Toledo Streets Issue #10

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Universal language, page 3 Farming in the city, page 3 Toledo Bike Co-Op, page 4 Streetwise, page 4 Second Chance, page 7

Mobile clinics seen as way to cut U.S. health costs, page 8 Dire Means—author interview, page 9

Poetry, page 5 Hoboscopes/Sudoku, page 11

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Toledo Streets - The Paper with a Mission

Issue #10

Taking to the streets:

Serving where the rubber meets the road Amanda F. Moore, Managing Editor We’d like to thank you for purchasing this copy of Toledo Streets. We hope you’re enjoying it and discovering a new facet of your community.

Please continue to support our vendors when you get the chance. For other ways to support them and the paper, contact us or visit our website for more details.

Toledo Streets is a monthly publication called a street paper. We are part of a worldwide movement of street papers that seeks to provide simple economic opportunities to homeless individuals and those experiencing poverty.

Our vendors purchase each paper for 25¢, and ask for a dollar donation.

In exchange for their time and effort in selling the paper, they keep the difference. They are asking for a handup, not a hand out. By purchasing this paper, you have helped someone struggling to make it. Not just in terms of money, but also in the dignity of doing something for themselves. Many thanks again!

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This means that any donations made to us c/o 1Matters.org (our fiscal agent) are tax deductible - not to mention greatly appreciated.

Our mission is to empower individuals struggling with extreme poverty to participate on a new level in the community through self-employment, job training, and contributorship.

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ost programs serving the unhoused and poor require the people come to them. In some cases, this only makes sense—if you are going to house people, they need to come to the shelter; if you are going to serve three hot meals a day, it’s easier on everyone to have a fully-equipped kitchen nearby.

There is, however, a significant consideration when making goods and services available to the unhoused and poor—transportation, or a lack thereof. When money is tight (or nonexistent), sacrifices are made in order to meet immediate needs in the most efficient way possible. So quite often, if someone can’t walk there, they probably won’t get there.

Enter in mobile units. They come in all shapes and sizes, from something as ridiculous as a purple and gold “Buszilla” to a simple 17-foot trailer to fully-rigged dental centers

and health “vans”. The premise behind these vehicles is simple: bring essential services to people who cannot come to them. You can read more about these mobile units and the wonderful work they do in our feature on pages 6 and 7, Mercy on the move.

Mobile units are a growing trend in the U.S., seen as efficient vehicles (please pardon the pun) for meeting the country’s dire health care crisis. For more on that, please see page 9 for Mobile clinics seen as way to cut U.S. health costs.

One of the units featured is the LifeLine Ministry’s “Buszilla”, which is fast becoming a local celebrity. In Universal language on page 2, Michelle Davis recounts her experiences as part of a team arriving on Buszilla to a migrant camp in Bowling Green.

This issue is about creativity, ingenuity and compassion meeting great need. Beyond the facts presented, there are literally thousands of stories

You’re now a part of a local, social microenterprise program. It’s simple...

of lives impacted. Let me note for you that all of these units were present, as they always are, at Tent City this year, representing a community coming together on all levels to serve each other.

This was incredibly visible during the inaugural 1Mile Matters Walk, where at least 200 people showed up to march from Promenade Park into Tent City on October 30th—a literal movement of love toward bringing hope and relief to Toledo’s neediest citizens.

While it may seem these efforts are only making a modest dent in a huge issue, how else does anything happen but by consistent, responsive and inventive effort, and by reminding each other that...

THERE IS NO SUCH THING AS SMALL CHANGE.

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Vendor code of conduct

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hile Toledo Streets is a non-profit, and paper vendors are considered contracted self-employers, we still have expectations of how vendors should conduct themselves while selling and representing the paper.

The following list is our Vendor Code of Conduct, which every vendor reads through and signs before receiving a badge and papers. This Code is also printed on the back of each badge. We request that if you discover a vendor violating any tenets of the Code, please contact us and provide as many details as possible. Our paper and our vendors should be positively impacting the city.

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I will try to help in this effort and spread the word.

Issue #10

Toledo Streets - The Paper with a Mission

Universal language

Farming in the city: Gehry’s monstrosity Michelle Davis

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his past summer, I had the amazing opportunity to be able to visit a migrant camp near Bowling Green. I honestly didn’t know what I was going to do when I got there, because I wasn’t part of the medical team going to minister to their physical needs, and I hadn’t brought food or supplies like some of the others that were planning to pass those out. I didn’t know a lick of Spanish. All I had brought was myself, and my two kids. But it turned out—that was enough.

I felt hesitant as I climbed down off the bus, and stepped onto their front yard and headed for their porch.

What would I say? How would I be received? I hadn’t needed to worry, though, because kids have a way of getting around all of the things us adults get hung up on. Before I knew it, my kids were kicking around a soccer ball with their kids. Someone got out bubbles that were on the bus, and we all (kids and adults alike), started blowing bubbles, our inhibitions popping with every bubble that broke on the blades of grass. You could see smiles start to form, could hear giggles and shrieks coming from across the lawn as the kids played. You could hear us adults starting our poor and comical attempts at communicating. They laughed at our Spanish, as we asked them about their lives, their work, and their families.

I found that hugs were their own universal language, and a smile spoke volumes. One of the adults that spoke English told us that they knew we were good people by how well we played with their kids. You don’t need to speak the same language to communicate Love.

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William James O’Fahey

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his hackneyed poem is my attempt to contrast the worst elements of city living against the pastoral ideal country living.

But mind you, the sicknesses of city living are cured by city farming, and the rural family farm is like unto the city family farm... both are, to my mind, sustainable and beautiful...

Frank Gehry’s Collingwood architectural monstrosity is considered by German architects to be his greatest achievement.

Is Balboa, Spain, close to Toledo, Spain?

