National first aid systems in most of the world came out of the medical corps of popular and liberation movements of the 1950s and 1960s. This was also true in the United States, where street medics were operating and training in Mississippi and New York City at least four years before the first statewide EMS program was established (in Maryland).
Street medics
Street medics are an international informal community who have provided medical support during the last half-century at protests, direct actions, uprisings, and natural disasters complicated by police or military targeting of survivors. Becoming a member of the street medic community involves completing a 20-28 hour training (or a bridge training for medical professionals), working at an action as the buddy of an experienced street medic, and maintaining relationships in the street medic community.
Street medic training prepares one to operate ethically in dangerous scenes. Street medics:
- Establish safety with preparedness and prevention.
- Maintain safety with ethical, dependable field medics.
- Enter unsafe scenes and establish safety for the sick and injured person.
- Render first aid and education to injured comrades until they recover or reach definitive care.
- Rehumanize situations after brutality and burnout so that communities feel safe again.
Street medics have varying levels of training. Many have the skills of first responders and knowledge of some herbal remedies. Street medics are expected to keep their skills current by pursuing continuing education and maintaining involvement in action medical response. Many contemporary street medics identify as anarchists or radicals, and these values inform the street medic approach.
A brief history of street medics and action medical
Many street medics trace their lineage to medics during the Civil Rights Movement. In 1963, the Medical Committee for Civil Rights formed an integrated affinity group of medical professionals and joined the March On Washington to demand civil rights for black Americans. As the March wound down, MCCR transitioned into a standing group that offered health support to Civil Rights workers at Mississippi Freedom Summer in 1964. Their name changed to the Medical Committee for Human Rights as their ideology shifted. Early in the summer of 1964, the need for first aid led to a nurse with a Red Cross family background to train civil rights workers to administer first aid at protests.
Street medics developed specialized protocols and ethics and a particular approach to training health workers. By the late 1960s licensed health professionals were attending street medic trainings in order to be cross-trained to work in the great variety of protest environments that had emerged. Trainings were often offered by medics with no medical licenses or certifications. One of the earliest peacetime paramedicine programs was based out of an independent black-run inner-city community self-defense organization in Pittsburgh, and the first Emergency Medicine residency training program was established in Cincinnati after a march on Cincinnati General Hospital by working-class black patients.
Community public health
Street medics considered medical knowledge a form of self-defense, and provided health education and medical support the movement to end the war in Vietnam, the New Left, and movements for the equity and independence of women, queers, veterans, Native Americans, prisoners, and mental patients. In the course of supporting long-term struggles, street medics shifted from a focus on prehospital care to a focus on community health and mental health. In the 1970s, street medics worked in Black Panther community programs and People's Clinics, the American Indian Movement battle at Wounded Knee, and other revolutionary projects.
Street medics and health professionals partnered with national liberation organizations pioneered in the field of public health. Together with organized communities, they helped develop rat abatement programs, lead testing programs, children's free breakfast programs, and community drug prevention and treatment programs. They helped force more equitable inner-city garbage collection, fire safety and firefighting, and they supported long struggles to reform the VA hospital, recognize Agent Orange sufferers, define and acknowledge post-traumatic stress, close the mental asylum system, and end the diagnosis of homosexuality as a mental disorder.
As the remaining first wave of street medics maintained their focus on long-term community support, new traditions of protest health care emerged in the 1980s and 1990s. ACT-UP, nuclear disarmament and native sovereignty long marches, and extended backwoods direct-action campaigns all had medical wings. The Peoples' Medics did urban healthcare and protest healthcare in the Bay Area in the 1980s, and American Indian Movement Street medics worked together with other medical professionals in the Guatemala Acupuncture and Medical Aid Project (GUAMAP) to train displaced Mayan survivors of the Guatemalan civil war in Guatemala to provide comprehensive health care in their new isolated communities.
Convergences against militarized austerity
The values and lessons of thirty-five years of protest medicine reached a new generation in the months before and after the 1999 World Trade Organization (WTO) protests in Seattle, Washington. Many communities of health workers converged in the medical response to Seattle, with backgrounds in Earth First!, ACT-UP, community herbalism, and radical feminist health collectives. The street medic model broadened through battle testing and new forms of horizontal organizing.
Almost every month for several years mass mobilizations converged throughout the world and engaged in direct action that paralyzed trade summits and meetings of institutions that coordinated the growth of the globalized system driving increasing global disparities. The movement forced reforms of several institutions and cancellations of some of the worst planned trade deals.
Anti-globalization, global justice, forest defense, and environmental justice convergences faced a growing militarization of police equipped with tear gas, pepper spray and pepperballs, flash-bang grenades, helicopters, plastic bullets, beanbag rounds full of 00 buckshot fired from shotguns, dowels fired from shotguns, tasers, police dogs and horses, and a growing national security apparatus.
Medics trained tens of thousands of protesters in short courses focused on health and safety, eyeflushes, critical incident stress management, herbal aftercare, and day-long Affinity Group Medic trainings. Street medics functioned as a second tier of care to an informed public, and thousands were trained in the United States and Europe. Dozens of medical professionals attended bridge trainings and joined the street medic community; several became accomplished trainers after seeing action and co-training with experienced trainers. Dozens of medics pursued advanced medical training after finding a life purpose in medical work. Some entered war zones during mass deportations in Europe and during the Second Intifada in Palestine, where they provided support and care with voluntary ambulance services and on foot.
Disaster mutual aid
As mass convergences became fewer and farther between, street medics entered new fields. A team of Native American medics and traditional clowns responded to the impact of the 2004 Asian tsunami on indigenous fishing villages in coastal Thailand, where they provided mental health and medical aid and helped bury bodies. Street medics developed the first medical clinic in New Orleans to provide care after Hurricane Katrina and transitioned control of the clinic to the local community. The clinic was the highest-volume free clinic in the U.S. for much of its first year and won awards for the quality of care and health education provided.
Street medics rendered medical care and medical education to relief workers, undocumented immigrants, and poor blacks and Vietnamese people in urban and rural parts of Louisiana. They provided medical support and training to poor Appalachian families and their supporters over half a decade in the ongoing pitched battle against mountaintop removal coal mining. Street medics formed community health collectives in their home communities. Four affinity groups of street medics from the United States and Australia responded during the early aftermath of the 2010 Haiti earthquake, and a group of street medics visited thousands of elderly residents of NYC Housing Authority developments who were trapped in their buildings after Hurricane Sandy.
As world governments fall into debt to the wealthiest 1%, many new medics and radical uprisings of teachers and students in Oacoxca, the UK, Chile, and Quebec; and from the Occupy Indignant movement and Arab Spring.
Medics find themselves fifty years in, being re-formed again through dialogue with a new generation of protesters and health workers and new challenges, ready to meet the challenges of the next fifty years together.