'Go to the people': Street medicine teams bring health care to the unhoused

Northern Maine is home to some of America's poorest - but it ranks high on national measures of health. Hospital programs visit more patients in their homes where they can be more comfortable and receive everything they need, which in turn reduces medical costs.

Assertive community treatment teams working through outreach-centered programs in Maricopa County have become an industry standard for treating those with persistent and severe mental illnesses who have recently been incarcerated. They provide a long-term approach, aiming to halt a cycle of incarceration and hospitalization by focusing on underlying issues such as what caused the police interaction and incarceration.

Activists in Berkeley, California, are filling in what they say is a gap in homeless services during the coronavirus outbreak. Volunteers are safely delivering food and other supplies to those without shelter.

As an alternative to traditional courts, community courts provide resources to those experiencing homelessness. Fines and jail time are often the punishment in traditional courts for those charged with trespassing or loitering, but community courts provide services that help people find housing, jobs, health care, and even offer mobile showers, food stamp assistance, and mental health care. While the long-term data are lacking and don't offer a clear picture of recidivism rates, community courts do provide a better quality of life for those living on the streets.

Milan’s tampone sospeso or “suspended test” initiative provides rapid COVID-19 tests to stop the spread of the virus. The initiative sets up in highly visible public areas of Milan and is based on a model of mutual support where everyone pays what they can. It is run with the help of over 50 volunteers and Medicina Solidale, a group of medical professionals who provide free medical advice to those who can’t afford to access care. The project has raised 24,000 euros from 436 donors, which has enabled them to administer rapid antigenic swabs to more than 3000 people.

The New Leaf project ran a controlled trial to test the power of direct cash transfers with people experiencing homelessness. Fifty people were given a one-time cash payment of $7,500, which roughly equaled the sum of government income assistance spread out across the year. The impact was measured over 12 months and found that people in the cash group moved into stable housing faster, spent fewer days homeless, and saved more money. The organization found the lump sum, rather than monthly increments, allowed people to make decisions about how they could move their lives forward aimed at stabilization.

A Mumbai school located in a remodeled shipping container meets kids on the street where they are at. Signal School results from a collaborative effort between the city and a non-profit, and focuses on bringing education to migrant children, so that they are less likely to be forced into child labor or street begging. Signal School does more than just teach, it also provides meals, works with families to change the cultural perspective that education is an amenity for the privileged, and helps migrant families find permanent housing.

A coalition of local groups in the Cowichan region focused on the welfare of vulnerable populations during COVID-19 opened five tenting sites that have provided people experiencing homelessness with safety, meals, and access to service. The temporary solution, pending the opening of 100 units of housing to open in 2021, has uncertain financing after its initial $392,000 phase. But, almost immediately, the well-managed sites have had a visible effect: many fewer people wandering the streets.

Cornerstone Baptist Church is spearheading the redevelopment of Struggs’ Cornerstone Heights Neighborhood. In 2019, the church opened a laundromat and bike shop and last year the Cornerstone Community Kitchen began serving free hot meals to locals experiencing homelessness. The Church is soon launching a community market where local residents can access fresh, affordable food.

Teams of Community Direct Distributors (CDD) are leading drug distribution campaigns to prevent and eliminate neglected tropical diseases in hard-to-reach, rural areas. These CDDs are members of the community they serve and are trained to educate the locals on disease prevention and administer the drugs themselves. With the CDDs’ help, several states have already eliminated some diseases and greatly reduced the spread of others.