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October 23, 2011 9:55 PM   Subscribe

Dr. Jim Withers practices street medicine in Pittsburgh, PA. Operation Safety Net provides house calls to the homeless - to meet them on their terms.

Withers notes that Operation Safety Net, the group he founded in 1993 with a $50,000 startup grant from the Sisters of Mercy, does more these days than fund street medicine and operate homeless shelters. With the assistance of local government, charitable foundations, corporate sponsors and individual donors, the group is also finding permanent housing for the chronically homeless... According to one study from the 1990s, the group’s work with the homeless saves between $200,000 and $300,000 per year in emergency-room costs at local hospitals.

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What little money Withers makes comes mostly from grants and teaching at a medical school. But he doesn't think about money. In fact, he doesn't think at all like a typical doctor. "The essence of healthcare is going to where people are. Either physically or even more importantly spiritually, emotionally," he said...

"You know, if I could I'd write a prescription for a house for all the street people because it is immensely important for health," Withers said.

...Over the years, Operation Safety Net has been able to help so many that today homelessness in Pittsburgh is literally half the problem it used to be - half as many people on the streets.
posted by flex (28 comments total) 22 users marked this as a favorite

 
Geez I wish he could just leave the fairy tale crap out of this.
posted by ReeMonster at 10:00 PM on October 23, 2011 [1 favorite]


Yeah, because the idea that the wealthiest country in the world might be able to provide shelter and accomodation for all its citizens is just so far fetched....
posted by PeterMcDermott at 10:09 PM on October 23, 2011


Oh.. sorry Peter, I didn't mean it like that. I just meant all the religion.
posted by ReeMonster at 10:11 PM on October 23, 2011


Thanks for posting this.
posted by chinston at 10:14 PM on October 23, 2011


You know, ordinarily religious stuff bothers me, but it says the guy reduced the homeless problem by half and he doesn't make them accept Jesus before he treats them, so I'm going to give him a pass this time.
posted by bleep at 10:15 PM on October 23, 2011 [11 favorites]


After reading all the links (can't watch the video right now) the only reference to religion I see is that the organization is partnered with a Catholic hospital.
posted by bleep at 10:27 PM on October 23, 2011


I think Jesus would have liked this fellow, have no problem with the jesus stuff, if he is following the directions of Christ--feed the hungry, clothe the naked, visit the prisoners, etc
posted by PinkMoose at 10:34 PM on October 23, 2011 [15 favorites]


I saw no evidence that treatment or assistance is at all contingent on acceptance of any particular religion or beliefs. That's when religion in relief work becomes a problem.

But those of you who find the mere presence of religion so objectionable are welcome to start your own religion-free organizations to help the homeless.
posted by unannihilated at 10:36 PM on October 23, 2011 [3 favorites]


Unannihilated, did you mean.. say:

www.pointsofdistribution.org ?
posted by Mattachine at 11:07 PM on October 23, 2011


Geez I wish he could just leave the fairy tale crap out of this.


We see your complaint on Metafilter every time someone demonstrates Christian theological virtues. What is it to you if they are comforted and strengthened by their faith? There are many Christians out there; surely you don't want to pick on this one just because he makes you feel inadequate?

I'm not a Christian, but I would have no difficulty naming half a dozen Christian groups that exist for the purpose of doing good to others. I cannot name a single atheist group that is anything other than a debating society or social club. It wouldn't be enough to get me to change my colors - but the world would be considerably better if there were more people like Dr Withers.
posted by Joe in Australia at 11:20 PM on October 23, 2011 [32 favorites]


According to one study from the 1990s, the group’s work with the homeless saves between $200,000 and $300,000 per year in emergency-room costs at local hospitals.

There's an old Malcolm Gladwell article, Million-Dollar Murray, about (among other things) housing the homeless to save money on emergency-room treatment.
"We came up with three names that were some of our chronic inebriates in the downtown area, that got arrested the most often," O'Bryan said. [...]

The first of those people was Murray Barr, and Johns and O'Bryan realized that if you totted up all his hospital bills for the ten years that he had been on the streets—as well as substance-abuse-treatment costs, doctors' fees, and other expenses—Murray Barr probably ran up a medical bill as large as anyone in the state of Nevada.

"It cost us one million dollars not to do something about Murray," O'Bryan said.
The point is that there are lots of homeless in a big city, but most of them are homeless for a day or two, maybe a week or two here and there, and then they find somewhere to live. It's just a relatively small number that are 100-percent year-round homeless. If you gave every one of those people, no questions asked, a real apartment all to themselves (not just a bed in a shelter), you'd end up saving a lot of money on those people and thus have more money and resources to devote to other people.

Of course, it also does the homeless person a lot of good to live in an apartment, but even if you scorn them and wish them nothing but the worst, it's still beneficial to you as a taxpayer (the person paying for emergency medical services, police services, etc.) to get them off the street and into apartments.
posted by pracowity at 11:50 PM on October 23, 2011 [8 favorites]


Great man doing great work. Largely agree with Joe above, but you do need the debating or questioning side of things too, though. The famous quote from Dom Helder Camara springs to mind, “I feed the poor, I’m called a saint. I ask why the poor have no food, I’m called a communist.”
posted by Abiezer at 1:36 AM on October 24, 2011 [13 favorites]


I wish I could favorite Joe in Australia's comment 100 times.

