Hurricane Harvey cut off critical access to health care in coastal Texas.

People were forced to evacuate without vital medications. Roads were “underwater,” according to Dena Hughes, CEO of Triangle Area Network Healthcare, based in Beaumont. And many health care organizations lost access to power and clean water.

In the aftermath of the storm, Direct Relief reached out to health centers throughout impacted communities to ask what was most needed. One request came up repeatedly: mobile units.

Mobile units would allow health centers to set up clinics in or next to churches and community centers, reach people isolated in their homes, and even transport sick patients.

But while these Direct Relief-donated units began as a way to improve services after a disaster, health centers quickly found that they had unanticipated benefits.

Patients who lacked access to health care long after the storm had passed were able to get primary care. Going out into local neighborhoods helped health centers reach patients too wary to come into a permanent clinic. And the mobile units made health center workers familiar faces in the neighborhoods they served, helping them engage patients who had never made health care a priority.

Direct Relief profiled four health centers whose mobile units have allowed them, post-Harvey, to make greater inroads into their communities, developing relationships and improving access.

Bee Busy Wellness Center in Houston, Texas

Bee Busy, a Federally Qualified Health Center established in 2009, already had a small cargo truck that the health center used for local clinics. When Harvey hit, Norman Mitchell, the center’s CEO, immediately realized it wasn’t enough.

“It couldn’t even drive through the waters,” he said.

There were just too many patients who needed help or medications and couldn’t get them, with too many hospitals and clinics shut down. Busy Bee jumped in, first borrowing a mobile unit, then working with Direct Relief to develop a large, custom-built model.

“The waters hadn’t even receded yet, and we were there providing medications to patients,” Mitchell said.

But months after the storm, clinic workers noticed that many of their patients still didn’t have access to health care. By working with community leaders, they were able to do more than just offer care to people in remote areas. They earned the trust of people too wary to come into a permanent clinic – including a community originally from Somalia, Ethiopia, Eritrea, and Sudan.

“These are families who had not been to a doctor even before leaving their own countries,” Mitchell said.

He recalled an Ethiopian family of five with multiple chronic conditions – including a grandmother who had diabetes and hypertension, but no access to medication – who agreed to seek care after it was coordinated through their local church.

A mobile unit may be high-tech, but Mitchell loves that it can provide old-fashioned care.

“We’re in the days of telemedicine and telehealth, but these are individuals without internet access,” he said.

“This takes medicine back to the days of old, when the doctors actually came to your house.”

TAN Healthcare in Beaumont and Orange, Texas

The staff members of TAN, a primary health clinic founded in 1987, weren’t exempt from the effects of Harvey. “Our nurse practitioners were horribly impacted,” recalls Hughes, TAN’s CEO. “One had to be rescued from her roof.”

Nonetheless, the health center immediately began offering help and supplies to people stranded by the storm. Hughes recalls a woman who was having trouble breathing, and was stuck without a nebulizer or her medication. Despite severely flooded freeways, the health center managed to get the woman the supplies she needed.

“It was just a wonderful experience,” Hughes said. “It was one of the things that made us say, how can we do this? How can we make sure we’re meeting [people’s] needs?”

Hughes said Direct Relief told her team to take the lead in assessing what would help them most.

They settled on two vans: One for doctors to carry supplies and set up day clinics at food pantries and churches; another to transport patients who couldn’t travel easily. But the clinics quickly developed into something more.

Patients “were coming for primary care, but they were also coming just to be out, to have engagement, and they would come and seek other services” like housing assistance or emergency preparedness information, Hughes said.

AccessHealth in Fort Bend and Waller Counties, Texas

AccessHealth, a Federally Qualified Health Center, serves patients who are used to extreme weather. Harvey was different.

Many people whose evacuation centers were flooded or without power were forced to make their own arrangements, which meant they couldn’t access health care even when it was on offer.

AccessHealth had had a smaller mobile health unit for 19 years. But after Harvey, the health center noticed, it wasn’t enough.

“We’re about 780,000 people in a predominantly undeveloped county,” said Mike Dotson, AccessHealth’s CEO.

AccessHealth’s patients needed optometry and dental services, which the health center offered at clinic locations but couldn’t provide in the old mobile unit.

“The need for what we do is growing, and this is a way we can expand services without a lot of capital expenses,” Dotson explained.

The new mobile unit is already up and functioning as a clinic location in more remote parts of the community, but Dotson has grand plans for it, including pop-up appearances at schools, community events, and health fairs—as well as future disaster responses.

“Our county has gotten a lot more calculated as to what the disaster response is, with more drills and meetings,” Dotson explained. As a mobile health provider, AccessHealth has “a seat at a much larger table.”

Pasadena Health Center in Pasadena, Texas

Pasadena Health Center, which provides care to underserved patients, was open and ready to help during Harvey. There was only one problem.

“If people are in their houses and they’re dealing with a disaster, they can’t come to your health center,” said John Sweitzer, Pasadena’s CEO.

“We literally had to go out to all the different [evacuation] sites, and we were getting calls to ask if we could pick up other people with diabetes and no medication.”

The solution? Sweitzer’s vision– realized with Direct Relief’s help – was a 45-foot mobile unit with two exam rooms, a waiting area, and a small laboratory that would allow Pasadena Health Center to travel wherever the larger community, primarily composed of low-income families, needed care most.

When Sweitzer first came up with the plan for a mobile unit, “I thought, ‘Nobody’s going to help me.’ You feel like you’re just wandering around the forest,” he said.

Direct Relief’s offer of funding came as a welcome surprise: “It was just a tremendous thing for us.”

Being out in the community, Sweitzer said, has made all the difference.

“The fact that we went there and started meeting them and building friendships with them [means] there’s been a continuous flow of patients signing up for the clinic.”

The unit is emblazoned with state symbols – a space shuttle, Battleship Texas, the San Jacinto monument – to make it recognizable and familiar to patients.

“We made it Texas,” Sweitzer said.  “If you put it in New York, nobody would know what it was.”