Treating "Slum Housing Disease"

Published on
January 22, 2011

Image removed.Dr. Rishi Manchanda wants to practice smart medicine. From a clinic in South Los Angeles, he told the California Health Journalism Fellows, "It is not smart to take a cockroach out of an ear and just send that child home," Manchanda says.

Manchanda is the director of Social Medicine at St. John's Well Child and Family Center, a network of clinics that see 40,000 patients per year at 10 sites in Los Angeles. The Center couples medical care with community activism and some unexpected services for patients. The Fellows visited the Center before taking an unusal tour of the Figeuroa Corridor, about two miles north, with Roberto Bustillo, a tenant organizer for Strategic Actions for a Just Economy (SAJE).

Fellows R. Jan Gurley, Roseann Keegan and Ryan ZumMallen tweeted about the tour and shared photos. National Health Journalism Fellows visited a rundown apartment in the same neighborhood last year.

Back at the clinic, Healthy Homes Healthy Kids, has seen over 8,000 chuildren with housing-related health problems since September, 2009, and addressed not only their health problems but the conditions of their housing that causes those problems. Machanda remembers one young patient who had rashed from bed bugs. A pediatrician at the clinic wrote a letter to the landlord of the building where the patient and her family lived, asking for improved conditions and citing building codes. A community health promoter delivered the letter and followed the case. Ultimately, the landlord not only improved the building's condition but was exposed for overcharging on rent. The patient's family got a check from their overpayment.

The Center's Medical-Legal Community Partnership combines patient care with legal services. Unsurprisingly to those familiar with South Los Angeles, the majority of the community's medical legal problems had little to do with access to health care -- the most common complaints were about housing conditions and food access.

Jim Mangia, president and CEO of the Center, makes this declaration: "There is a health and human rights crisis in South Los Angeles. When a patient walks into the exam room, we're not only treating the symptom -- we're treating the cause of the disease," he says. He showed California Health Journalism Fellows a video that introduces health and social justice in the neighborhood.