A few things that people out on the streets might get treated for today:
Trench foot.
Hypothermia.
Bacterial skin infections.
In battered tents or under bridges, some homeless people will weather this week’s atmospheric river with no lodging in Orange County.
After a county location debacle downsized plans for a regional storm shelter – and delayed its opening by months – street medics like Michael Sean Wright now attend to the wounds of those who couldn’t get safe from the rain.
“Imagine breathing all of that wet and cold, while you’re also breathing in direct exhaust from the freeways,” said Wright, the founder and leader of Wound Walk, a street medicine team attached to the Orange-based Lestonnac Free Clinic, which provides medical services for the uninsured.
In the grand scope of saving homeless lives from the storms, Wright said his team is the triage – the M*A*S*H medics of sorts who assess injuries and infections and pitch ice fishing tents to warm people up on the spot.
In fact, the group stabilizes wounds in all parts of the county. They’ll dry the wounds, remove foreign objects and clean them. The work, Wright added, often requires saline, silver alginate or calcium bandages, sterile manuka honey, and bacitracin.
Despite tension between government officials and the homeless advocates reporting what they see on the ground, the concept of a team like Wright’s is gaining steam.
CalOptima is set to pilot its own street medicine unit in Garden Grove around April.
And in Santa Ana this week, one elected official expressed public interest in hearing more.
“Can we have CalOptima come to give a presentation about the new fund to develop a street medicine program?” asked City Council member Jessie Lopez to staff at Tuesday night’s regular meeting. “I would love to learn more about that, and how they’re implementing that in the City of Santa Ana.”
Out in the Rain
Wright estimates his team has conducted around 1,700 medical encounters this year during rain and cold events, before his team was slated to go into the field today. But Wright notes that many of those encounters were treatments of the same people on more than one occasion.
And the group goes out around times like this.
“As folks had been outside … soaking, drenching in the cold rains, we have seen an increase in wounds that are advancing, upper respiratory infections, complications from underlying conditions, such as chronic heart failure, diabetes management,” Wright said.
With hypothermia – a regular face for the street team – “our body uses a lot more energy to stay warm. And when we deplete those energy sources, and we divert it to major organs, we are not able to feed into the healing process (for wounds and extremities). So we’re going to see things like trench foot.”
It comes at a time where “even the very limited 90 beds at the north county cold weather shelter require waiting in the rain to catch a shuttle,” said Brooke Weitzmann, a high-profile attorney for homeless people with the Elder Law and Disability Rights Center.
“If you wait in the rain long enough and the cold weather shelter isn’t full, you might get in.”
The cellulitis, fungal advances and unabated infections Wright said his team has had to treat this year point to a failure by the County of Orange to come up with an adequate supply of emergency rain cover, Weitzmann said.
“This rain wasn’t a surprise, right? We all knew that it was coming. There’s really no excuse for not being in a position to open more safe places.”
The county had only recently set up its current cold-weather at Independence Park in Fullerton – managed day-to-day by the nonprofit known as PATH – and a few months into the cold season.
It came after Santa Ana threw a wrench into officials’ original plan, one that homeless advocates said would have provided a higher level of service.
‘We’re Doing Our Part’
The Fullerton shelter has 90 beds, compared to the 400 typically available in the past, when cold-weather shelters operated during a much longer period: from October through April or later.
Late last year, the County of Orange had a contract ready to go for a cold weather shelter in Santa Ana, to be operated by the Salvation Army.
But City of Santa Ana officials, opposed to their city becoming what they called the county’s homeless “dumping ground,” filed a lawsuit seeking to block the shelter in federal and state court.
At Tuesday’s regular meeting, some city officials again argued they’ve done more than their fair share to shelter and house people, making strides to meet their state-mandated goals for housing construction.
Councilmember Phil Bacerra turned the focus to “criminal drug activity.”
“We have fentanyl in the streets … The narcotic activity is prevalent,” said Bacerra. “As much as we have homeless problem and as much as what we’re doing with shelters and permanent supportive housing, we need to address the criminal drug activity that is happening.”
Councilmember Thai Viet Phan said “the entire community of people who are homeless are people who have no homes. Homelessness is a housing issue.”
As she applauded Sacramento’s efforts to enforce housing construction mandates in neighboring Huntington Beach, Phan also echoed a sentiment driving the city’s opposition to being the county’s go-to location for regional shelters and services.
“I encourage our community members, the county and state, to continue to fight for housing development, including affordable housing,” Phan said. “And it’s not just Santa Ana. We should not be the ones bearing the brunt of this. We’re doing our part.”
Councilmember Jessie Lopez asked staff whether the county might relax entry restrictions at the city-managed shelter on Carnegie Avenue for the cold weather.
“It’s been raining and I see people out on the streets,” Lopez said. “I know we’ve been very stern this entire time about only allowing Santa Ana residents to be able to enter, but because of the weather, have we relaxed any of our rules?”
City Manager Kristine Ridge responded that a cold weather shelter already exists in Fullerton.
And the county-owned shelter at Yale Street — “They claim to be at capacity,” Ridge added.
Ken Gominsky, a retired deputy police chief who now works as the city’s Homeless Services Manager, told Lopez:
“I do not believe that anybody that wishes to go into the Carnegie shelter has been turned away, cold. And we understand that people need a place to be. That would be my response to your question.”
U.S. District Court Judge David O. Carter initially sided with the city in October – effectively shelving the contract with the Salvation Army – only to reverse his stance later that same month, while the Salvation Army had pulled out.
Meanwhile, the wet and cold storms kept rolling in – bringing out other types of mobile care.
Mobile Medics Prevent ‘Real Problems’
Families Together of Orange County, a nonprofit community health center, has been using mobile medical clinics for people on the street and in shelters for the past five years.
Every month they visit 15 shelters in the county and last year they had about 15,000 visits, according to Parsia Jahanbani, the mobile operations manager for the health center
In a Monday interview, Jahanbani said there are people that, no matter what, can’t make it to a doctor’s office.
“All we do is try to eliminate these barriers from people and make genuine quality health care available to them. We’re able to pretty much do everything that we do at the office,” he said.
Jahanbani said that when the pandemic hit, the focus of the mobile units shifted to COVID testing and later vaccinations.
He adds they are now waiting for the arrival of a new van they intend to use for street medicine and behavioral health.
In a Tuesday follow up interview, Jahanbani said with the weather they’ll be visiting emergency shelters testing people for COVID and offering medical help.
He also said teams will be headed to local parks and encampments Wednesday to provide people with medical attention and prescribe medicine if needed.
“We have some ponchos on hand to give out. We have some socks because believe it or not, that’s the number one item that people request,” Jahanbani said
He said while the current weather is not cold enough for hypothermia, homeless people are vulnerable to catching colds or the flu and don’t have the resources to take care of themselves.
“One of the bigger things that we see is their clothes get wet and if they have any prior wounds on their body their clothes get stuck to their wounds and they start bleeding and getting infections and then they’re more prone to having real problems,” Jahanbani said.