By Zhihong Li
It is a rainy night around 7:30. A red Ford van pulls over to the side of Union Square in East Boston. Six young people in their 20s come out of the van and take a couple of bags of clothes and gloves, a big plate of muffins and a basket of chicken soup to the table, where five people are already waiting for them.
The six young people are college students from the Boston University School of Medicine. They are also volunteers of the Outreach Van Project, a student organization founded at BU in 1997 and now has developed as a 30-member community outreach group. Every Thursday night, six or seven volunteers ride the van with clothes, food and medicine to help homeless people in East Boston.
Jaime Stull, a second-year medical student who works in the leadership team of the program, has served in East Boston for almost two years. She said it is a good learning experience to work with the medically underserved population that she had never known before. “I‘ve learned a lot about the struggles and the life of homeless individuals,” Stull added.
Maria Torres came to the van for the first time following the recommendation of her friend. “I will probably come again. The food is very good,” Torres said, pointing to a bowl of chicken soup she just got.
“I sometimes got some T-shirts and pants. They have a doctor, so you can consult with her if you feel uncomfortable,” said Jose Tipian, a client who visits the van every week.
Dr. Jessie Geata, a primary physician of internal medicine from Boston Health Care for the Homeless Program, comes to East Boston with the volunteers almost every week. She joined the program last August when she knew the student volunteers needed a physician to work with them in the van.
Besides helping volunteers send out food, drinks and clothes, Geata prescribes medicine, does simple medical exams and provides suggestions to people coming for help.
Standing in the light rain without an umbrella, Geata asks a homeless man beside the van about his insurance conditions. The man answers in Spanish, and then a student translates it into English for her.
Geata said she is trying to help people connect with medical centers and local community health centers if they need medical treatment. She also tries to help them figure out how serious their health issues might be.
“I can do some physical exams, I can check blood glucose levels and other vital signs, and help them to figure out why people are having barriers to receive medical care treatment and help them navigate their medical system,” she said.
A man suddenly falls down 20 feet away from the van while Geata is talking with others. She runs to the man, checks his condition and calls an ambulance.
People who are experiencing homelessness and are suffering the same chronic medical conditions as the general population might be undertreated, Geata said.
“A lot of people having been to the outreach van have high blood pressure that is out of control, diabetes that is poorly treated, and a lot of orthopedic issues that stress on joints and other mental health issues as well,” she added.
“Some individuals are also struggling with substance use disorders, and if they could see a physician on a regular basis, then they might be better treated,” Stull said.
The Boston Health Care for the Homeless Program provides medication to people with alcohol use disorders in addition to therapy and a 12-step program, a set of spiritual principles helping people with substance addiction. In Massachusetts, substance addiction is the biggest issue among homeless people, and drug overdose is the first cause of death, Geata said.
“The average age at death that we practice in the Boston Health Care for the Homeless is 51. It’s very young. Common causes of death are relevant to substances, both of alcohol and primarily opioid use,” she explained.
JAMA Internal Medicine reported in a study that drug overdose causes one-third of the deaths among homeless adults under 45 years old in Boston. Opioids cause 81 percent of overdose deaths. The study also shows that the second and the third causes of death among the homeless population are cancers and heart disease.
“The diseases are very similar with the general population, but we are seeing them at a younger age and more advanced,” Geata said.
She also said that in addition to physical health care, many homeless people seek help in mental health care treatment and to feel less isolated.