I *am* a Christian and somehow I've managed to stick around Metafilter for a relatively long time now, despite every time something like this coming up, the first or very close to first comments always being dismissive of the whole based on a usually trivial relation to anything religious.

I don't care if Withers worships Jesus or Buddah or Allah or the Steelers or if he loathes religion altogether. What the shit does that matter if he's able to reduce a major metropolis' homeless problem by 50%? If he's able to single-handedly eliminate massive strain on the health care system there? If he's able to address the national crisis that is the US' failing health care system at a local and fundamental level that our highest-paid professionals and politicians will never in our lifetime even begin to approach?

Give me a fucking break.

I like to look back on my early days in NYC as a time where my Christianity was "liberalized." I had a gay boss - well, a few of them, I worked in fashion, after all. I was meeting all kinds of people from all kinds of different backgrounds and ideologies and points of view. It was fascinating. At first I thought I had to hide my church-going behavior and actually would lie about the fact that I spent Thanksgiving with the youth group serving food at a homeless shelter, stuff like that. But then, after a while, I realized that people who actually, authentically practiced relativism, an acceptance of all beliefs rather than one in particular - they had to accept where I was coming from too. I could actually talk to them about it and they'd accept me and not ostracize me or think me some babbling idiot. And I could be open minded enough to do the same for them in reverse. And we all got on splendidly. Fancy that.

Somehow that's never boiled down to the Metafilter level. Somehow here it remains a constant of cool to berate people for their beliefs, for something as fundamental to them as their faith. Even when its those who are demonstrating the very best parts of their belief system, walking the walk rather than talking the talk.

I don't get it. I seriously, and sadly, just do not get it.
posted by allkindsoftime at 1:52 AM on October 24, 2011 [33 favorites]


I think you're awesome. Please stay, allkindsoftime.
posted by By The Grace of God at 2:11 AM on October 24, 2011 [3 favorites]


[going forward, it would be most excellent if we could thwart the impulse to effectively derail into a one-note theist/atheist thing which can already be found in its millions on mefi]
posted by taz at 2:24 AM on October 24, 2011 [3 favorites]


Oh.. sorry Peter, I didn't mean it like that. I just meant all the religion.

Thats fine that you consider it a fairy tale. You should get to believe what you want to.

But you gotta understand that there are some people in this world who act do the things they do because of the "fairy tales".

I'm not a christian, nor do I support the catholic church. But upon seeing someone cutting down this story because they disagree with a doctor who fixes homeless people because he might be a catholic...i would trade all atheist trolls for 1 catholic doctor.

Self-serving and oftentimes offensive posts on the internet are not as helpful as some dude who takes care of people because he believes he has an obligation to it.
posted by hal_c_on at 2:40 AM on October 24, 2011 [4 favorites]


I wish this kind of pragmatic approach was more common. It reminds me of the controversy about housing for wet alcoholics (which has been argued about here before, too). To me, if it saves money and adds to people's dignity and quality of life, then it's a no-brainer and we should be doing more of it. But these things cross some kind of moral line in the sand for a lot of people, and they'll oppose them even though it might save millions of dollars every year, because of the principle of it.
posted by Forktine at 5:24 AM on October 24, 2011 [3 favorites]


I have a friend who is a producer for a local news station. His wife is a nurse (was in the ER for 5 years or so). For years, they've been trying to get the station to do a story on how people use the ER for standard medical stuff, like colds and sinus infections, because they can't afford to see a doctor and/or can't afford the treatment.

They wanted to show how it costs everyone so much money to take up the expensive ER services and how it would be much better to have some sort of affordable health plan available to everyone, but of course, that is too controversial.

She used to see so many people come in who were really, really sick for want of a $5 antibiotic or other simple treatment. If they had gotten the drug or treatment when they first got sick, they wouldn't have had the cascade of other problems that descended when the infection/illness/pain in their $BODYPART went untreated. I've had sinus infections and some bad cavities. I can't imagine living with that for months or even years because I was afraid to go to the ER or doctor because I knew I couldn't afford it.

So yeah, this guy is amazing. Where is the morality in letting people suffer needlessly? Not all homeless people are saints, but that doesn't mean they deserve to be sick and in pain for lack of basic medical care.
posted by sio42 at 5:37 AM on October 24, 2011 [5 favorites]


What a great article - thank you for sharing. The idea of social justice as a tenet of religion is very different from proselytizing and evangelizing - it's showing faith through actions, not words. More important than faith, it's just a real life example of how people should treat people.

As someone who isn't particularly religious, I love that Dr. Withers example is one that more of us could follow. Who among us spends one weekday night every week helping the homeless with the knowledge gained from his or her career?
posted by glaucon at 5:51 AM on October 24, 2011 [2 favorites]


ReeMonster, as an atheist, I vote he can believe in all the religion he wants, so long as he helps those in need. Even better if he doesn't proselytize while doing it; he doesn't even do it in these interviews, AFAICT.

