Freedom House Ambulance Service v. The City of Pittsburgh — Mistakes Were Made
Before the mid-1960’s, ambulance service in the U.S. was typically provided by either the fire department, the police, or a local funeral home. In police-operated ambulances, the ambulance crew would typically load the patient into the back of of a police van, while the police ambulance crew rode in the front.
In Pittsburgh, the city police handled ambulance service within the city, transporting patients via Paddy Wagon while funeral homes provided ambulance service in the suburbs. As is still the case today, wait times were often longer for service in predominantly Black lower-class neighborhoods, like the Hill District. Tension between police and the Black community made many Black residents reluctant to call the police ambulance service.
Phil Hallen, a former ambulance driver, sought to improve responses to medical emergencies and create employment opportunities for African-American men in Pittsburgh. Peter Safar, a physician, offered the ideas of intense paramedic training and improved ambulance design to Hallen for the new ambulance service.
Hallen contacted Freedom House Enterprises, a local nonprofit to help recruit paramedics for the new service. The Freedom House Ambulance Service program began in 1967 and started officially operating in 1968 with two ambulances and a majority African-American staff. Pittsburgh contracted with Freedom House Ambulance Service to handle emergency transportation in the downtown area and some predominantly Black neighborhoods.
Freedom House came to be known for the high standard of care they provided and were sometimes specifically requested by callers over the police ambulance service. Freedom House responded to almost 5,800 emergency calls its first year, and transported over 4,600 patients, primarily in African-American neighborhoods. Data shows Freedom House saved 200 lives in their first year of operation. The previous slow service that the Black neighborhoods were accustomed to was obliterated by Freedom House response time of under 10 minutes. Freedom House Ambulance Crews were trained in Intubation, cardiac therapy, and I.V. drug therapy to help patients.
The Freedom House Ambulance Service became a model service across the U.S. and internationally. Freedom House was awarded a major grant to develop the first national standards for paramedics. Miami, Los Angeles and Jacksonville would all follow the Freedom House model. The Freedom House ambulance was adopted by the National Highway Traffic Safety Administration as the official standard.
Despite their success, the Freedom House paramedics faced racism from hospital staff and patients. The paramedics were sometimes assumed by hospital staff to be orderlies and were asked to mop the floor. White patients were often surprised by or resentful of black paramedics, and would sometimes refuse to be touched or helped by them.
Some Pittsburgh police felt Freedom House had taken jobs that were rightfully theirs, Police dispatchers would often refuse to contact Freedom House to dispatch them to emergencies that were within Freedom House’s areas of responsibility. Freedom House started listening in on police radio frequencies to get news of emergencies within their area, then hope to get to the incident site before the police van. The Police would threaten to arrest the Freedom House paramedics unless they turned response to an incident over to the police,
Peter F. Flaherty was elected mayor of Pittsburgh in 1970. Flaherty was a vocal opponent of Freedom House, he believed services paid by the city should be directly overseen by it. Despite Freedom House’s, sterling reputation, it was denied its request to expand its services to other parts of the city by Flaherty. Under Flaherty’s regime, the city began providing payment for Freedom House’s contract late and cut its portion of the ambulance service’s operating budget by 50%.
Flaherty also signed an ordinance barring the use of ambulance sirens in the downtown area. This act slowed Freedom House’s paramedics and allowed the police to reach more calls before them. At the end of 1974, Flaherty announced the creation of a citywide ambulance service to be staffed by non-police paramedics and the end of the city’s contract with Freedom House.
Freedom House Ambulance Service closed on October 15, 1975. All the paramedics initially hired to staff the new city ambulance service were white. The medical director for Freedom House accepted the medical director position with the city’s ambulance service. The director agreed to take the position only if the Freedom House paramedics and dispatchers are hired and that their ambulance crews be kept together, The city agreed but then promptly broke up the crews and fired anyone with a criminal record. Pass/Fail exams were instituted on materials that the Freedom House paramedics had not been taught. Many Freedom House paramedics were fired because of the non-passage of the tests. The remaining Freedom House workers were reassigned to non-medical or non-essential work. Of the 26 Freedom House employees who joined the city service, only half remained a year later. Ultimately, only 5 remained with the city and only one was promoted into a leadership position.
Mistakes Were Made:
It’s a shame when racism destroys good ideas and services. Freedom House was a shining model of good emergency services across the world, yet jealousy and racist view points helped kill it off in 7 years. Instead of focusing on providing excellent emergency services to all of his constituents, Flaherty seemed hell bent on destroying Freedom House. Its ideas and legacy lives on through the modern day ambulance services we have today. As the patient Zero of EMS services, it’s a shame Freedom House doesn’t get the recognition or accolades it so rightfully deserves.
Originally published at https://mwmblog.com on August 21, 2020.