Offering Health Care That Is Safe For People Who Are Homeless

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About 1980, this writer attended a presentation by a physician from El Salvador. He talked about practising medicine in a civil war. He spoke about his patient who needed stitches in his scalp. Training told the doctor that he should shave the area to be stitched. But given the circumstances, the doctor knew that the shaving would make his patient a target for imprisonment, torture and potentially death. The patient kept his hair and he got stitches.

Let’s move on to 2024 and north to California, where thousands of people are homeless and living outdoors. Many of those people need health care, but aren’t accessing it. Some are concerned that if they show up at a hospital, they will be deported. Some do not feel safe entering an emergency shelter or a mobile clinic that provides outreach health services to people living outdoors. Like the man who needed stitches in El Salvador, the homeless people in California are very vulnerable.

And like the physician in El Savador, there are doctors, nurses and other health professionals in California who believe that there is a duty to provide care to people who can’t access existing health services. Can more be done?

The California Street Medicine Collaborative at the University of South California (USC) says, “Yes.” The Collaborative has several activities to support health care professionals working in the field. Part of the Collaborative’s work includes placements for physicians who are training in the USC’s family practice residency. The residents provide treatment and support to people who are living outdoors. The Collaborative also supports volunteers to work in the field.

Is it helping? The California Street Medicine Collaborative began in 2018 in Los Angeles County. Since it began, more people living outdoors are getting primary care. They are also less likely to need repeat hospital visits.

Another part of the Collaborative’s work is leaning on the formal health care system to provide care in a way that works for people who aren’t able to use the existing system. Leaning is accomplished by meeting regularly with formal health providers to build a relationship that is open to problem solving. From there, the Collaborative works with the formal health care system to offer health services that feel safe to people who are homeless.

Here are two articles about the California Street Medicine Collaborative, both from the University of Southern California’s Keck School of Medicine: California Street Medicine Collaborative and New Doctors Train By Serving L.A.’s Underserved In First-Of-Its-Kind Street Medicine Residency Track

The University of Southern California is not the only pioneer in delivering quality health care to people who are living in marginal situations. Try this post from 2022, which reports the work of Paul Farmer and how his work could apply in Canada’s north: Indigenous Housing – Doing Better