SAN PABLO -- The 33-foot-long van was parked behind Lake Elementary School awaiting its first visitor of the day. Though an image of a cheerful group of kids wearing red soccer uniforms smiles out from its side, this van is not a sports bus.
In fact, the crew piloting this RV battles asthma, the most common childhood illness, affecting more than 7 million children nationwide, according to the Centers for Disease Control and Prevention.
This is the Northern California Breathmobile -- an asthma clinic in a Winnebago -- which started serving communities in West Oakland in 2009. It has expanded its coverage area to include Hunters Point in San Francisco, and schools in Richmond, San Pablo and San Leandro.
Thanks to grants from Kaiser Permanente and Chevron Corp., Breathmobile is further expanding over the summer to serve kids in North Richmond at Project Pride, Las Deltas Head Start and Verde Head Start.
One in five kids in the East Bay suffers from asthma, according to Mary Frazier with the Breathmobile project. This is more than double the average national rate.
The goal of the program is to reach kids and families who have difficulty getting to services. For families who can't manage regular visits to the doctor, care becomes episodic and the Breathmobile fills the void, Frazier said.
"Asthma is an illness of the poor. It's socioeconomic," she said. "Rather than keeping control of asthma every day, they wait for it to get really bad and then have to go to the emergency room."
Twenty percent of emergency room visits from children result from asthma attacks, according to Frazier. While expensive for everyone, many families in West County may soon find accessing the emergency room even more difficult. Doctors Medical Center in San Pablo is on life support, and without new funds the emergency room won't survive past the summer.
The Breathmobile's expansion into North Richmond is also significant because of the geography and demographics of the area. Contra Costa Health Services reports that African-American kids in the county are four times more likely to be hospitalized for asthma than white non-Hispanic kids.
"There are some parts of the community like Parchester that are very much separated and isolated from where the services tend to be concentrated," said Erica Browne, community benefit manager with Kaiser Permanente.
Davina Carr, medical-assistant-in-training on the Breathmobile and a Richmond resident, knows what it's like dealing with asthma firsthand. Her daughter goes to Kaiser to have her asthma treated, but Carr said not all parents make the trip.
"Most people in the community, they're comfortable where they live. And most people won't go to Kaiser if they stay in North Richmond," Carr said.
Adding the new stops in North Richmond to the current stops at Grant Elementary in Richmond and Lake Elementary in San Pablo allows the van to go nearly everywhere the children are, Carr said.
Frazier said they are working to build trust and relationships in these new service areas.
"We acknowledge that people are different colors; they speak different languages. We're not here to bring white people's medicine to the poor people," she said. "We're here to interact with the community, to become a part of the community and to teach the community how to take care of themselves."
Janet Magana, a bus driver and medical assistant, greeted the first patient of the day, Julie Esparza, and ushered her in accompanied by her mother and 2-year-old sister. As the team tested Julie's blood pressure, pulse and oxygen saturation, Magana translated for mom, Carolina Esparza.
Finally, Julie was brought back into the "office" -- the back of the RV is sectioned off with a small door. Julie and her family sat on a narrow couch as Dr. Patricia Granberg examined her and prescribed her latest round of asthma medications.
Granberg, the pediatrician for the team and jokingly called "the-doc-in-the-box," said the glory of the program is that the Breathmobile allows her to meet children and parents where they are.
"And when we can get the child on that medication, you know their asthma improves considerably," she said. "It's not rocket science."
Last year, their project showed considerable success. In the schools that Breathmobile visits, the number of school days missed by kids because of asthma fell from 322 to 27. Emergency room visits declined from 120 to six, and hospitalizations fell from 114 to zero.
These are impressive numbers, especially when you consider the cost savings. Based on data collected by Breathmobile, it is estimated to have saved more than $2 million in the past year for Alameda and Contra Costa counties.
Lisa Herndon, a medical assistant on the bus, said parents and kids are getting to know the Breathmobile.
"They leave here saying, 'Oh, thank you so much, I learned a lot,'" Herndon smiled over her Spider-Man scrubs. "They seem to appreciate us when we come. You know, you develop a relationship with them after seeing them for so many years. They come regularly. You see the kids grow."
The Breathmobile will be at Project Pride from 10 a.m. to 12 p.m. on Thursday.