Taking It to the Streets

The Family Van reimagines community health care during COVID-19

For more than 28 years, The Family Van has been a familiar sight in some of Boston’s most under-resourced neighborhoods. The Harvard Medical School mobile community health program works to reduce health disparities in Boston by bringing medical services directly to neighborhoods with the largest prevalence of preventable disease.

Four days a week, the mobile health clinic visits neighborhoods in Roxbury, Dorchester and East Boston. Van workers screen clients for blood pressure, cholesterol, blood glucose, glaucoma and depression, also offering family planning services, pregnancy testing and HIV counseling.

One-on-one counseling is provided to help clients make healthier choices for better health outcomes. Clients may also ask for help understanding a diagnosis or treatment plan. Referrals are provided for health insurance, housing, employment and other needs.

The services are furnished in clients’ preferred languages and with an understanding of their cultural backgrounds.

“The Family Van is the knowledgeable neighbor,” said Rainelle Walker-White, The Family Van’s assistant director.

In her 26 years working with The Family Van, Walker-White has become close with many clients, some of whom call her “Aunty Rai.”

“We are there each and every day,” she said, “meeting the needs of each and every person, touching the lives of people that other people would look over.”

When the coronavirus pandemic hit and public health guidelines encouraged physical distancing to slow the spread of the virus, Family Van workers and volunteers had to rethink a service model that relied on face-to-face interactions.

“Pre-Covid … people would get on board [the mobile clinic],” said Walker-White. “We would give hugs. We would give touches. … It’s a part of healing and people had an opportunity to just speak what they needed to speak, feel what they needed to feel and say what they needed to say, and be heard.”

“During the pandemic, we had to really think creatively,” she added.

The Family Van began began calling their clients at home to check in.

“A lot of them were isolated,” said Walker-White. “A lot of them did not have family members that could look after them. They loved that somebody called them each and every day just to say how are you. They loved us for just reaching out and touching them via phone call.”

New clients can call The Family Van seven days a week and be connected with volunteers who can answer their questions about COVID-19 and provide counseling and health care referrals.

The Family Van has also gone into communities to distribute COVID-19 information in multiple languages, along with face masks, diapers, baby formula and grocery store gift cards with funding from the Boston Resiliency Fund.

Much of the creativity and flexibility to respond to the coronavirus came from volunteers, according to The Family Van’s volunteer program manager, Beatrice Antoine.

“Our volunteers—even at a time that is so difficult to grasp—they still want to help and encourage our clients as much as they can and empower them in any way they can,” said Antoine.

Masks were needed at the time and a lot of The Family Van’s clients did not have them, Antoine said. So, one volunteer, a local college student who had returned home after her Boston-area campus shut down, organized a mask-making drive at her university.

“All of a sudden I would open the door and see all of these boxes of masks arrive at my door,” Antoine said. “I could have 500 masks delivered. This was all organized by one person. This was an effort to show that anything counts. Anything you can do to help is something worth acknowledging.”

Caring for the community

Joanne Suarez joined The Family Van almost a year ago as a community health assistant. Living in East Boston she had seen The Family Van in her neighborhood and heard from neighbors about the work the program did.

“I said, ‘I have to be a part of that,’” said Suarez. “When I came on board, I just felt alive. I still feel alive today.”

Suarez completed a master’s degree in in bioethics at Harvard Medical School this spring. She values the work she does with The Family Van and the way it allows her to support her community.

“Every day—whether I’m on my computer coordinating services or I’m out in the community—I know that I’m doing what I need to do to take care of my community.”

While the impact of the coronavirus is unprecedented in recent memory, in many ways the extraordinary circumstances brought about by the pandemic have laid bare the circumstances that necessitated The Family Van program in the first place.

“This pandemic has really highlighted some of the issues that we already know are existing in our communities,” said Suarez. “It has widened the chasm of how health disparities are impacting Black and brown communities.”

“Justice is a long haul, and I’m very fortunate to be a part of the Van, that we’re doing this work,” Suarez said.

Humble service

Nancy Oriol, The Family Van’s leadership council president and faculty associate dean for community engagement in medical education at HMS, co-founded The Family Van in 1992. At the time she was the director of the Division of Obstetric Anesthesia at Beth Israel Deaconess Medical Center. One of her patients had been hospitalized after having a seizure, she said. The patient had been experiencing headaches for weeks but hadn’t wanted to "bother her doctor," Oriol said.

The experience made clear for Oriol the importance of meeting patients where they are and of treating all patients with respect and care.

“Our students learn firsthand that trust, cultural humility and respect are essential components of health care,” said Oriol of the medical students who have volunteered with The Family Van.

Looking back over the service The Family Van has provided for almost 30 years, Oriol is awed to see how the program has grown.

“Working with The Family Van team has been amazing,” Oriol said. “Seeing how a simple idea has had ripples that went across the city—in fact, across the country—and into generations of medical students. It’s just…it’s awesome, that’s all I can say.”

Reflecting on her own tenure with The Family Van, Walker-White echoed Oriol’s gratitude.

“It has humbled me,” Walker-White said. “If we look at people with eyes of love then we’re going to be able to prepare them, and we’re going to be able to take care of them the best way that we can.”