Family van provides healthful hope to poor

Brian Mickelson

Dr. Nancy Oriol had a good idea.

Back in 1992, she started the “Family Van” as a unique way to eliminate the barriers between the health care system and communities of color in Dorchester, Mattapan and Roxbury.

The van made weekly trips throughout these three neighborhoods and offered citizens free health care counseling, education and services. An estimated 50,000 people have received services over the years.

It was Oriol’s work as a pediatric anesthesiologist at what was then called Beth Israel Hospital (now Beth Israel Deaconess Medical Center) that prompted her desire to close a huge gap in the health care system.

“What she was noticing in her practice was that the women she was seeing from Roxbury, Dorchester and Mattapan were experiencing more instances of things like toxemia and lower birth weight babies,” Family Van Executive Director Jennifer Bennet said. “And these are preventable conditions. So she thought that clearly there are people out in the community who are not getting prenatal services and here we are in Boston, the center of medical research and innovation. So why aren’t [some people] getting access to these services?”

The result was the purchase of a medically equipped Winnebago, which until very recently made regular stops throughout the neighborhoods.

The original Family Van recently broke down in the middle of Massachusetts Avenue. Fortunately, a new van had been ordered three months beforehand. Unfortunately, it wasn’t going to be ready until the spring.

To continue providing service without having to cut back or rearrange its schedule, the Family Van has teamed up with the Dana-Farber Cancer Institute, which has lent its own mobile health care van — originally slated for cancer research — as well as its employees to assist in bringing health care to the people.

“From day one, we have gone out and addressed a number of chronic illnesses, like diabetes and hypertension and obesity, that all — with prevention and education — can really impact the overall quality of life,” Bennet said. “So the idea is, let’s go out and educate people. Let’s help them understand how they can be their own health care advocate and affect some lifestyle changes so that their quality of life will be better and some of these illnesses won’t manifest themselves.”

The Family Van certainly offers a different means to health care treatment and advice than your typical neighborhood medical practice. Patients do not need appointments, medical insurance or even identification. All information patients receive comes free of charge, and the information they share is kept private. And staff on the van goes out of their way to be warm and welcoming, which Bennet said has been a major attraction for people in the community.

“Oftentimes, one of the barriers that people experience in accessing health care is lack of trust with medical employees and doctors,” she said. “By bringing the health care to the community, people see that we are committed to them. The environment here is not as clinical and intimidating. People routinely lie to their doctors. When they come on to the van, everyone feels very comfortable and will fully disclose what their issues are. I think there’s just a real appreciation for that.”

The Family Van’s partnership with community health centers allows it to be a medium through which patients can become familiar with primary care providers. In fact, the van has an incredibly high referral success rate, with 85 percent of those referred keeping their appointments. For the uninsured and impoverished, establishing a comfortable link with something as alien as an HMO is one of the first steps to reducing health disparities in minority communities.

In the meantime, the Family Van is “trying to teach people how to manage lifestyle issues around diet, nutrition and exercise, so that they can enjoy longer and healthier lives,” Bennet added.

Financial support for the program is provided by a number of sources. “We get a lot of support from local foundations like the Boston Foundation, the Oral Health Foundation, the Harvard Children’s Health Care Foundation and Blue Cross Blue Shield,” Bennet noted. “And then we have private individuals that support us and a number of federal subcontracts: one to address glaucoma and another to do education and testing around HIV/AIDS for people at risk.”

There are also the dedicated individuals who donate their time and skills in making the Family Van a success. People like Norman Britt of Dana-Farber, Tufts University student Natalie Kornbluth, or Rainelle Walker White, the woman who gives the most time of anyone to running the Family Van as its manager of direct service.

Community health centers also provide staff, whether to help translate for the 23 different ethnic groups the van treats or to perform tasks like testing blood pressure and blood sugar levels.

“There’s a lot of fear out there,” Bennet said. “People don’t understand the implications of [health care] changes for them, and we’re trying to play a role in helping communicate the impact.”

The new Family Van arrives in March 2007. The old van has been parked on the Harvard Medical School campus to promote the program’s fundraising campaign, which has raised a little over half of what it will cost to pay for the new van.

For more information on the Family Van, visit www.familyvan.org, or call Jennifer Bennet at (617) 442-3200.