Care for Where There Is No Justice: The modern history of street medics and how they support social movements
By Julia Nakad
Street medic groups have been on the front line of many groundbreaking movements, from the Civil Rights and New Left movements, to modern day movements such as Occupy Wall Street and Arab Spring. Perhaps more importantly, however, street medics have played a role addressing root causes of ill health and supporting the movements which transform dynamics of power, privilege, and access.
One only needs to look at the involvement of the Medical Committee for Human Rights (MCHR), one of the most well-documented and long-lived medic organizations to exist in the United States, which illustrates well the scope and magnitude that street medic efforts have had.
Over the course of their decades-long tenure, MCHR members attended hundreds of marches to tend to the maladies of bludgeoned, shocked and sore protesters, and visited protesters in hospitals and jails to advocate for their treatment. And importantly, the work of MCHR members continued between protests. MCHR doctors were involved with hospital desegregation, with members among the ranks of committees investigating whether southern hospitals were complying with Title VI of the Civil Rights Act. Members Jack Geiger, Bob Smith, Jo Disparti and others began the first community health clinic, the Tufts-Delta Health Center, in Mound Bayou, where doctors wrote prescriptions of ‘food’ for starving patients and started farming projects to counter widespread malnutrition, inspiring the community health clinic movement. MCHR activists volunteered at free clinics started by the Black Panthers to support uninsured and discriminated against populations, and were also among the first advocates of a national health care platform. Although the work of MCHR petered out in the 1980s, projects initiated by MCHR members altered the structure of health care in the United States, and the committee itself acted as a radicalizing force for healthcare professionals for decades.
The sheer scope of what MCHR doctors have accomplished is too great to describe here, but fascinating detail can be found in The Good Doctors by John Dittmer. Quentin Young, former chair and longtime MCHR volunteer, also relates his personal experiences in many of these movements in his memoir, Everybody in, Nobody Out.
Curious about the work of modern day movement medics, I interviewed Grace Keller, a medic who trained in 2001 in preparation of the protests of the World Economic Forum meeting, and who has since worked alongside the collectives affiliated with Common Ground Clinic (a street medic clinic started in the wake of Hurricane Katrina), Occupy Wall Street, and most recently, the Ferguson uprisings. Asked about the role of modern medics, she said her colleague from the Common Ground Clinic, Rachel Stern, described it best: “Street medics reverse the medical hierarchy — instead of the practitioner being on a pedestal, the patient and their community is on the pedestal. We are not the heroes, we are not the rescuers.”
Throughout our conversation, she deemphasized the medical role of street medics, who for the most part are not the activist doctors or medical students of the MCHR who were trained to provide more specialized care. Most street medics today access trainings ranging from 4–20 hours, with varying degrees of technical emphasis. Grace doesn’t have a bad opinion of street medics — she just sees their role as not primarily medical. “We don’t make the people we support well, they make themselves well,” said Grace, “We just stand with them while they do that.”
Instead of being in the spotlight, street medics tend to organize alternative health care structures for people with higher levels of expertise. “For health care workers,” said Grace, “it can be hard to work outside of their institutions. For a street medic, on the other hand, their average level of health knowledge is lower than most health professionals, but their ability to rapidly deploy a voluntary health infrastructure is very high, so they are able to create structures for doctors and nurses who want to help.”
Street medics also teach protesters how to problem-solve when resources are scarce. For instance, medics in Tahrir Square during the Arab Spring taught protesters to wipe tear-gassed faces with soda pop, which was readily available. In Ferguson, medics did 2–4 trainings per day that were about 20 minutes long. “Medics would teach people how to do things like eye flushes, how to do psychological first aid, and would switch up their training topics,” said Grace. “Then people attending would snapchat and tweet pictures of cardboard posters of our popular education materials to reach other protesters.”
Yet these practical skills don’t fully explain the leap that medics have sometimes made to become essential parts of political movements. Grace explores this in her essay, A Political Medicine: Trust and Power in Ferguson where she argues that medics were perceived as one of the structures that helped build trust among protesters as they reimagined their community’s capacities for countering pervasive racism, violence and inequity. In my conversation with Grace, she pointed out that the medics, many of whom were white out-of-towners, became highly regarded and asked to stay, even after other solidarity activists had been asked to leave by local organizers. While it is difficult to parse out particular moments when confidence was built and trust was won, Grace credits both the medic’s willingness to be accountable to the people with whom they were working and their “magic tricks.”
By Grace’s definition, “magic tricks” are the skills that all health workers possess that create demand for them to begin with — how they make people feel better. For instance, how a medic makes pepper spray stop hurting. Another magic trick is a medic’s ability project a calming affect onto a crowd during dangerous or tense situations, such as after a person has been injured or when cops encircle a group of people. Grace noted:”Cops also project affect onto a crowd, but their affect is fear. Other people can project a calming affect — nurses and EMTs might do that for an individual, or even a family, but medics can do that for a whole crowd.” It might be as simple as people registering that medics are on the scene to help, or the medics encouraging people with chants or songs to “Walk, Walk,” thus preventing them from trampling each other in an attempt to flee.
Grace’s signature magic trick is white flower oil. She often used this to help a fellow protester who would hit the streets with a megaphone. “He would rally people using his megaphone until his blood pressure shot up,” Grace described. “When he would start to get worked up, he would ask me for white flower oil to calm him. Instead of going home or going to the hospital, we built a relationship and he chose to seek care from me and other medics. It saved him time and indignity, and allowed him to stay in the middle of the action where he wanted to be.” This story underscores street medics’ capacity to assess and prevent grave medical problems.
In another example, in Ferguson, “People were tense with fear, excitement, anger as they waited to hear about the grand jury — that tension prevented sleep many nights. As the weeks dragged on, the sleep deprivation and intense emotions caused psychosis in some of the more vulnerable people. I heard people worrying that their sleep-deprived friends would commit suicide.” said Grace. Recognizing that protesters were more likely to be in grave danger if they were severely sleep deprived, street medics shared messages about how to sleep in shifts as part of their general messaging.
To help new medics develop assessment skills, Grace often uses Hesperian Health Guides materials, because they are often written with this assessment approach in mind. She especially likes using the “Mental Health Chapter” of Where Women Have No Doctor, as well as the chapter entitled “Solving Health Problems,” which she describes as “one of the best introductions to community health work I’ve ever seen.” A chapter from Helping Health Workers Learn entitled “Learning and Working with the Community” also comes in handy, because “in street medic trainings people get this idea about ‘the community’ as a monolithic thing, so I’ve used this chapter to have a more realistic idea of how to work with communities and the conflicts that are already there.”
The practitioners of MCHR and modern day street medics are usually not the leadership of the movements they participate in, but more often than not they have been a radicalizing force and a source of inspiration for both social and healthcare innovation. As Grace put it: “many of the causes of poor health we medics can’t cure with medicine. But we have the opportunity to be at the ringside while people work to change those root causes.”