Alisa Davis (background) playing on the steps of LifeLine Ministry’s “Buszilla” at a migrant camp, with friends Milana, left, and Jasmine, right. Jasmine works out in the fields with her family. Photo: Shawn Kellerbauer

Each time that we went to visit, even though we were getting there as the sun set, most of the families were still out in the fields. Not just the parents, but the kids, too. I was taken aback to learn that children, my own kids’ ages, were out in the fields working the same hours as their parents—from about 7 in the morning, until sunset. I was told a typical day for everyone was about 12 hours out in the field. To see the kids out playing at night with my own kids, you would’ve never guessed they’d just put in a 12 hour day. These kids were so vibrant and full of life, and so mature too. They were happy to help us with our translating, or to help us move things in order to set-up for the passing out of food and supplies.

When I think back to the amazing families I met last summer, several words come to mind: courageous, cohesive, hard-working, content, determined...and most of all: strength. ts

Children make up 23% of people experiencing homelessness on any given night in the HUD Homeless Support Service Network.

I.

Gehry’s monstrosity began 50 or 60 winters before

with an eight year old boy named Goldberg sitting on the floor

in front of a woodstove. His grandma knelt beside him. They stacked logs and sticks spilled out from a canvas bag.

It was a canvas bag to carry logs and sticks from the woodpile to the woodstove.

II.

You see, even Gehry’s— that is, Goldberg’s—modern museum architectural monstrosity; monument to bland steel

and industrial glass; a sterile,

futuristic rendering of rotten, scaley fish;

a rusting ship; or sodden and soiled sails; even this metallic abstract re-creation of Earth’s earthy past, was begun in real earth.

III.

It was begun in birch bark, tree frogs, carpenter ants, and pine tar or maple sap;

real earthly human breathing on the real earth, before Goldberg grew to Gehry;

before “the architect as contemporary cubist or sculptor”.

IV.

And although this modern architectural monstrosity lies at the uttermost center of soulless industrial and urban despair,

the memory of that boy and his grandmother—

stacking logs and sticks on the floor in front of their woodstove—persists in the heart of a retired farmer now confined to his downtown nursing home, and in the heart of

a troubled and challenged young man who was born in the countryside,

but who now sits smoking on the porch of his downtown city group home. ts

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Toledo Streets - The Paper with a Mission

Toledo Bike Co-Op

Streetwise: Getting there Bonfiles

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he St. Mark’s Episcopal Church cemented its place in the Old West End community long ago. Every month, the church hosts a dinner for the entire community, in addition to being the meeting place for a lot of smaller groups. It sits proudly on the “Avenue of Churches” at 2272 Collingwood Boulevard, and in the last five years, St. Marks is again making some noise by housing the Toledo City Bike Co-op.

The Toledo City Bike Coop was founded five years ago by the combined efforts of Andy Stepnick and Robert Hannow, with assistance from Mark Heinzer, John Bell and Andrew Smith.

I volunteered for several hours over a five- to six-day period, and found the experience to be completely positive and rewarding. Twice I mowed the lawn for St. Mark’s, readying the church for Sunday service, while other times I performed simple repairs on bikes that came in for maintenance.

Once, I simply polished a chrome fender for a classic Schwin that was in for repairs. There is always something to be done, and the Co-op is always alive with activity.

Simple repairs can be performed immediately, depending on the number of people in the shop.

You may also affect minor repairs yourself, using the resources of the Coop. Often, bikes are left at the shop for maintenance and repairs, and worked on by volunteers earning ‘credits’ towards the purchase of other bikes or parts, or in some cases, earning a fair wage from the Co-op for services rendered. Whatever the case, the Coop is always working, from simple repairs to major overhauls, to building a bike from the ground up.

There is everything to like about The Toledo City Bike Co-op: • It builds community; • It is environmentally-friendly; • It creates workers; • It provides training; • It is a “cost conscious” service; • It is local; • It is interactive; • And perhaps the “crown jewel” of the Co-op’s programming is it has become an alternative to detention

with juvenile offenders.

The ‘Co-op’ is a perfect fit for the Old West End with its strong sense of community and central location.

The Co-op is also a great fit for today’s economy. A finely tuned bike could possibly be used as transportation to and from an employment opportunity.

The Co-op offers simple classes as needed on repairs, building a bike from the ground up, and the aforementioned ‘community integration for training and employment’. This last class is the Co-op’s partnership with the Lucas County Juvenile Court System, and its alternative to incarceration. This is a great program, and I have seen firsthand the success of this program. On my last visit to the Co-op, I had the occasion to witness Andy Stepnick working with one of the young men in this program.

By day, Andy is a civil servant, working in the clear water division of the city, but clearly he has a gift for working with young people as well.

The same can be said for Robert Hannow, a letter carrier by day, who works well with anybody who comes into the shop. He is personable and efficient. Finally, there is Maxwell Austin, the shop manager, who balances schedules, people, and materials with equal efficiency, and a positive attitude.

You will not be wondering where the love is at the Toledo City Bike Co-op.

Some friends of Toledo Streets dropped in on the Co-op the last time I was there, and both of them went on to purchase road bikes. Doug Lutman thought this was a great idea, and could feel the sense of community in the place. Helen Grubb echoed Doug’s sentiments, and immediately struck up a partnership for “art bikes”, something of her own design.

The sign over the door says: “It is not free, it’s a Co-op”. So go there looking to be ‘hands on’ and ready to cooperate. To learn. And finally, it appears the success of the Co-op has made the space, or lack of, a problem. The Co-op is out-growing its space. Still, Maxwell manages to keep everything running smoothly. Check it out. bonfiles. . .

