Mobile asthma clinic makes its debut at Berkeley school

Outside the Breathmobile at Malcolm X Elementary School, Oct. 18, 2012. Photo: Emilie Raguso

A mobile asthma clinic designed to keep kids in school and out of the hospital debuted Thursday at Malcolm X Elementary School in south Berkeley.

The Breathmobile, a 33-foot-long Winnebago RV, drew inquisitive looks and questions from students throughout the day. The vehicle was parked in the school courtyard to offer easy access to families that signed up for its first day ever in Berkeley. The program, which provides free asthma and allergy treatment, has ties to ongoing city-wide efforts to target the achievement gap and bring more accessible healthcare to a high-risk population.

Dr. Washington Burns of the West Oakland-based Prescott-Joseph Center for Community Enhancement brought the Breathmobile program to the East Bay in 2009. It began in Emeryville and has since expanded to serve 18 sites around the Bay Area. It’s the only one of its kind in Northern California, according to Burns’ staff, though there are also about a dozen other Breathmobile RVs that operate across the nation.

The Breathmobile is a kid-friendly environment. Charts and diagrams about asthma and respiratory health are surrounded by kids’ drawings. Photo: Emilie Raguso

Nanci Armstrong-Temple, a Berkeley mother with twin kindergartners at Malcolm X, said she signed up for an appointment for her daughters after seeing a flier at school.

“One of my daughters was coughing a lot after running, and both get allergic reactions to things like pollen and cats,” she said Thursday. “The appointment answered questions I’ve had for a long time.”

Armstrong-Temple said the on-site visit was much less disruptive to her daughters’ schedule than a typical doctor’s office visit. Instead of missing, for example, part of lunch, afternoon classes and their after-school program, the girls had an hour-long visit inside the Breathmobile then immediately returned to their normal activities.

Armstrong-Temple also said she appreciated the Breathmobile team’s expertise regarding asthma and allergies, as well as the kid-friendly environment. (Drawings by dozens of children decorate the walls and ceiling of the RV, surrounding charts and diagrams about asthma and respiratory health.)

“You definitely have some new fans,” she told one of the nurses after the visit.

Dr. Janet Berreman, who runs the city’s public health office, said bringing the Breathmobile to Berkeley is part of the city-wide 2020 Vision campaign to close the achievement gap by the year 2020.

“I think sometimes, in the 2020 Vision conversation, it’s been a little bit hard to communicate how health is involved,” she said. “And I think that, with asthma and school attendance, there’s a really clear connection. People understand that, if your child has asthma, and you don’t have access to care, your child can miss a lot of school.”

Berreman said data have shown for quite some time that black children under 5 show significantly higher rates of hospitalization due to asthma than other children. A range of factors, such as physical environment, limited access to care and higher levels of stress, can all contribute to the inequity, she said. As a result, children in this group are more likely to miss school and fall behind.

“We know that kids who are healthier do better in school, in part just because they’re there,” she said. “Kids who do better in school end up healthier and living longer the entire rest of their lives. The health and education nexus is a two-way street.”

Berreman said the city public health department has been working closely with Berkeley schools to find a way to address the problem in hopes of narrowing the achievement gap.

Enter the Breathmobile. Because the service is located on school campuses, time spent missing class is minimized. Instead of several hours, or longer, spent seeing doctors or waiting in an emergency room, children are in and out in 30 minutes to an hour.

Berreman said city health workers teamed up with the Berkeley Unified School District to help identify which schools had the most children with asthma and asthma-related absences. The health department then helped broker an agreement between Berkeley schools and the Prescott-Joseph Center to bring the Breathmobile to Berkeley. The van will begin with monthly visits to Malcolm X and has plans to add Rosa Parks Elementary to its rotation in the spring.

Keiko Barfield, a Prescott-Joseph Center staffer who helps run the Breathmobile program, said the results of the service speak for themselves. Families sign up for appointments and begin with an hour-long assessment, then return for follow-up visits every four to six weeks.

