‘It can be you.’ How Miami medical students are hitting the streets to treat the homeless

The true measure of any society can be found in how it treats its most vulnerable members, Mahatma Ghandi once said.

“The word patient in Latin means one who suffers, and doctors treat patients,” said Dan Bergholz, founder and executive director of Miami Street Medicine. “The role of the physician isn’t necessarily to fix the problem. It’s to be there for the person.”

Being there means Bergholz, a third-year student at the Miller School of Medicine at the University of Miami, and a volunteer team of medical students and physicians hit the streets with a free mobile clinic to provide medical care for the homeless men and women around Miami.

There are 591 unsheltered homeless persons in the City of Miami, up by 36 persons last year, according to the Miami-Dade County Homeless Trust’s January 2022 census.

Treating the homeless in Miami’s Health District

Miami Street Medicine reaches out to about a third of Miami’s unsheltered homeless population, or 196 homeless people who reside in Miami’s Health District. The district, also known as Civic Center, is bound roughly by Northwest 20th Street and 14th Avenue to the northwest, the Dolphin Expressway to the south, and I-95 to the east.

The Health District is a hub for Miami’s burgeoning biotechnology and medical research industries. It is also home to Jackson Memorial Hospital, which has affiliations as a teaching hospital with the Miller School of Medicine and Florida International University’s Herbert Wertheim College of Medicine.

Other hospitals in the district include the Miami VA Medical Center, University of Miami Hospital, and Holtz Children’s Hospital. Miami Dade College’s medical campus is nearby, offering programs to ready students for healthcare jobs.

Bergholz has an interest in primary care and psychiatry. One of his “wisest” patients, he said, told him that “almost everyone out here wakes up thinking about killing themselves.”

The haunting words motivate Bergholz and his crew to rise early and greet patients. Being approachable is critical, he says. Instead of donning white coats and stethoscopes, the team wears ball caps, T-shirts and sneakers.

Medical gear is tucked in backpacks. Clipboards hold patient information; plastic bags contain snacks.

“Most everyone on the team is a UM medical student,” Bergholz said.

“Addressing healthcare needs of people experiencing homelessness is a critical part of the mission of caring for the underserved that our medical school takes so seriously,” said Dr. Amar R. Deshpande, the Miller School’s associate dean for medical education/administration, and the faculty adviser for the Mitchell Wolfson Sr. Department of Community Service.

The group takes direction from Street Medicine Institute founder Dr. Jim Withers, a physician from Pittsburgh, who dressed in tattered clothes when he made medical visits to people living on the streets in that city.

In total, MSM has a staff of about 50 that provide curbside consultations, medical screenings, wound care, writing prescriptions, counseling, follow-up visits and foot-washing events.

During a recent run that started one block east from Bascom Palmer Eye Institute, part of UHealth, a medical team combed the tent-dotted streets along Northwest 17th Street.

“They are very nice people,” said Ronald Jones, 32, a graduate of Miami Carol City Senior High, who lives on a sidewalk in the Health District and recently received a check-up from the medical students.

Jones may not be at the same corner for long, as he has been arrested multiple times for trespassing, according to the Miami-Dade County courts’ database. Police often use criminal trespass laws to arrest and evict homeless persons, which keeps them moving.

And last year, Miami city commissioners passed a law that bans homeless encampments on public property, paving the way for even more violators to be arrested.

But some cannot move so fast. Mobility remains an issue, as a large percentage of the homeless men and women have chronic conditions and are disabled, Bergholz said. Many use wheelchairs or walkers.

Launching a mental health branch

Some, too, are in the throes of mental crises.

“In terms of major mental health disorders, like schizophrenia or psychosis, we have done research and it seems to be upwards of 20 percent of our population,” said Bergholz. This may be an underestimate, he admits, since MSM often cannot obtain a thorough mental health history.

However, a more accurate tally may soon be underway. Starting in April, MSM will launch its new mental health branch. The unit will provide addiction specialists and counselors with an emphasis on mental health screening.

Aside from its weekly street rounds, MSM operates seven days a week, as a lot of work is done behind the scenes, often at its home base at 5505 NW Seventh Ave., Bergholz said.

New clinic in Liberty City

“We opened up a clinic [on Feb. 26] in Liberty City, like a free urgent care as part of the Healing and Justice Center,” said Dr. Armen Henderson, medical director of Miami Street Medicine, an assistant professor and internal medicine doctor at the University of Miami and founder of Dade County Street Response. “That day was the 10-year anniversary that Trayvon Martin was murdered.”

Currently, the clinic, in the Black Men Build Hub at Northwest 54th Street and Seventh Avenue, is open only on Fridays, Henderson said, but plans are underway to expand hours and possibly include telemedicine.

A social justice advocate, Henderson’s mettle was tested in 2020 when he offered COVID-19 testing to Miami’s homeless population in what he called an act of “civil disobedience” because there was a county order to stay off the streets. He was handcuffed and detained by Miami police outside his home while unloading items from his van.

The officer told Henderson he was patrolling the area after complaints of illegal dumping. The doctor wasn’t released until his wife came out with identification.

The incident sparked national headlines. Miami’s police chief quickly declared there would be an investigation. The officer was cleared of wrongdoing within a month.

While Miami’s homeless population includes people with serious mental illness, it is intertwined with children and families, pregnant women and those who have fled unstable relationships, Henderson said.

Though many have jobs, they cannot afford housing and have faced eviction. In February, Miami topped New York City and became the country’s least affordable housing market, with households needing to contribute 78.71 percent of their income toward home homeownership costs, according to realtyhop.com

It is a misnomer, Henderson says, to impart that Miami’s homeless are from out of town or addicted to drugs. And as its population expands to Miami’s suburbs, the homeless have faced NIMBY (not in my backyard) pushback.

Last year, the Miami Springs City Council voted 5-0 to create a Nuisance Abatement Board that would preside over civil disturbances. The city pointed toward two hotels in its “adult entertainment district” that served as emergency shelters for about 200 homeless persons.

Despite the actions of some local governments, Miami Street Medicine remains focused on its mission, and has caught the attention of some key players.

“They have a blueprint for the things that they do, and we are exploring other opportunities with them to somewhat expand what they are doing,” said Ronald Book, the lobbyist and volunteer chairman of the board overseeing The Homeless Trust, a tax-funded arm of Miami-Dade government and the county’s homeless agency.

On March 1, the Miami-Dade County Commission passed a law requiring building owners to provide short-term emergency housing for residents forced to evacuate over structural issues tied to neglected maintenance. If owners don’t, Miami-Dade could send them a bill for up to 90 days of government-funded housing assistance.

MSM’s work underscores Miami’s homeless plight, said Henderson.

He described how he and his team, in conjunction with other agencies, helped a homeless woman who was six months pregnant and in an abusive relationship obtain housing and an ID.

As Dream Defenders’ director of health programs, Henderson spearheaded the placement of portable showers and toilet stalls in the parking lot of St. John Institutional Missionary Baptist Church in Overtown. The mobile site was open for eight months and served thousands of people during the pandemic.

“We need social services that provide things with dignity for people who need them most,” Henderson said.

Henderson wants the community to search its soul, open its heart, and have more empathy and compassion toward people they might otherwise ignore.

“It can be you,” Henderson said.

For more information, visit: miamistreetmedicine.org

This story was originally published March 22, 2022 at 12:00 AM.