University of Hawai'i medical students who are offering free medical services at a temporary homeless shelter in Kaka'ako soon may be doing outreach work to other parts of the island with a van donated by the city.

This month, UH faculty and students began running a bare-bones clinic at the Next Step shelter on Tuesday nights.

The shelter, in a warehouse off Forrest Avenue next to the John A. Burns School of Medicine, opened May 1 for people displaced when the city closed Ala Moana Beach Park at night. Shelter manager Utu Langi said about 200 adults and 90 children live there.

About 20 medical students and other volunteers work at the clinic, which grew out of a community service project by three medical students. They have seen about 25 patients each of the past two weeks.

Dr. Shaun Berry, a member of the medical school faculty, said the group expects to have a van from the city next month and hopes to be on the road by fall. The van would offer medical services, perhaps adding social services later.

It would go out once a week, to whatever areas are not being served by van programs offered by the Waikiki Health Center or the Wai'anae Coast Comprehensive Health Center, said Dr. Jill Omori of the medical school faculty.

Carrie Marshall, a medical student, said she is especially looking forward to using the van to help people in the homeless camps along the Wai'anae Coast. Homeless advocates have reported a growing homeless population there in the past few years.

"I think the homeless situation on this island has reached a point where people can't ignore it," Marshall said, looking around the crowded warehouse in Kaka'ako. "I feel like this is why I went into medicine, seeing this."

Darlene Hein, who heads the Waikiki Health Center's Care-A-Van Program, said for best results, a van program should have a strong social services contingent as well as medical care.

The Care-A-Van runs five days a week on all parts of the island except the Leeward Coast, which is served by the Wai'anae Center van.

"We see 80 to 100 people a day," Hein said. "They're all homeless."

She estimates that 40 percent of them have medical insurance, mainly because her group has invested an intensive effort to get people to sign up for state and federal insurance programs such as Quest and Medicare. She has four nurse practitioners supervised by a medical director at the center, and 10 outreach workers.

Yvonne Santos, case management supervisor at the Wai'anae Center, said its van serves the Wai'anae Coast plus Kalaeloa.

The van goes out twice a week with a nurse, a social worker, an eligibility worker and a legal aid worker. They help link homeless people to providers of medical services, mental health services and employment and housing.

Berry said the medical school would consult the other van programs to ensure there is no overlap or conflicting efforts.

The clinic and the van effort all grew out of a requirement that first-year medical school students conduct community health work.

BAKE SALE FUNDRAISER

To do their part, Marshall; Keith Errecart, a self-described Hawai'i military brat who grew up near Hickam Air Force Base; and Jason Pirga of Waimalu decided to participate in an effort being run by Berry and Omori.

"At first we were going out to Ala Moana park, doing surveys to determine what homeless people needed," Marshall said. But the city closed the park at night and the homeless left. "Then when they opened Next Step so close to the medical school, it offered the perfect opportunity."

The students no longer had to go out and look for the homeless; they were practically on their back doorstep.

"The city closed the park and the state opened the shelter — that gave us the opportunity," Pirga said.

Omori and Berry used a federal grant to start the program to help the homeless, but that money was earmarked for administrative costs. The clinic operates with donated medical supplies from Wahiawa General Hospital and the medical school, free labor and some money from fundraising efforts.

"We started out with $1,000 raised at a bake sale," Marshall said.

The warehouse is awash with small cubicles. People hang blankets for a bit of privacy. Inside the tiny rectangles, there are little pieces of furniture, makeshift beds, stuffed animals, TVs, photos of children on the walls.

MAKING 'HOUSE' CALLS

At the clinic's vitals screening area, a family from Chuuk — three women and several small children — were getting their ears examined. Medical students crowded around them, shining lights down their ear canals. The women sat patiently, holding screaming, wriggling babies.

"We see a lot of chronic disease, diabetes, high blood pressure, thyroid conditions. Along with skin diseases, the basic flu, colds, ear infections," Marshall said. "We haven't seen any infectious diseases like hepatitis yet."

Randen Bolten, who moved to Hawai'i from the Marshall Islands, was being examined for a skin disorder on his feet.

Bolten said he is "struggling right now" but hopes to get a full-time job so he and his girlfriend can find a place. The clinic is a big help, he says, because he has no insurance.

Eugene Freeman, 37, who has lived at Next Step "since day one," was being examined for a cold. His blood pressure was taken, his throat examined, his chest tapped.

"It's helpful," Freeman said. "It's really helpful."

Daisy Asuncion, a third-year medical student from Waipahu, made a "house call" at one of the cubicles. A man with an abscess on his arm lay on a mattress, as his wife explained to Asuncion that he was thrown against a reef while surfing.

Asuncion had the abscess lanced, and the man was given antibiotics and painkillers.

Berry said a survey of the shelter's residents showed that 70 percent of them have some form of medical insurance.

Social workers from Waikiki Health Center help people with no insurance apply to state or federal programs that might cover them, said Langi, the shelter manager.

Reach John Windrow at jwindrow@honoluluadvertiser.com.