Student Reflection: Where the UN and medical students meet

Homelessness is a reality of our world. In September 2018, the Secretary General of the United Nations reported on the global housing crisis to reveal almost 25% of urban populations, 833 million people total worldwide, live in overcrowded, unsanitary and often dangerous "informal encampments."[i] Upgrading these slum-like settlements is an imperative of the United Nation's 2030 Sustainable Development Goals.

The United Nations report speaks to the inhumanities of homelessness -- a self-perpetuating entrapment. Nonetheless, political efforts lack the energy to meet or solve the challenges at hand. In a recent New York Times article, former New York City Council member Christine Quinn called the opposition to initiatives for the homeless a "fear-fueled ignorance."[ii] Aptly named, this piece asks a crucial question: through our public service efforts and local governance, are fighting a war on homelessness or a war on the homeless?

A separate New York Times profile on a homeless man named Mark-Steven Holys further elucidates this issue. Mr. Holys is a previous sommelier who is as genuine in his passion for wine as he is in his responsibility for those choices that perpetuated his homelessness. In this piece, he observes there is a lack of understanding regarding who lives in highway-adjacent encampments:

“You’re going to find the criminals, prostitutes and the malefactors.... But you’ll also find people who are saving money wherever they can and who are trying to get out of the homeless quicksand.

“I’ve met a stockbroker and former athletes on the street... Once you’re deeply tattooed by this thing it’s very hard to get the ink out of your life.”[iii]

A compassion deficit is a bleak explanation for the mismatch between the obvious injustices of homelessness and our inability to sustainably and sufficiently react to it.

When speaking with the individuals who seek healthcare through TBSM Street Runs and at our Community Clinic, it is hard to ignore the infrastructural, social and political systems that perpetuate homelessness. Solutions to these issues appear elusive. I often wonder how we, as future physicians and change-makers in healthcare, can we reconcile that health-related activities often occur in non-clinical spaces that do not forward our patients' wellbeing. As important as building our clinical and scientific aptitude, we must prepare to care for and empower our patients, and provide conscientious, culturally-aware counseling.

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[i] United Nations, General Assembly, Report of the Special Rapporteur on adequate housing as a component of the right to an adequate standard of living, and on the right to non-discrimination in this context, A/73/310/Rev.1 (19 September 2018), available from https://www.undocs.org/A/73/310/rev.1.

[ii] Bellafante, Ginia. "Are We Fighting a War on Homelessness? Or a War on the Homeless?" New York Times. [New York, NY] 31 May 2019. <https://www.nytimes.com/2019/05/31/nyregion/homelessness-shelters.html?auth=login-email&login=email>

[iii] Fuller, Thomas. "How a Tuxedoed Sommelier Wound Up Homeless in California." New York Times. [Oakland, CA] 28 Sept 2019. <https://www.nytimes.com/2019/09/28/us/homeless-san-francisco.html>

USF Homecoming Mission Partner

As part of USF's mission to Make Life Better, students gathered as part of USF Homecoming to help us make the hygiene kits that was use on our Street Runs. Thanks to all who came out to support TBSM!

Student Reflection: TBSM's Narcan Initiative

Both of my parents are accountants. To say that they don’t understand what I do on a daily basis is, to put it gently, an understatement. But that doesn’t mean they aren’t interested. They are always excited to ask questions about my day when I call on my way home from clinic. They ask so many questions that I don’t understand how they can keep coming up with more to ask. However, it’s their curiosity that sparked the whole Narcan project idea.

Last winter, I went home to spend some time with my family. Like many families do, we decided to watch an episode of 60 Minutes together. Sure enough, there was a segment about a program in Utah where they showed people walking around the streets of Salt Lake City just passing out Narcan to seemingly everyone. Knowing about my involvement with TBSM and our street runs, my mom turned to me and asked if we were doing something similar. We were not.

After researching the opioid epidemic in the Tampa area, I quickly learned that there was a need for a similar program especially amongst TBSM’s patient population – yet none existed. The Florida Department of Children and Families (DCF) started an Overdose Prevention Program (OPP) in September 2016 designed to equip organizations like TBSM that serve populations at-risk of experiencing or witnessing an overdose with Narcan free-of-charge. The goal of the OPP is to train individuals in the recognition and reversal of an overdose. I helped lead TBSM’s effort to enroll in this program and ultimately begin distributing Narcan to our patients.

Over the past 6 months, we have equipped nearly 90 individuals in downtown Tampa with Narcan and have trained them in the recognition and reversal of an overdose. We have heard countless stories of tragedy of individuals who are addicted to opioids or who are worried about friends and relatives that use them. They are incredibly thankful for this program. And just a couple weeks ago, we received word that thanks to this training, we helped reverse a Fentanyl overdose and save a life.

It is quite rewarding to see our hard work make an impact amongst the patients we serve. To have started this program was a feat on its own, but to have played a part in reversing an overdose was truly unimaginable – well, maybe not for a couple of interested parents.

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Josh Mizels is a third-year medical student at USF Morsani College of Medicine and a Mobile Clinic Coordinator for TBSM.

As reflection imbues work with meaning, provides deeper insight, and promotes complex learning, TBSM volunteers are invited to write about their personal experiences and the process of service learning with TBSM every month.