A fall 2020 Public Health Grand Rounds event, moderated by Mario C. Browne, revisited the Freedom House ambulance service model as a means to discuss the present state of EMS training while maintaining a focus on the future.
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Freedom House Enterprises ambulance services was a pioneering program designed to be representative of the community it served (Pittsburgh's Hill District), provide a pathway for upward mobility, and address a severe disparity in pre-hospital care. The collaboration between Phil Hallen, Peter Safar, and James McCoy Jr., developed into a groundbreaking endeavor that shaped modern EMS. Walt Stoy invoked the need for a new type of practitioner with roots in EMS that focuses on the community and the needs of patients that can't be addressed solely in an emergency event. Paula Davis, highlighted the need to make EMS education comprehensive, raising the awareness of first responders regarding the social determinants of health and better preparing practitioners on the resources available to them as they are deployed into our communities. Behavioral and mental health concerns in our communities is an area which Community Paramedicine is uniquely positioned to tackle. Dan Swayze described how Community Paramedics help patients navigate crises and directing them to different systems of care in an all-hazards approach. He suggested this may lead to future iterations of EMS core competencies to include the assessment of social determinants of health and how providers may best address them.
Modern EMS remains largely homogenous across the nation, and our illustrious panel confronted the current lack of representation head-on. Recruitment efforts and bias training are part of the solution to reduce disparities in health care. Representation matters and Swayze noted the importance of having a shared experience with patients, to identify people from the marginalized communities we are serving to become the role models of the next generation of EMS. Although some of the same resistance to diversify that contributed to the dissolution of Freedom House Enterprises ambulance service in 1975 is still evident today, there is a unified and concerted effort to transform EMS into a more inclusive space. Deputy Chief Amera Gilchrist, Rickquel Tripp, and Sylvia Owusu-Ansah are among the figures leading the next generation of EMS and preserving the Freedom House legacy, forging new pathways while acknowledging and appreciating the past. The lessons learned then continue to shape future models of EMS.
In 1966, when Phil Hallen's original memo was drafted to address the delivery and quality of pre-hospital care, he didn't know the long-term effect it would have and cement Pittsburgh as a leader in EMS. During the panel discussion, Hallen recognized that new figures are emerging, "picking up the threads" where Freedom House left off, and "weaving it into something new." The importance of mentorship was the common thread the emerged from the panel discussion as Dr. Safar provided rigorous training to people like Columbus Councilmember Mitchell J. Brown, a former Freedom House paramedic, which allowed him to rise within the ranks of the Freedom House organization in the 1960's and 1970's. Before going on to a distinguished career in public safety in neighboring Ohio, he was able to open doors for others, such as John Moon. After Freedom House, Moon eventually went on to become assistant chief for the City of Pittsburgh Bureau of EMS. For decades he attempted to preserve the Freedom House legacy and implement diversity efforts in Pittsburgh. Despite facing severe opposition, his devotion to this cause prompted Gilchrist a means to join the city of Pittsburgh as an EMT. Now deputy chief, Gilchrist is presently the first woman and first African-American to ever hold that position in the City of Pittsburgh Bureau of EMS and credited Moon for inspiring and mentoring her.
The oft-forgotten Freedom House contributed not only to modern EMS design, but its effect is most evident and palpable in these aforementioned examples. The legacy of Freedom House Enterprises ambulance services will hopefully persevere for generations to come.
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