Closing East Baltimore's Health Care Gap at Charm City Clinic

East Baltimore is home to one of the greatest health care institutions in the country in Johns Hopkins Hospital. But mere feet from its grand golden dome sits one of the poorest neighborhoods in Baltimore, McElderry Park. The area is pockmarked by vacant homes, and many nearby blocks are void of cars and pedestrians. Many neighborhood residents suffer from easily prevented illnesses, but are often unable to access the top-tier services available in Baltimore -- a city saturated with health care facilities and treatment options.  

Charm City Clinic, a non-profit staffed primarily by Hopkins medical students, is working to combat this disparity. Housed on the corner of Jefferson and Madeira Streets in the Men & Families Center, the clinic acts as a conduit between the hospital and the surrounding underserved community.  

Staffers at the clinic have taken steps to ensure that they aren't duplicating the work of other health care organizations across the city.

"I think a lot of existing organizations were doing quite effective work," says Dasha Nikolaeva, co-director of Referrals at Charm City Clinic. "But when people are working in a provisional health care capacity, sometimes that element of following up and addressing big picture issues may fall by the wayside."

While it is important for clients' immediate medical concerns to be addressed, Charm City Clinic workers are also trying to foster a more sustainable approach to overall health in the folks that pass through its doors each Saturday. This includes preventive screenings for hypertension, diabetes, HIV, and high cholesterol. The clinic puts strong emphasis on follow-up visits, regardless of whether or not a client's medical needs demand subsequent treatment.

"I think we want to make it extremely clear that the more valuable work that we're doing is trying to form a lasting relationship with someone, where we get to the root of their health issues and provide them with a long-term care solution," says Andrew Gaddis, director of Fundraising and Recruitment. "Not just taking someone's blood pressure, providing a medical service, and that's it. I think that's what sets us apart from most other established clinics and health care non-profits."

Charm City Clinic focuses on cultivating close relationships with members of the surrounding neighborhood, making them active stakeholders in the overall health of their community. In fact, clinic staffers insist that neighborhood clients are often their most valuable assets.  

"One of the things that we've found is that they've started to come back and help us out," says Michael Rogers, secretary and co-director of Neighborhood Outreach at Charm City Clinic. "They'll go door to door and tell the neighborhood about us. As we move forward that kind of outreach will be valuable, and we try to tap into those networks and their expertise."

Client involvement is now taking a formal role at the clinic, in the form of the new "Block by Block" outreach project. Clinic workers team up with clients and canvas their neighborhood a block at a time, knocking on doors to make sure every resident has access to healthcare.

Charm City Clinic, while it does have Hopkins physicians come through and provide free screenings, is more geared toward helping its clients navigate the dizzying labyrinth that awaits anyone seeking health care without insurance.  

Aside from the paper shuffle, there are other barriers. From problems as simple as a missing driver's license or birth certificate to struggles with substance abuse that mask medical issues, access to health care in Baltimore's poorest neighborhoods can be elusive.  

"The bureaucratic runaround that these people have to go through is unbelievable," Gaddis says. "I have a master's degree and there have been numerous situations where I wasn't sure if I could tell someone exactly what they would need, where they would need to go, or what documents they would need to acquire."

What's more, the clinics operating in the crowded health care market of Baltimore, while providing excellent care, aren't always communicating with one another in terms of what  treatment options they're offering. This can make seeking treatment for complicated medical problems a daunting prospect for those unfamiliar with the system.

In a market with this many options, awareness is often the biggest challenge.  

"I think a lot of people just assume that because they're low income, their only option is to wait until they're sick and go to the emergency room and be discharged and just follow that cycle," says Gaddis. "I think by being open on Saturday, and letting them know they're eligible for programs and they can receive medications at no cost makes a huge difference."

The clinic works closely with a number of existing community organizations, including its home at the Men & Families Center, Amazing Grace Church, the McElderry Park Community Association, and the CARE Community Association. Community activists have been eager to get the word out on the work the local clinic is doing to shorten the distance between resident's doorsteps and the care they need.  

"It's really about serving as an advocate for a client," says Nikolaeva. "Working to empower them by educating them on the resources that are available, and letting them know if they have questions they can always come back. Just having that relationship can be very helpful, and that's what we try to give people."


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Photos by Arianne Teeple

- Daria Nikolaeva, left, Andrew Gaddis, middle, Michael Rogers, right, with Charm City Clinic
- The Charm City Clinic
- Lekeisha Sullivan, left, talks with volunteer Renae Mitchell, right, at the Charm City Clinic
- The Charm City Clinic offers a health care referral center, assistance for low-income Baltimore residents in obtaining health insurance, and other social services including programs for low-cost prescription medications and providing referrals to other non-medical services.
- Michael Rogers, left, and Andrew Gaddis, right, work at the Charm City Clinic
- Volunteer Claire Sampankanpanich organizes paperwork at the Charm City Clinic