In New York City, behind the closed doors lining the halls of single-room-occupancy hotels, hide some of the city's most desperate populations. The homeless, the addicted and the HIV-positive find a temporary refuge from life on the streets in the cell-like dwelling units of these emergency-housing facilities.
Many residents are sick and need care.
For nine years physician Chinazo Opia Cunningham (WCAS90) has worked as the point woman at New York's Montefiore Medical Center, organizing doctors to enter SRO hotels in the Bronx and Harlem and provide medical treatment and services to these forgotten patients. "These people lead invisible lives in our society," says Cunningham.
The hotels are often places of violence and drug abuse, marked by filth and cockroach infestations. Because residents cannot satisfy even their most basic needs, many don't consider health care a top priority.
"We have fundamental problems that we haven't addressed in this country, like poverty, homelessness and drug use," says Cunningham. "If people don't have housing, it's hard to imagine how they could take a very complicated medication regimen."
But when a high proportion of residents of these SRO hotels are HIV-positive or living with AIDS, going without treatment can mean death or other dire consequences.
In an effort to make health care more accessible to people living in SRO hotels, Montefiore Medical Center partnered with the community-based organization CitiWide Harm Reduction to provide lifesaving programs. The program started out as an outreach operation to encourage residents to leave the SRO to seek medical care. By 2001 Cunningham and Daliah Heller, former executive director of CitiWide, secured a grant to allow doctors to join workers, knock on doors in the housing facilities and provide full medical care on site, focusing specifically on the needs of HIV-positive patients.
Today teams of three to five people, including one doctor, one CitiWide staff member and one peer worker, make weekly visits to about 15 SRO hotels. They serve between 400 and 500 patients overall.
Since becoming involved with the program Cunningham has worked with CitiWide to offer more services, including expanding care to the organization's drop-in center in the South Bronx and also starting a program to treat heroin addicts.
"Our health care system is failing in so many ways, and one of them is that we tend to be very uniform in our thought process about how the system should deliver care," says Cunningham, who is an associate professor of medicine at the Albert Einstein College of Medicine. "I hope that in developing these programs that people may see that there are other ways to address these specific problems in these specific communities and think outside of the box."
The ultimate goal of Cunningham's innovative programs is to transition patients into treatment with a regular provider. Many patients in SRO hotels avoid care because they have suffered from discrimination during past experiences in the health care system. Cunningham's programs rebuild trust, and that is reflected in Cunningham's own bedside manner.
"She treats people like human beings," says Heller. "She's very comfortable and allows people to be themselves, and patients respond to that as we all would."
Cunningham, who grew up in Cupertino, Calif., credits her Northwestern education and her experiences on the Wildcat softball team (the two-time academic all-district honoree was the 1987 Big Ten Freshman of the Year and the conference batting champ in 1990) for giving her the skills to work with many kinds of people as well as manage her busy schedule. Today she balances her time between finding funding to keep the programs afloat, treating patients and raising three daughters with her husband, Everett Cunningham (WCAS90), a vice president at Pfizer.
While that balance can be daunting, she carries on against the seemingly insurmountable obstacles of homelessness, poverty, drug abuse and HIV/AIDS because of the hope she has for those she treats.
"I think that there are definitely patients who after years of struggling with these obstacles have really turned the corner, have been able to control their drug use and have gotten on HIV medication and improved dramatically," says Cunningham. "They now live in apartments, have jobs and have really gotten their lives together. That is unbelievably powerful. To see this at the personal level, that's what brings me back day after day."
— Lauren Price (J08)
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