Carrying bags of equipment and supplies, a group of people navigates through a series of tents and tarps in La Crosse’s Houska Park. As they sidestep the different items spread out on the ground, avoiding damp patches of dirt along the way, they quietly talk with residents of the park.
Consisting of medical students and employees from health care systems around the area, this group of individuals makes up the mobile medical team that provides medical care to the homeless population of La Crosse. A large part of their work takes place at Houska Park, a designated safe space for people experiencing homelessness in La Crosse to live during the summer months.
Through the work of this group, residents of the park are able to receive medical care, and other services, directly from health care professionals — something that isn’t always possible for people experiencing homelessness.
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Living outdoors in a communal setting also poses its own additional challenges, especially when it comes to cleanliness and overcoming personal struggles. This story is part of the weekly Finding Home series, which dissects the growing issue of homelessness in La Crosse and tells the stories of the community members who are experiencing it.
The mobile medical team usually visits the park on Wednesday mornings for several hours, although health care providers will come and check-in throughout the week. During this time, the group examines patients, administers antibiotics and treats cuts, scrapes and bruises. They also assess mental health issues and can make recommendations for individuals to get further treatment at a clinic or hospital when necessary.
With only tents and tarps acting as shelter for most of the people living in Houska Park, the elements have a large impact on health. Poor nutrition, lack of quality sleep and general hygiene also contributes “in a huge way,” said Ben Thompson, a medical resident in family medicine at Gundersen Health.
Infections are also common among residents of the park as a result of the outdoor conditions.
“When you’re here, are you thinking about brushing your teeth twice a day? Not necessarily, but that contributes to your overall health,” Thompson said.
Urging the people living at Houska Park to begin seeing health care providers regularly is one of the main goals for the team’s visits to the park, Thompson said. While the team can treat a variety of medical conditions and administer inhalers and antibiotics, it can be hard to fully remedy persistent and underlying issues like heart disease and diabetes.
“It’s very rare that you’re going to really help somebody with one visit, it’s better to have a long-term relationship with somebody and you’re seeing them multiple times over and over,” Thompson said. “You can’t often predictably do that [at Houska], and that’s where care coordination helps with things like housing and transportation.”
It takes time to build a trusting relationship between a patient and a medical provider, especially when someone is experiencing homelessness, Thompson said.
One man currently living at Houska has received treatment from the team for swelling in his legs since last summer. They aren’t sure exactly what the cause is, but have been administering antibiotics and checking up on him regularly. After several visits to Houska, this individual has since asked Thompson to be his regular doctor, a step towards receiving more quality treatment and that efforts to build trust between medical providers and those facing homelessness is working.
On their weekly visits to the park, the mobile medical team will visit certain individuals regularly to monitor ongoing health concerns, and treat others on a case-by-case basis when issues arise.
Sandy Brekke, a senior consultant with Gundersen’s Office of Population Health and volunteer for the St. Clare Health Mission’s Street Medicine Team, visits the park more regularly to stay up to date with health concerns and help the team plan their visits.
“We’re really dependent on community health workers and on our public health workers, and other people to guide us,” said Paul Klas, a family medicine doctor with Gundersen Health. “These problems are very deep and complex.”
Having the majority of La Crosse’s homeless population living in one place allows support services, like the mobile medical team, to reach more people, Brekke said. Before Houska became a designated safe space for people experiencing homelessness last summer, Brekke said they would visit people living near the marsh in La Crosse, but the remote location made it hard to provide medical care regularly.
Other support networks are also providing services to Houska Park with the goal of reaching more people. Residents are taken to shower almost daily, and representatives from various agencies and programs around the area stop in frequently.
While the communal space has its advantages, Thompson said the environment of Houska Park can make some components of health care more difficult to target. For example, overcoming addiction can be difficult in a space where others may be using drugs or alcohol.
“I hear that over and over from patients — they say that they’re not going to get sober here, and we find that’s oftentimes true,” Thompson said. “We have to get them into inpatient rehab, take them out of the environment. So it comes with good and bad.”
Despite this, Thompson said providing this kind of care to people experiencing homelessness is important. Although it may appear relatively simple, securing transportation to and from a medical facility and arriving to appointments as scheduled becomes a significant hurdle for many people without housing or other resources, he said.
“Coming down here closes the loop,” Thompson said. “It really helps.”
Gaining experience working with people outside of traditional medical settings is also important for both future and current physicians, Klas said. If physicians don’t find ways to meet this group of individuals where they are at, it often results in people going without care.
“We’re really hoping to train the next generation of young physicians to be not in the hospital, but in the community,” Klas said.
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