Quit threadshitting.

--

Dr. Withers is helping my neighbors. I love him, now that I know of him.
posted by IAmBroom at 6:00 AM on October 24, 2011 [2 favorites]


More on the Corporal Works of Mercy.
posted by jquinby at 6:37 AM on October 24, 2011


Self-serving and oftentimes offensive posts on the internet are not as helpful as some dude who takes care of people because he believes he has an obligation to it.

What? Nothing was opined against the act, just the motivation of said. I found the comment an ironic take on progressives. It may not be meant that way, but can definably be taken as snark.
posted by Mblue at 6:38 AM on October 24, 2011


This is a great post. I've been working for the past year or so with a Catholic Worker clinic here in Phildelphia, and street medicine has been one of my interests ever since starting med school. I'm proud to say that Philadelphia is starting to take a similar, housing-first approach to homelessness.

A number of my classmates take the same knee-jerk Dawkinsonian position outlined above, and to a man I can promise you that none of them have ever come down to the clinic or familiarized themselves with the Catholic Worker movement. For them, it is enough to crack a joke about child abuse and go on not giving a shit.

There is no over-arching hierarchy of Catholic Worker houses, so I can only speak for mine. If my classmates had condescended to actually visit the clinic, this is what they would have seen:

We try to arrive at clinic about fifteen minutes before the official opening time. By that time, there are already some folks queuing up for showers. We pass the sign-up list around and start setting things up. The shower closet gets stocked with toiletries, razors, and the six pairs of socks that we'll hand out during that session, the bathrooms get checked, and the windows get opened. Last item on the agenda is a short inspirational reading, frequently by an activist from the movement but also from sources as diverse as Rumi, Ghandi, and Dr. Martin Luther King, Jr. That paragraph and a couple pieces of religious art are the full extent of the Catholic Worker clinic's religious mission. The book gets put away, we don our stethoscopes, and we open the doors.

Usually, we have one person coordinating the showers/comfort items, two people taking histories and vitals on the ground floor, and two Nurse Practitioners, Physicians Assistants, or Doctors upstairs doing more involved work (foot care, draining/packing abscesses, filling out Medical Assessment forms to get patients real, long-term primary care). In a given 2.5 hour session we might see as many as twenty patients and give 10 showers.

And all that is important, especially the Medical Assessment forms, but just as important is that we all make a special effort to recognize the community members as real people, to acknowledge the humanness of each patient who walks through the door. When they go to a certain local hospital that shall remain nameless, they get treated like addicts and street trash. Some would rather drain their own abscesses without anesthetic using razor blades than they would endure the condescension that they get at the local ER. Above all else, THIS is why people keep coming back to our clinic; this is why I'm there every Thursday evening.

I am a nonbeliever and I will continue working with the Philadelphia House of Grace Catholic Worker as long as they'll have me.
posted by The White Hat at 7:28 AM on October 24, 2011 [20 favorites]


Woohoo hometown! Helping people! Yeaaaaahh....

Why the hell don't we have single payer yet for these people. Cmon Pitt, Vermont got there before us and we have like... 4 hospitals in town and a couple more in the suburbs. Seriously, the place that lives on maple syrup got health care before the place that lives on greasy noodle things stuffed with potatoes and fried in grease.
posted by Slackermagee at 7:46 AM on October 24, 2011


Seriously, the place that lives on maple syrup got health care before the place that lives on greasy noodle things stuffed with potatoes and fried in grease.

Slackermagee, not quite following your metaphors there.

Should the place that smokes too much get health care before or after the place that develops black lung from mining?
posted by IAmBroom at 8:43 AM on October 24, 2011


Here's a video of Jim Withers speaking at a conference I ran a few years back.

I've met lots of visionaries and innovators through the conference over the years, and Dr. Wither is easily one of the most impressive human beings I have ever had the privilege to meet. His work deserves a lot more exposure and credit.

BTW, one of the offshoots of his work is the International Street Medicine conference, which brings together street medicine practitioners from all over the world. For anyone interested in getting involved, this would be a place to start.
posted by mark7570 at 10:47 AM on October 24, 2011 [2 favorites]


(Wither -> Withers, sorry)
posted by mark7570 at 10:47 AM on October 24, 2011


I used to volunteer at a soup kitchen. It seems that a lot of discussions about the chronically homeless start with the assumption that they are essentially the same as everyone else but imho they're not at all. They demonstrably cannot look after themselves or "pull themselves up by their bootstraps" and no amount of wishful thinking will make them be able to do that. For whatever reason they are overwhelmed by life and cannot deal. Once you accept that you can start to look at helping them. And you're going to be helping them forever, they're not going to magically become able to cope with things.

The ones that killed me were the middle aged women, most with ex-husbands and grown kids from a former life and who had given up trying to get them off the streets. For some reason that hit me the hardest.
posted by fshgrl at 10:22 PM on October 24, 2011 [1 favorite]


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