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Care by the Some walked over from a grove of trees. A few arrived by car. One rode a bike and another pushed a stroller. They left with food supplies, personal hygiene and health items -- and a warm feeling that someone cares about them.
vanload helps
those in need
Waikiki Health Center's
Care-a-vans need care too
Care-A-Van program helps
homeless live easier
Outreach an uphill battle
By Helen Altonn
Star-BulletinActually, on this day, two people cared: Bryan Talisayan, a homeless specialist and outreach worker, and Carmen Fisher, a nurse practitioner, who had pulled up at a Leeward Oahu beach in the Waikiki Health Center's Care-A-Van.
"They do plenty good," said Troy, a fisherman who drove up with his girlfriend, Charlotte, and two dogs.
He asked for "something for itching" because of a rash, while Charlotte sought advice from Fisher for a swollen thumb, injured in a car accident, and picked up some vitamins and personal items. "The staff is really nice, plus services," she said.
Talisayan gave the couple an application for state QUEST health benefits and said he would mail it.
Debbie, pushing 15-month-old Anella in a stroller, said she had been living in a van at the beach for a month because of "a situation I couldn't help."
Talisayan is helping her look for an apartment. He gave her some supplies and a toy phone with candy for the baby. "I'll see you next week," he said. "Don't disappear."Talisayan, 26, also works at the Waianae Coast Comprehensive Health Center as an HIV counselor and tester and provides social services one night a week to prostitutes in Waikiki.
Fisher, 41, has other jobs at Friendly Neighbors, providing volunteer services for the elderly in Waikiki, and at Kapiolani Medical Center at Pali Momi.
They love the Care-A-Van program. "We're going on rounds providing health care to people who otherwise wouldn't come," Talisayan said.
"Instead of draining you, it's rewarding," Fisher said. "I always go home feeling good about it."
She said they try to give everyone respect and unconditional assistance. Additionally, they help people obtain medical benefits and housing, and provide bus passes to help them get to doctors.
Vans provide medicine, food
The Care-A-Van carries ointments, bandages, vitamins and other supplies to meet minor medical needs and prevent health complications. The nurses consult with a doctor when necessary.They treat a lot of bug bites, cuts and abrasions -- the biggest medical problems among the homeless, Fisher said. "We follow more chronic problems, such as blood pressure and psychoses, and prescribe medicines we have."
"We find out the most adamant need," Talisayan said. For example, he said, the first priority of a woman with a child may be to stay away from an abusive husband. "The ultimate goal is to get into housing."
"Even though that's a good thing," Fisher added, "it's so stressing to move into an apartment on their own ... We monitor them; we want it to be a success."
Someone who has been homeless for years doesn't know how to live in an apartment, Talisayan said. "We have to try to educate them, to transition them into services."Just going to a grocery store created anxiety for one woman, Fisher said. "She was thinking she was living on the beach. She forgot to buy anything needing refrigeration."
Another homeless woman didn't know how to use a shower because she had been using garden hoses.
"People are afraid of change," Talisayan said. "They miss the camp fire and night sky. They develop a culture and bond that way."
They also fear for their safety, even within four walls, Fisher said. "Especially women. They're always on the alert."
Jo Ann, 49, had her blood pressure taken by Fisher, picked up a few items and went to some trees where she spread her blankets on the ground. She said she was living on the beach because of "something within the family" and wouldn't apply for welfare "because they keep doing me in."
Besides, she added, "what's the sense of living on a tropical island if you can't be near the ocean?" She had lived under a bridge and on a sidewalk and prefers being at the beach under the stars. "We're -- how you say -- friends of nature."
But Alvin, who's lived in his car on the beach for 13 years, wants a change: "It's hard sleeping in the car. It's hard to shower. It's hard to go to work. It's cold."
He last worked at the airport as a carpet cleaner and was looking for another job. But the water pump in his car was broken and he had no money to catch a bus.
That's why he wasn't doing yard work at the Ewa Historical Mansion -- community service required for a traffic violation, he explained.
He was given a bus pass, some vitamins and food, and sat in his car eating his lunch -- clam chowder straight out of the can.
Two dogs played around the car. "Someone dumped them and I take care of 'em," Alvin said. "They're just like me -- homeless."
Beach is their home
Norman, 42, who lives in a van and travels by bicycle, complained about "outsiders who come and dump all the rubbish" on the beach, where he said he's lived off and on for 29 years. "That's the problem. This is our house."He said he can't work because of a pinched nerve that affects his balance and causes numbness in his hands, but a doctor won't sign his disability form.
He asked for snacks but the van's supplies were down to canned beans and fruit.
'We love you, too'
Talisayan said he was saving some rice for "Uncle Richard," who maintains the beach park for no pay and acts as the residents' human resources person. The white-bearded old-timer is the only one at the Leeward beach with electricity. Hence, he's the popular owner of a rice cooker.Talisayan delivered mail to Richard that was sent to the Care-A-Van office in Waikiki, while Fisher treated a hand injury and gave him a tetanus shot for cuts.
"We're trying to have a program to update people on immunizations," she said, pointing out homeless people get a lot of cuts and scrapes that can be life-threatening. The Care-A-Van also would like to offer flu shots, she said.
Asked if he needed anything else, Richard accepted some cereal. He already had peanut butter and books and was reading a Readers Digest medical book.
