R oving enterprises are hot these days, with food trucks and carts making up the biggest share of New Haven’s mobile services ecosystem. But some industrious locals have dabbled in smaller niches—retail, coffee, lawyering, even barbering—using buses, trucks and vans, including one “van” that’s been on the streets since well before mobile took off.
Its specialty? Healing.
For 22 years, the Community Health Care Van has been providing medical attention to poor, underserved communities with speed and agility. Staffed by two to three healthcare professionals at any given time, the CHCV gives patients access to primary medical care, STD screenings, drug treatment assessments and more. The average wait time is 15 to 30 minutes, they say—at most an hour for more involved cases—sometimes with no wait at all.
This medical Swiss Army knife wasn’t always so multipurpose. When Dr. Frederick L. Altice started the CHCV in 1993 it was designed as a mobile needle exchange service to help curb the spread of HIV via intravenous drug use. It began with a Dodge Caravan minivan, then moved up to a box truck, then graduated to its current state: a 40-foot bus, like a blue whale among New Haven’s many mobile fishes.
The bus’s custom interior approximates the layout of a clinic, with sliding accordion doors for privacy. It has a waiting area, an intake room, an exam room, a Direct Observation Therapy room and a driving area that provides a little extra space when needed.
The CHCV provides physicals; blood pressure checks; glucose screenings; pregnancy tests; HIV and Hepatitis C testing and treatment, plus rapid testing for a variety of other STDs; free condoms and sex education; screenings for entry into drug treatment; tuberculosis testing; and, as it always has, free needle exchanges.
According to Sharon Joslin, an Advanced Practice Registered Nurse and the CHCV’s clinical director, one of the biggest advantages to having a health clinic out on the street is that it reduces barriers to service. The staff lowers them further by wearing casual everyday clothes instead of imposing white lab coats, and by speaking both English and Spanish. Almost everyone aboard speaks Spanish, and wait times—perhaps the most important barrier to health care for the demographics the van serves—are often short enough to get patients in and out over the course of a single lunch break.
When I walked on the bus, Angel P. Ojeda—an HIV counselor, research assistant and driver who’s been with the CHCV for 14 years—sat in the intake room with a Hispanic man in a neon-green construction shirt. The patient had shown up during his break without an appointment and was seen virtually immediately. During the screening, Ojeda discovered the man’s blood pressure was extremely high and told him to start taking blood pressure medication immediately. About fifteen minutes after his arrival, he was on his way back to work, with potentially life-saving knowledge.
In New Haven, where it can take months to get an appointment with your primary care provider, that’s a huge gain.
The CHCV operates in three locations throughout the city. Twice weekly it’s at 580 Ella T. Grasso Boulevard (near Columbus House) and 1308 Chapel Street, and, every first and third Thursday, it parks at 210 State Street. While Dr. Altice no longer rides on the bus, he remains the CHCV’s medical director, wherein, among other duties, he obtains most of the van’s funding through grants. But limited funds means the van can only operate on weekdays, and only in mornings. In any given session, CHCV staff estimate they see 12 to 20 patients a day, many of whom are either uninsured (they’ll still get served), in a rush or find the big blue bus more inviting than a big institutional sickbay.
Working on a bus isn’t for everyone. “You’ve got to be able to rock and roll like you’re on a boat,” Joslin tells me. Everything needs to be strapped down and put away in special secure shelves so that pens, vials, tape dispensers and medical tools don’t go spilling on the floor upon shipping out. Even the mouse of the onboard computer has its own rubber seatbelt.
Handling patients quickly also comes with the territory. She finds it satisfying getting people back to work fast, adding that working on the bus gives her a greater sense of being close to the community.
It’s a pretty healthy outlook to have while doing the hard work of giving others a healthier outlook.
Community Health Care Van
Office: 270 Congress Ave, New Haven (map)
Mon & Wed, 8am-12:30pm, at 580 Ella T Grasso Blvd (map)
Tues & Fri, 8am-12:30pm, at 1308 Chapel St (map)
1st & 3rd Thurs, 9am-11:30pm, at 210 State St (map)
Written and photographed by Daniel Shkolnik.