A big white van was parked in New Haven’s Fair Haven neighborhood on a sweltering summer day. Standing next to it were a group of nurses and a case manager.
The group, from the Cornell Scott-Hill Health Center, a nearby community clinic, was waiting for unhoused patients to come to them.
“I like to say we are like a rural community medicine practice where we get to know everybody, individually by name,” said Phil Costello, a nurse and clinical director of homeless care at Cornell Scott-Hill.
Across Connecticut, the number of people experiencing homelessness is increasing, and with it, so is the rise in demand for health care. To address that growing need, Costello and his team are working to meet and treat patients where they are.
The team’s core mission is to provide medical care. They do that by diagnosing, prescribing, and referring unhoused patients to specialists. Costello regularly changes wound dressings for people.
While it’s not every week that someone needs help, Costello still goes out of his way to say hello – buying coffees and handing out water.
“What that does is it creates a level of humanity, a level of trust,” he said.
That kind of trust brought to them a man on a rickety bicycle who the team greeted with a bottle of water.
The man said his name was Gustavo Sepulveda, and he lived on the streets.
“Yo a veces vivo en la calle,” he said.
Sepulveda said he had been sheltered just one or two times, but right now he’s unhoused.
“I live in the street, yeah,” he said.
Sepulveda came to receive medical care. The white van, with its Scott-Hill logo, shows up at this location weekly and he has been a regular patient.
Shannon Collier, a nurse, took a look at Sepulveda’s foot wound – it's an infection, she said – as the two chatted.
“Let me see, yeah, he has an infection in his toe,” Collier confirmed. “He's gonna shower.”
“You're gonna shower, right?” she asked him, and he nodded.
“Once he showers, we'll change the dressing on his toe,” she said.
The shower is actually a big bus, a free service called Power Shower, and it’s parked right across from the medical van. It was Sepulveda’s turn and he was going to first wash his wound.
As a long-time diabetic, his wounds can take time to heal. In fact, he lost a finger to a previous infection, he said, holding up his hand.
Costello said his team treats patients like Sepulveda every day.
“Especially for diabetics, a callus can get thick enough or it will start cracking, and then it will open up not just the outer part of the skin, but the inner part of the skin and be a vector for infection,” he said. “It’s very common out here for people, if not treated, to lose toes and feet from infection.”
After Sepulveda was done with his shower, he headed back to the van. The nurses helped him climb, as he found it difficult to walk. There he leaned back on what looked like a comfortable recliner, feet stretched out.
When he was through, he emerged smiling.
"Me siento mejor. Ellos me limpiaron,” he said. “Tenían esos antibióticos.”
I feel better, he said, they cleaned me. They had those antibiotics.
And he got the antibiotic at no cost.
It’ll help him for now. But in the long run, Collier explained why diabetes is one of the hardest conditions to manage when someone is experiencing homelessness. One reason is that blood sugar is tied to diet.
“They don't control what they’re eating,” Collier said. “They’re not able to say ‘I can’t have this, or that.’ They’re taking the meal that’s given to them.”
Despite the magnitude of suffering they see, the team is uplifted when they are able to offer some relief – big or small.
Every bit matters, said Martha Lopez.
She was unhoused for almost five years, she said, but now she’s coming here to give back – helping to translate, informing patients about services available and where to go.
“I was also in drugs,” she said. “I volunteer a couple of times a week. This work that these people do is awesome. I love it. This is something that I wish I had when I was out here.”
As Sepulveda got on his bike to ride off, Costello turned to help another patient living on the street.
This person needed a prescription refill – something that Costello accomplished on his phone within seconds.
Raquel Zaldívar, visuals journalist with the New England News Collaborative, provided translations for this story.
