Aug 3, 2012, 11:55 AM, Posted by Roseanna Means
Roseanna H. Means, MD, is the founder of Women of Means, which provides free medical care to homeless women in the Boston area, a clinical associate professor at Harvard Medical School, and an internist on the attending staff at Brigham and Women’s Hospital in Boston. She is a 2010 Robert Wood Johnson Foundation Community Health Leader.
The prolonged recession of the last four years has hit many people hard. My work is taking care of homeless women, which I have done for the past 20 years. I lead a team of volunteer physicians and part-time paid nurses who provide free walk-in care to women and children in Boston’s shelters. We fill in the gaps left by larger, more bureaucratically rigid systems that put unrealistic and unattainable expectations on those who are disabled by extreme poverty, mental illness, trauma, and cognitive dysfunction.
I designed a program of “gap” care that brings health care to them. We act as the communication and advocacy bridge between the shelter/street world and the hospitals and health centers. Gap care is part of a continuum that I feel has an important role to play in health care access for vulnerable populations.
Here is a glimpse of our work.
Walking into one of the women’s shelters on a recent morning, I see a woman standing glumly in line for coffee, her hands chapped and shaky, her face pale and dry, a blanket heaped around her shoulder, pouring hot liquid into her body before staking out a cot where she can sleep for a few hours, let her guard down, away from the doorway where she was prey to drunk men who jumped her, raped her and stole her stuff.
She is hungover. She drank to escape the horror of having been attacked. She has been on and off the wagon so many times we have all lost count. She’s also been raped and stabbed more times than any of us can remember. She doesn’t go to the police any more. She’s just one more homeless woman who has been raped, a “nobody”; just more paperwork. I give her a hug and remind her that I love her no matter what. I know that she has a library of negative and self-loathing messages in her head. Mine is the one that can break through that chatter and give her a shred of self-respect.