Tuesday, December 27, 2016

Street medicine brings health care to the homeless

Night Ministry medical case manager Tiffany Green talks to a homeless man on Lower Wacker Drive.

     You can't always tell if it is a person in there, or if that person is alive or dead.
     "Night Ministry!" Jeff Ayoub calls out, approaching a human-shaped pile of blankets on Lower Wacker Drive. "Night Ministry!"
     The Night Ministry is the last strand of our fraying safety net. Despite "ministry" in its name, it is not a religious group, except in the sense that all religions have scripture about helping the downtrodden, edicts generally ignored by the faithful but the linchpin of this 40-year-old Chicago organization, which runs a shelter and a medical clinic on a bus that offers health care, counseling and life necessities to Chicago's homeless.
     I tagged along Thursday because, one year ago, the Night Ministry began a program, where nurses carry backpacks filled with medical gear seek out the homeless under viaducts, in fields, and other odd places where they hide.
     "We were restricted with what we could do with the bus," said David Wywialowski, director health outreach.    

Smoking crack cocaine. 
     The Night Ministry was inspired by Dr. Jim Withers and his Street Medicine Institute in Pittsburgh. So last year they visited him, observed his operation, and brought it here.
     Homeless people are prone to asthma — one complained of the dust raised by cars blasting by. They have allergies from the rat feces scattered inches from their heads, difficulty filling prescriptions, early onset arthritis and undiagnosed diabetes. Not to mention the woes of addiction that cause many to fall off the grid in the first place.

     As we moved from one encampment to another, handing out bottles of water, food, Christmas gift bags of toiletries and sweets, it struck me that homeless people do not gather randomly. They might live on the street, but they separate out into communities that reflect society. Thus you have African Americans along one stretch of Lower Wacker Drive, while around the corner is a neighborhood of young white IV drug users.
     Guatemalans live under an overpass near Chinatown, where some have jobs in nearby restaurants. And the neatly tented people living under Lake Shore Drive at Wilson and Lawrence tend to be the de-institutionalized mentally ill.
     Just as in the society they've tumbled from, different groups scorn one another.
     "They really do," said Matthew Sorenson, 54, a nurse practitioner at the Night Ministry. "There's definitely an elitism among substance abusers. They separate themselves from other groups, have their own identities. The alcoholics will speak badly of the heroin users; the heroin users hate the meth addicts — everyone hates the meth addicts."
     Though they had invited me to see the medical program in action, on Thursday there wasn't a nurse with us — I interviewed Sorenson later, by phone. Requests for inhalers and other treatment requests by the dozens of homeless people we met had to be deferred.
     The big difference between what the Night Ministry is doing in Chicago and Pittsburgh's program is the lack of a Dr. Jim Withers. Their street medicine team started going out only one day a week, saw the enormous need, and now goes out five, but staffing and funding is still an issue.
     They are hoping to hire a part-time nurse, What they could really use are a bunch of medical volunteers — nurse practitioners who want to give back to the city, and maybe get some experience treating trench foot and scabies that they might never get at some shiny suburban hospital. Christmas is over, but the need remains, and one truth of helping such people is that the person you end up helping is yourself.


  1. When I was a kid, the "poorhouse" was what we were threatened with should we leave lights on and food uneaten. As far as I know poorhouses went out of style long before my parents were even born, but they were a powerful incentive nonetheless. I don't know: do suburban parents tell their kids that if they don't straighten up and fly right, they'll end up like that bedraggled, bearded, stinky man shaking a coffee cup at passersby?


  2. "Are there no prisons?" "Plenty of prisons said the gentleman. "And the Union workhouses? Are they still in operation?" Both very busy sir." "Oh, I was afraid from what you said that something had occurred to stop them in their useful course."

    "A few of us are endeavoring to raise a fund to buy some meat and drink. What shall I put you down for." "Nothing." Scrooge replied.

    Tom Evans

  3. This is an excellent column worth sharing. I have mixed emotions, of course: empathy for the victims who end up homeless, gratitude for the Night Ministry and organizations like them, the nurses and medical caregivers, people who volunteer time and money to help. And anger mixed with worry and helplessness that nothing can be done to end the despair. The road to homelessness has so many paths, but what I firmly believe is that everyone deserves a shelter from the outside elements. No-one should be living outside under a viaduct.


    1. yes everyone deserves a shelter. sadly more than half a million people are homeless on any given night in the US. half a million , 10s of thousands are children . millions of different people experiences homelessness for some part of the year. why?

  4. I have mixed feelings on that too and there is some responsibility involved but will say that Rauner is like Ebeneezer.


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