Below a Highway 99 overpass, and sandwiched between the D Street homeless shelter and the railroad tracks, is an unlikely beacon of hope for Merced residents low on luck. It’s an RV that houses Golden Valley Health Center’s mobile health clinic for the homeless.
Nick Arellano, 55, has come to the mobile unit to see Dr. Salvador Sandoval, the homeless clinic’s doctor. Arellano has long hair and blue eyes that shine from his weathered face.
“How are you doing?” Sandoval asks.
“OK, I’m in a little pain, still,” Arellano responds. “As a matter of fact, not a little pain, I’m in a lot of pain. As you know, the change of the weather increases a lot the pain. I’ve run out of my sleeping pills also.”
Arellano is looking for relief from the chronic pain stemming from a construction accident. He’s also looking for help kicking a heroin habit that’s haunted him for more than 40 years.
The doctor asks if Arellano has ever been on a methadone program for his heroin usage.
“Yes, I was on one for two years, but it seems like my body doesn’t accept it,” Arellano says.
“The heroin, or the methadone?” Sandoval asks.
“No, the heroin is fine!” Arellano responds good-naturedly, and both laugh.
The doctor leans against the wall, and looks directly into Arellano’s eyes as he asks him about his health and living conditions. He asks when Arellano last used drugs.
“A good five weeks, longer than that,” Arellano pledges.
Dr. Sandoval will see Arellano, and about eight to twelve more patients, during the weekly, half-day clinic. The clinic costs between $3,000 and $4,000 a month to operate. It receives no grants, and is funded solely through employee contributions and community donations.
But what the mobile clinic may lack in resources, it makes up in heart. The passion starts at the top, with Sandoval. He believes that, “ultimately, we need a health care system that’s fair and that’s available to everyone as a right.”
Sandoval’s been practicing medicine in Merced for about 35 years. He’s an old-school type of physician, who still visits the homes of elderly patients, and makes an effort to connect with each of his patients.
He says he’s always been driven by a mission to help the underserved, especially the homeless.
Of his patients, he said, “some of them have drug problems, some of them have mental illness, but I think those things need to be addressed societally. They are humans.”
He’s seen ranks of the homeless swell during the economic crash. That’s created an even greater need for the health clinic. It takes patients on a first-come, first-served basis, and is almost always booked to capacity.
“Lately, I’ve been seeing people that never thought they would be homeless,” he said. “Like a nurse, a guy that was doing public relations for a major company, a public relations person for the city, a person that was doing psych tech, an instructor at the college, people that were truck drivers, construction, people that probably, if you talk to them five, ten years ago, would probably say, ‘no, I’d never be homeless.’”
If anyone’s familiar with the homeless population’s need for medical care, it’s Sandoval. He’s been caring for the homeless off and on for about 15 years. Before the doctor began offering care to the homeless through the mobile unit, he did it from the trunk of his car, using medicine samples donated by other local doctors.
“I kept all my equipment, supplies there, and I’d take them into the National Guard Armory during the winter,” he recalled.
Golden Valley launched the mobile clinic about five years ago. Today, it’s one of the few places where the homeless can see a doctor, and receive medications, at no cost. Patients can also get free dental extractions and vision exams, through the Golden Valley network.
Take it from 38-year-old Zane Howard. He lives in a tent in a homeless encampment. He was at the clinic last Tuesday to get the results of some blood work.
“I think there’s a big misconception that just because you’re homeless, you qualify for the medical assistance program, and let me assure you, that’s not the case at all,” he said.
He was stabbed in the back, and has a two-foot knife wound. He turned around, and pulled up his brown shirt to reveal the scar.
“I went to the health department, but I wasn’t in the hospital long enough and don’t qualify.”
Beyond that, he comes to the clinic to see Dr. Sandoval.
“Dr. Sandoval is absolutely amazing,” he said. “He’s a very thoughtful, compassionate person. He’s just listened to everything I’ve had to say.”
Dr. Sandoval’s work at the mobile clinic is supported by a receptionist, a medical assistant, and eight student volunteers from UC Merced. He hopes it evolves into a student-run clinic, where undergraduate and medical students can gain on-the-ground healthcare experience.
Already, many of the students, like the patients, say Dr. Sandoval is a major draw for them. Isidro Ramirez is one of them.
“I think he’s a very well-rounded community physician,” said Ramirez, a UC Merced graduate who’s been volunteering at the clinic for about two years. “He’s very compassionate, he’s down to earth. I just can’t describe it – he’s a very humble, caring man.”
Ramirez is inspired by Dr. Sandoval’s dedication to the homeless. It’s shaped his future medical goals.
“It’s been I think life-changing in the sense,” Ramirez said of his experience at the clinic. “It paints a bigger picture of how medically underserved communities such as this are. Working with the homeless gives a whole dimension to working with those most in need.”
Inside the clinic, Dr. Sandoval is finishing up his visit with Nick Arellano, who winces as the doctor gives him a cortisone shot in his arm.
“Does this mean I’ll be able to sleep tonight?” Arellano asks.
“Hopefully,” Sandoval replies.
“Oh my god, God is good, God is good,” Arellano replies joyously.
He also prescribes Arellano medication for his chronic pain.
“I wish I knew you better a long time ago,” Arellano tells the doctor. “My body probably wouldn’t be as destroyed as it is.”
With the help of Dr. Sandoval and the homeless clinic, Arellano now has a fighting chance.