street-medicine-mercy-hospitalHealth care volunteers with big hearts and high hopes last March brought “Street Medicine” to the homeless of Sioux City, Iowa.

Every Monday and Thursday evening the team of 16 volunteers from Mercy Medical Center, Siouxland Community Health Center and Sunnybrook Community Church go to shelters, food banks, soup kitchens and other sites where the city’s homeless people gather.

The volunteers take blood pressures, check blood sugars and offer basic first aid with medical supplies provided by Mercy Medical Center. They also offer hope and comfort to about 100 homeless people who for too long have had too little of both. 

The volunteers are nurses and other health care workers, and most belong to Sunnybrook Community Church. They wear charcoal or light gray T-shirts emblazoned on the back with “Street Medicine” in bright orange letters.

Their outreach is inspired by Street Medicine pioneer Jim Withers, M.D., a physician at Pittsburgh’s Mercy Health System – like Mercy Medical Center a part of Livonia, Mich.-based Trinity Health. Withers began providing medical care to Pittsburgh’s homeless 25 years ago. Today, there are about 60 Street Medicine programs operating across the country.

Mercy Medical Center invited Withers to Sioux City on Nov. 1 to talk about his Street Medicine outreach. His presentation “ignited the effort,” says Jerry Hernandez, Mercy Medical Center’s multicultural outreach coordinator. “He raised awareness about how we could work as a community to address the issue, because the hospital can’t do this alone. No one can.”

After Withers’ presentation, members of Sunnybrook Community Church reached out to various area health and service organizations, including the medical center, community health center and the Community Action Agency of Siouxland, to garner their support of Street Medicine.

Sunnybrook’s congregation looks for ways to make a difference beyond the church’s walls, says Kevin Neygaard, the church’s executive director. “We believe we are called to be the hands and feet of Jesus in our community,” he says. “If we didn’t exist in Sioux City, would anyone notice? That drives us to make sure we are getting out into the community.”

But he adds that “you can’t do this without the support of physicians and the hospital and the clinic. Fortunately, everyone jumped on board.”

The Street Medicine team typically treats common ailments – open wounds, high blood pressure, diabetes or foot problems – that afflict the homeless. “We address the types of things that, if left untreated, could lead to a more serious illness or condition,” says outreach coordinator Kristi Gaither, a registered nurse and Mercy Medical Center’s manager of employee health and wellness. “We meet their immediate needs and try to follow Doctor Withers’ motto of meeting people where they are in life.”

When volunteers come across patients who need non-emergent medical care beyond basic first aid, they transport them to Siouxland Community Health Center. “Street Medicine greases the wheel to get immediate care to the most fragile members of society,” says Michael Piplani, M.D., the health center’s chief medical officer.

Withers coined the term Street Medicine by treating homeless people wherever they call home – in doors and alleyways, along riverbanks, or beneath bridges and highway overpasses. In the same vein, Gaither says Sioux City’s Street Medicine team “wants to get our backpacks on” and reach those who tend to stay away from shelters and other facilities.

“The facilities are good places to start our outreach and we want to maintain our presence at those locations, but we do want to expand into the streets” to treat more of the underserved, she says. 

The Street Medicine partners also wants to build broad-based community support for more comprehensive programs like wraparound social services and a 24/7 detoxification center that can make a deeper impact on the city’s chronically homeless population.

A 2016 University of Iowa survey indicated that Native Americans made up about 47% of Sioux City’s homeless. It said most homeless residents are in their 40s – an increasing number are single fathers with children. 

Reasons for homelessness varied from case to case, such as loss of a job or substance abuse. The Street Medicine volunteers say use of alcohol, methamphetamines and marijuana are common among the population they serve. The survey found that most homeless want to change their situation, but felt they lacked the support they needed.

While most homeless people feel shunted to the margins of society, Street Medicine tells clients their lives matter and there are people who care about them.   

“One of the things we learned from Doctor Withers is that the homeless are used to people coming in and out of their lives or throwing them a buck and never really being a part of their life,” says Sunnybrook Community Church’s Neygaard. “So when we started [Street Medicine] it was key to be consistent. To have the same people at the same sites on a regular basis so we could develop good relationships and build trust.”

The volunteers say their homeless clients appreciate what the program does for them. “Their faces light up when we enter the building … and the high-fives we get are something special,” Gaither says.  

The high-fives aren’t the only rewards.

“It is very satisfying to see the way the community has come together to save lives,” Hernandez says. “If we are not out there to help them, eventually they will end up in our emergency department in far worse condition. We’re making a difference and we’re saving lives.”  

The stories below look at what other hospitals and health systems are doing to address homelessness in their communities.

Deaconess Health System sees opportunity to help homeless heal and recover

Health care safety net for the homeless

 Stable housing for elderly residents 

 Homeless patients’ best prescription is permanent housing, says UI Hospital

 Street Medicine makes house calls to the homeless

 Housing is health care for homeless

 Mount Carmel Street Medicine team brings healing, hope to the homeless

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