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Hitting the streets in hepatitis A battle

Scott Harpin administers shots

With an armed police officer and grocery cart stuffed with backpacks and suitcases behind him, Scott Harpin snapped on his latex gloves and fished out his supplies from a six-pack cooler.

“Which side?” Harpin asked, as he de-capped a needle. His patient tapped his left arm in response and rolled up his sleeve.

“I’ll try to avoid the ink,” Harpin said, quick with some tattoo-related wit designed for relaxing his patient as he aimed the needle just below the man’s left shoulder.

Hardly the sterile, quiet scene of a medical office, Harpin’s mobile clinic environment that bright July morning included trees, fountains and the roar of traffic as he circled Denver’s central Civic Center Park in search of people in need of hepatitis A shots.

Harpin, PhD, MPH, RN, a University of Colorado College of Nursing and Colorado School of Public Health associate professor, joined a volunteer crew of public health workers focused on halting a hepatitis outbreak largely hitting the city’s swelling homeless population.

“This is my chance to come out and be a nurse,” said Harpin, whose research and community service projects focus largely on the nation’s homeless health issues. “I miss the one-to-one contact,” said the popular instructor, whose genuine smile and upbeat personality worked well with the day’s slightly leery clientele.

‘One shot is better than no shot’

“No, I’m good,” a lone woman on a park bench said, rejecting the free vaccine offer after hearing Harpin and his partner’s spiel about the viral liver disease spreading through homeless encampments nationwide.

“Are you sure? We’re in an outbreak. People are getting sick, and it’s really easy to spread,” said Harpin, co-director of the DNP/MPH dual degree program educating tomorrow’s public health nurse leaders.

Scott Harpin gives shot in Denver
Harpin gives a hepatitis A shot to a homeless person in Denver’s Civic Center Park.

The woman shared a common concern expressed that day — the vaccine requires a booster in six months, a tough commitment with a transient lifestyle.

Although the woman stuck with her decision, a few people changed their minds after Harpin explained an initial dose supplied at least 75% protection (up to 95%) against the liver disease. “One shot is better than no shot,” he told them.

Homeless conditions feed outbreaks

The threat is serious, particularly within large homeless populations. The unsanitary conditions of street living feed hepatitis A outbreaks. The virus spreads through infected stool, including via traces on the ground and unwashed hands. Washing hands with soap and water, often hard for people experiencing homelessness, was a chief message of the day.

Other routes of infection include sexual contact, shared smoking materials and IV drug use, with the opioid and homeless crises both boosting infection.

Although rarely fatal, the disease can kill people with compromised livers, such as those already infected with cirrhosis or hepatitis B or C. And it can make people really sick for as long as six months. A 2017 California outbreak centered on its homeless population, infecting 700 people and killing 21.

On the streets: ‘I can’t afford to get sick’

As of July 31 in Colorado, 106 cases and 75 hospitalizations had been reported in the state.

“Shoot me up,” one man said, sticking out his arm, after learning the disease’s transmission routes.

“I don’t want to get sick,” another man said. “I’m out here on the street, and I can’t afford to get sick. My health is already bad enough.”

With upwards of half of Colorado’s 10,000-plus homeless population entrenched in the Denver-metro area, health providers are offering free vaccine clinics across the city until the threat ceases.

Officer helps with team’s success

“This isn’t even the tip of the iceberg,” Denver Police Department Officer Toby Wilson said of the scores of homeless people filling the park.

Wilson works on the Homeless Outreach Team, monitoring and educating people generally in or near the city’s shelters.

Although it was his first time escorting a mobile vaccine clinic, his caring demeanor and ability to connect with people dramatically increased Harpin’s team’s success that day.

“He’s the hero,” Harpin said of Wilson, who, at times, was convincing people to get a vaccine faster than Harpin could keep up.

Volunteers make a difference

“Before we’d even gotten started, he called us over to check out a man who was sick,” Harpin said of Wilson. The man’s yellow skin and eyes were telltale hepatitis signs, and the team gave him a taxi voucher and sent him off for care.

Hepatitis A symptoms

Yellow eyes or skin, diarrhea, pale stools, cola-colored urine, nausea, fatigue.

“It’s an important drop in the bucket for public health,” Harpin said of his couple of hours of work that morning, which he does regularly. “Even if people have already been vaccinated, we are making connections with them and educating them,” he said. “We are letting them know that we are here for them and that we care.”

To volunteer for the city’s campaign, which has resulted in more than 4,200 people being vaccinated since October 2017, contact Allison Seidel at allison.seidel@dhha.org or 303-602-3587.  

