Mobile clinic brings care to rural vets

REPUBLIC, Wash. – The Spokane Veterans Affairs Medical Center’s mobile clinic brings health care to veterans on the fringes of society.

To some, it is the difference between health care and no health care.

During a recent visit to this north central Washington town, a three-person staff saw about 14 patients on the full-size bus, which was parked outside Ferry County Memorial Hospital.

Bob Sonderman, the bus driver and mechanic, also orders radiology and lab work, which is done at the hospital through a contract with the VA.

“Some of these guys live in tents out in the woods,” Sonderman said of the patients. “There are a lot of homeless vets; some don’t trust the government anymore. A lot of these guys have post-traumatic stress disorder and could get 100 percent disability, but they don’t.”

Nurse practitioners Lester Peters and Rob Bauerle share mobile clinic duty, checking the lab results and consulting with patients in the bus’s two examining rooms. If the patient’s condition can’t be treated on the bus, he or she is sent to the Spokane hospital for care. Peters screens the patients at least once a year for PTSD, but many of them don’t want counseling, he said.

“It’s something they live with,” Peters said. “They moved up here to get away from people.”

But if they want counseling, Peters can get it for them, usually through a local counselor if one can be contracted.

The mobile clinic staff see about 20 to 25 patients on a typical day. The bus makes about 14 visits a month to rural towns including Okanogan, Moses Lake, Wenatchee and Kettle Falls, Wash.; Moscow, Bonners Ferry and Osburn, Idaho; and Libby, Mont.

Before the patients in Republic are treated on the bus, they are greeted by local volunteers Steve Gorton of the American Legion post and Katie Richardson of the American Legion Auxiliary. The two help with paperwork.

“If I don’t do it, who will?” Gorton asks. He said the nation’s obligation to its troops does not end when they return from combat. “It’s always – through thick and thin.”

Sonderman said the only time many rural homeless veterans get health care is when the mobile clinic participates in annual medical “stand downs” sponsored by veteran service organizations in places such as Colville or Post Falls. All the veterans have to do is show some military credentials and they get medical checkups, dental exams and a chance to talk with a counselor about emotional problems.

During the stand downs, groups such as the Veterans of Foreign Wars or American Legion provide homeless veterans with a haircut, a toothbrush, a warm coat or a blanket.

The Spokane VA’s mobile clinic was one of six buses in operation nationwide when the program began in 1991. Now the Spokane bus, with more than 500,000 miles on it, is the last one still on the road.

Sonderman said the bus has never missed an appointment because of weather and was on the road to Libby during the ice storm of 1996. He said it takes $5,000 a month to keep the bus running, including fuel and breakdowns, which Sonderman can fix on the road if they are not too serious.

In 1992, the mobile clinic was airlifted on an Air Force C-130 cargo plane to Florida to assist in the Hurricane Andrew relief effort. The bus’s 20-kilowatt generator powers the clinic’s systems, including a hot water tank, with electricity to spare local communities in an emergency. Its batteries are good for 12 hours of operation.