Past Recipient Check-In: Dr. Jim Withers & The Street Medicine Institute

November 26, 2014 by Kat Krieger
Early-Withers-PMHS

There are people – there human beings out on the streets of cities that are living and dying and it doesn’t need to be that way. The Jefferson Awards highlighting the work that we do enabled us to have the credibility within the medical community, it inspired so many of the volunteers early on to seek us out, and it really gave us the boost and encouragement we needed to go forward.” — Dr. Jim Withers

At the time of my 1993 Jefferson Award, the program I founded, Operation Safety Net was a very new concept.  As a teaching physician, I became convinced that we needed a new “class room” in which we could more directly experience the reality of those who were socially excluded from healthcare, and from society in general.  I feel this is a critical time in history because health care has become largely an enormous business in which the humanity of our patients – and the humanity of health care professionals – is being lost.  Unless we can really see through the eyes of those we serve we will lose the insight and empathy needed to bring healing.  I realized this class room must be a radical departure from the traditional system, but that hopefully the lessons could be brought back to transform our health care system.

Dr. jim Withers

Image Courtesy of Pittsburgh Mercy Health System

In 1992, I began to dress as a homeless person and make visits to those living on the streets, along the rivers and in the abandoned buildings of Pittsburgh.   My guide was a formerly homeless man and soon there were other volunteer nurses, medical students and formerly homeless partners who joined us.  Realizing that a new health care system was emerging, I developed electronic records, case management, a hospital consult service, a medical education curriculum, an office specifically for the street homeless, and other services.   In time, we have grown to be a significant “street medicine” program which provides 24/7 coverage for all those who must sleep on the streets.  We have brought people into primary care, housed over 1,200 chronically homeless persons in the past 11 years, created a severe weather shelter, legal services and educate over 100 students per year.  Not only are the lives of many saved, but we have been able to reduce the costs incurred by emergency rooms and hospitals.

Street Medicine Institute, Bangkok, Thailand

Street Medicine Institute, Bangkok, Thailand

Due largely to the recognition of the Jacqueline Kennedy Onassis Award, my work was recognized throughout the United States.   Inspired to provide for their own street homeless, health care professionals began to make contact with me and I was able to counsel them to begin their own programs.  I realized a new field was emerging and in 2003 decided to give it a name, “street medicine”.  Traveling throughout the US and overseas, I have discovered a few similar pioneers of this field as well as working with many groups to begin new programs.  To bring the movement to a higher level, I was able to create the annual International Street Medicine Symposium in 2005.  It remains the only gathering in which those who bring care specifically to the unsheltered homeless can share best practices and inspiration.  As momentum gathered further, I founded a new non-profit organization called the Street Medicine Institute (www.streetmedicine.org) in 2009.  It is the ‘global home’ for the field of street medicine, providing consultation to all those seeking to provide care for their own street homeless.  This October marked the 10th International Street Medicine Symposium in Dublin Ireland.  Six continents were represented, including many disciplines, students, formerly homeless individuals and political figures.  Most significantly, they represented hundreds of thousands of human beings sleeping on the streets of their communities.

Dr. jim Withers

Street Medicine Institute, Kolkata, India

I believe that the street medicine movement not only saves the lives of the most vulnerable, but is a transformative force to humanize communities.  Every day and night it advocates directly for those who otherwise have no voice.  I am most grateful that street medicine has been overwhelmingly embraced by students throughout the world.  Dozens of new programs have been created through student leadership in the US, Asia, Africa, Central America and Australia.  These student leaders will be a powerful force to humanize healthcare worldwide.

Dr. Jim Withers

Street Medicine Inistite – Kano, Nigeria

The Jefferson Award came early to me and I felt unworthy of the great honor.  But when I met the other awardees I felt I finally met others who shared my passion of service to those most in need.  That encouragement I have carried with me until today.  I was very moved that those honored were people who were heroic, but not otherwise highly public figures.  Two of my formerly homeless colleagues received Jefferson Awards.   At the 25th anniversary of the awards, I once again was overwhelmed with the spirit of public service that was uplifted.   Personally, I was moved when Sam Beard and his daughter came to Pittsburgh and joined us on street rounds.   I have no doubt that the recognition through the prestigious Jefferson Award brought most of our critical early funding, and that only that timely opportunity allowed my work to have a life of global impact.  The Award came early, but it came at the most important time.  I thank the wisdom of those who nominated and judged my work.

Dr. jim Withers

Image Courtesy of Pittsburgh Mercy Health System

In over 20 years of street work I have been blessed to share in the lives of those who sleep there.  It would be very difficult to point to any one individual who most touched me, but I always remember one of the first.  He was a dignified 85 year old man who insisted we call him only, “Grandpa”.   Suffering from chronic mental illness, he was unable to fit into the existing systems of care.  He slept next to dumpsters and his swollen legs often had maggots in the open wounds.  What I remember most was how difficult it was to “fix” or “cure” him.  As I got better at finding solutions for other unsheltered homeless patients, there never seemed to be a solution that would satisfy both Grandpa and the rigid medical establishment.  Finally one morning he was sleeping in front of the door of my clinic and saw me dressed as a doctor.  “You’re really a doctor!”, he exclaimed with joy.  Though we laughed, I realized how important it was for this precious man to have his “own” doctor – one who would meet him on his terms and provide care for him as he would a family member.  It was a great day.

I am once again honored to communicate with the Jefferson Awards community.  So much has happened and it is a small opportunity to thank you for the immeasurable gift of your support.  Though we remain a grassroots movement, I have faith that we will continue to grow.  Our vision is that as long as people remain on the streets anywhere, there should be those who bring medical and social care to them on their terms.  We also are committed to bringing the “classroom of the streets” to every health science school for those who seek to make service a central part of their lives.  Not only will we begin to transform our communities, but we will hopefully carry the Jefferson Awards spirit of service to the leaders of the future.

To learn more about Dr. Jim Withers and the Street Medicine Institute, please visit: http://streetmedicine.org/

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