Imagine a bustling street where the cacophony of city life drowns out the whispers of those in desperate need. This is Skid Row in Los Angeles, a place where unhoused women face health crises that often go unnoticed. But one doctor is determined to change that. Dr. Mary Marfisee, armed with a stethoscope and unwavering compassion, is on a mission to bring healthcare to those who need it most—right where they are. And this is the part most people miss: these women’s health struggles are not just about physical ailments; they’re about systemic failures that leave them behind.
On a sunny December day in 2025, Marfisee navigates the chaos of Skid Row, her focus unwavering. Amid the noise, she approaches Hermione, a young woman pushing a stroller filled with her belongings. Hermione’s nervousness is palpable, but Marfisee’s calm demeanor reassures her. ‘I’m going to listen to your lungs,’ she says gently, her every movement deliberate and patient. This isn’t just a medical check—it’s a moment of human connection in a world that often forgets these women exist.
Hermione’s lungs are tight, a sign of her worsening asthma. Her inhaler is nearly empty, and she’s lost her emergency EpiPen. Yet, when Marfisee offers help, Hermione hesitates. ‘Maybe later,’ she says, prioritizing shelter over health. This is a stark reminder of the harsh reality: for unhoused women, survival often comes before self-care. But here’s where it gets controversial: Is it fair to expect someone struggling to find a safe place to sleep to also prioritize their health? Or should the system be designed to meet them where they are?
Marfisee, an assistant professor at UCLA and the family medical services director at the Union Rescue Mission, has spent nearly two decades caring for the unhoused. She’s a familiar face on Skid Row, delivering ‘street medicine’ with a team of medical students. Her approach is simple yet profound: treat the person, not just the problem. But the challenges are immense. Women experiencing homelessness face unique health barriers—lack of access to gynecological care, prenatal services, and even basic screenings. And this is the part most people miss: these gaps aren’t just inconvenient; they’re life-threatening.
Take the story of one of Marfisee’s patients, a woman who suffered from decades of lower abdominal pain. It wasn’t until Marfisee’s team took the time to dig into her history that they discovered the cause: an IUD placed 32 years ago, never removed, and embedded in her uterine wall. This isn’t an isolated case. Union Rescue Mission’s studies reveal that 87% of women lack up-to-date preventive screenings like pap smears and mammograms. Boldly put, this is a crisis within a crisis.
Marfisee’s solution? A women’s health initiative that brings care directly to the shelter. She’s partnered with a local hospital to launch a mobile health van, offering free pap smears and mammograms. But even this faces hurdles—red tape, scheduling conflicts, and logistical challenges. The van is three months behind schedule, a frustrating delay for women whose lives hang in the balance. Here’s the thought-provoking question: Why is it so hard to provide basic healthcare to those who need it most? Is it a lack of resources, or a lack of will?
Despite the obstacles, Marfisee remains optimistic. ‘No matter what it takes, we’ll get it done,’ she says. Her determination is infectious, inspiring medical students and volunteers to join her on the streets. As she wraps up her day, checking in on patients like the older woman in the park, her impact is clear. These women may be overlooked by society, but they’re not forgotten by Marfisee.
Here’s the call to action: What do you think? Is Marfisee’s approach the right one? Or is there a better way to address the health needs of unhoused women? Share your thoughts in the comments—let’s start a conversation that could spark real change.
