October 29, 2003
Phone: (504) 865-5714
I never saw homeless kids before I started working here, and now I see them everywhere," said Eddie Bonin, director of the Adolescent Drop-In Center. The kids have always been there, of course. But if you're not aware of them they're easy to overlook.
Lately they've become more visible thanks to an article in Rolling Stone focusing on "gutterpunks" drifting through New Orleans, and subsequent articles in the Times Picayune.
The problem with the media attention is that it has contributed to a less-than-friendly backlash from the police and the business community in the French Quarter. The Adolescent Drop-In Center was founded more than 10 years ago by Sue Ellen Abdalian, associate professor of pediatrics and adolescent medicine, who still serves as the medical director of the center.
It's funded through a variety of federal, state and local grants, and through donations to the Drop-In Center fund, which pays for things not covered by the grants. The center is located on Rampart Street, a block outside of the Quarter, where many homeless kids hang out. It has two parts. Located downstairs is the Health Care for the Homeless clinic, which provides free medical services to those under the age of 24 who are homeless or at risk for being homeless.
Up the graffiti-littered staircase (where the kids have permission to "tag") is supportive services, which is open four days a week to provide homeless kids with washers, dryers, showers, phone and Internet access, snack food and clean socks, as well as case management, HIV-prevention groups, and general assistance in finding jobs, shelter or whatever else is needed.
A separate clinic is run two nights a week and on Saturday morning to provide reproductive healthcare for at-risk youth, whether or not they are homeless. The center actually serves two distinct populations, according to Bonin. There are the inner city kids, mostly African-American, who find themselves homeless, and there are the transients who circuit through the country by hopping trains or hitchhiking.
"A lot of them are living in abandoned buildings, or doubling or tripling up in substandard housing. They could be living in a car or moving from house to house, what we call 'couch-surfing,'" Bonin said. No matter where they came from or where they're staying, the center is seeing more of them. "This year has been busy," he said. "When the economy heads south, we see more people in the streets. Generally, July and August are slow months, but this year we didn't slow down."
Bonin, who is a nurse practitioner, serves dual roles as clinician and administrator. He and another nurse are at the clinic every day. Abdalian sees patients there twice a week, and residents from Tulane University School of Medicine and nursing students from several schools also help out. Bonin's goal in the clinic is to provide as much healthcare as possible in one visit, because he may never see the patient again.
Those who come in for an HIV test will get a full physical while they wait for results. The clinic is one of the sites that offer a new HIV test that yields results in 20 minutes. Staff also can refer patients to dental and eye clinics for the homeless, and to the pediatric units at Tulane or Charity for problems that can't be handled on site. The biggest challenge has been providing mental health services.
Recently, a psychiatrist from Louisiana State University has begun coming in once a week for four hours, which helps, but isn't enough. "We see a lot of kids who have been abused, who have mental disorders or substance-abuse problems," Bonin said. "We do what we can, but we often can't refer them to services in town because they don't have identification."
Bonin was recently named chair-elect of the steering committee of the Health Care for the Homeless Clinicians' Network. Health Care for the Homeless is a federal program of which the New Orleans clinic is a part. Facilities for both adolescents and adults are under the Health Care for the Homeless umbrella. Research has shown that adolescents are more likely to seek care if they have access to a clinic dedicated to their age group, or at least separate access to a general clinic.
"There haven't been a lot of adolescent providers on the steering committee, even though quite a few of the clinics around the country are dedicated to adolescents," he said. "I'm happy to be in a position where I can have a say in federal policy and reduce some of the barriers to care."
Heather Heilman can be reached at firstname.lastname@example.org.
Tulane University, New Orleans, LA 70118 504-865-5000 email@example.com