Coffee and dog treats might not strike you as important medical tools, but for Clinica Sierra Vista’s street medicine team, these items can be used to help build trust with an individual. Once they build that trust, that opens the door to providing them with important medical assistance.
“Medically speaking, a lot of these people have been wronged. They don’t give them the services they think they should have so they don't have trust for the medical field period,” said Scott Dopp, a member of the street medicine team.
Practiced in Bakersfield for years by Sierra Clinica Vista staff, Alanna Costello, a nurse practitioner at Clinica Sierra Vista’s Wofford Heights location, brought the program to the Kern River Valley in July.
“Street medicine is good because you are bringing care to them just to help build trust again with the healthcare establishment which I think is important,” Costello said.
Every Wednesday Costello goes out with a team including herself, who can provide medical care, a medical assistant, who takes notes and keeps records, a caseworker, who can connect unhoused individuals with housing resources and Dopp, who does everything.
“He drives us, he knows the area, he has a really good rapport with people, he’s kind of like a peer support worker, handing out supplies, establishing conversations with people,” Alanna said.
The team drives around the valley offering care to unhoused individuals.
“We’ve got medications with us, wound care, we can try and get you connected to people that work with housing, and hygiene kits and stuff like that.”
“Is there anything you need today?” said Alanna talking to an individual she had just met outside of the Kern River Branch Library.
“A lot of people are very hesitant at first, you walk up to them with a badge and a clipboard,” Alanna said, “Their previous experiences with people with badges and clipboards might be a police officer telling them to stop doing something or get out of here or code enforcement telling them to pick up their encampment and leave.”
After making their first impression they ask for some information, exchange phone numbers if possible, and let them know they will be around again on Wednesdays.
“The best approach is just being friendly,” Costello said.
During the outing, a patient they met a few weeks earlier called them seeking supplies to treat their partners wounds, as well as Suboxone, a medication that is used to help people with opioid addictions transition from a life of addiction.
“I contacted you for it because I really don’t want to keep doing this anymore,” the patient told Alanna.
In the van they have supplies to give out like hygiene kits, wound care supplies, safe injection kits, narcan, fentanyl test strips, ibuprofen, as well as necessities like socks and underwear.
Dopp told me the street medicine team faces unique challenges in the Kern River Valley.
“We put in a lot of miles just to find the people we find here,” Dopp said.
The team travels all over the Kern River Valley to find those in need of help, going to parks, and approaching tents set up near the Kern River.
“It’s been difficult gaining trust up here, but we’ve made a foothold,” Dopp said.
One of the gentlemen we met today, I know that he's got this like chronic leg wound and chronic leg swelling, but he actually has never let me look at it before. I don't know why. Maybe just like not trusting you. But today he did let me look at it and you know, it looks pretty bad. I think we do need to get him in with a vascular specialist,” Costello told me.
The team’s consistency helps build trust with those they meet.
“It’s good to see you, tell Dougie we said ‘Hi’,” Alanna said talking to a patient.
“Thank you for coming,” the patient replied.
“Of course.”
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