Guest contributor: Debra Melani,  CU College of Nursing.

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The hero and the dental student: A tale of friendship

Willie Peterson is an Army veteran who has lived through his share of hard times. He has learned to cherish small blessings and pay attention to positive role models. One such role model sat across from him over a string of dental appointments which saw Willie’s once-shy smile transform into a mouth of pearly whites.

That person is Bill Berguin, a recent graduate of the CU School of Dental Medicine. Bill has been the architect of Willie’s new dentures and a close witness to the inspired and ever-upward trajectory of Willie’s life.

Willie and Bill at the Heroes Clinic at CU Anschutz
Army veteran Willie Peterson, left, proudly shows off his new teeth, which were created by Bill Berguin, his Heroes Clinic caregiver.

At a recent dental appointment, Willie was all smiles. Besides gaining his stellar teeth, the soldier was excited to fill in Bill about yet another achievement. “Check out my credit score,” he said with a beaming grin. “Also, I’ve got a job. I haven’t had a good job in a long time.”

‘He’s a good man’

Willie met Bill about a year ago when he became the first Pathway 1 patient in the dental school’s Heroes Clinic, a Delta Dental of Colorado-sponsored program which provides free and discounted dental care to military veterans. Pathway 1 provides dental care to veterans served through the Bill Daniels Veteran Services Center, which helps link homeless veterans to jobs.

They come from different backgrounds – Willie is from Wisconsin and Bill hails from the Western Slope – but they bonded during Willie’s many visits to the dental chair. “I got to sit and talk with him about life – where he’s from and what he’s doing and how he was trying to go back to school,” Bill said. A few good-natured jabs also found their way into the conversations. Bill likes to razz Willie about being a Green Bay Packers fan, while Willie dishes it right back on the Broncos.

Kidding aside, Willie once confided to Bill, who was in the fourth year of dental school, that he had planted in the soldier’s mind the notion of returning to school. “I thought that was really neat,” Bill said. “I told him he might want to see a graduation, so he’s going to come to my graduation.”

Sure enough, early last Friday morning, Willie boarded a bus near his Denver apartment and rode to the CU Anschutz Medical Campus to attend Bill’s graduation. He hadn’t been to a graduation since his own from high school some 40 years ago. When Bill said he was looking forward to having his new friend meet his family, Willie smiled, extended a hand for a firm shake and said, “I want Bill to come to my graduation, too.”

Willie Peterson and Bill Berguin at CU Dental School graduation
Willie Peterson shakes hands with Bill Berguin at Bill’s graduation on May 26.

Willie has his sights on becoming a technician in heating, ventilation and air conditioning (HVAC). He recently enrolled in the HVAC program at Emily Griffith Technical College in Denver.

Asked what he found inspiring about Bill, Willie said, “I just think he’s a perfectionist. He’s a good man.” 

Putting his life back together

Willie performed a seven-year hitch in the Army, serving in Korea and Japan and, stateside, in Florida and California. He was discharged in 1983, but soon fell into drug abuse and homelessness. “The whole thing,” he said, shaking his head, “just a few years after I got out of the service.”

Gradually, he began to pay heed to the few positive influences in his life. He reconnected with a Lutheran pastor he’d first met during a spell of living in California. When the pastor moved to Wisconsin, Willie followed and began seeking the clergyman’s counsel.

“He helped me kick drugs,” Willie said. “I needed that – I really did – because I was heading down a bad street.”

Things turned more for the better when he sought the help of his mother. “I was just tired of how I was living, so I had to make a change. I started to hang out with my mom and going to church, and then I got the hang of it.”

About a year ago Willie made the move to Colorado, where his sister lives. Still, life was a struggle, as the veteran didn’t have a place to call his own. The Bill Daniels Veteran Services Center connected him to the Samaritan House, a transitional housing facility. Willie was riding the 16th Street Mall shuttle one day when he bumped into Heidi Tyrrell, RDH, assistant director and clinical instructor in the dental school’s Heroes Clinic.

“He was grinning ear to ear and wearing a suit that was a little too big for him,” said Tyrrell, who also noticed that Willie was in need of some dental work. “He ‘ma’amed’ me and I said, ‘Are you a veteran?’ He said yes and I handed him my card.”

Willie, Bill and Heidi at CU School of Dental Medicine graduation
At the CU School of Dental Medicine’s graduation on May 26 are, from left, Army veteran Willie Peterson, graduate Bill Berguin and Heidi Tyrrell, assistant director and clinical instructor in the dental school’s Heroes Clinic.