Issue #10

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Angie Bowser & Michael Fisher

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elcome to a new feature column for advice about real life questions that matter most to the unhoused or those in poverty level circumstance. In this issue we’re going to look at using public transportation. Even if you’re used to hoofing it everywhere, there are still a few things you may suddenly need to use public transportation for, such as; • To find safety: Things can happen quickly out there and sometimes it’s best to get out of a situation as far and as fast as possible • To find shelter: Weather can change your plans, so can your environment or the people that are in it • To get food or support: Missions, churches, food banks and charity events may provide quick help or much needed compassion when you bottom out • To find work: Sometimes opportunities pop up unexpectedly, whether it’s a friend telling you of a job opening somewhere or just some legitimate sidework that pays cash, you want to be ready and able to get to it, now • For medical care: Injuries, illness, and emergencies won’t wait for you to learn how to get around town especially since prevention is always your best form of treatment so hop that bus and get checked out

In the Toledo area TARTA is the public transportation, but regardless of where you are, you may have questions. Here are some answers to some common questions: Q: Is it safe to ride public transport?

A: It’s designed to be a safe reliable source of transportation, but you should still strive to always travel wisely.

In Toledo, TARTA enforces an expected Code of Conduct for all passengers.

Violent, offensive, rude, racial or threatening behaviors are prohibited on all buses, stops and stations. Weapons, criminal activity, alcohol, threatening and inappropriate language are banned, too. These policies are enforced by the bus operators, management and local law enforcement (if need be). All users are expected to respect the rights of others at all times. The seating nearest to the front is designated for elderly and disabled passengers. If an elderly or disabled person enters the bus, any individual occupying those seats will be directed to other seating designated for general riders.

Mindful, some problems do

consistently exist in all cities. As the schools have continued to cut transportation funding, more teen students are riding public transport more often. Grown passengers speak of an increase in harassment, verbal abuse, and even some physical abuse when teens gather in groups. Altercations are generally youthon-youth, though. The young are not the only offenders either. As in any public setting, you’re never fully aware of the intentions of anyone around you, so be conscious of your surroundings at all times. Many experienced riders seem to advise simple solutions like “stick to yourself”, “stay near the front” and “avoid large groups at bus stops and stations”.

Q: How much will it cost?

A: Bus fare in Toledo costs $1.00 per ride.

Transfers are now also $1.00. Bus passes can be purchased weekly for $10, which allows a customer to ride as often as needed, from Monday through Sunday. Monthly passes can be purchased for $40. Passes can be purchased at most local banks or the TARTA office at 1127 W. Central Avenue. Discounts are given to senior citizens, disabled and Medicare members.

A reduced fare card can be picked up at the TARTA office or passengers can just show their Medicare cards to the drivers.

Q: Is it confusing? How will I know how to get to where I want to go?

A: It can be, yes, but it gets easier quickly.

Schedules are available at bus stations, libraries, banks, large grocery stores, shopping centers and the TARTA office in Toledo.

First, locate the route you need by finding your destination on the schedule.

Each map has a route number and a letter which will be displayed on the front of each bus. After locating the right schedule, a time table is listed on the inside as well as a map of the route each bus will take. All stops on each route are listed in both places. Next, find the closest bus stop to where you are and the time the bus will arrive at that stop.

Before getting on any bus; make sure the number on the front is the correct route you need. Several buses may use the same route with different destinations so don’t hesitate to ask the driver before paying any fare.

You don’t want to waste money or go to the wrong place.

Reading the actual schedule is unfortunately considered the most confusing part for inexperienced users so you may want to plan to ask for help at first. If you have access to a phone, the easiest approach to “Getting there” continued on page 10

Issue #10

Toledo Streets - The Paper with a Mission

Poetry Refutation on Refuse New Life everywhere and chaos ensues -refuse and waste littering dung-heap avenues; fresh fertilizer for cyclical growth: the impetus to change rooted in this present pain.

Yet, better the wet and teeming funk than the sanitized complacency of more gentrified and myopic humanity.

This disorder can break your back, for sure, but in the sweat and decay the germination of a different way seems less oppressed -more plausible than it might in more structured and hallowed ground.

The cesspool as waters of life -swamp and stinkwater giving rise to things transcendant -a more organic notion of Progress.

What, what, what is this blight?

Urban or otherwise?

It seems more loaded, perhaps, than the expended shells, pistols and seed of those other institutions: drowsy and narcotic in their glorified apathy.

of things far too easily -migrating toward more peacefully disposed locales -places like the eye or petal, the brain or leaf where, no doubt, growth, change, transformation (as in the strange and systematic alchemy of photosynthesis) can and do occur, but for the forfeiting of blood, semen, bile and spore-type transmogrification employed by the blue-collar intestine or uterus.

Yes, the grunt-work is left to those less inclined to accept the praise or flaunt their flora and, as a result, their lymph-node beauty is rejected; while the benefits thereof are reaped by the face or plumage.

But as for me and my house -we will till the sweat gland, farm the condemned housing project, beat the Wild Turkey bottle on the lawn into a flute (or jug-band piccolo at the least).

Yes, we will serve the spleen and serve it well!

Their bent may well be the improvement of society and yet, they vacate (evacuate?) the bowels (heart) Will Stuart

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Toledo Streets - The Paper with a Mission

Issue #10

Mercy on the move: Toledo’s

The Food For Thought Mobile Pantry being loaded with fresh produce. Photo: Food For Thought

FOOD FOR THOUGHT MOBILE PANTRY

F

ood For Thought Toledo’s 17foot trailer is a Mobile Pantry, carrying nonperishable food to those who don’t have ready access to a pantry in their neighborhood.

The Mobile Pantry participates in the CARE (Community Asset & Resource Engagement) Team. Each month, the CARE Team travels to a different neighborhood to provide resources.

In addition to these CARE Team events, the mobile pantry visits four locations monthly: • 1st Thursday—Monclova Community Center, 8115 Monclova Road, Monclova, 10am-noon • 3rd Monday—Lake Township Fire Department, 4505 Walbridge Road, Walbridge, 5pm to 7pm • 4th Thursday—NuVizion Church, 2014 Cherry Street, Toledo, 10amnoon • Last Tuesday—CedarCreek Church Toledo Campus, 2600 West Sylvania Avenue, Toledo 2:30pm to 5:30pm

If you need food, you will need to bring a photo I.D., as well as social

security cards for every dependent. You may visit any location; however, you may only visit us once per month. You will not be permitted to visit two separate locations in the same month.