Inside the Breathmobile at Malcolm X School, Oct. 18, 2012. Photo: Emilie Raguso

From its start in September 2009, through August 2012, according to data collected from patients by Breathmobile staff, families have reported drastic reductions in emergency room visits, hospitalizations and school absences.

The 283 patients seen by the Breathmobile health team reported a drop in ER visits from 247, in the year prior to being connected with the program, to 11 after starting treatment. The group reported 92 hospitalizations in the year prior to receiving Breathmobile care, and just four afterward. School absences for the group dropped from 613 days to just 38.

“We haven’t been around that long, so to have these kinds of dramatic results over a three-year period is pretty spectacular,” said Prescott-Joseph Center Deputy Director Diann Castleberry. “We’re very pleased with the results, and we want to continue to do this work.”

Inside the van, patients find an intake station and small waiting space, along with a testing area for vital signs and skin allergens, as well as an exam room. The Winnebago has two computer systems, a health risk assessment system for asthma, a screening module for pre-diabetes, and an electronic medical records system called “AsmaTrax.”

The health team inside the Breathmobile includes a doctor, nurse practitioner, nurses and patient services coordinator.

Barfield said all the records collected during Breathmobile sessions are shared with primary care physicians “so they also know what’s going on. We’re just there to provide the specialty care.”

The Prescott-Joseph Center provides all services free of charge with the help of individual donations, along with grants and foundation support from organizations like the Bay Area Air Quality Management District and the California Endowment.

Fast facts on asthma via the Prescott-Joseph Center 

  • In California, about 1.5 million children aged 5 to 17 have asthma. That’s about one out of every six kids.
  • In Alameda County, one in four children in this age group has asthma.
  • Black children visit emergency rooms at a rate four times higher than Hispanic and white youth and 12 times higher than Asian/Pacific Islanders.
  • Of all the cities in Alameda County, Oakland has the highest rate of emergency room visits, 40% higher than the county rate.
  • In West Oakland, black children are five times more likely to be hospitalized for asthma than other ethnic groups.
  • 20% of all children and 37% of all adults have asthma in West Oakland.
  • Other areas with similar demographics, such as southwest Berkeley, Emeryville, parts of Contra Costa County and Bay View Hunter’s Point in San Francisco, have similar asthma problems.

Related:
2020 Vision aims to close achievement gap in Berkeley [10.18.12]

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  • Lhasa7

    Can anyone suggest treatment resources for uninsured, low-income adults who have asthma symptoms? A friend of mine who was asthmatic in childhood recently began showing symptoms again and needs to see a doctor.

  • bgal4

     

    I fully
    support the Breathmobile, that said,  

    Data
    shows that youth violence is responsible for hospitalizations in Alameda County
    at a higher rate than other CA counties. This is the result of Alameda
    County’s  inadequate response to youth violence. At the local level this
    includes the 2020 Vision, which still has not discussed youth violence despite
    evidence that victims of youth violence are at the greatest risk for academic
    failure, AOD use and high risk behaviors.

    This article allows me to connect the dots because of my personal experience
    with the inherent hypocrisy and enabling of youth violence by the agencies we
    rely on,  such as the west Oakland center
    spotlighted in the story. 

    In
    Sept 2007 I called Dr Burns to inform him that the Center theater director’s
    sons were responsible for a violent robbery of several teens connected to my
    family  including one young man who required medical treatment.

     

    I
    identified the perpetrators through an internet search for their gangster rap
    names. I located a wealth of information  since their mother is a self
    promoting theater artist benefiting from civic arts grants. She also gained
    notoriety for a serious accident involving one of her sons.

    http://www.sfgate.com/bayarea/article/East-Bay-artists-rally-to-help-burn-victim-2818474.php

     

    Several
    of her sons are known  multiple police agencies for robberies, illegal drug
    and gun sales.

