Street Medicine in Pittsburgh

January 15, 2011

Bringing hope, health care and a way out to people living on the streets



Carrying a backpack stocked with medicine, bandages and pamphlets about free clinic care, Dr. Jim Withers walks the riverbanks and underpasses here searching for people who sleep under bridges and in hidden encampments.

His usual entourage includes a psychiatrist; a medical student; and a scout, preferably someone who has lived on the street and understands its etiquette and how to stay clear of its dangers.

Withers, seen above at left, started his street medicine practice about 18 years ago. Word of the work spread, volunteers joined the effort, and resources followed. The outreach evolved into Operation Safety Net, a program of Pittsburgh Mercy Health System that is sponsored by the Sisters of Mercy. Withers is that program's founder and medical director.

Operation Safety Net, which received CHA's Achievement Citation in 1994, now fields 10 teams of clinical volunteers who provide street outreach and staff its medical van. It has a staff of caseworkers, operates a severe weather emergency shelter and collaborates with other agencies to optimize resources for Pittsburgh's homeless.

Since its inception, Operation Safety Net has reached almost 10,000 people. In the past four years, it has helped more than 400 people secure temporary or permanent housing. And, it has provided those clients intensive case management to help them transition from homelessness to a more stable way of life.

Not everyone is ready to take help or come off the streets. Withers accepts that, and he and other Operation Safety Net workers earn trust and build relationships by showing up week after week. "You do see people you know quite well who depend on your fidelity in coming out on a regular basis," Withers says. "Those relationships are really as profound, if not more deep, than any primary care relationship I've had in any other setting."

Withers seeks out and listens to people whom others avoid or ignore. "So many people on the street feel that they have never really been listened to," he says.

Every community should have a street medicine practice, according to Withers. It's a life safety service akin to a fire department. Operation Safety Net supports a monthlong elective for service-oriented third- and fourth-year medical students. Some of the students have gone on to launch street medicine programs elsewhere.

Clinicians have come to Pittsburgh from across the U.S. and the world to observe the street medicine practice in the hopes of replicating it. Operation Safety Net presents an annual International Street Medicine Symposium, which draws participants from four continents.

Withers, an assistant clinical professor at the University of Pittsburgh School of Medicine, says that street medicine goes to the heart of the Catholic health care mission: "Every individual, no matter what their circumstance, is a precious part of our community."

About this project

Pittsburgh-based photojournalist Martha Rial accompanied Dr. Jim Withers and an Operation Safety Net team on their street rounds once in October and twice in November. An audio slide show she produced based on those outings is available here


Copyright © 2011 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Copyright © 2011 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.