What is Street Medicine?
It's exactly what it sounds like.
Quite simply, street medicine is the provision of patient-centered, reality-based healthcare outside the traditional clinical setting.
It can be thought of as an old-fashioned house call where the roof over someone’s head might be a bridge, a tarp, a tent, the canopy of trees, or the open sky. There are no refrigerators to store medications. No running water to keep wounds clean or attend to personal hygiene needs.
No easy access to transportation, making trips to clinics and pharmacies difficult or impossible.
Due to the austere conditions and realities of street life, street medicine efforts cannot provide comprehensive care to our unsheltered friends; rather, teams aim to build meaningful relationships by caring for acute needs of patients where they live and coordinating more robust care in the community for issues outside the scope of a street medicine practice.
Street Medicine San Antonio began providing services to the homeless population of Bexar County in January of 2019. To date, the majority of patients have required basic primary care, wound care, and pain management treatments. We have also worked to provide related services such as tattoo removal and eye glasses, as well as collaborating with other agencies to arrange housing, engage in harm reduction initiatives, and coordinate drug rehabilitation treatment.
Street Medicine San Antonio is fortunate to have relationships with two day shelters and a church in the city where we hold clinics two half days a week. These clinics allow us to interact with folks we might not otherwise see and can serve as referral sites for follow-up appointments.
Our predominant modus operandi, however, is what we refer to as backpack medicine.
Under the supervision of our medical director, Dr. Hans Bruntmyer, the Street Medicine team spends the majority of their time walking the streets and remote areas of San Antonio and Bexar County. In addition to predetermined rounds, the team also responds to calls from local outreach workers and law enforcement. They carry backpacks – some filled with very basic medical supplies and others with water, socks, and hygiene kits – doing their best to accommodate the environment and effectively care for whatever they might encounter.
Imago Dei Ministries has an agreement with the University of the Incarnate Word – School of Osteopathic Medicine to serve as a site for their required Rural & Underserved Medicine rotation. As a result, Dr. Bruntmyer is accompanied by two third-year Osteopathic medical students as part of his established street medicine team. Additional providers include local doctors and nurses who volunteer as their schedules allow. We have also had the great privilege of taking law professors, pharmacists, physical therapists, and local government officials on our rounds. Whenever possible, Street Medicine San Antonio works closely with other local non-medical agencies to provide comprehensive, holistic care to our friends living on the street. Our goal is not only to achieve a level of physical health, but to do all we can to encourage feelings of safety, self-worth, and purpose in those we care for.
Where are we headed?
Quite literally, only God knows.
This has been a grand and sobering adventure for all involved; therefore, understanding the importance and fragility of the people we encounter, we intend to proceed prayerfully and cautiously.
These early days have brought a few areas of need to our attention, though. Practically, we’ve seen a real need for street-based mental health, as well as respite and hospice care. Philosophically, we have had to grapple with redefining what health and wellness means for this population. Time and again, standard physiologic markers for successful patient outcomes have proven inadequate to measure vital patient-centered constructs of health such as felt safety and what it means to “feel better”.
Our beliefs have been challenged and our training stretched to its limits and beyond. There is no way to know what’s on the horizon, but we welcome it. We look forward to the blessings, the challenges, and the friends we’ll work alongside as we serve some of the most vulnerable in our community.