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Chance 'EmWinter 2009 IS Magazine

HOME is Where the Healing Is

A UH Manoa project brings health care to the homeless.

By Chance Gusukuma

They give and they get. For the past two and a half years, student volunteers from the Homeless Outreach and Medical Education (HOME) project of the University of Hawai‘i John A. Burns School of Medicine (JABSOM) have provided basic health care at three O‘ahu shelters while gaining valuable practice in clinical skills.

Each week, the students visit the state’s three homeless shelters in Kaka‘ako, Kalaeloa and Wai‘anae. Under the supervision of JABSOM faculty and attending and resident physicians, students do everything from treating cuts and colds to administering physical exams, TB screenings and vaccinations. They also see individuals with chronic conditions like diabetes or heart disease.

According to project coordinators, many of the homeless who stop in at the clinics have regular primary care physicians and health care coverage. But “sometimes, there may be a delay in seeking care because of all the other things they’re worried about,” says Damon Lee, M.D., one of the JABSOM faculty members who helped organize the project.

“Sometimes their doctors don’t know where [the homeless patients are], so they have no way to contact them,” explains Utu Langi, director of H5, the nonprofit that runs the Kaka‘ako facility.

In addition to providing care, the doctors-in-training learn that not all health care takes place in a physician’s office or hospital. “Our hope is to plant a seed,” says Shaun P. Berry, M.D., another founding faculty member. “We have an obligation as providers. We took the Hippocratic Oath to help people in all situations.”

One of the program’s main goals is to spark an interest in family and community medicine. And a big part of its appeal is the real-world, hands-on experience the students gain.

“To be a burgeoning physician and to have a patient trust you, even when you feel incompetent and you feel like you don’t know what you’re doing … is huge,” says Carrie Marshall, a fourth-year medical school student who helped start the project.

The project was launched by a few faculty members and some medical students not long after the state opened the Next Step homeless shelter in May 2006. “I don’t have any words to describe how important their services are to the folks from the streets,” says Langi.

As part of the school’s family and community medicine curriculum, all third-year students help at the shelters for seven weeks as part of their family medicine class. Some students and faculty even organize Halloween and Christmas parties for children at the facilities.

HOME was a good fit for Keola Adams, M.D. Born and raised in Wai‘anae, Adams got involved in the project from the get-go and now works at the Wai‘anae Coast Comprehensive Health Center as a family medicine resident physician. “I had so many doors open for me,” says Adams. “I feel like I [am] repaying what was given to me.”

For all the good the program does, its future is not guaranteed. The federal grant that covered administrative expenses ended in June, and government spending on such programs has been slashed.

Still, the HOME team continues. “I really believe that we’re a stepping stone, trying to get people as healthy as they can so they can make a better future for themselves and for their kids,” says Marshall.

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