A high-tech white van will begin to roll through L.A. streets on Tuesday, bringing free medical care--and a glimmer of hope--to children who have fallen through the cracks.
That will be its primary mission.
But, as the President grapples with health-care reform--and the county's public health facilities struggle to stay afloat--the people behind the L.A. Children's Health Project hope the van will also be a visible reminder that something's wrong and has to be fixed.
The secondary mission is to show public policy planners that innovative, community-based projects may be one answer to a burgeoning problem.
The 33-foot van is a rolling pediatric clinic, self-contained, with a computer for storing patient records. All it needs is a legal parking space, says Dr. Clyde W. Oden Jr., president and CEO of the Watts Health Foundation.
The foundation, in partnership with Charles Drew University of Medicine and Science, will run the clinic with support from the New York-based Children's Health Fund.
Oden calls the van a "can't miss" program. "In Los Angeles County, we have literally thousands of children who have not been properly immunized against preventable diseases. We have tens of thousands of young people who do not have access to primary health care."
The van's medical staff will be pediatricians to children at risk for AIDS and those caught in the cross-fire of street violence. It will serve a population that has relied largely on health care of last resort.
Some are homeless, some are not. But they are children who get no medical care until simple problems--such as an ear infection--turn into crises.
In addition, Oden says, the mobile unit will dispense not only shots and bandages, but also "a sense that this is an organization that is advocating in their behalf."
The L.A. project, the eighth mobile clinic started by the Children's Health Fund, is not just "a kind of do-good, feel-good project," says Dr. Irwin Redlener, chief of community pediatrics at Manhattan's Montefiore Hospital and president of the fund.
Redlener is talking about fundamental change--"as opposed to doing God's work, Mother Teresa style."
Redlener estimates that more than 10 million American children get no health care. "Unconsciously, society has written off a very large segment of the population" as unreachable, untreatable. "We're here to say, 'This is not acceptable.' "
The L.A. project joins a network of clinics-on-wheels. Others are in New York City, Newark, the Mississippi Delta, Dallas, rural West Virginia, Miami and the District of Columbia. This year, the clinics will see about 15,000 patients.
It started in 1987 with musician Paul Simon, who wanted to help Manhattan's homeless. He'd been on the "We Are the World" fund-raiser for USA For Africa and knew that 10% of proceeds was set aside for U.S. charities.
He called Redlener, who was then medical director of USA For Africa, and asked for $50,000. They met and Redlener, a pediatrician, told him his concern was for children. Together, they visited one of Manhattan's squalid welfare hotels and, Redlener recalls, "We were absolutely devastated by what we saw."
Right then, Simon says, he realized "It was probably going to be a lot easier to get people to care about the welfare of children than about the welfare of guys sleeping on benches."
A social worker suggested that a mobile medical van might bring doctors and nurses to the children in the hotels. Simon, enthused, said he'd get people to fund it. But he couldn't--"People weren't concerned about the problems of homelessness that much at that time."
So he bought the $85,000 van himself. Redlener pledged, "I'll put together a medical program."
Later, Simon organized a Madison Square Garden concert with Bruce Springsteen, Billy Joel and others that raised $500,000, enough for two more vans and some operating costs.
Last March, an L.A. concert headlined by Simon and Art Garfunkel raised $1 million for the Children's Health Fund.
Although Simon can't be in Los Angeles for Tuesday's launch--he's rehearsing for a show in New York--his involvement is very hands-on. He has visited five of the other projects and has met with the principals in the L.A. mobile clinic.
"It's just being a good citizen," he says.
Drew president Dr. Reed Tuxson--who, like Redlener, was on the President's Health Care Reform Task Force--sees this as "a very important opportunity" to deliver care while training a competent and compassionate new generation of health-care professionals.
Aboard the van, medical students will get an education geared to the future.
"We need to shift our emphasis from what happens in the hospital to what happens in the community itself," says Tuxson. "What is the daily life of our children who come into our hospital sick and dying?"
He hopes staff and patients will talk, really talk--"about guns and violence, about responsible sexual behavior. The health problems of our children are complex."
The parent fund is providing the van (by now a $150,000 item) and a $150,000 one-year operating grant. Other major supporters include Citibank, Sega Youth and Education Health Foundation and Time Warner.
The Watts Health Foundation staff will decide where and when the van will go. Medical care will be supervised by Dr. Francine Peters, new to Drew from Montefiore. It is Oden's intent to serve a number of Southern California communities, but the major outreach will be in South-Central, East L.A. and downtown. He estimates that the clinic will operate four or five days a week, seeing 20-30 patients daily.
However, the goal of the Children's Health Fund is not "a universe dotted with mobile medical units," reiterates vice president Holly Redell. "We're kind of a Band-Aid on the way to adequate health care in all areas, for all children."