No Hands But Yours - Taking Health Care to the Streets

November-December 2008


Mr. Kiley is managing editor, Health Progress, Catholic Health Association, St. Louis.

BIRMINGHAM, Ala. It's the last Tuesday of August on another rainy day as the remnants of Tropical Storm Fay drench this southern city for what seems

like the umpteenth day. A line of people starts to form mid-afternoon under an Interstate 59 viaduct in the city's cultural district.

One man we'll call Charlie tells newcomers, "You ain't seen nothin' yet." He correctly predicts a long line of homeless men and women will gather on this asphalt parking lot as rush hour traffic continues to noisily speed along above.

By close to 6 p.m., the number of men and women has grown to about 50. Most are regulars who know what to expect at this monthly medical event.

A few minutes later, Cindy Underwood, a nurse at St. Vincent's East, and a team of volunteers — family, friends and hospital colleagues — arrive on the scene. Some of the waiting homeless join volunteers and staff setting up and organizing tables, chairs, medical supplies and equipment. For Underwood and her team of about 15 volunteers, it's another opportunity to help less fortunate people attend to basic medical and hygiene issues. For the next 11/2 hours, volunteers work with about 70 people to help address a myriad of problems: athlete's foot, hypertension, rashes, fevers, respiratory problems and stress. Patients later receive a hot meal.

Underwood's volunteer health care program is an offshoot of "The Nest," a local ministry through Agape Baptist Church in Birmingham.

Driven by faith and a responsibility to help those without consistent access to health insurance, Underwood and her volunteers returned to this spot every month for the past two years regardless of weather conditions. She views her visits as a sign of respect to the people living on the streets.

"When you give somebody blood pressure medicine, they have to know — just like anyone who goes to their doctor — that they can come back next month to get a refill," Underwood said. "I only give them 30 days' worth so I have to be back here next time."

"The Nest" comes to this same area three to four nights a week and serves hot meals to many men, women and children who gather under one of the downtown bridges. The ministry started several years ago when 40 churches from the area shared the responsibility of preparing, delivering and sharing hot meals with anyone in need.

While participating in the ministry four years ago, Underwood observed that many of the people could use and benefit from basic medical and hygiene products such as Tylenol, Band-Aids, vitamins, soap, toothbrushes and toothpaste. At first, she bought items with her money and collected donated supplies.

But Underwood wanted to do more. Two years ago, she took her efforts to another level. She recruited fellow nurses from St. Vincent's Health System to help. "It got to the point that it was more than I could do by myself," she said.

Today, as many as 25 volunteers — mostly health care workers and some from non-affiliated hospitals — participate. These medical professionals perform simple medical screens and blood pressure tests, and measure glucose levels. A doctor writes prescriptions. Recently, eye exams and free "reader" eye glasses for patients were added. Those with acute problems are offered transportation by taxi to a local emergency room or health clinic.

Looking Out for Patients
Several people waiting in line on this late summer night are familiar to the volunteer staff. Underwood estimates that 80 percent are regulars with men slightly outnumbering women. A few children are also there. Most have a patient history recorded and filed by Underwood.

"You would be surprised how many people appreciate that little bit of confidence from society," Underwood said. "Most of them have had society fail them in so many ways so they don't trust anybody. To know somebody on the same day every month will be there to get them Band-Aids or simple stuff, it does more for them than people realize. In the long run, that's what is going to help them get back on their feet."

Underwood mentioned several examples of people she helped two years ago that are now employed, have adequate housing and are showing other signs of personal growth.

"We see enough positive results to keep us going, knowing that this ministry is the right thing to do," she said.

Staying Prepared
Preparation for the next program begins immediately after the evening is over. "We average anywhere from 50 to 80 people a night so I have to make sure I have enough of each kind of medicine," Underwood said. "If I don't have enough, I have to order it and count it all out in little bags. It takes me all of every weekend from now until the next time to get ready."

Reimbursement isn't guaranteed, yet Underwood will place orders on her credit card. Through donations, she is usually able to cover expenses. She also receives contributions of over-the-counter products from colleagues and outside organizations.

"It's the most miraculous thing I've seen happen every month," Underwood said about keeping her program afloat.

A Special Skill Set
Admirers of Underwood's program credit her leadership and organizational skills, and her dedication.

"When one person like Cindy takes the initiative, you find others catch the spark," said Sr. Dinah White, DC, senior vice president of mission integration at St. Vincent's Health System, headquartered in Birmingham.

Underwood's program is "a very beautiful outgrowth" of the health system's mission of service to the poor and vulnerable in the community, White said. (St. Vincent's Health System does not sponsor this program.)

Hal Wycott, a member of "The Nest" and leader of the meal program, admires Underwood's guidance in overseeing this health care program.

"Cindy grabbed hold of the idea and went to town with it," said Wycott, who helps organize the patients as they wait for health screenings. "These people get attention that they normally don't receive. They come here to get better."

Underwood's husband, Dennis, regularly joins his wife at this monthly health care event. "I know how tired she is being on her feet all day, but she still makes it down here," he said. "She just loves it. She's always loved ministry and doing anything she can to help other people. Mostly, it's her faith in God."

Closing Thoughts
As night falls in the city, Underwood is dripping with sweat and tired from another long day. As she reflects on the day's efforts, she encourages fellow health care professionals across the country to find creative solutions to help the homeless address their health issues.

"It's pretty staggering that on any given night in the Birmingham area, there are 3,000 homeless people. If this city has this many, how many homeless do bigger cities have?" she said.

Underwood said her heart goes out to the homeless as they struggle to survive day after day. That's why she keeps coming back to the same parking lot every month.

"Where we stand is where some of them are going to sleep tonight," she said. "We figure we can help them for two hours if they can stand out in it all the time."

For more information on this program, contact Cindy Underwood at [email protected].

Nominate a Program

Are you involved in a program that deserves attention for continuing the mission? If so, contact us at [email protected].


Copyright © 2008 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

No Hands But Yours - Taking Health Care to the Streets

Copyright © 2008 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.