“We need at least 5 volunteers to run the pantry; some of larger drops have as many as 20 volunteers,” said Amanda Aldrich, the organization’s executive director. “We are blessed to have an incredible volunteer, Michael Schiewer, to oversee and execute our mobile pantry site visits.”

As of the end of October, the mobile pantry had served 11,518 Toledoarea residents. This does not include the 300-plus brown bag lunches delivered downtown every Saturday by the pantry.

“The people we serve are much more important to us than the food we give to them,” Aldrich stressed. “We try to alleviate some of the hardships they endure by providing a friendly smile, dignity and respect.”

As of this printing, Food For Thought is struggling financially to make it through the end of the year without any interruption of its services.

Nurses Terri Swartzlander and Jim Davis caring for a migrant worker in August 2010. Photo: Amanda Faith Moore

LIFELINE MINISTRIES MOBILE RELIEF

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ome call it the “Peanut Butter & Jelly Bus”, but it’s more affectionately known as “Buszilla”. The mobile relief unit of LifeLine Ministries is swiftly becoming an icon of hope, in a very large, very purple way.

Since its first service in Toledo at 2009’s Tent City in late October, Buszilla has certainly made the rounds.

Most frequently, it can be seen along the curb next to the main library downtown on Saturday mornings during Food For Thought’s brown bag picnics (often, right next to the Food For Thought mobile pantry). While there, the bus serves as a medical unit. On most weekends, nurses Terri Swartzlander, Annette English and Jim Davis conduct blood pressure and blood sugar checks, with help from waiting room attendant Lisa Craig.

Typically once a month, Project Black Bag shows up with a doctor, a pharmacist, University of Toledo medical students, and nurses of the Neighborhood Health Association and Mildred Bayer Clinic for the Homeless.

“On these days,” said Pastor and

ministry director Steve North, “triage operations are conducted outside the door of the bus, medical students interview patients to construct a complete medical history, the physician conducts a complete physical exam and writes prescriptions where they are warranted, the pharmacist calls the scripts in to the pharmacy at St. Vincent Mercy Hospital, and the meds are in the patient’s hands before they leave the site.

It’s a great sight to behold!”

North estimates between 700 to 800 individuals have received medical care from Buszilla in just over a year.

Beyond medical services, the big colorful bus has served as a transportation unit for various events, such as disaster relief efforts in June, visits in the summer to migrant camps, the 4.5 Teen Poverty Immersion course, and visits to homeless encampments along the Maumee River.

More activities are desired to put the bus into service, but the ministry is prohibited by lack of funds.

“The bus has already saved lives,” said North. “There is so much more we’d like to do, so much more need.”

JOIN THE MOVEMENT Your help is needed to keep these mobile units on the road. Volunteer time, supplies, and money are needed in order for these great organizations to continue fulfilling their missions and meeting the needs of our community. Please consider how you might become a part of their support network.

Read more online at www.toledostreets.org.

Issue #10

Toledo Streets - The Paper with a Mission

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fleet of mobile care units

The St. Charles Mercy Hospital Mobile Health Van at Tent City in October 2010. Photo: Amanda Faith Moore

ST. CHARLES MOBILE HEALTH VAN

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or 16 years, the St. Charles Mobile Health Van has delivered medical services to the community, usually starting its season in mid-April and running through October. Bob Richard, the unit’s sole driver, also does bood pressure and blood sugar monitoring and scheduling for the vehicle’s various site visits.

A community resource in much demand, the Mercy Health Partners-run Mobile Health Van is headquartered out of St. Charles Mercy Hospital in Oregon, but serves at all kinds of events throughout the Northwest Ohio area.

One of the van’s major partners is the Regional Advisory Group, made up of the Toledo Lucas County Health Department, Bowling Green State University, University of Toledo Medical Campus, the AIDS Resource Center, and SASI (Substance Abuse Services, Inc.). Using the van, the Group this year alone has visited 19 different locations and tested 393 individuals for HIV, as well as providing crucial

prevention and education regarding the disease. 51 of those people were tested at Tent City. Other recent sites were the Owens Community College Health Fair in October, where 63 people were tested, and the Erie Street Market Health Fair in September, with 95 people tested, according to reports from Art Madden at the Toledo Lucas County Health Department, who also coordinates the scheduling of these events.

Beyond these assignments, the unit makes appointments for community festivals, fairs, events, senior centers, and migrant camps.

Richard says running the van keeps him busy, with some events lasting 10 hours, some only three to four hours, and sometimes making two visits in a day.

Since first being put into service in 1994, the van was updated two years ago. The Mobile Health Van has a long history of helping Toledo area citizens receive much-needed care, and has become an integral part of health care in Northwest Ohio.

One of two full-sized operatories in the Dental Center Smile Express. Photo: Amanda Faith Moore

DENTAL CENTER OF NWO SMILE EXPRESS The Smile Express Mobile Dental Center, a program of The Dental Center of Northwest Ohio, brings general dentistry right to low-income patients throughout the region. Right on the side of the unit is a lengthy list of the 18 counties served. In order to do their best to meet the demand, the Smile Express staff operates full-time all year, which it has been doing for the last five years.

The unit is brightly lit and colorful inside, one wall lined with cabinets and sinks. Two full-size operatories, both with a networked overhead dental education video system. At the far end of the mobile center, a Panorex machine produces 360-degree diagnostic x-ray capabilities.

The full-time dental staff serves in the center just as they would in a normal dental office, providing fillings, root canals, sealants, extractions, pulpotomies, flouride treatments, along with the making of full and complete crowns, dentures, sport guards, bite guards, space maintainers, and thumbsucking appliances. Beyond this, oral health instruction and education is given through printed educational materials and

videos distributed and shown during the registration process and wait time. Each patient leaves the mobile dental center with “a kit containing an appropriate toothbrush, toothpaste, mouthwash, floss and educational materials with oral health instruction specific to his/her exam findings by an oral health educator,” states the Dental Center of Northwest Ohio’s website.

