By Paula Day

A little after 7 p.m. on a cold January night nine people loaded into a van parked in front of St. Joseph Hospital’s emergency entrance. They were headed across town to a shelter for homeless women and children. The tenth member of the group would meet them there.

Their common link? Except for one, they shared varying degrees of expertise in the science of healing and all wanted to help the homeless.

The group is one of many who volunteer to man the Mercy Mobile Health Unit which visits shelters in Atlanta three nights a week. The mobile unit is part of a coalition. The Atlanta Community Health Program for the Homeless. The Program recently received a grant of nearly $1 million through the federal Stewart B. McKinney Homeless Assistance Act. The money will be used to expand the coalition’s services.

This night the mobile unit’s destination was the United Baptist Women and Children’s Shelter in southwest Atlanta. There the volunteers would take temperatures and monitor blood pressure, listen to the breathing of congested lungs and peer into aching ears. Vitamins, cough syrup, medications, medical advice and more would be given to the women and children who took a number and patiently waited their turn.

“It’s fun going back to the same shelter,” explained Mary Wall, R.N., who headed the team this night. By returning each month with the unit, Ms. Wall can follow patients. “We were able to get two ladies with hypertension on medication and now their blood pressure is under control.” Premature twins who had lost birth weight “now look terrific and are bouncing all over,” Mary Wall adds. “Even their mother has changed. She wasn’t taking care of herself and now she’s dressed up and in a Bible study group. She looks sharp.”

Other members of the group this night were Dr. Thomas Mancuso, anesthesiologist at Henrietta Egleston Hospital’s pediatric intensive care unit; pediatric nurse-practitioner Ann Voigt whose daytime work with the Centers for Disease Control will take her to Nigeria next month; Don Maxwell, a pharmacist; Angi Caton, an oncology nurse and her husband, Mark. Completing the team were two pharmacy students from Mercer Southern School of Pharmacy, Chris Alley and Ray Cope, who will receive their doctoral degrees in March, as well as Donna Lavender and Susan Staley, senior nursing students from Brenau School of Nursing in Gainesville.

The shelter is a large, unpartitioned gym, filled, wall-to-wall, with cots where an average of 95 women and children sleep each night.

“Some are there temporarily,” Mary Wall explained. “Most have jobs. They get along very well. They take care of each other’s kids. Volunteers of all kinds come to the shelter. One time it was a group with video games for the kids to play. Another night we were here, some volunteers were helping them make Christmas cards.”

One night a month the Mercy Mobile Unit goes to the United Baptist Shelter. Its other monthly stops are Hispanic Services, Golden Harvest, YWCA Phyllis Wheatley Center, all Saints Episcopal Shelter, Clifton Presbyterian Shelter, St. Anthony’s Catholic Church, Wheat Street Shelter, Milton Avenue Shelter, Atlanta Union women’s Mission and West Hunger Shelter.

The mobile unit’s origins are simple and humble. Two people saw a need, responded from their own resources, and the response grew.

In 1983 Tim Porter O’Grady, then nursing administrator at St. Joseph’s Hospital, was with a group of parishioners from Sacred Heart parish in Atlanta who helped serve a spaghetti dinner to the homeless at St. Anthony’s Shelter in southwest Atlanta.

“We noticed other problems besides the need for shelter and food,” O’Grady recalls. “Respiratory problems, skin and food problems.”

O’Grady began carrying along cold and skin-care medicines in a paper sack on his Thursday trips to the shelter. “Dr. Dwana bush from Holy Spirit parish saw what we were doing and got involved. We began doing blood pressures and making referrals to Grady Hospital. She decided to come along every Thursday, too, and brought her little bags of medicine,” O’Grady continued.

“Then we heard that St. Anthony’s was not the only shelter and asked, ‘Who’s taking care of the others? Where else do they need medical care?’”

The answer they found was that no concerted effort was being made to give the homeless any medical care. O’Grady approached Sister Michelle Cary, R.S.M., an administrator at St. Joseph’s, who put him in touch with the Mercy Action Foundation. The foundation provided funds for the van and, in 1985 the Mercy Mobile Health Unit was in business. In the past two years it has helped 45,000 homeless people with their health problems.

