A man limped into a room at the Sunday Breakfast Mission and was greeted by Kara Cohen, a young woman wearing nursing scrubs and an easy smile. She asked him how she could help.
“My foot,” he said, almost stammering. “There’s a hole in it.”
Cohen, a physician, runs the Best Foot Forward clinic at Sunday Breakfast Mission every other Thursday.
“The people here, they’re angels,” said William, who chatted with One Step Away while attending the clinic.
“They tell me my feet are OK, but there are a lot of people who come in with real problems. And even if you don’t have anything seriously wrong, to get a foot bath and a foot massage, who wouldn’t want that?”
Best Foot Forward provides foot soaks, free socks and podiatric assessments for the homeless, and the clinic also engages people in health literacy. Foot examinations often become a gateway to a longer conversation about health care, allowing people to become empowered to take greater care of themselves.
“We always have plenty of help,” said volunteer Casey Alrich during a rare moment of calm amid the hustle and bustle. “Kara is so passionate about this, it rubs off on people. I wouldn’t want to be doing anything else. It’s been rejuvenating for me, working with the people here.”
Ten years ago Cohen was working in Boston doing homeless outreach when she saw the desperate need for this kind of service. She also noticed that podiatric health impacted upon people’s overall emotional wellbeing.
“When your feet hurt, it’s hard to feel good,” she said. “Just something simple, like a foot bath, a foot massage, a fresh pair of socks, is really restorative. You sit and talk with people, just talk and try to connect. It’s a very relaxed, non-threatening way to engage people, and this is a population that sometimes can be reluctant to access services and get healthcare. I wanted this to be a holistic experience, and we feel like it is. We’ve seen people take greater care of their health; we just feel like cheering to see some of the progress they’ve made.”
Cohen began tracking the clinics’ activity from the start. She appeared in the Sunday Breakfast Mission cafeteria at dinner time and told the audience what she was doing, stressing it was free and that no one would be pressured to accept services. Then she waited and watched as a line of people formed.
During the first four months, Best Foot Forward saw 205 people. Half of those treated had no insurance and roughly 30 percent reported being in pain. The most common ailment was a fungal infection called Tinea Pedis although some 15 percent of visitors discovered they had developed something serious enough to warrant a referral for outside care including, occasionally, immediate emergency care.
The clinic has a friendly, almost casual environment with music playing in the background. William takes great pride in the sounds that come from the speaker.
“Oh, when I first started coming here, she was playing folk music or some such thing, and that just wasn’t going to happen,” he said, chuckling. “I got her to upgrade the music. Every time I see her, I give her a new playlist.”
Best Foot Forward is designed to enable and encourage exactly that type of interaction.
“I hope we’re able to create awareness of the unique health issues facing people who experience homelessness. And I hope we can engage people and empower them to take greater care of their health. But mostly I hope we’re able to show that no action is too small to make a difference. If you can get people to come together and do something— no matter how small— that’s how you create something very big,” Cohen said.
For her work with the homeless, Cohen was honored as a Greater Philadelphia Schweitzer Fellow for 2012-13, one of more than 200 Schweitzer Fellowsin the United States. Since 2007, the Greater Philadelphia Schweitzer Fellows Program has supported nearly 70 Schweitzer Fellows in delivering more than 13,000 hours of service. Upon completion of their initial year, 16 local fellows will become Schweitzer Fellows for Life.