The Smile Express focuses on making visits to health departments to better coordinate its schedule, visiting five of these sites monthly, and serving the dental needs of 30 to 40 patients on each visit, though the schedule varies somewhat depending on the time of year.

The unit also makes some other site visits, such as Head Start locations, nursing homes, St. Charles Mercy Hospital, and the yearly event Tent City. It also showed up in Findlay this last October for the first “satellite” Tent City event for Hancock County.

“The need is so great,” commented Vicky Peet, the moile manager. “While we do see some return patients, there is a long waiting list for each site.”

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Toledo Streets - The Paper with a Mission

Issue #10

Mobile clinics seen as way to cut U.S. health cost

Scott Malone

Client Julius Wayne Dudley (L) reacts as volunteer Jeffrey Pierre-Paul picks his finger for a cholesterol test in the Family Van in Boston, Massachusetts REUTERS/Brian Snyder

Despite the passing of a historic health care bill into law earlier this year, health care in America remains expensive for many. An increasing number of so called ‘Mobile Health Clinics’ which aim to operate in the poorest areas hope to change all that.

Every Monday afternoon, a 40-foot (12-meter) motorhome converted to serve as a mobile health clinic pulls into Boston’s gritty Roxbury neighborhood and opens its doors to people like Angie Santiago.

“I work from 8 a.m. to 5:30 p.m. I don’t have time to go to the hospital. Here I can just walk in,” the 34-year-old teacher’s assistant said recently as she waited during her lunch break for a test.

“I have kids to support. I can’t afford to take a day off from work.”

Santiago is one of some 3,000 people each year who visit the Family Van for free checks of their blood pressure, blood sugar and cholesterol level.

The nonprofit clinic affiliated with Harvard University provides simple tests that can give an early warning of an impending health problem or help manage an existing condition, such as diabetes.

The van—which visits six low-income neighborhoods around Boston weekly—is one of about 2,000 such mobile clinics in the United States. Advocates say the approach can help control the rising cost of health care by helping people with chronic diseases to stay out of the emergency room, often the first recourse for inner-city residents.

“Our medical system in this country is focused on illness. What we are doing is helping people when they’re sick,” said Jennifer Bennet, executive director of the Family Van, which is backed by Harvard Medical School.

“It would be a lot less expensive and people’s quality of life would be vastly improved if we as a society and as a country start to look at addressing these problems long before they get to that acute stage.”

The United States spends some $2.5 trillion on health care each year. That works out to about 15 percent of gross domestic product, considerably higher than any other developed economy, according to a Kaiser Family Foundation analysis.

GROWING NUMBERS

A growing number of clinics like the Family Van operate in the United States, according to the Mobile Health Clinics Network, which has been tracking clinic numbers for six years and finds more each time it conducts its informal census.

“There is no doubt about it, it’s growing,” said Darien DeLorenzo, executive director of the San Francisco-based group.

The mobile clinics are largely nonprofit and most provide general medical care, though smaller numbers specialize in dentistry or mammography.

Many urban clinics keep budgets tight by relying on healthcare educators and students as staff, referring patients to doctors or hospitals when more is needed. Their

rural counterparts more frequently have doctors and nurses on board, to serve communities without health care facilities.

The Family Van estimates that every dollar it spends on its operations pays off $36 in economic benefits, including the effect of averting nonemergency visits to hospital emergency rooms and the value of the tests it provides.

The average visit to the Family Van costs $117, versus $923 for a nonemergency visit to a hospital emergency room, according to an analysis by the clinic, Harvard Medical School and other experts.

These programs can also help push the nation’s overall medical tab down by alerting people to nascent health problems before they become critical, advocates said.

SERVING THE UNDERSERVED

“When you’re serving the underserved, healthcare is a luxury,” said Kathy Ficco, executive director of community health at the St. Joseph Mobile Health Clinic in Rohnert Park, California, which operates a similar clinic.

“Their main focus is food and shelter ... It’s not until a problem creates pain or suffering that they will seek care.”

A visit to the Family Van can take as little as seven minutes, though staffers will spend as much as 45 minutes with people who have questions about their conditions.

“Going to the hospital takes a long time,” said Badshah Rahman, 38, who stopped in on an August

afternoon for a regular blood pressure check. “This is really easy.”

Many of the Family Van’s patients are regular visitors who drop in every few weeks. That level of frequency may be the clinics’ greatest benefit.

“What you need there is ongoing monitoring of folks with chronic conditions and to the extent they don’t have that kind of ongoing monitoring in the traditional health care system, the van fills in that gap ... that’s terrific,” said Michael Sparer, chair of the department of health policy and management at Columbia University’s Mailman School of Public Health.

Still, he noted, clinics staffed by educators cannot provide the same level of care as a visit to a doctor.

“They are a stopgap solution,” Sparer said.

Even in Massachusetts, where a law passed in 2006 requires almost every resident to have health insurance, many inner-city residents turn to hospital emergency rooms first.

This is a problem that may play out across the United States in the wake of the healthcare reform law, which aims to extend health insurance to 32 million uninsured Americans.

“Everybody has a doctor on paper but they can’t get in,” the Family Van’s Bennet said. “The number of doctors hasn’t changed, just the number of people who have insurance.” © Reuters. www.streetnewsservice.org

Issue #10

Toledo Streets - The Paper with a Mission

Dire Means—an interview with the author Marc Goldfinger: I was homeless and upon reading the section of Dire Means where Mark Denny was being treated as if he was homeless, it really brought me back to how I felt in regards to the way people treated me. How were you able to do this so accurately? What experiences in your life helped you write this part of Dire Means?

Geoffrey Neil: First of all, thank you. I have, so far, avoided homelessness, so when a person like you, who has survived both homelessness and drug addiction, says that I accurately portrayed a homeless person’s point of view, it’s an enormous compliment.