This January night 45 women and children were seen by team members. The number of patients seen, their ages, diagnosis, and treatment were carefully recorded and then summarized by Mark Caton to be filed in a computer. The mobile unit keeps track of each night’s activities.

The main complaints this evening were colds, earaches, congested lungs. Ann Voigt observed that poor nutrition (tea and grits for breakfast) and the close living conditions would contribute to the spread of respiratory problems among the children at the shelter.

Adults, too, received needed attention. Several complained of flu-like symptoms; hypertension patients were checked. A woman’s pregnancy test was negative.

But the children dominated the scene. Ms. Voigt dispensed attention by listening to lungs and checking temperatures while Dr. Mancuso questioned concerned mothers and examined their sick infants. More than once the two conferred, referred patients, confirmed medication dosage.

A pharmacist’s skill and knowledge are vital to the work according to Mary Wall. Don Maxwell was kept busy retrieving drugs from the cache of supplies and advising on proper dosage. He sorted through the supplies, finding matching brand names for generic medications needed for patients.

Pharmacy student Ray Cope improvised for the lack of a teaspoon by showing a young patient how to use a syringe to draw out a dosage of cough medicine and explained to the boy that the lozenges he was giving him were not candy. After urging him to “drink a lot of water,” Cope concluded, “Thanks, Ronald. Good doing business with you.” Later he advised the boy’s mother of his treatment. Mutual respect between care givers and their patients was evident. In the crowded conditions, “Excuse me” could be heard everywhere.

Midway through the evening, the children’s “take-a-number” cards ran out. Many card holders just want the extra bit of attention, Mary Wall observed. “One night in the summer when we didn’t have many patients, we gave all the babies baths – stayed a couple of hours. That was all we did that night.”

A nine-year-old patiently waited. When Dr. Mancuso finished caring for her sick younger brother, he turned to her. “You all right or you want me to give you a check-up?” A nod, “Yes.”

“Want to hear?” He slipped his stethoscope into her ears and let her listen to her heartbeat. Checking her ears he said, “Oh my goodness, so many brains in there.” More seriously, after examining her mouth: “Do you ever go to the dentist? Do you brush your teeth? It doesn’t hurt to brush your teeth.” Before the team leaves they hand out toothpaste and brushes to each child.

Mercy Care Corporation manages the mobile health unit. Together with St. Luke’s Clinic for the Homeless, the Fulton-DeKalb Substance Abuse Programs and the West End and Healthsouth Community Health Centers, it makes up a coalition under the title, The Atlanta Community Health Program For The Homeless.

The grant of $936,666 received by the coalition in December will allow the group to expand their services and outreach. Funds will be funneled through St. Joseph Mercy Care Corporation in whose name the grant was given.

Sister Josephine Patti, G.N.S.H., director of mission effectiveness for the hospital, says its portion of the funds will go to hiring a staff to work during the day while keeping the night-time volunteer assistance. The paid staff will give the referrals it makes. Funds will also be used to begin transporting the homeless to health care locations for needed attention. Grant money also will be used to buy data management equipment giving the staff the ability to keep track of the patients and their health needs. Making rounds during the day will give the staff greater access to street people.

Sister Patti, who will be involved in coordinating the grant, said, “The Atlanta Community Health Program for the Homeless coalition will address the most urgent needs of the homeless for health care and will attempt to insure that maximum benefits are derived from existing resources. It is exciting to engage in the challenge of networking with existing public and private agencies in these collaborative and cooperative efforts.”

For team members returning in the van that night to their private lives, the challenge was to find expression for their feelings about the evening’s experience.

“You just see a whole different side of living,” Mark Caton remarked. “Would you like to sit around in a place like that – just sit around doing nothing? I’ll definitely come back with Angie. It’s nice to do something together. Too bad more don’t help. We’re all guilty of taking things for granted. Who’s to say any one of us might not be in the same situation next week – next month?”

Donna Lavender felt the experience gave an added depth to her nursing. “there’s a different perspective to this nursing as compared to hospital nursing. We’re giving basic needs to these people who have no other way of getting it. It makes it more worthwhile. It’s like – oh, it’s really what I came into nursing for.”