Street Medicine

Street Medicine is an emerging collaboration of health care professionals, formerly homeless outreach workers, and others that has been happening globally since the early 1990s. Street medicine practice is defined as those health care and related services that are delivered directly to persons sleeping on the streets, along the river banks, and in the abandoned buildings, etc., of cities.

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Pioneers of street medicine have been practicing their art as the world’s homeless population has increased, but largely in isolation. Networking efforts over that past two decades have resulted in the recognition that a new field of medicine has emerged. The term Street Medicine, in this context, was coined by Dr. Jim Withers who has been one of the leaders in the movement.^[1][2] His program, Operation Safety Net in Pittsburgh, Pennsylvania, has hosted the annual International Street Medicine Symposium in various cities since 2005.^[3] At this first meeting, the keynote speaker was Dr. Jack Preger, who has been practicing street medicine in Calcutta, India since 1979. The group collaborates to improve the care of the unsheltered homeless (“rough sleepers”), to support street medicine practitioners, to conduct research, and to advocate for health care justice. As of 2007, twenty-one cities of the United States and eleven international cities in four continents are represented.

The Street Medicine Institute is being formed as a nonprofit to coordinate and enhance these activities. It has been supported by the Robert Wood Johnson Foundation and the Glaxo Smith Kline Foundation. The purpose of the Institute includes the development of best practices for street medicine, the creation and enhancement of street medicine programs as requested, and the training of health care students who wish to specialize in the skills of street medicine practice. In 2007, the Street Medicine Fellowship was initiated through the Donald E. Withers, MD Memorial Fund for Street Medicine Education.

The Street Medicine collaborative group welcomes any persons or groups that have an interest in improving the lives of those who sleep on the street. Major partners include the National Health Care for the Homeless Council (contact John Lozier) and the European Federation of National Organisations working with the Homeless (contact Dr. Igor van Laere).

References

• Choucair, Bechara MD. “An Editorial: Health Care for the Homeless in America,” American Family Physician, October 1, 2006.

• Dermody, Cynthia. “Street Medicine: This caring doctor makes house calls where there are no walls” Reader's Digest, May 2006.

• Leung, Lester. “Careers in Medicine: Clinics in Underserved Communities — An Interview with James O' Connell, MD, Boston Health Care for the Homeless Program,” Pathways in Medicine, September 2006.

• Montauk, Susan Louisa MD. “The Homeless in America: Adapting Your Practice,” American Family Physician, October 1, 2006.

• Singer, Jeff MSW. “Taking It to the Streets: Homelessness, Health, and Health Care in the United States,” Journal of General Internal Medicine, November 2003.

• Umar, Kauthar B. MA. “Health Care Headaches: Accessing Safety Net Services,” HHS Office of Minority Health Closing The Gap, August 2003.

Street medicine programs

International and national

• Direct Relief International Provides medical assistance for people victimized by poverty, disaster, and civil unrest throughout the world
• European Federation of National Organisations working with the Homeless (FEANTSA) A non-governmental network that focuses exclusively on homelessness in Europe
• National Health Care for the Homeless Council An advocacy, training, research and support organization in the United States
• Protecting America's Uninsured An Association of American Medical Colleges online directory of programs for the uninsured, by area
• Street Medicine An international collaboration of street medicine organizations and personnel
• Where to Find Health Care An HRSA Bureau of Primary Health Care online directory of health centers that care for people regardless of ability to pay or health insurance coverage

Local
Canada:

• Toronto: Street Health

India:

• Calcutta: Calcutta Rescue, see The Pavement Doctor of Calcutta

The Netherlands:

• Amsterdam: Municipal Public Health Service

Spain:

• Barcelona: Centra Catala de Solidaritat

Sweden:

• Stockholm: Ersta Diakoni

United States:

• Phoenix, Arizona: Health Care for the Homeless
• Tucson, Arizona: El Rio Healthcare for the Homeless
• Los Angeles, California: JWCH Institute
• Santa Barbara, California: Doctors Without Walls
• Santa Cruz, California: Homeless Persons Health Project
• San Francisco, California: Street Outreach Services (SOS)
• Denver, Colorado: Colorado Coalition for the Homeless Outreach
• Washington, DC: Unity Health Care Medical Outreach Van
• Jacksonville, Florida: IM Sulzbacher Center for the Homeless
• Miami, Florida: Camillus House
• Orlando, Florida: Health Care Center for the Homeless
• Savannah, Georgia: Union Mission
• Honolulu, Hawaii: Hawaii HOME (Homeless Outreach and Medical Education) Project + Waikiki Health Center Homeless Services
• Chicago, Illinois: Heartland Health Outreach
• Louisville, Kentucky: The Healthcare for the Homeless Project
• Baltimore, Maryland: Health Care for the Homeless
• Manchester, New Hampshire: The Health Care for the Homeless Program/Mobile Community Health Team Project
• Piscataway, New Jersey: Homeless & Indigent Population Health Outreach Project (HIPHOP)
• Albuquerque, New Mexico: Albuquerque Health Care for the Homeless
• New York, New York: Project Renewal
• Cleveland, Ohio: Care Alliance
• Columbus, Ohio: Mount Carmel Communty Outreach
• Portland, Oregon Outside In Medical Outreach Program
• Pittsburgh, Pennsylvania: Operation Safety Net
• Chattanooga, Tennessee: Homeless Health Care Center
• Memphis, Tennessee: Baptist Memorial Health Care Operation Outreach
• Houston, Texas: Healthcare for the Homeless—Houston
• Salt Lake City, Utah: Fourth Street Clinic Healthcare for the Homeless
• Seattle, Washington: Health Care for the Homeless Network
• Morgantown, West Virginia: Multidisciplinary UnSheltered Homeless Relief Outreach of Morgantown (MUSHROOM)