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Public Health Clinic on Wheels Starts Service in Concord, Calif., Area

By Jack Chang
Contra Costa Times, August 23, 2000

CONCORD, Calif.--A long-awaited health van offering a range of basic medical services opened its doors Tuesday morning on Monument Boulevard and immediately drew a crowd of uninsured adults and children.

Women holding sleeping babies, day laborers taking the morning off from work and others from the mostly Latino neighborhood waited patiently under the van's shade for up to an hour to get a few minutes with nurses.

About 90 percent of the patients had no health insurance, said nurse Al Gatmaitan, or "Nurse Al," to his colleagues.

Some 70 percent of the patients would not give their Social Security numbers, which suggested to nurses they were undocumented immigrants, Gatmaitan said.

The abundance of such cases offered to Gatmaitan a hint of the overwhelming public health challenges he and other nurses will face serving the neighborhood, a 10-square-mile region known as the Monument Corridor.

"Many of these people just wait until they end up in the emergency room to get medical help," Gatmaitan said. "We can take care of most of the preventable problems, but not all of them. We can make a small impact."

About half of all adults in the neighborhood have no health insurance, with 40 percent of children going uninsured, according to a recent study by the Monument Community Partnership, a public health group funded by the John Muir-Mt. Diablo Health System.

A quarter of all of the county's uninsured hospital discharges come from the corridor, the study found.

About 25,000 people live in the neighborhood, with 61 percent of them qualifying as low- income, according to the study.

"These statistics are huge red flags," said Juan Cruz, a partnership coordinator. "I think there is a profound health crisis there. And if it's not already happening, it's definitely brewing."

Purchased by the health system and staffed with four nurses from Contra Costa County Health Services, the $ 200,000 health van will try to step into the neighborhood's health-care gap, Cruz said.

The mobile clinic will offer immunizations, basic checkups and referrals at schools and parking lots around the neighborhood two days a week.

Earlier this summer, getting the van out onto the streets became a rallying cry for neighborhood activists after management changes at the health system postponed the clinic's deployment for more than a year.

In early July, county health officials agreed to launch the van service.

But the mobile clinic is an interim solution, Cruz stressed.

What the neighborhood needs, he said, is a permanent public health clinic, which the partnership is working to build.

For now, residents will have to make the most of the van. On Tuesday, they did just that.

In the van's first two hours of service, the number of patients using the facility surpassed organizers' estimates for the entire day, said van driver Tom Quesada. About 50 patients used the van Tuesday.

Several people showed up with health problems that had long gone untreated either because they could not afford medical care or could not get time off from work to see a doctor.

Juliana Rojas, a 24-year-old Concord woman, asked clinic nurses to check her two young sons' tonsils.

They are insured only for emergency care, and she has no insurance at all, she said. The two boys got a clean bill of health.

"Nobody has insurance," Rojas said about her Monument Boulevard neighbors. "They do their own medical care, at home."