‘We go where they are’: Street Medicine at Pitt provides care to homeless people

Instead of just walking past homeless people around Oakland and greater Pittsburgh, Becky Mackenzie and her team help take care of them.

Mackenize, along with Antonio Gumucio, started Street Medicine at Pitt last year. The club aims to provide acute medical care, food and support to homeless people through weekly visits around Oakland.

Mackenzie, a bioengineering Ph.D. student, said she and Gumucio were inspired by the work of Dr. Jim Withers, a local Pittsburgh physician. Withers began in 1992 to visit homeless people and provide medical care to them directly. Withers, according to Mackenzie, was assisted by a “field tracker,” a homeless man who would take him around the area to help those in need. She said Withers brought help to people who needed it most.

“Instead of making them come to a clinic, he decided he was going to go out on the streets and basically make house calls where they were,” Mackenzie said.

For Mackenzie, the issue is more than just about helping those in need — it’s very personal. Mackenzie spent her teen years homeless on the streets of Buffalo, New York and panhandled. After hearing about Withers, she said she knew that she had to make a difference, so no one else had to face what she did.

Since Withers started street medicine in Pittsburgh, Mackenzie and Gumucio, a Master’s of Public Health student, decided to start the club at Pitt. Gumucio said he was humbled to be part of something that could help a person who many simply walk past.

“The reality is, the trust our patients bestow upon us, more often than not, ends up changing our lives more than we change theirs. It is easy for folks on the street to remain invisible or forgotten,” Gumucio said. “As a society, we have to do more to show people that they matter, regardless of the circumstances that may have led them to their current state of living.”

Many members are Emergency Medical Technicians. Priya Gupta, a sophomore psychology and history and philosophy of science major, said this training is important in being able to help homeless people.

“When you’re an EMT you have to work creatively. I think that that kind of translates over into street medicine. That creativity to find unique solutions and to meet patients where they are is something that I have noticed that has come from my EMT experience,” Gupta, the club’s public relations and social media manager, said.

Mackenzie said she has both wilderness and forensic certifications in Emergency Medical Services, but added that homeless people the club assists are in places of easier access like on a street corner.

“A lot of the camps, sometimes, are way off the street. They are not obvious. You really have to go through woods and brush to find them. It sort of does become a search and rescue job to find them. But we go where they are,” Mackenzie said. “If they are under bridges, that’s where we go. If they are in the woods, that’s where we go. If they are on sidewalks, fine.”

Street Medicine at Pitt provides medical care, food and even items like a phone charger. Mackenzie said every person’s needs are different, and that their team is very open-minded in the ways they can help.

“We listen. We don’t tell them what they want. We listen to what they want. We don’t make them follow an agenda. We say, ‘What do you want, what can we do for you, what do you need?’ It may not necessarily be medical care,” Mackenzie said. “It can be such things as, ‘Do you need batteries or a charger for your phone?’ Or even stopping down at a Burger King, saying, ‘Hey, have some dinner.”

According to Nicole Alindogan, a senior environmental studies major, a common misconception is that most homeless people have been on the streets for a significant amount of time. She said club members recently encountered a woman who just spent her first night on the streets as she was not accepted at a certain shelter. Alindogan and another team member helped the woman get on the right bus to the woman’s shelter.

Although nothing was done “medically,” Alindogan and her team helped to prevent the woman from spending another night on the streets.

Mackenzie said the most important part is recognizing a person’s humanity. Even small gestures of kindness like saying “hello” can make a big difference in a person’s day.

Clinically, club members can provide acute medical care like wound care, blood pressure checks and prescribing medications if needed. This is made possible under the direction of Dr. Anna White, a UPMC physician. Although much of the club’s “street medicine” isn’t always clinical, White said the majority of what the club does is “getting to know people’s stories and building trust.”

White is able to provide her expertise to the team and their patients for the best possible outcome. Her expertise includes clinical knowledge, but she also works to keep the team safe from a COVID-19 standpoint, as well as making sure the group has adequate supplies to treat patients.

Part of the interactions with a homeless person is to acquaint them with the medical team and to gain trust. White gave an example of a patient with high blood pressure opening up to her team and telling them their story. Even though the patient still did not want to be touched or assessed for hypertension, White and the team considered that an interaction gone well.

“Eventually, this patient who feels like clinics aren’t for him or her may gain trust in us and let us check his or her blood pressure despite not having allowed anyone else this privilege for years,” White said.

Gumucio said the club’s vision is bigger than just helping homeless people — part of the mission is to change the system of treating this population and to garner better outcomes for them.

“My hope is that the work we do here, the depth of the relationships we develop with our friends,” Gumucio said, “will impart on Pitt students that any discrimination or mistreatment of rough sleepers within our health systems is unacceptable and they will advocate for them when other providers won’t.”