Street by Suzanne Hanney / photos by Kathleen Hinkel
It’s 9:48 p.m. on a Monday night in February and the downstairs lobby of the CTA Blue Line terminal at Forest Park is set up for The Night Ministry’s street medicine program. On one side is a table manned by peer support advocate Keith Belton (a former StreetWise vendor), who is distributing “survival supplies”: socks, underwear, water, sandwiches, hygiene kits, harm reduction equipment and, when available, donated shoes, tents, backpacks or sleeping bags. On the other side behind the privacy screen is senior nurse practitioner Stephan Koruba. In the middle of it all is volunteer Kenneth Burnell, serving soup. by Hannah Ross Many people may be familiar with the large bus that The Night Ministry takes to various neighborhoods on set nights. Since 2015, the street medicine program has used a smaller van to literally meet people where they are at encampments and stops around the city. The CTA program is an offshoot that began in winter 2020 and grew in response to reduced shelter capacity during the pandemic, which led to more people sleeping on the L. From April 1, 2020 to March 31, the combined street medicine/CTA outreach program provided 1,109 free health assessments, treated 308 conditions that would have otherwise gone without care and prevented 75 emergency room visits. The programs also handed out 11,053 meals and 6,529 hygiene kits. Mondays and Wednesdays from 9 p.m. to 1 a.m., the street medicine program will see an average of 120 people at the Forest Park terminal and 80 to 100 people at the 95th Street end of the Red Line. Forest Park draws more people because the Blue Line route from O’Hare to downtown and out to the near western suburb allows more time for uninterrupted sleeping. As soon as a train pulls into Forest Park, two security guards walk its length and invite sleepers to come downstairs for food and services. They don’t even have to come through the turnstile, which would mean another fare. A social worker who is also a notary can help people get identification cards and birth certificates and sign them up for stimulus checks. Case manager Sylvia Hibbard describes the street medicine staff as a team, “a little family that forms a circle around each client.” The nurse can help with wound care, blood pressure checks, as well as HIV, Hepatitis C, syphilis and COVID-19
testing – and now the vaccine. Long term, the hope is to connect the patient with a medical home: a primary care physician or health clinic that is accessible to them and can provide ongoing care. Mile Square, a federally qualified health center at 1220 S. Wood St. on the University of Illinois medical center campus, is one option. Harm reduction materials start with Narcan nasal spray, an emergency medicine to reverse heroin overdoses, which Noam Greene, lead street medicine outreach worker, likens to an “EpiPen.” Short plastic straws are used for snorting; alcohol prep pads prevent skin infections; cotton takes the dust out of the drug; sterile water can be mixed with the drug in a metal cooker similar to a tealight, which is also included. HIV and Hepatitis C are two of the main diseases that can be transmitted through blood via shared needles. Dirty needles can also lead to skin infections at the injection site or in blood sepsis that can lead to heart problems. That’s why clients at both at the CTA and the regular street medicine program receive clean needles – “rigs” – and sharps containers for used needles. Later on, the team will accept the filled containers, which are bagged up and taken back to the office as medical waste. “Mental health issues and addiction go hand-in-hand,” Koruba said. “Many, many homeless people have it. It’s hard to say which comes first. A lot of folks get out here and start using to dampen the cold, the miserableness, the loneliness.” Treatment to break opioid dependency with the drug Suboxone is a new facet of the street medicine program. Access to Suboxone improved with the U.S. Food and Drug Administration’s approval of a generic in 2018. “As addiction is increasingly viewed as a medical condition, Suboxone is viewed as a medication for a chronic condition, such as a person with diabetes needing to take insulin,” Peter Grinspoon, M.D., wrote in a Harvard Health blog in 2018. Since the COVID pandemic, insurance programs no longer require in-person visits and will pay for telehealth, which means that the street medicine clients can do their required psychiatric visits by cell phone and pick up the supplies from the street medicine crew.
