A worldwide pandemic. Loss of your home, loss of your country, loss of your extended family. You don't speak the language. You are quarantined in an emergency shelter for months with your mom and older siblings all living in one room.

And you have an uncomfortably itchy, painful medical condition on top of all that. And no long-term connections to healthcare providers who can help. And no transportation to get to one.

Sound a bit overwhelming?

The giggling 3-year-old girl who put her face and arms close to the computer screen did not seem to be thinking about any of the above. She just wanted to laugh and play ... though she couldn't help scratching the irritated, red, peeling skin on her arms and face. Over the previous 8 months, her mom could not overcome the many barriers to get her to a doctor.

Because this little girl happened to be in a shelter where staff truly cared and wouldn't stop until she had appropriate care, this story has a good ending.

The little girl's dedicated case manager brought her to a CHOP health education class where she could virtually meet Melissa Bennett, MD, medical adviser for the Homeless Health Initiative at Children’s Hospital of Philadelphia (CHOP). She in turn connected the little girl to a local pediatric allergist friend (who generously offered to see her without charge) and to CHOP Allergy and Dermatology. HomeFront Family Preservation Center staff facilitated scheduling appointments and arranged for transportation; they helped find a long-term primary care doctor in Trenton, NJ.

They also identified a volunteer grandmother who spoke Spanish to support the entire family regularly. CHOP Allergy also offered a translator at her medical visits. HomeFront nurse Linda Sichel, BSN, MPH, has also advised and supported the recommendations of the medical specialists.

This is one of many stories of how HHI has worked TOGETHER with an incredible team of people to lift and support one family in need.

Worry and Action

During the pandemic, the staff at CHOP HHI have worried about the many families like the one here. Are they healthy, and do they understand COVID risks and precautions? Are they stressed? Are they able to connect to primary and specialty care? Are information, resources and telehealth visits available to them and, if so, do families know about these options?

HHI has tried to navigate these unprecedented waters over the last year. We are working with healthcare networks to explore testing and telehealth options. We collaborated with infection control experts to develop safety plans for the day in the future when we can return to in-person shelter visits. We have tried to connect to families by computer and phone.

Problem Solved

One successful connection occurred right at the beginning of the pandemic. During our February CHOP Night visit to a local shelter, we met a family new to the shelter and new to Philadelphia.

The 11-year-old child needed to find a new primary care provider. We referred the family to the Nicholas and Athena Karabots Primary Care Center, but when mom called to make a new patient appointment in March, she was told that they were not scheduling new patient visits due to the pandemic. She called me for guidance. I learned that there was a CHOP network-wide rule that new patient visits would not be scheduled for children who did not need immunizations.

Mom told me that her child needed immunizations, so I called our incredible PSR at Karabots, Juanita McKnight, for help. As always, Juanita came to the rescue! She helped mom work out some insurance issues and scheduled her child’s visit for June.

While she waited for her child’s appointment, mom took advantage of our weekly virtual health/wellness support workshops. She received compassionate advice from our intimate partner violence, PriCARE and medical resident volunteers on how to support her and her child’s emotional health while living in shelter.

On the day of the child’s scheduled appointment, mom arrived to find that Karabots was closed. Again, she called me for help. I found out that Karabots had closed early that day due to local protests of the murder of George Floyd. Unfortunately, mom had not received the call that the office would be closing early. Fortunately, Karabots Medical Director, Kari Draper, MD, acted swiftly to get this child’s appointment rescheduled. The child is now up-to-date on immunizations and connected with high-quality, compassionate care at Karabots.

HHI is so grateful for the strong relationships and teamwork with our shelter partners, hospital experts, resilient families, and generous volunteers and donors. We do not know what the future holds, but we do know we can — and will — work together to understand and meet the needs of families experiencing homelessness and crisis.

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