When third-year Yale School of Medicine (YSM) student Kedous Mekbib tested a New Haven community member’s blood sugar while volunteering with the Neighborhood Health Project (NHP), he saw the levels were dangerously high. Mekbib also observed that the individual displayed symptoms of hyperglycemia. Mekbib and a faculty attending encouraged the individual to go to the emergency room, but the individual was hesitant because of concerns about the cost of an ambulance. Mekbib says NHP paid for an Uber, to ensure the individual received the immediate medical help he needed.
This is one example of NHP’s important role providing free blood pressure and blood sugar screenings in the New Haven community. Yale medical, physician associate (PA), nursing, and public health students volunteer at the NHP, while a rotating set of 30 faculty serve as attendings. Public health student Jessica Ainooson ’22, the NHP’s budget/supplies director, states “while blood pressure and blood sugar screenings might appear simple, NHP provides an essential and consistent health care access point for members of the New Haven community, who might not have regular health care access.”
For the many NHP patrons with high blood pressure and the 20-25% with high blood sugar, NHP provides information about how to address these issues—and for the sizable number with no primary care provider, it connects patrons with providers at Cornell Scott-Hill Health Center, HAVEN Free Clinic, or Fair Haven Community Health Care for additional care.
NHP operates through a collaboration with Loaves and Fishes, at the nonprofit’s Saturday morning food and clothing pantry at New Haven’s St. Paul and St. James Church. Mekbib is very grateful to James Cramer, Loaves and Fishes’ executive director, for doing “so much for the community and making NHP possible.”
Yale School of Nursing (YSN) student and NHP flu clinic/special projects director Kathy Doan ’21 says, “our patrons are oftentimes our most underserved community members, whether it be in lacking housing or food, health insurance coverage, or basic access to care.” Some are undocumented immigrants, reluctant to provide their name, and many others are homeless or unemployed.
NHP medical advisor Jeffrey Bender, MD, Robert I. Levy Professor of Medicine (Cardiology) and professor of immunobiology, notes that many patrons become long-term repeat visitors, including some he has seen over the 15 years he has been involved with NHP.
When NHP was founded in 2002, only medical school students were involved. According to Doan, NHP has “grown exponentially in terms of community awareness, patron attendance, and student/volunteer engagement.” Just a few years ago it served 8-12 patrons each Saturday morning; pre-pandemic in 2020, that had increased to 30-40.
Bender, Yale Health CEO Paul Genecin, MD, and YSN Professor Robin Whittemore, PhD, APRN, serve as NHP’s medical advisors, while Akinosun, Doan, Mekbib (attending director), YSM student Daniel Jacobs ’21 (volunteer director), and YSN student Alexandra Mountford ’21 (YSN liaison/finance director), served as its five directors this year.
Bender notes that NHP provides students an opportunity early in their education to work on interdisciplinary teams, under the supervision of an attending, performing health care screenings and engaging with members of underserved communities. Mekbib, who was responsible for scheduling the attendings each week, is grateful that busy faculty members spend Saturday mornings at NHP, adding they are “amazing” at helping patients and teaching and mentoring students. Bender reciprocates this praise, “the students are amazingly dedicated,” and notes they engage with patrons in a manner that creates trust and demonstrates they truly care about the patrons.
The student and faculty volunteers believe NHP’s role in the community is critical during COVID-19, although the pandemic required it to temporarily shut down from March through September. Ainooson explains, “while we wanted to serve the community, we also did not want to risk spreading a virus that has had a disproportionate impact on the community we are meant to serve.” When it reopened, operations had to be changed to ensure the safety of community members, attending providers, and student volunteers.”
The safety measures implemented at NHP included operating outside, requiring all volunteers to have a COVID test pre- and post-shifts, and to wear face shields and surgical masks. Screening tables were at least six feet apart and equipment was thoroughly wiped down between patrons. NHP purchased some automated blood pressure cuffs to reduce the need for close contact. Patrons were required to pass a COVID-19 screening process, including temperature check, and wear a mask. The number of volunteers was reduced significantly to avoid unnecessary exposure and crowding. Over the 10 weeks of fall operations, no students or attendings tested positive for COVID-19.
These measures reduced NHP’s capacity. Ainooson notes that while the Loaves and Fishes food pantry is busier than pre-pandemic because of COVID-19’s impact on the economy, “for many people, a health screening might not be their number one health priority, especially if they have to wait outdoors on a cold day.” But Mekbib says over time, the number of patrons seeking screening rose to almost 30 per session, close to the pre-pandemic numbers. He adds that the data from October and November reflected that blood pressure and blood sugar numbers were generally worse than pre-pandemic. Mekbib wonders if this is because patrons with PCPs have become disconnected from the health care system during the pandemic, demonstrating “how important our services are. If we are not there, some people may slip through the cracks.”
Ainooson says that even while NHP was closed, they stayed connected with patrons. For most of this period, the food pantry was operating, and NHP donated supplies including cleaning materials, masks, and hand sanitizer. Doan coordinated a mask-making project in which individuals around the country took out their sewing machines and made 500+ reusable cloth masks to give to patrons alongside their food and clothing services. Additionally, the NHP’s YSPH intern, Deyri Garcia ’21, created informational pamphlets about health management during the pandemic, thousands of which were shared with patrons over the summer.
Doan says that during the pandemic, it was especially important that NHP provided its free fall flu clinic, through which YSN volunteers vaccinated 50 people.
Bender believes the relationships NHP has with patrons will be critical when the COVID-19 vaccine is available to the general public. “They trust us, so if we say getting a vaccine is the right thing to do and is really important,” there is a greater likelihood they will get it than if that relationship did not exist.
Doan says, “in spite of the obstacles that stood in the way of us re-opening, our student board was able to quickly adapt and devise safe alternatives to protect patrons while still providing services that they have come to rely on at NHP since 2002.”