I don’t presume to understand the harshness of living on the streets, however, I do know the feeling of being avoided or placed under suspicion for something that I cannot help—my appearance. Trying to date while attending predominately white schools, being pulled over by police and detained and harassed because I “fit the description” and a host of other experiences have given me some insight into feeling “different.”

In some places, if I walk into a store wearing sweats and a baseball cap after not having shaved for a couple days, I see women clutch purses tighter, men keep a closer eye and concern spread on the clerk’s face before I smile to cut the tension.

None of these reactions happen if I enter wearing a tie.

Stereotypes exist and I understand that. I may react to my own prejudices sometimes. These experiences have given me a clear sense of how it feels to be avoided and suspected. To write the scenes in Dire Means from the homeless perspective, I exaggerated the feelings I’ve experienced, hoping to capture the abject feelings of a homeless person when he/she is simultaneously conspicuous and ignored.

MG: The difference between a writer and a stage performer is that writers work in isolation, without immediate feedback. Did you have dark times while writing this book, and how did you get through them GN: I’m okay with the isolation and sometimes I embrace it. I prefer to write with the door closed, in

bed with a laptop. My family can always interrupt me, but generally they don’t. I take the isolation a step further by needing absolute quiet in the room when I write. If I hear music, my sentences come out staccato and screwed up—and it’s much worse if the music has lyrics.

When I turn off the music and read my sentences back, I’ll inevitably hold down the backspace button until the gibberish disappears, and then start over.

As for the “dark times,” becoming too involved in my story is a problem I welcome.

The opposite problem is far more frustrating. A couple of times while writing Dire Means, I felt like I was being sucked into a dark emotional whirlpool. One of those times was while writing Pop’s (the “villain”) perspective on the tour of the underground sty. He took so much pride in his death chambers. In order to illustrate the scientific method (and glee) Pop took while “dieting” those who abuse the homeless, I did some rather extensive medical research on the stages of dehydration and starvation. Initially, I illustrated every symptom in the victims from skin discoloration to liver and muscle glycogenolysis to the agony of a completely dried stomach and nasal lining. (Yes, I agree, that’s too much.) Finally, I scrapped all the physiologic symptoms, realizing it’s just as terrifying to simply describe being sealed in a soft, well-ventilated, underground, suicide-proof chamber with no hope of escape and let the reader’s imagination work out the 10-or-so days worth of details. That section was darker than I expected and I had to write it in shorter sessions.

MG: Tell the readers a little about your life. Go anywhere you choose with this question.

GN: I grew up in a wonderful town in upstate New York called Natural Bridge. My dad was the town doctor, and Mom spent all her time with my two sisters and me. We enjoyed an ideal country lifestyle with a nice house, chickens, ducks, horses, fishing, the most fantastic friends and anything a child could want. I feel fortunate to have

experienced my first taste of life there and still call it home.

After leaving New York at the age of ten, we moved back and forth between the east and west coast three times, settling in southern California. Ours was a fairly conservative Seventh-Day Adventist home, with regular church attendance on Saturdays. For high school I attended a private boarding academy on Sunset Beach in Central California on Monterey Bay. College was back in Southern California where I earned a BA degree in communication, preparing me for absolutely no career. After a number of years in sales, I’ve settled into self-employment, providing computer support to a number of clients in Los Angeles. I’ve always enjoyed writing to entertain and have kept many personal journals over the years. A few years ago a close friend of mine gave me an opportunity to write a weekly column for some local newspapers.

I enjoyed that and decided to take on the task of completing a novel.

I fantasized about slapping a book on to the kitchen table, pointing to it and saying, “I wrote that.” It happened last year with Dire Means and now I have a taste for more.

MG: If, suddenly, civilization all around you was devastated by a storm or an act of terror, etc. and you and your family became homeless, such as in New Orleans, what do you think you would do?

You create the scenario.

GN: I’m an innately paranoid person, so I imagine these scenarios all the time. Living in southern California, the biggest threat to us is probably a devastating earthquake.

My wife and I have taken some preparatory steps. We have some stashed cash hidden within walking distance of our house. We always have extra water on hand and plenty of canned goods. If our car

Page 9

Marc D. Goldfinger

Geoffrey Neil. Photo: Spare Change News, USA

wasn’t crushed in our underground garage, I imagine surviving in our SUV until we could access resources to rebuild. If that’s not possible, I have a number of wealthy friends nearby who would let us stay in their furnished garages or pool houses—and I’ve actually discussed it with one of them! It may sound ridiculous to imagine this, but it isn’t. In California, unless you own multiple homes and a helicopter you keep in your back yard, you could find yourself stranded in a matter of seconds.

Thank you, Marc, for scaring me half to death all over again! I realize that unexpected homelessness is a risk and reality for more people than ever in our economy. For me, realizing my own vulnerability keeps my empathy alive when I see people who need help after experiencing misfortune.

MG: Is writing your primary calling or do you have other major career interests?

GN: I enjoy writing enough to make it a career, but, of course, that’s dependent on sales. I’ll keep writing either way. It has become therapeutic for me. Unlike my computer job, results in my stories always happen just as I wish them to!

MG: What would you tell someone “Dire Means” continued on page 10

Page 10

Toledo Streets - The Paper with a Mission

Issue #10

Getting there Dire Means continued from page 4

finding answers is by contacting 419-243RIDE, with an operator giving you the exact bus number, bus stop location and times.

Q: Is it reliable? Can I count on it?

A: For the most part, bus routes are reliable.

Timing, however, is not. It’s important to be at your bus stop prior to the time listed on the schedule, as buses often arrive earlier (or later) than the scheduled time shown. In very rare situations buses can break down. Generally, they’ll provide a replacement bus, but you can expect a long delay.

Q: Are there other options besides walking?

A: A bicycle is a faster, easier way than walking during the three good seasons, but winter can ruin plans, lose jobs or become dangerously cold without a backup plan in place. Some churches and charities often offer bikes to people in need. Ask around (and see below).

