For nearly five years, Northwest Human Services’ Outreach Team lugged backpacks and carted a small wagon into Salem’s homeless encampments, treating everything from bug bites to infected amputations.
The team would often scramble to find a vehicle from the organization’s drop-in resource center downtown or at the West Salem clinic to provide a service that’s a step below a 911 call.
“I think it about broke all their backs trying to get services out to people to try to make them a little bit more comfortable,” said Kellee Borsberry, an outreach nurse on the team.
The team includes nurses and community health workers who treat minor injuries and secure follow-up care when needed, in addition to guiding people through signing up for insurance, housing services, food and mental health assistance.
Now, a new van will make their work more convenient for all involved.
The City of Salem contributed $135,000 for the van, and the Willamette Health Council granted $25,000, according to Kristin Kuenz-Barber, the organization’s strategic partnerships manager. The outside of the van depicts Salem landmarks like the capitol building and the Peter Courtney Minto Island Bridge in cheerful blues and greens.
Its drawers store hygiene kits, hand warmers, hats, rain ponchos, over-the-counter medicine, dog treats and more. It took its first drive to a homeless encampment in late January, and operates Mondays through Fridays to find people in need throughout the city.
The outreach team was formed in 2019. With both basic medical care and connections to make clinical care appointments at Northwest Human Services, it’s the only medical outreach team of its kind in Salem.
Northwest Human Services is a federally-qualified health center, which means they provide care regardless of ability to pay and commonly have patients who are uninsured or underinsured. One in five of their patients lack housing, and legal issues, debt, problems with landlords and other life stressors frequently impact their health.
“It’s non-judgmental, meeting them exactly where they’re at and seeing what we can do to make their life a little bit better that day,” Borsberry said, even if it’s just handing them a granola bar. “It’s those interactions that we have to build that rapport and trust.”
The outreach team’s work means they see what happens when someone falls through the gaps in Salem’s medical services for unsheltered people.
Most people they come across have been traumatized by trips to the hospital where they felt like their needs weren’t heard, or worry what will happen to their belongings if they leave their camp, said Justin Davis, an outreach nurse.
“All those barriers prevent them from actually getting cared for, and so then their infection that could have been cured with an antibiotic, now they have deep ulcers and then that ulcer has dead skin cells, then that brings flies coming in and they get maggots. So we’ve seen maggots in people’s legs,” he said.
A major part of their work involves building rapport with people to figure out what help they need, and how to make it last with additional support beyond wound care.
One of their patients came to Oregon to fight wildland fires, and ended up homeless with an opiate addiction. When the team’s community health worker, Jacob Johnston, first met her, she had tunneling abscesses all through her body.
“Her legs just looked like Swiss cheese,” he said. “We made continued efforts to try to get her engaged in a methadone program,” a form of addiction treatment.
Eventually, she ended up spending 45 days in the hospital to treat sepsis in her spinal cord.
The team used the Northwest Human Services’ crisis and information hotline to help reunite her with her family who had been working hard to find her.
“When she’s got the strength and the health, then we’ll have a nice happy ending to this pretty scary situation where all of us kind of thought, ‘We’re not going to be surprised when we find out that she’s passed away,’” Johnston said.
The team takes as long with each patient as needed. Some days, they can treat as many as 50 people with a walk through Wallace Marine Park. Other days, they’ll treat 10 people relatively quickly and find that the 11th person needs hours of help.
Peter Buekea, outreach coordinator, said that complicated systems for securing housing or health care means their work is often a cycle of quests that unlock even more tasks. Getting someone to the homeless coordinated entry assessment allows them to access additional services, which then reveals that they need a state ID card. That means spending half a day driving to DMVs and waiting in line with them.
A recent patient of Borsberry’s had a bone sticking out of her foot which had become infected. Mental health issues and drug addiction made her disorganized.
“Finally (I) get her to the doctor, get the X-ray, get her to the doctor, get her surgery scheduled — yesterday? Can’t find her. So I searched and searched and searched for her yesterday, probably for about two hours. Couldn’t find her. The doctor called me that night, I’m her contact person — she got hit by a car two days ago,” Borsberry said.
“We need to do a better safety net for these folks, so that I would know, so that I could do something different,” she said.
The work is hard, and emotionally draining, the team said. It’s made harder by housed people who have biases toward unsheltered people, said Johnston. Beyond cruel comments, some people once threw fireworks at them when they were treating patients under the Market Street Bridge.
“That’s the hardest thing. Not dealing with the people who are in psychosis, not dealing with the ones who are in the throes of their addictions, not dealing with the people who aren’t willing to engage in their care, it’s frankly dealing with the civilians who have such a bad taste in their mouth and a bad approach and perspective of what these people are dealing with,” he said.
Another key part of the work is making sure their patients feel loved and heard, and that they understand that their lives are irreplaceable.
The new van means they can work faster, and help more people, they said. They’re looking forward to giving patients privacy inside it when receiving antibiotic injections or filling out paperwork to get on the Oregon Health Plan, or get disability or SNAP benefits.
The team agreed that Salem needs an inpatient rehab facility, more low-barrier shelters and more housing to improve unsheltered people’s medical outcomes.
Davis said that the work has shifted his perspective on nursing. Unlike housed people, his patients often can’t get the necessary sleep to improve their heart health, eat their vegetables or store their insulin in a fridge.
“How do I get you to have your things that you need, and they and they don’t get ruined, to take care of your health? It’s like a different mindset of nursing,” he said.
Contact reporter Abbey McDonald: [email protected] or 503-575-1251.
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Abbey McDonald joined the Salem Reporter in 2022. She previously worked as the business reporter at The Astorian, where she covered labor issues, health care and social services. A University of Oregon grad, she has also reported for the Malheur Enterprise, The News-Review and Willamette Week.