As the van pulled out, Richard told the health team, "I love you guys."
"We love you, too," the two responded.
The Waikiki Health Center's two Care-A-Vans are giving out. The facility is seeking donations to replace the vans, worn out after more than 10 years of service. Van program
pushes limits
of resources"Adding one also would be good, but that's a major dream for us," said Lisa Dunn, the center's program director.
Nurses and outreach specialists travel around Oahu five days a week in the two vans, giving homeless people medical care and friendship. They distribute hygiene supplies and food, which are donated. The Care-A-Van program's three part-time nurse practitioners provide direct health care and can prescribe medicine, Dunn said.
"If someone needs antibiotics, they can take care of it then and there at a beach site. Otherwise, they have to figure a way to get them to the clinic. It increases the capacity to provide medical care."
The Care-A-Van office, at 421 Launiu St. in Waikiki, also is busy with homeless people dropping in for services or to pick up mail they can have sent there.
The staff includes Patricia Glancey, Care-A-Van program coordinator; Kai Takayama, intake specialist; Jon Nahmias and Bryan Talisayan, outreach workers and homeless specialists; Lisa Perry, Joline Labbe and Carmen Fisher, nurse practitioners, and Terri Buford, mental health outreach worker.
Demographically, they find mainly single people living at Leeward beaches, a lot of families with little kids on the North Shore, and older people on the streets of Waikiki.
Many dogs accompany the beach people, Fisher said. "Most are big dogs, for safety and companionship."
Glancey said the teams do a good job helping people who are ready to get off the streets and beaches.
"Many are mentally ill and don't see a problem being there. They think it's their calling to be there, or that they're unsafe anyplace else."
Most frustrating to workers is knowing some people are harming themselves and they can't do anything about it, Glancey said.
"They have to watch them go downhill and hope the person survives until the person gets to imminent danger, and they can get them in someplace."
By Helen Altonn, Star-Bulletin
The gray-haired woman sat in a back pew of St. Augustine Church, her head down on a plastic bag of belongings. Homeless outreach
often an uphill battleMental illness is common;
many clients resist getting
the help they needBy Helen Altonn
Star-BulletinTerri Buford and Carmen Fisher had been looking for her.
Buford, a mental health outreach worker, and Fisher, a nurse practitioner, are with Waikiki Health Center's Care-A-Van. But homeless people in Waikiki who need help don't go to the van. The workers have to go to them -- on foot, toting medical supplies on wheels.
"It's so overwhelming," said outreach worker Bryan Talisayan. "We're looking for people we're not even sure we'll find in the park."
Buford sees at least six people every week in Waikiki, and others sporadically. "They are very mobile," she said, noting she recently saw one at the airport.
Mental illness is a big problem among homeless in Waikiki, she said, but it's difficult to get them into a hospital if they aren't an imminent danger to themselves or others.
"One should be in a care home but she is not willing to do anything," Buford said, referring to the woman in the church. After finding the woman, who appeared to be in her 70s, Buford and Fisher spoke quietly to her.
"I've never seen you like this," Buford said. "I'm concerned. Would you like a juice?"
The woman asked for a pad to write on, saying she needed an address book. She also asked for a particular skin medicine. She held out some dollar bills.
Buford told her not to worry about money, that she would get the items and bring them to her in the afternoon.
"I'll take vitamins, too," the woman said. "What do you have for a cold?"
Buford asked if she wanted to see a doctor, but got no response.
"How are your legs doing?" Fisher asked. The woman said she was exhausted and couldn't sit up. She wanted something to swallow for her cold.
"Do you want me to look? Do you think you need an antibiotic?" Fisher asked, getting no answer.
The woman took vitamins from Fisher, but wouldn't let her clean a bandaged leg.
"If I peel it off, my leg starts weeping," she said. "I need water to rinse and rinse and rinse and there is no restroom to do it in."
"You want to take care of that so it doesn't get worse," Buford said, offering several times to pick the woman up in a taxi and take her to the health center for treatment.
When the woman resisted, Fisher said she would return to the church in the afternoon with water to wash the leg.
Buford headed to a nearby store to get the woman a soft drink. She said the woman was "fairly coherent" that day, which was unusual.
How did she end up sick, alone and homeless?
Fisher often asks herself, "What is their story? How did it happen? There are a lot of very alone people in Waikiki," she said. "Friends or family move to the mainland and as they get sickly, they rely on volunteers.
"Physically, they can't leave easily, and mentally, they don't know where to go (for help)."
Buford found a client she has had for about two years sitting at a concrete table at Kuhio Beach. "She talks about her son. She talks about her husband. Where are they?" Buford asks.
At Honolulu Zoo, she and Fisher found Sharon under a big banyan tree with her coffee, ashtray and all her belongings.
Buford offered to look for her birth certificate and try to find her parents. Sharon said she last lived in a house on the Big Island, where she was raised. She never accepts anything from Care-A-Van workers. Some homeless people are paranoid, Buford explained, noting a male client who wouldn't take a Granola bar until she ate one. She has to be creative -- but is never deceptive -- to get homeless people to accept her. It took six months in one case. Many have been to shelters and won't go back, Fisher said. "They don't see that as a positive step."
"They're out here," Buford said. "It's so frustrating. I'd like to do so much more."