Homeless in need of community support

During the bombing of Kosovo, Dr. Ashley Christiani was part
of a UCLA mission that joined the International Medical Corps to
help refugees. She remained in the region for two weeks, but the
conflict redirected her career in Los Angeles to care for the
city’s homeless. Now a medical director at Homeless Health
Care Los Angeles and the Union Rescue Mission, Christiani spoke
with the Daily Bruin about her experiences.
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Daily Bruin: How did you got involved with working with the
homeless?

Ashley Christiani: In medical school we learn a lot about
deductive reasoning , the scientific method, rational thought
processes, and coming to a diagnosis. Many times I would say,
really, the most important things are the ability to listen and to
connect with the humanity of the patients you are caring for
““ regardless of their ethnicities, their language, their
cultural backgrounds ““ you find that common thread to provide
support for them … and we had the opportunity to do that in
Kosovo.

DB: How long were you in Kosovo for?

AC: I lived in Kosovo for two weeks and then the bombing ended.
… It was very short, but it changed my goals for my career and
life.

DB: Were you involved in working with the homeless
before?

AC: No, I wasn’t at all. … It was just one of those
experiences where you feel like, this is it ““ this is why I
became a doctor. I realized there is a probably a similar
population back home, that we have our own refugees.

DB: What is your role in getting UCLA involved?

AC: With primary care, one of my goals has been to allow
students to have the opportunity to have something like what I had
in Albania, which was that students learn the joy of helping those
that are really extreme cases.

DB: What concerns you most with what you see? Do you think
homelessness is a bigger problem in Los Angeles than other cities
in the United States?

AC: Los Angeles definitely has a large homeless population. On
any given night there are about 8,000 homeless. It concerns me that
there are more women and children because that is a particularly
vulnerable population. With the economy being down, I feel they get
hit the hardest ““ and I feel like I see it first. … The
concern I have is that there doesn’t seem to be a clear
solution to the problem, although I’ve been working with a
group, the Skid Row Collaborative, all of the service providers in
Los Angeles and Skid Row are finally coming together to create a
network where we can figure out how to best care for the homeless
people.

DB: Where does the funding come? Does UCLA offer
anything?

AC: There is no financial funding; it relies on volunteer work
and faculty giving up their Saturday mornings.

DB: How does working with the refugees compare with working
with people here?

AC: It’s actually very similar. The difference is most of
our homeless are using substances ““ either alcohol, cocaine
or other drugs, heroin is a big one ““ so they are almost more
debilitated than the refugees. And they also, to a large extent,
lack social support. They have no family, or they have a deviant
social support, like other users, so part of the challenge is to
create an enriching network system of support for them.

DB: What do you think can be done on a long-term
basis?

AC: The approach would be to, one, get universal health care.
It’s amazing actually how many people I treat who became
homeless because of their medical conditions. They couldn’t
pay for the medical bills. … Also, the community needs to
recognize they are only as strong as the weakest link, and all of
us need to come together to work on stamping out poverty and
homelessness ““ and from a political standpoint, understanding
some of the issues that feed into homelessness. It’s amazing
how much pressure we have got, not in Los Angeles, but from the
federal government, not to have things like needle exchange
projects. … We need to understand substance abuse and addiction
and some of the behavioral or psychological forces that create
homelessness. We need to address those to be effective.

DB: Right now do you see the war on drugs as helping or
hurting the problem?

AC: I don’t see it as clearly related … but Proposition
36, which allows those convicted of non-violent drug related crimes
to get treatment, was probably the most effective piece of
legislation we have come across.

DB: What progress do you see over the next decade? Where do
you want it to go and where do you think it will be?

AC: I would like to see Californians come together and recognize
the importance of treating mental health issues, substance abuse
and provide the answers. … Universities, particularly UCLA, need
to reach out to the community. That creates a situation where
everyone benefits. The community receives the attention it needs
and our students are reminded of what brought them to medical
school in the first place: the joy of serving others and feeling
like they are really connecting with other human beings and being
reminded of the richness and value of human life.

Interview compiled by Rachel Makabi, Daily Bruin senior
staff.