Health care and homelessness
October 24, 2011 - 12:30pm
Jim Withers, who founded Operation Safety Net in 1992, says his early years of practicing street medicine in Pittsburgh were a product of his imagination.
"I made it up, and I had a philosophy that drove it. It's 'The streets have to teach health care how to meet them on their terms.' "
And have they?
"They've taught us a great deal, and they're continuing," he said. "I feel like we're in the, maybe, sixth grade at best, but we're learning."
A Man and His Mission: Dr. Jim Withers
This sounds like a wonderful approach to health care. Does anyone (paging Sineed) know of a similar program in Canada?
* answers page *
I can speak for Toronto, where there's Streethealth, of course.
http://www.streethealth.ca/aboutus.htm
Toronto Public Health also provides a number of programs, such as needle exchange, STD testing, condoms, free medications for STDs, vaccines, and free tuberculosis medications for all TB patients, and educational materials in numerous languages.
I imagine our programs would differ from American programs because of our single-payor health care. That said, the trouble with health care for homeless people is not a lack of access to care; many homeless people are heavy users of the health care system. It's the discontinuity in their care; ie, they rely on emergency rooms, seeing different doctors all the time, having to submit to rather basic work-ups over and over. When I try to track the health care received by a homeless person, the report I often get from doctors' secretaries is the patient was "lost to follow-up."
Thanks Sineed!
Reading this made me think about the way "access" is constructed in terms of health care--folks with homes might think that simply having free access to health care, even with several clinics or hospital emergency rooms available for walk-ins, constitutes open access. Certainly, the American site (metafilter) I plucked this from thought that single-payer health care would solve this problem or make this program redundant. As we know, that's not the case.
The fact is the homeless don't have a say in the way their care is delivered--they don't have any purchase on that conversation. That's why I was struck by Withers' "on their terms" approach. I don't know of any approach like that in the DTES, where too often programs like this are non-transparent and non-negotiable.