Also, in the greater Toledo area TARTA does offer call-a-ride services for areas that do not have regular routes (Maumee, Sylvania, Perrysburg). To schedule these services, a customer must contact the TARTA office and make arrangements.

Anyone receiving Medicare/Medicaid may have the opportunity to utilize cab services for medical appointments. Check with your insurance carrier or caseworkers to determine eligibility for these services.

Lastly, TARTA offers a service specifically for disabled riders. These services can be arranged by contacting (419)382-9901. ts

On any given night, there are 100,000 homeless veterans in the VA Supoort Network.

continued from page 9

who wishes to pursue a career in writing? Assume that this person is really writing and not just talking about writing.

GN: Write often and a lot, no matter what. And then regularly convince some people who don’t love you to read it, and tell you what they think of it -the majority of their opinions will probably be the truth. Then, if you love writing, keep writing despite what the people said.

If you’re serious about writing you won’t wait for the perfect story to come to mind, or a high powered agent to sign you, or a dream publishing contract; you’ll just write and write. Mark Twain said, “Write for no pay until someone offers to pay.” That’s been my mindset. It requires discipline for me to sit down and write daily when I’m tired and when there’s a perfectly good television nearby. I write a great volume of words each day, but most are technical, for my work. My schedule forces me to do any creative writing in smaller doses at night. I try to do 500-1000 words a session when drafting. On the weekend I can do more. I know those numbers are nothing to some writers, but that’s the pace I seem to be able to afford at the moment.

My personal record was about 4,800 words in one day, but that night my wrists ached; I freaked out and rested four days—ruining any advantage the record gained me!

MG: Dire Means has a Karmic theme. Do you believe what goes around comes around? Or do you think, at times, that life can be random chaos?

GN: Yes, I believe what goes around comes around. My belief in Karma doesn’t preclude my belief in God. I think people who don’t believe in Karma are confused because they insist that they should be able to recognize the form and timing of payback—good or bad. (Who doesn’t want the jerk that just cut you off to get a traffic ticket in the next block?) In my favorite novels, Karma plays out in a simple, much more direct and identifiable way than it does in real life. I think

you’ve correctly detected my fascination with it in Dire Means.

MG: What, assuming your writing career takes off and you find yourself with more money than you ever thought you would make, would you do to help others in the world? Obviously, we pick and choose where we give. Tell readers a little bit about your choices and why you make them.

GN: My wife and I already give a minimum of 10% of all we make to various charities. Our choices are based on causes that we discover and that move us. Having lots of money would change nothing except that we’d be able to give a larger percentage. Homeless charities are always good candidates for our giving and anyone who reads Dire Means will understand why I’ll always give to charities that benefit the homeless.

MG: Let our readers know how to find Dire Means. Talk a little bit about your future plans, both in computer support and writing.

NG: Dire Means is available in soft cover only from online retailers for the time being. This helped to keep it affordable. Barnes & Noble and Amazon are the largest retailers to offer the physical copies for sale online. It now has wide e-distribution and you can have a copy of Dire Means for only $2.99—and that’s after having read a free sample of 50% through Smashwords.com.

Future plans—I’m approximately one-third of the way through my next novel entitled Human Resources. One character from Dire Means has been brought forward. Hopefully this will give some additional satisfaction to those who enjoyed my first book. It will be published sometime in early 2011. Meanwhile, I continue my computer support business in Los Angeles, funding my livelihood and my writing.

MG: Is there anything else you want to tell us about? Open field here.

NG: Yes, I’m flattered that you wanted to interview me—thank

you. I also want to remind readers (if they happen to be homeless) of something that’s easy to forget: that many of us “housed” people truly care about the plight of the homeless even though our concern may not be obvious in public. Some of us want to help, but are fearful— particularly if mental illness or intoxication is apparent. The braver of us volunteer at shelters while yet others prefer to swipe a pen across a check to help.

Out here in Los Angeles, there is a radio talk show host who annually has a special show during the holiday season where he plays soft, soothing holiday music in the background while he invites listeners to call in and simply give their opinion of homeless people. The act is a tongue-incheek exposition of ignorance.

I’m always amazed at how many people call to vent their hatred for those they call “eye sores.” Caller after caller rings in to spew hatred and advertise their ignorance by blasting homeless people for not getting a job. The host says very little, masterfully presenting the irony of “live” hate speech overlaid on soft songs like Joy to the World.

This makes a powerful point and I always get out of my car vowing not to be like the callers.

The theme of Dire Means came from my frustration that goodwill toward men hasn’t been strong enough to solve the problem of homelessness. I decided to channel my anger and frustration into my own dark fantasy where love and a feeling of brotherhood could be forced -as a last resort. I hope that anyone who reads my book will recognize my desire to portray homeless people as important and kindness to them as honorable.

Marc D. Goldfinger is a formerly homeless vendor who is now housed. He can be reached at: junkietroll@ yahoo.com Originally published by Spare Change News, USA. © www.streetnewsservice.org

ts

Issue #10

Toledo Streets - The Paper with a Mission

Hoboscopes SCORPIO | When Vincent Perrugia, an employee of the Louvre, set out to steal The Mona Lisa in 1911, he worked out a plan so complex and detailed that it could have been thought-up by a four year old.

He would hide in a closet on a Sunday night and on the following morning he would walk out of the museum with the world’s most famous painting hidden under his artist’s smock. Amazingly, it worked. Sometimes the direct approach is best, Scorpio. Even if it seems too obvious, you’ll never know until you try. Of course, try to keep it legal. When Perrugia used the direct approach to try to sell the painting to an Italian museum two years later, he was arrested.

SAGITTARIUS | I’ve heard you have a better chance of being struck by lightning than winning the lottery. Roy Sullivan never did win the lottery, but doctors verify that he was struck by lightning seven times during his 35 year career as a park ranger. Sullivan’s seventh and final lightning strike occurred while he was fishing. As he tells it, after the bolt passed through his body, he discovered that a bear was trying to steal the trout he’d caught. Sullivan hit the bear with a tree branch until it left him alone. He says this was the 22nd time in his life he had hit a bear with a stick. Sagittarius, I really have to recommend you stop buying all those lottery tickets. You haven’t even hit a bear with a stick once.