That’s how Willie ended up in a dental chair with Bill as his care provider. Growing up in Grand Junction, where he saw many friends join the military, Bill has a built-in respect for veterans and he felt honored to care for Willie. “I treated him the way I treat all my patients,” Bill said. “He’s a really good guy, so it was easy.”

With each visit, Willie’s smile brightened and his sense of accomplishment soared. “One less thing to do,” he said with another big grin.

‘Cool to feel like I was helping’

Willie enjoys his job as a housekeeper at the VA Medical Center in Denver. Besides his recent enrollment in technical college, he now has a permanent home, a new girlfriend and a burgeoning sense of security.

“I’m tired of living poor – I don’t want to keep living like that,” said Willie, sporting a U.S. Army hat and the ever-present Packers lanyard. “I feel good about myself now.”

Bill likes the idea of giving back to veterans and said that of all his clinical rotations during dental school, the Heroes Clinic became his favorite. Willie was even more special in that he is the clinic’s first Pathways 1 patient. “Folks in that population are a little more at risk,” Bill said, “so it was cool to feel like I was really helping somebody out.”

Bill will return to Grand Junction with a goal of eventually having his own practice. His father is a dentist, and he plans to join his dad’s practice to learn the ropes of daily dentistry while paying off student loans.

Bill said his rotation in the Heroes Clinic, especially his time with Willie, will remind him of the very reason he aspired to become a dentist – to help people. “I want to do community service and whatever I can to volunteer and give my time, so I can provide care for people who can’t afford it,” he said. “It’s something I want to continue and not lose sight of.”

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CU Pre-Health Scholars Program’s Community Strengthening Project

CUPS high-school student
CUPS high school student

A select group of young adults with an interest in pursuing health careers receive an introduction to the many diverse opportunities available to them through the CU Pre-Health Scholars Program (CUPS) at the University of Colorado Anschutz Medical Campus in Aurora while they’re still in middle school and high school. The program often takes the students beyond the classroom into the community providing some highly impactful experiences. A Community Strengthening Project provided by the CUPS students to the Comitis Crisis Center near CU Anschutz, in conjunction with the CU Anschutz Medical Campus Office of Inclusion and Outreach, CU School of Dental Medicine’s American Student Dental Association Colorado Chapter, CU Skaggs School of Pharmacy and Pharmaceutical Sciences and Walgreens Pharmacy, included a pancake breakfast, along with free flu shots and take-care bags for center clients. The Comitis Crisis Center provides a safe shelter for individuals and families that find themselves homeless. In addition, the center offers visitors ways to rebuild their lives, support with family emergency housing shelter, daily meals, emergency cold weather shelter 24/7, mental health and substance abuse treatment.

The CUPS junior & senior high school students from around the Denver/Aurora metro area had the opportunity to serve pancakes, sausage, and orange juice to over 40 guests from the Comitis Crisis Center. CUPS participants played volleyball, football, and did crafts with the children.

A Walgreens pharmacist, along with two CU Pharmacy students, administered over 25 free flu shots to guests 7 years old or older.

CUPS high-school students
CUPS high school students
CUPS high-school students
CUPS high school students

Daisy Chapa, a senior from Overland High School and the CUPS class president, said, “It’s incredibly rare that students get an opportunity to sit down with homeless individuals and learn about their background and experiences.” The primary objective for the CUPS participants is to engage them in community service while learning more about the health disparities among the homeless population. In addition to flu shots and pancakes, CUPS participants gathered and donated hygiene items and created take-care bags for children, men, and women. Bags included items such as winter socks, feminine products, soap, lotion, toothbrushes and toothpaste.

Chapa continues, “I had envisioned middle-aged men with drug problems or mentally ill dependents; instead, we met families with tiny children and single parents. Some of these children were happy with their lives despite not having a home to live in or any material goods. They improvised with what they had and saw themselves as no less than anyone else, which is a mindset that even many grown adults fail to adapt to. Having the opportunity to meet with and interact with these individuals showed me to be grateful for what I have and, one day, I will work towards helping those who have fallen on hard times.”

CUPS Program Director Abenicio Rael said, “This was an eye opening experience for many of our students as well as our staff and myself. It reminded me of my own privileges and how to be aware of them before imposing them on others unconsciously.”

“The Anschutz Medical Campus Office of Inclusion and Outreach has done many wonderful things for my pre-collegiate group from exposing us to cadaver-based anatomy to professionalism in the academic world”, said Chapa. “But, the greatest thing they have ever done is remind us to be humble and human by not getting carried away with ignorance or selfishness. The pancake breakfast served as a reality check for some of us, for others, it was a reminder that we are all humans struggling to find one thing- happiness.”

