Katrina, through a pediatrician's eyes

Even before a Category-5 hurricane tore through the Gulf of Mexico region in 2005, Mississippi was not a great place to raise a child. Crushing poverty helped contribute to it having one of the worst child-health rates in the country.

Some of those who left the Gulf area drove up to Atlanta, where Persharon Dixon, MD, was preparing to practice in a retail-based clinic. Local fundraisers were dropping off essentials like bottles of water and diapers for the evacuees literally next door.

While Dixon was caring for the evacuees, she talked on the phone with a friend from Biloxi, Miss. who told her about a program that needed a pediatrician on-site in the Delta.

That project was the Mississippi Gulf Coast Children's Health Project. It needed a pediatrician to work in a mobile care center that would traverse the 190-mile stretch of waterfront between Louisiana and Alabama. Another vehicle offered mental health care.

Dixon accepted. It meant moving into a trailer, like many other Missippians hit by the hurricane. And it meant administrative duties; being responsible for the crew of both vehicles, a staff of 12, and some driving as well. Dixon's team sets up shop in schools, churches, community centers, and FEMA trailer parks.

The primary care vehicle functions as a true medical home for those it sees, emphasizing preventative care, dental health, even community services. If someone doesn't have insurance, Dixon's staff will guide them through the Medicaid or SCHIP paperwork, even buy their child's birth certificate.

The mental health vehicle offers more. Its crew can see about 25 children a day, saving those patients from the four-month wait for a child psychiatrist. Using telepsychiatry lets the mental health staff have a one-on-one chat with any connected room in the state. Psychiatrists who drive to a local neighborhood to take care of patients is unusual even in a big wealthy city like Atlanta-but it's happening in Mississippi.

Funding for the project was originally through a grant from the Children's Health Fund and the Coastal Family Health Center, based in Biloxi. "Now we have to take over, and begin to bring some of that funding in ourselves," notes Dixon. She sees families multiple times before their insurance kicks in, if they have it at all. And programs like telepsychiatry aren't reimbursable in the state.

But the financial woes of some of these families is minor compared to their medical problems. "These families weren't in a good place before it started," Dixon said. Many of the children of Katrina have now moved five or six times, and seen their parents go through as many jobs. "A lot of the world thinks we're back on our feet again," she said: Mississippians are not.

Fundraising is now part of her job. She's working with state health departments to get more kids screened for medical evaluations. On the mental health side, Dixon is pushing to get counselors in neighborhoods, and focusing on anger management and bullying.

In short, the Atlanta native is not going anywhere. "We are a permanent fixture in the community," Dixon said. Ironic, for a mobile medical center.