    Video
    of their  gangster rap group.

    http://www.youtube.com/watch?NR=1&v=H1ddPCcCm6k&feature=endscreen

     

    But
    perhaps the greatest ironies I discovered is this :

    http://www.berkeley.edu/news/berkeleyan/2006/09/28_violence.shtml

    New UCB ISSC center probes causes and prevention of youth
    violence. Visiting-speakers program launches next week.  Focusing on high-risk teens and their communities.
    Youth Violence Prevention Speaker Series
    Ayodele Nzinga: “The Art of Envisioning
    Change”
    Ayodele Nzinga is the founder and director of the Lower Bottom Playaz at the
    Sister Thea Bowman Memorial Theater in West Oakland. Working with a diverse
    group of actors, including many West Oakland residents, she has adapted Macbeth
    to create Mack: A Gangsta’s Tale (on stage Oct. 6-15). Nzinga will discuss her
    adaptation of Macbeth and the way her theatrical troupe moves between Ebonics,
    classic Shakespeare, and spoken word to express graphically the anger and
    anguish of living in violent conditions. She will explore the connections
    between expressive arts, violence prevention, and the fostering of social
    responsibility though enactment of story.

     

  • southberkeleyres

    I wonder how much of the dark particulate matter comes from Chevron’s refinery.  I hope that the recent fire will lead to them doing the right thing and upgrading to the newer Clean Air requirements.

  • UnderPressure

    Good questions. This is what scares me about Measure T. What type of R&D will be conducted in our flats? What will happen to our air quality due to increased traffic?

  • Anonymous

     Oh my, I haven’t thought about Nzinga since she lit her poor kid on fire. I still can’t believe she wasn’t charged for that and it sounds like the other six kids wouldn’t have been any worse off without her. It’s so…appropriate that she’s somehow hustling money from BUSD though.

  • Anonymous

     Apparently if you make a comment about Nzinga pouring gasoline on her son’s head and lighting him on fire your comment gets removed.

  • The Sharkey

    Some of that crud on your car is dust from our crumbling asphalt.

  • The Sharkey

    Whatever it is, it’ll be cleaner than heavy industrial business like Pacific Steel.

  • The Sharkey

    Ayodele Nzinga had heard somewhere that gasoline was effective for killing head lice,
    and she was applying the fuel to her son’s hair in her Berkeley kitchen on Sept. 18 when a spark from the pilot light on her stove flared, and the boy caught fire. Koran Akindele Jenkins, 13, was severely burned over 22 percent of his body, particularly his head and hands, from which he lost most of his fingers.

    Why on earth didn’t Child Protective Services take her kids away from her?Anyone stupid enough to douse their child in gasoline is obviously a danger to their children.

  • Guest

     If the kids of Berkeley got to go to their neighborhood schools (and therefore walk or ride their bikes), that would certainly reduce a lot of vehicular emissions. Rather than walk to one near our house, we were assigned to one we have to drive to, forcing us to use our car twice a day. People in my neighborhood had their kids assigned to the school in our zone even further away. All of this driving contradicts the city’s goals for reducing emissions. It would also make much healthier kids and families.

  • Guest

    I wish there were something like this for vaccinations.  The vaccination rate at Berkeley elementary schools is deplorable and only a tiny fraction of that can be accounted for by the personal beliefs exemption. 

  • Jaiwaggoner

     Yet Berkeley is one of the very few districts who provide free bus service for elementary school students. Hundreds of students take the bus every day rather than being driven.

  • The Sharkey

    Moderators, why are comments about the news story that @bgal4:disqus posted about Ayodele Nzinga dousing one of her children in gasoline being deleted?

    Is there a specific posting guideline that these comments violate, or is this a case of moderators censoring opinions they don’t agree with?

  • Guest

    Bus service is only available to people who live over 1.5 miles away (and they seem to calculate it as the crow flies). Plus, with working parents and afterschool activities on each campus, the bus isn’t able to take many of those kids home.