Patients at homeless shelters on O`ahu have received medical care more than 7,600 times from University of Hawai`i medical student volunteers in the six years since the Hawai`i Homeless Outreach and Medical Education (H.O.M.E.) Project was launched at the John A. Burns School of Medicine (JABSOM). Nearly 450 medical students at various stages of their medical education have volunteered to be part of the outreach during that time, setting up mobile medical clinics three times a week at state-sponsored shelters in Kaka`ako, Wai`anae and Kalaeloa. The homeless people who have been helped during that time include the unemployed and uninsured, both adults and children.
“Thank you for helping me! If it weren’t for HOME clinic, I would not have been able to go back to work,” one of our patients reported. The patient continued, “I really hated going do the doctor before and they always treated me like a second class person…but after seeing you guys I have faith in medicine again.”
Wrote another, “I am so thankful that you guys come to the shelter every week. It has been really hard for me to get insurance and I wouldn’t be able to see doctors or get my medicines if it wasn’t for this clinic.”
All medical students in their first year at JABSOM must participate in a yearlong community health setting, and H.O.M.E. is one of ten options available to them. At H.O.M.E., the students perform medical check-ups, taking patients’ vital signs and discussing their medical histories. The students, under supervision of volunteer faculty and community physicians, also are asked to interview one of their patients to learn more about what led them into homelessness. Students write essays based on their interview—and it’s a lesson that sticks with them.
“It’s easy to just judge someone as a homeless person without asking yourself, ‘what caused the homelessness? What factors in their lives or the economy or within their families, or whatever, led to the problem’,” said H.O.M.E. founder Dr. Jill Omori, JABSOM Associate Professor of Family Medicine and Community Health.
Second-year medical students have the opportunity to work as managers of the H.O.M.E. Project or its spin-off program formed in 2011, the Hawai`i Youth Program for Excellence (H.Y.P.E.) H.Y.P.E. is aimed at teen-agers in the shelters, and helps them get physical exercise and work toward better self-esteem. A mother living at one of the shelters found H.Y.P.E. to be a godsend. She wrote, “My daughter anxiously looks forward to the HYPE events every month and has really opened up a lot since starting the program. She feels comfortable talking to the students and knows that it is a safe environment for her to share her troubles and concerns.”
Third-year medical students at JABSOM perform a Family Medicine and Community Health Clerkship with the homeless outreach project, where–for every week for nearly two months (seven weeks)–they must work at two to three clinics. For 10 fourth-year medical students, an elective also is available which requires them to provide health care at no fewer than 25 clinics in their final year of medical school. Every year since its inception, the fourth-year elective has been filled to capacity; a sign of how successful the medical school’s curriculum promoting care for the underserved has been.
Dr. Omori started H.O.M.E. after homelessness began to spread dramatically throughout O`ahu, a problem noticeable in the Kaka`ako neighborhood where the medical school opened a new campus in 2005. That year, Dr. Omori surveyed students and faculty at JABSOM and learned that 94% of students and 88% of faculty members felt homelessness and treating the underserved was a problem that needed addressing even more in the medical school’s curriculum.
The next year, in 2006, H.O.M.E. was launched, and since then, shelter residents have sought help from our students more than 7,600 times. In 2009, the H.O.M.E. Project also began driving its mobile clinic van once a month to the United Methodist Church in Honolulu, where the community provides outreach to homeless who do not reside at shelters, those who are living their lives full-time on the streets of Honolulu.
Details of this story are derived from the September issue of the (See “Hawai`i Journal of Medicine & Public Health.”)
Pictured: students helping to treat a resident of the Kalaeloa homeless shelter in 2012.