SMI Program Collaborations Around the World

The map below depicts most of the cities throughout the world where Street Medicine Institute leaders have engaged in collaborative efforts toward the development and improvement of Street Medicine Programs.  To become a Program Member, click here.


Jim Withers' Blog

December 30, 2020

2020 is coming to a close and we look forward with hope to a better 2021.  For those living on the streets, the pandemic has been yet another tragedy in the chronic disaster that is homelessness.  In March, we saw the familiar reactions of society during times of fear.  Somehow many assumed that those living on the streets were dirtier and more dangerous than the rest of us.  Vital services and access to food vanished, leaving our people feeling abandoned.   It became even harder to access medical care as most clinics shifted heavily to telemedicine.  Soup kitchens and drop-in centers closed.  Those businesses that were still open were increasingly hostile to folks from the streets.  Ironically and predictably, those who always suffer exclusion suffered more.  Although some cities rallied to respond, many cracked down on those experiencing homelessness by wiping out camps and destroying their few belongings.  Some of us working with those on the streets were particularly avoided by friends and family.  Once again, we were called to choose the way of fear or the way of love.  And, of course, our local experiences were a reflection of the much larger political forces at work throughout the world.  Hate and fear thrived in 2020.

As we were soon to discover, however, the prevalence of COVID 19 on the streets was remarkably low.  Within a short time, we began to see ourselves as the dangerous ones when we entered camps and visited isolated tents.  We admired the courage and perseverance of those we sought to serve.  Once again, our perspective was forced to shift.  Many of us used the heightened political atmosphere to demand washing stands, water, and toilet facilities that should have been provided years ago.  We began to coordinate with other agencies and the local government like never before.  The field workers were fewer, but they were more determined.  Sadly, we saw the ravages of less primary care for our population.  And with the stress and despair, and less access to harm reduction measures, deaths from overdose also rose dramatically.  The annual memorial service will be even more heartbreaking this year.  As winter weather descends upon the streets, the people are facing the terrible choice of crowded emergency shelter with the risk of infection or enduring the freezing cold.  All of us are exhausted as 2020 comes to a close.

But there is much to bring hope.  Times of crisis give us a clear vision of not just how selfish and cruel mankind can be.  We also predictably see how such times can pull us together.  In fact, our collective demand for justice has made us stronger.  Those who would manipulate our fear and hatred have no real response to the power of a love that does not run away from our sisters and brothers in need.  A love that refuses to believe there is not enough for all of us.  A love that sees victory in our unity, not in “succeeding” at the expense of others.

It seems obvious that our world will be tested more frequently and more profoundly in the future.  How we respond will define who we choose to be.  Not just locally, but globally.  Vaccines will soon be available.  We must fight to ensure that the excluded and most vulnerable people benefit from these vaccines as a priority.  Likewise, we must demand that nations with fewer resources are not pushed aside.  

Let us be inspired by the courage of those on the streets who have endured yet another crisis.  Let us take the lessons of 2020, of how we have fought together to face this pandemic forward to the challenges that await us.  If we can ‘go to the people’ when we are most needed locally, there is hope that we can find a way to do so globally.  That is the greater healing we must find. May you all have a blessed and hopeful 2021.


We heard your concerns about differing economies around the world

Since we introduced our paid membership approach this past July, we have received feedback from friends around the world indicating that the donation levels we have asked are inconsistent with the economies of many countries outside of the US.  We appreciate these observations and want you to know that the Street Medicine Institute remains committed to our global community.   

Recognizing different Costs of Living (COL) around the globe, we are now offering membership discounts to citizens of countries outside of the United States – 40%, 60% or 100% (free) – depending upon the local COL.  Please click here to read more and to join.  We have learned from past symposia and historical exchanges with our international colleagues that the basic principles of caring for rough-sleeping homeless persons are similar regardless of location.  We are members of a global street medicine family and celebrate the expertise and diversity each of you contribute to the street medicine movement.  We hope this adjustment helps us remain an inclusive community in which we learn, share ideas, and innovate together. 


In solidarity,


The Street Medicine Institute Board of Directors