The team of nurses in gray sweatshirts and backpacks approached the sprawling homeless camp with caution, stepping gingerly between the maze of tattered tents and sleeping bags still drying out from the previous night's thunderstorm.
"The gray shirts are here! The gray shirts are here!" a street outreach worker yelled. "Anybody sick?"
Moments later, an elderly woman in a wheelchair emerged from along a highway sound wall, a wool blanket drawn to her chin to keep out the biting wind. A trio of health professionals surrounded her, taking her temperature and blood pressure while also carefully checking her colostomy bag. They found it needed to be emptied, and the woman, who has been homeless off and on for years, joked with the nurses as they wheeled her toward a portable toilet nearby.
The street medical team is part of the first sustained and coordinated effort to bring medical care to the fast-growing encampment in south Minneapolis since people started arriving here in large numbers in early August. Alarmed by recent deaths at the camp and reports of communicable illnesses, an unprecedented coalition of local government agencies, American Indian tribes and private medical providers has joined forces to identify sick inhabitants and treat them on site. Health professionals now walk from tent to tent, treating open wounds, filling prescriptions and connecting residents with primary care clinics.
Testing for diseases
And, for the first time, city, county and state health officials are taking steps to prevent the sort of deadly disease outbreaks that have occurred at homeless camps in other large cities, primarily on the West Coast. Hennepin County Healthcare for the Homeless has begun offering vaccinations against the flu and hepatitis A at a medical tent near the center of the encampment. And this week, the state Department of Health will start testing campers for HIV, syphilis and hepatitis C. Anyone who tests positive will be referred to a nearby medical clinic for treatment the same day, officials said.
Minneapolis Health Commissioner Gretchen Musicant said the project is the largest mobilization by the city's public health agencies since the H1N1 flu pandemic of 2009. Her agency alone has assigned a dozen staff to the encampment, which is now home to nearly 300 men, women and children on a narrow stretch of land along Hiawatha Avenue near the Little Earth housing project.
"It's all-encompassing," Musicant said of the outreach effort. "We have really invested in a more preventive and collaborative approach, so we can avoid the sort of challenging consequences that have occurred in some of our sister communities across the nation."
The street medicine project is the result of a partnership hatched within the past two weeks by the Native American Community Clinic (NACC), Livio Health Group and the Red Lake Band of Chippewa Indians, which have committed to providing medical services at the camp indefinitely.
"We are connecting very vulnerable people to the care they need without asking them to leave the camp, their belongings and the people they trust to keep them safe," said Antony Stately, chief executive of NACC, which is several blocks from the encampment on E. Franklin Avenue. "This model will give us the tools we need to stem a growing health crisis."
While outreach efforts have focused on infectious diseases, mental health problems remain a serious concern. The Indigenous Peoples Task Force, a Minneapolis nonprofit, surveyed about 40 of the camp's inhabitants in early August and found that nearly two-thirds said they needed mental health treatment. The round-the-clock noise and crowded conditions — many of the tents are just inches apart — have put new stresses on people who are already struggling with untreated mental illnesses, outreach workers said.
Two weeks ago, a woman who has been living at the camp threw herself in the middle of rush-hour traffic on E. Franklin in an apparent suicide attempt. She was rescued after a group of volunteers with the street outreach group Natives Against Heroin formed a protective circle around the woman until police arrived, according to people who witnessed the incident.
Also last week, teams of nurses and health workers with a mobile health provider, Livio Health Group of Minneapolis, began arriving at the camp each morning in sport-utility vehicles stocked with medical supplies. Over the next several hours, they walked from tent to tent, treating wounds, enrolling people in public insurance plans and arranging medical appointments for pregnant mothers and people with serious illnesses. Many inhabitants said they are battling serious illnesses but are afraid to leave their tents for fear their belongings might get stolen. In just a week, the teams of nurse practitioners and community health workers have interacted with more than 100 inhabitants at the camp and treated dozens for illnesses ranging from strep throat to stomach ulcers.
On Monday afternoon, Jessie Horan, a licensed practical nurse, and Lewis Simpler, a nurse practitioner, looked buoyant as they walked through the center of the encampment in their gray shirts, with walkie-talkies on their hips and backpacks full of first-aid supplies.
They stopped to chat with a man who appeared to be resting along the grassy highway embankment that borders the camp. The man, Anthony Nichols, 52, who is homeless, calmly informed the medical team that he suffered from high blood pressure and was scheduled to undergo heart surgery, but had not been taking his regular medication. As the afternoon traffic rushed by, Horan crouched next to Nichols to check his vitals and discovered that his blood pressure was so high that he required immediate medical treatment. Paramedics and an ambulance soon arrived to take him to the hospital.
"It's like we're making house calls without the four walls," Horan said. "We're just doing our best to meet people where they're at."