CAPRICORN | The larva of the guinea worm enters the human body through contaminated drinking water.

Once in the body, the parasite creates no harmful effects whatsoever (whew!)... for almost a year. As the worm matures and mates inside of its host, it works its way down, usually into the feet and legs and then begins to burrow its way out.

This is when it really starts to hurt. There have been a few things building inside of you, Capricorn. They’ve been breeding and growing and moving their way down and now they’re finally coming out. It hurts a lot right now and it’s hard, but you’ll make it through the pain.

The important part is that you get these things out in the open and dealt with.

For me, it’s been therapeutic just getting this repulsive analogy out into the open.

AQUARIUS | I know the brake pedal has always served you well in the past, but what’s that other pedal over there to the left? It’s time to hit the gas,

Page 11

Mr. Mysterio Aquarius! This may be an unfamiliar sensation at first. You’ve been weighing all the options, you’ve mulled it over and done your research, you’ve looked both ways more times than you can count. We all know acceleration can be a little scary, but I think it’s time, friend. Don’t just move forward, move forward at full-speed!

PISCES | At last count, there are almost 25 billion chickens in the world. That’s more than four times the number of people on Earth. Personally, I’m not scared. If the chickens rise up against us, it would simply be a matter of making sure every person takes responsibility for defeating four chickens. I’m always ready to do my part for humanity if it comes down to it. What does concern me is all this chicken counting going on. The eggs haven’t hatched yet, friends. Same goes for you, Pisces. You may feel like you’ve set yourself up for an easy victory, but wait till the payments start coming in.

Make sure the money is in the account before you write any more checks.

ARIES | You work hard to push all that anger down, Aries, but it just keeps bubbling back up. The Buddhist teacher and poet Thich Nhat Hanh says that “Just like our organs, our anger is part of us. When we are angry, we have to go back to ourselves and take good care of our anger. We cannot say, ‘Go away, anger, I don’t want you.’ When you have a stomachache, you don’t say, ‘I don’t want you stomach, go away.’ No, you take care of it. In the same way, we have to embrace and take good care of our anger.” So when you start to feel your blood boil, you may want to just throw that feeling away. This month, care for it instead. Treat that anger tenderly.

TAURUS | The common housefly can travel over 300 times the length of it’s body in one second. That must be why this one is driving me absolutely crazy. It lands on my arm and I slowly bring my hand up to swat it, carefully moving closer to it without scaring it away. And then I let go a swing at full force, slapping my arm as hard as I can just as the fly buzzes away. I swear I can faintly hear it laughing and saying “Stop hitting yourself! Why are you hitting yourself?” You may think you’re smarter and stealthier, Taurus, but look at the outcome. You’re covered with bruises from your own open hand. Think this through again, maybe you’re using

the wrong tools.

I hear a rolled up newspaper can work wonders.

GEMINI | 404, Gemini. Future not found on this server.

You’ve been heading through life clicking on everything that looks even mildly interesting and lately it’s just been a lot of dead ends.

Stop! Stand up, turn around three times, jump on one foot for 15 seconds and then hum as much of Swanee River as you can remember. I’m just trying to shake you awake here, Gemini.

Before you make one more bored, disinterested move, look around and notice where you are (or aren’t) going.

CANCER | Quick! What gets ketchup out of carpet? No, besides the dog! Cool it, Cancer, it’s gonna be ok. As a matter of fact, just leave it alone. I know your tendency is to scrub and scrub until every little sign that you ever made a mistake is completely gone. But think of it this way, if mistakes are how we learn, then a stain is kind of like a diploma. Wow, my t-shirt is practically a doctorate. So why not let the world know you’ve been down this road before and survived? Who better to pass the ketchup than one who’s seen it hit the floor.

LEO | They look like good, big, strong hands, don’t they? And you’ve been hanging on so tightly. That’s why it seems strange when, one by one, everything you’ve tried so hard not to let go of flies off, leaving you holding a big fat nothing. Listen and listen good, Leo, that “nothing” may be everything you need. Friends, jobs, food and hobbies have kept you distracted, and have kept you busy and kept you from knowing yourself. Take this opportunity to search inside and find what really makes you who you are.

Find it, look it square in the face and give it a name.

VIRGO | Let’s talk about the difference between millions and billions, Virgo.

Both big numbers, lots of zeroes, what’s the difference right? Think of it this way: a million seconds is about the same as 11

days. You could read a good book in the next million seconds. A billion seconds, on the other hand, takes 31 years.

You could become a controversial yet often-quoted author in the next billion seconds. So, what are you spending your 3 billion seconds on? TV? Worry?

Video blogging? Of course, when it’s all laid out in front of you like that, it starts to feel like you’re running out of time.

Time isn’t after you, Virgo. Just take a few deep breaths, count to a million and you’ll feel better.

LIBRA | Depending on which account you go by, Zeus had between five and twenty wives. Some were relatives, some were enemies, some goddesses, some mortal. One he ate. Metis was a goddess who presided over all wisdom and knowledge. Zeus became afraid of prophesies that Metis’ next child would take his place, so he did the only logical thing. He ate her. Libra, you always think you know what’s coming and what you ought to do about it. Sometimes you go to extreme measures to prevent what you see as otherwise inevitable. But what if you’re wrong? Maybe the next time you think you’ve got the situation figured out, you should let it play out just a little longer. Maybe you’ll regret it, but at least you won’t end up eating anybody important.

Mr. Mysterio is not a licensed astrologer, duck hunter, or driver.

Hoboscopes appear courtesy of The Contributor street newspaper in Nashville, TN Want more from the cornucopia of confounding comprehension? Follow Mr. Mysterio on twitter at: http://twitter.com/mrmysterio

Thank you, Toledo!

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