Armed with care packages, clothes and clinical supplies, medical students in Detroit are learning outside the classroom. They are putting their knowledge and boots to the pavement, providing free health care to the city’s homeless.
Each week, students under the supervision of a registered physician or nurse practitioner get on their bikes and look for those in need.
“One of the first experiences I had in the world of street medicine was with a young man who had gotten into an accident and broken his arm,” said Ellie Small, a second-year med student at Michigan State University and president of Detroit Street Care. “He was put into a cast the day before, though nobody had seen to the road-rash that covered half of his forehead and the side of one of his legs.”
Small and a group of volunteers went to work removing the dirt, stones and debris from the grateful patient’s wounds.
It’s a job that Small describes as making “invisible people visible.”
The medical students treat wounds, check vital signs and provide patients with blood pressure medicine, insulin and antibiotics. Perhaps more importantly, they connect with people experiencing homelessness on a personal level.
“You’re seeing them in their home, whatever that home might look like. We teach all our volunteers to be eye level with patients. If your patient is sitting on the ground, you need to sit on the ground. It goes a long way for their comfort,” said Small. “We need to realize what’s most important medically might not be the most important thing in their life at that current time. That’s unique to this population. We always ask about someone’s housing status.”
Programs such as Michigan State University’s Detroit Street Care, Wayne State University’s Street Medicine Detroit and the University of Michigan’s Wolverine Street Medicine work together to treat as many of the city’s homeless as possible.
According to the Homeless Action Network of Detroit in 2018, there were over 10,000 people experiencing homelessness in the city.
Members of the programs compare notes on patients and map out routes to ensure all pockets of the city are covered. They also host clinics at shelters and work with organizations to place people in housing whenever they are ready.
Jamie Wojahn, Director of Homeless Recovery Services at the Neighborhood Service Organization, says programs like these are crucial to the homeless population.
“If it wasn’t for all these schools and all these volunteers, there would be so many more people dying. They are giving vaccines on the streets to people who haven’t had vaccines in several years. They give a lot of basic medical needs to people who have diabetes and hypertension that have been unaddressed for years.”
Changing people’s days
Jedidiah Bell, a fourth-year med student at Wayne State University and president of Street Medicine Detroit, says seeing issues from lack of health care access in his home country of Zimbabwe made him want to participate.
“When I moved to the states for university and medical school, I saw the similar things [lack of access] with the homeless population,” said Bell. “When I saw street medicine, I appreciated the model of how can we take medical care to the street and build up trust to bridge the gap between the homeless and the medical world.”
While the programs provide a vital service to the community, Bell says the real-world experience teaches students things the classroom or clinic can’t.
“It teaches medical students to hone-in on, not just medical conditions of patients, but to be able to sit down and form relationships and discuss other things that might be contributing to [patients’] health but might not come up during a traditional medical encounter.”
Bell says there’s a widespread belief that the “students take away more from people on the streets than they take away from us.”
Anneliese Petersen, a second-year medical student at Wayne State University and volunteer with Street Medicine Detroit, says the experience also shows upcoming medical professionals another side of health — the social determinants.
“Things that are not strictly medical-based but have a strong impact on health and well-being. Income, access to health care, access to medication, being able to eat well, sleep well, to be able to relax and not be under chronic stress.”
Learning to see how patients live outside a doctor’s office could help the students provide better treatment once they begin working inside one. But the main goal for the students remains with those on the streets.
“If we can improve the situation for the person sitting in front of us and even just make their day or afternoon a little bit easier, we’re serving our purpose,” said Small.