Guest Contributor: Dominic F. Martinez, Ed.D., Senior Director of the CU Anschutz Medical Campus Office of Inclusion and Outreach

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The Turtle Project

Volunteers help Matthews transport donations.

Volunteers help Matthews transport donations.

 

 

As a scientist, Shawna Matthews, PhD, was used to spotting problems and searching for solutions. But when she became concerned about the people experiencing homelessness in her community, the last place she expected to find a solution was in her daily commute to work.

Shawna Matthews

Shawna Matthews

In fall 2015, Matthews began a postdoctoral fellowship researching breast cancer metabolism in the Department of Pathology at the CU School of Medicine la viagra se vende sin receta. She noticed that her new commute required her to carry a lot of stuff between home and the Anschutz Medical Campus. “I left the house every day with a minimum of four bags,” she said. “And throughout the day, I seemed to accumulate more.”

On the opposite end of the spectrum were homeless veterans visiting the Mile High Behavioral Health Center on campus. Matthews observed them struggling to carry all of their possessions. “The contrast struck me and I wanted to do something about it.”

Connecting the campus to the community

Matthews had been looking for an opportunity to engage with her new campus. Her volunteer experience up until then was limited to acting as a science fair judge. But as she encountered the vets on campus and other experiencing homelessness in Aurora, she wondered how she could help.

The solution arrived via social media. On Facebook, Matthews saw her cousin in North Dakota was offering her acupuncture clinic as a drop-off site for the Turtle Project, a campaign that gathers and distributes backpacks and bags for the homeless.

The Facebook post resonated with her. “I sensed that this project could make a difference here,” she said. “My instinct was that CU Anschutz could pool the resources (and excess bags) that we have as scientists to help a population in our immediate community.”

Carrying their homes on their backs

The Turtle Project accepts donations of bags and filler items.

The Turtle Project accepts donations of bags and filler items.

Last fall, Matthews looked into the background of the Turtle Project and learned that the campaign’s name of the campaign refers to the fact that, like turtles, people experiencing homelessness carry their homes with them. The original Turtle Project began in North Dakota, when Fargo resident Whitney Fear learned that the homeless were receiving donations but didn’t have a place to keep their things.

The relevancy of this problem struck a chord with Matthews. “Providing resources only addresses part of the problem,” she said. “People experiencing homelessness also need a way to carry their stuff, and to keep their possessions secure.”

With cooler weather and the holidays approaching, Matthews quickly organized her own Turtle Project at CU Anschutz. She put out a call for bags, personal care supplies and lightweight nonperishable food items. She connected with the Comitis Crisis Center, a division of Mile High Behavioral Healthcare, to receive the bags and distribute them to their clients.

Donate a bag, backpack or supplies to the Turtle Project

Between now and mid-January, the Turtle Project aims to collect at least 200 bags, backpacks, and suitcases.

For more information about drop-off sites on the CU Anschutz campus, or for charitable contribution tax forms, please contact shawna.matthews@ucdenver.edu.

The project was a success. Matthews donated 98 bags to Comitis, whose homeless clients reported loving the bags. At each distribution event, there was more demand than supply, and those clients who didn’t receive a bag looked forward to the next delivery. Purses were especially popular. “The female clients were so excited,” Matthews said. “It’s fun getting a new purse.”

Turtle Project 2016

Matthews’ first campaign for the Turtle Project was such a success that she is organizing the project again this year. With additional volunteers, new drop-off locations, and increased storage space, she hopes to double the size of the collection. As of this writing, she had collected 35 bags in just a few weeks.

For those interested in helping, the project is soliciting donations of new or used bags, backpacks, large purses, conference bags, satchels and wheeled suitcases. These bags can be empty, or they can be pre-filled with small, useful items, such as hotel soaps, toothpaste, toothbrushes, razors, Q-tips, hats, socks, gloves, small flashlights with batteries, ponchos and lightweight nonperishable food, such as granola bars or trail mix.

Other useful donations include items that provide some entertainment, such as playing cards, pen and paper, paperback books and puzzle books. The Turtle Project accepts these filler items, which it can use to stuff empty donated bags.

Seeing the unseen

For Matthews, the project has been a way to connect with her neighbors and co-workers by sharing resources, as well as to acknowledge and help often overlooked members of the community. She’s stepped outside of her comfort zone, but the results have been worth it.

“In academia, you can sometimes feel like you are a small spoke in a very large wheel,” she said. “I think the same thing happens to the homeless. The Turtle Project is a way of saying that we see each other.”

 

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