Mobile Health at the Market

February 20, 2013

By Marty Graham

When it comes to getting her kids the healthcare she needs, Monica Villalobos faces many challenges. A single mom with three kids under five, she doesn’t have a car, works long hours and shares parenting with her mom, who speaks very little English.

But it was easy for her to find her way to the Healthy Steps Medical Mobile Unit from the San Ysidro Health Center – they set up a mobile services truck in the parking lot of her grocery store on Thursdays. The grocery
store parking lot is across from the mobile home park where her family lives.

“It’s so good for us, I can get my kids’ check-ups and vaccinations, and even bring them here if they have a fever,” Villalobos said. “We see the same people when we come and they are so nice and they make it easy.”

Physicians’ Assistant Tara Oliveri and Medical Assistant Marissa Machaen see walk-in patients as well as those with appointments, for everything from the minimum exams required by schools to counseling pregnant teens and arranging for mammograms for abuelitas.

“It happens all the time that people come out of apartments in P.J.s and slippers and come to the bus,” Oliveri said.

At a table outside, patients are set up with insurance that gives them a month or two of coverage and then sent inside the van, with its intake area near the driver’s end and exam room at the rear.

In the intake area, Machaen gets patients’ vitals, checks their vision and hearing, does tuberculosis screening, checks their glucose if needed, and their hemoglobin.

“Hemoglobin is a key indicator for anemia or lead, and those problems are pretty common around here,” she says. “We refer them to our clinic and set up an appointment for them if we find problems. But it’s often something we can help get them started on better nutrition – that’s usually the problem in anemia. We’ve had patients doing fine at the recheck tell us they just followed our nutrition suggestions.”

For both Oliveri and Machaen, the visits – which often are for school entry exams – are a chance to begin engaging a whole family in healthy living.

“We always use this to give patients some education about nutrition and to get them engaged in our other programs, the women’s health and counseling programs, get them connected to (the state) Women, Infants and Children program,” Machaen said. “Many of our patients aren’t very familiar with the health care system – we’re their first contact with the clinic so we try to make it a valuable contact.”

In the very least, the children leave with their vaccinations. “We always do those at the end of the visit,” Oliveri said, smiling. “You don’t want to start a relationship with injections.”

San Ysidro Clinic started the Mobile Medical clinics in 2001, and the program has proved invaluable to underserved communities. Last year, the clinic’s two buses saw 3,091 patients at a variety of locations including food drives at Cesar Chavez Park and churches in San Ysidro, Barrio Logan and City Heights.

Northgate Markets, a family-owned chain of more than 30 grocery stores in predominantly Hispanic areas in Los Angeles, Orange and San Diego counties, gives the mobile medical buses parking lot space at five of the San Diego stores – in City Heights, Barrio Logan, Chula Vista and San Ysidro – on a weekly schedule.

The partnership has been fruitful – figuratively and literally. The stores have color-coded nutritional signs on the food, so a patient can carry the nutrition sheet into the store and pick out the vitamin and iron-rich foods they just learned they should be eating.

Many of the walk-in patients at the Northgate days are Northgate shoppers, people with sniffles or a sick child, or seeking a flu shot.

The stores also help the clinic get the word out about programs, Sanchez said.

“They let us distribute flyers through the store,” Maria Sanchez said. “The biggest challenge is getting the word out to people who are leading very busy and challenging lives – having a presence where people shop works really well for us, maybe the best of the many things we do.”

For Villalobos, who will leave with an antibiotic prescription after her children are examined and cross the parking lot to buy groceries, the mobile clinic is “a blessing.”

“You know we all have to shop,” she said.

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