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Health Care for the Homeless

As the coronavirus pandemic spreads, among the most vulnerable are the homeless, especially those living in dense populations in urban areas. The Coronavirus Bill that recently passed includes $4 billion for homeless assistance. Part of the bill helps support efforts by state and local leaders in placing the homeless in shelters to gain better control over the spread of the virus. At the front lines are outreach workers and medical personnel who voice concerns about the impact on the health care needs of the homeless. We turn to CNN Hero, Dr. Jim Withers, who started the “street medicine” movement bringing health care to the homeless, to find out his viewpoint on the coronavirus pandemic.

Rethinking Daily Health Care Operations

HOW ARE YOU, YOUR FAMILY, FRIENDS, COLLEAGUES, PITTSBURGH MERCY’S OPERATION SAFETY NET DOING?

I am doing well, as are my family and colleagues. I have been receiving messages from colleagues around the US and overseas. All of them are struggling with the COVID19 crisis at different stages and contexts.  One of our staff is self-isolating while tests are pending.

HOW HAS THE CORONAVIRUS AFFECTED YOUR LIFE, YOUR BUSINESS, ETC., AND HOW ARE YOU COPING?

The coronavirus has overwhelmed our daily operations, not yet with active cases, but with the extensive restructuring of all our processes. We worked very early to create new staffing models, procedures for seeing patients, and testing. At the national level, the Street Medicine Institute board rapidly collaborated with the CDC and National Healthcare for the Homeless Clinicians Network to create guidelines that were shared by mid-March. Within our local work, we are in full adrenaline mode and trying to make sure staff do not overextend themselves in terms of work or safety. We are working at unprecedented levels with our county, city, and other agencies to create a coordinated disaster response. We have kept up with current needs but are diligently working to find new resources for isolation, quarantine, and protective housing for the most vulnerable. Like the larger community, old paradigms are often set aside to create dramatically new solutions. I can foresee that many of these collaborations will likely improve how our community addresses issues well beyond this pandemic.

DO YOU HAVE ANY ADVICE FOR OUR BUSINESS LEADERS AND GOVERNMENT?

I am sure leaders in business and government are working as hard as we are to protect their communities, their organizations, and those they serve. My specific advice would be to continue to look at how things are actually going to play out at the street level. Global plans are critical, but there must be a constant dialectic with the reality of the people. I am particularly interested in those who may be excluded. For example, drive through testing centers do not help our unsheltered, often uninsured patients. The chasm between system centered thinking and reality-based community thinking is an ongoing problem, but the pandemic is magnifying that. Key representatives of those excluded groups are important in solutions your organization develops.

DO YOU HAVE ANY THOUGHTS, IDEAS, RECOMMENDATIONS, WISDOM, ETC., TO SHARE WITH OUR READERS?

My thoughts for your readers would be the same as those everyone else is saying — namely, to realize your vital role in “flattening the curve” by practicing the CDC guidelines and educating yourselves on strict hygiene precautions. You are all at least as important as anyone else in combating this crisis. That may leave many good people wishing they could do more to help those playing an active role in their community. There is an incredible number of creative responses that you can find online where people are raising funds, finding and sending supplies, as well as addressing the associated crises of unemployment and lack of resources such as food and shelter in their communities. Here in Pittsburgh, there are groups who purchase food from struggling restaurants and then work with programs like ours to get the food to those who desperately need it.

HOW DO YOU THINK THIS EXPERIENCE WILL IMPACT OUR LIVES AS WE MOVE FORWARD?

I believe that this experience will serve to improve our lives in a number of ways. First, I think it is a wakeup call as to how much we are all interconnected and how we need to shift our thinking to match that reality.  In addition, I believe there is an opportunity for all of us to look at “the time that we are given.” Personally, I am trying to spend some of my time on more personal reflection and intentional reconnection with family and friends by phone and digital means. Life is precious, and there are often more important things than those which we routinely pursue.

Doing Our Part to Help

Each of us can do our part to help ease overburdened hospitals and health care workers by following CDC guidelines, as Dr. Withers recommends. Let’s remember to help those in need in our communities and support the brave frontline medical workers who are tirelessly working to save lives. Be sure to read the inspiring story of Dr. Jim Withers and how he started an international movement to bring health care to the homeless.