nestled between shade trees and the interstate buffer wall, is a little camp – a handful of tents interspersed with hammocks and shopping carts overflowing with clothes, and other supplies. Each tent has its own “yard” – fist-sized rocks arranged in neat lines to demarcate boundaries.
“Hello,” the group calls out. “We’re from Health Care for the Homeless. We have coffee. Water. Bus passes.”
A woman, accompanied by a muscular, year-old black dog, comes out of her tent to say hi. She accepts the coffee and a bus pass and tells them about how her previous camp had been washed out in the recent heavy storms.
The group drops off water and a bus pass next to two other tents.
Then, they move on.
According to an annual survey by the National Alliance to End Homelessness, an estimated 1,340 people in Albuquerque are homeless on any given night – that’s 24 out of 10,000 people. This is double the statewide rate, where 12 out of 10,000 people are homeless.
The survey found that throughout New Mexico, the number of people experiencing homelessness peaked in 2011 and was declining until 2016, when it started rising again.
National surveys indicate the homeless population suffers from chronic illnesses at a much higher rate than people living in homes. They are also more likely to be victims of violence.
Whereas about 9% of people living in homes suffer from diabetes, the percentage doubles when talking about people who are homeless, according to a 2009 Health Center Patient Survey. And 20% and 36% of homeless people suffer from HIV and Hepatitis C respectively, compared with 1% of the housed population.
A mobile clinic
To increase access to treatment and services, Health Care for the Homeless – a clinic doing exactly what it sounds like its doing – holds a number of street- or site-based outreaches every week to bring services, information and basic medical care to the people who cannot or don’t want to make it to the clinic.
In September 2016, George Mercer, HCH’s behavioral health clinical director, started the integrated outreach program to bring behavioral health and medical care to the camps every Thursday. This particular outreach visits homeless camps, panhandlers and others living or staying in the southeast corner of the city along Central and Interstate 40.
In addition to visiting the more established campsites, the team also climbs up the steep embankments of overpasses to reach people nestled in nooks in the substructure. In one such area, they look at a woman’s sprained wrist as she sits on a pile of blankets and sleeping bags fashioned into a makeshift bed.
“It’s pretty much meeting people where they are,” said Gloria Sevilla, a nurse who was one of the first to join the Thursday morning street outreach. While the total outreach contacts last year were about 10,000, the Thursday morning programs can be less fruitful. Last Thursday, the team connected with seven people.
The crew carries Thermoses of coffee, water, cream and sugar and bus passes, but they also look at cuts, infections, bug bites, sunburns and other ailments and encourage people to visit the clinic for further care. They talk to people about suboxone and other drugs that can help addicts ween themselves from opioids.
“This takes away the power dynamic of us being in clinic and it being our turf,” said Dr. Sam Tri. “Going to them on their turf, wherever they want to get treated is more patient-centered.”
Sevilla said the biggest challenge is not being able to provide all the care they would like to while out in the world. That and juggling the patient’s privacy while on the side of the street.
“You’re on foot; you can only carry so much,” she said.
Sevilla said they’ve had some success stories over the years, including one man who was initially resistant to engaging with her and Mercer.
“But slowly but surely, he would see that we were coming around,” she said. “We would leave supplies for him – snacks, things like that. Over time, he eventually got housed and case managed.”
Therapist Melissa Grant said that after going out on the outreach missions, she had a better understanding about how hard it is for people living on the streets – from how “crushingly boring” it is to how you never know where you’re going to get your next meal, sleep or use the bathroom.
For that reason, Grant said, they stress that the clinic, the doctors, nurses and therapists won’t shame or judge anyone for not being able to get help.
“In some ways, having to reassure them that we’re here no matter what,” Grant said. “Whenever they can make it, they can make it, we’re always glad to see them. But if they can’t, they can’t.”