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Over several days in January, NBC Nightly News followed the Montefiore Mobile Health Clinic as it made routine stops in the streets of New York City, providing healthcare where it simply doesn't exist: for the homeless.
"We know that homeless youth are not going to come to a hospital or health center unless it’s an emergency," Dr. Alan Shapiro said. "So we bring the mobile clinic to them."
The mobile clinic – known as the "big blue bus" in some communities – travels throughout New York City’s boroughs, complete with nurses, a physician and fully equipped examination rooms. Parents are able to get check-ups for their kids, and consult the doctors when they have questions or concerns – all for free.
Shapiro has been working on the mobile clinics for more than 20 years.
"We bring [the mobile clinics] to a drop-in center where they’re getting food, where they can rest, where they can get clothing. It makes it a lot easier for them to access care," he said.
The mobile health care units first hit the road in 1987 as an initiative started by the Children’s Health Fund. There are now more than 50 mobile health units across the country – including in Michigan, West Virginia and Louisiana, each affiliated with a major local hospital system. Irwin Redlener, the founder of Children’s Health Fund, said they’re designed to fight the consequences of poverty.
"The health status of people that come to a clinic like this is affected by factors which are way more than infections and trauma,"Redlener said. "This has to do with the issues of poverty influencing health status – people who are in inadequate housing or who are homeless and people who are having transportation issues, and people who are experiencing severe domestic violence in their home."
According to the U.S. Census Bureau, more than 15 percent of the country – 46.5 million people – were living in poverty in 2012. In that same year, 16.1 million children under the age of 18 were impoverished. Those rates skyrocket in the South Bronx – where Shapiro spends most of his time working -- where one in every two children live below the poverty line.
For the kids and their families who utilize the services of the "big blue bus," the presence of the mobile clinic has had a significant impact – one that arguably goes beyond better health.
Juan Robles, one of Shapiro’s first patients, is now following in his footsteps.
Robles began visiting Shapiro’s mobile healthcare unit in his high school parking lot in the early 1990s, after he moved to the United States from Honduras with his four siblings. As he provided medical care to Robles and his family over the years, Shapiro eventually became a family friend – and mentor.
"He came to my wedding, he came to my graduation, so he has become, actually, part of our family," Robles said. "And from that moment when we met -- many years ago -- I felt that compassion, that friendship that he brought into the patient-doctor relationship made a big difference."
Shapiro inspired Robles to pursue a career in medicine. Robles recently graduated from medical school, and as part of his residency at Montefiore, completed a rotation on the "big blue bus." He now hopes to carry on Shapiro's work in the South Bronx.
"We have made significant progress, but there is a lot more that we can do," Robles said. "These children who have tremendous potential to become physicians, lawyers, we just, we got to do something with them."