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Doctor, Doctor: Healthcare For The Homeless

By Kamayani Bali-Mahabal

He used to dress like a homeless person. On purpose. Two or three
nights a week, he’d rub dirt in his hair and clothes before walking
the dark streets of Pittsburgh searching for the very people he was
trying to impersonate. This was his way of connecting with those who
had been excluded from healthcare. Meet Dr Jim Withers, a.k.a. Street
Doctor, who has pioneered the concept of street medicine.

As Founder and Medical Director of Operation Safety Net, part of
Pittsburgh Mercy Health System and Trinity Health, he, along with his
staff and a band of volunteers, brings quality healthcare to the
homeless right where they live – under bridges and overpasses, in
alleys, and along the rivers. Says Dr Withers, “I was really shocked
[to see] how ill people were on the street. It was like [being
transported] to a third-world country. Young and old, people with
mental illness, runaway kids, women [who had] fled domestic violence,
veterans… and each one has their own story.”

For over 23 years now, Dr Withers has been treating the homeless. He
explains his reasons for taking this stand, “As a teaching physician,
I became convinced that we needed a new [kind of] ‘class room’ in
which we could more directly experience the reality of those who were
socially excluded from healthcare, and from society in general.”

In 1992, he began to dress as a homeless person and interact with
those living on the streets. “My guide was a formerly homeless man and
soon there were other volunteer nurses, medical students and formerly
homeless partners who joined in. Realising that a new healthcare
system was emerging [one that is more commercially oriented], I
developed services, including electronic records, case management, a
hospital consult service, a medical education curriculum and an
office, specifically for the homeless,” he says, adding, “Over time,
we have grown to become a significant street medicine programme
providing 24×7 coverage for all those who sleep on the streets. We
have brought people into [the ambit of] primary care, housed over
1,200 chronically homeless persons in the past 11 years, created a
severe weather shelter, introduced legal services and educated over
100 students per year. Not only are the lives of many being saved [as
part of this initiative], but we have been able to reduce the costs
incurred by emergency rooms and hospitals.” When Dr Withers had
started Operation Safety Net it was a very novel concept. However, he
had figured out that, as healthcare increasingly became a profit
driven profession, a programme like this would have the potential to
make a real difference.

Interestingly, it was his time spent in India, as a medical student in
the early 1980s and then again in the early 1990s, when he had the
opportunity to meet up with Mother Teresa in Kolkata, that opened his
mind to the idea of practicing medicine for the benefit of the masses.
“I have a deep connection with India. In early Eighties, I was
influenced greatly by a two-month medical school experience I had in
Mysore [Karnataka] during which I saw scores of female burn victims
coming into the Mission Hospital. They seldom had any visitors and
would not speak to anyone. I sensed an indescribable sadness in them.
Many eventually died. When I asked the attending physician about this
situation he told me these incidents happened because the stoves were
dangerous and the women’s saris caught fire. It was much later that I
discovered that in reality these women had been burnt for dowry by
their husbands’ families. What was even more shocking for me was the
fact that this was a common occurrence and that the attending had
chosen to misrepresent this appalling reality. During that time I had
ended up marrying a south Indian woman whose brother-in-law was a
judge. He was constantly called to take statements from dying women
who had been burnt. Almost never would they testify against their
husband. I never forgot this brutal domestic violence and it later
encouraged me to dedicate my medical career to those who suffer from
all forms of social injustice,” he shares candidly.

He came back to India in 1993 after he had started Operation Safety
Net to look up a Dr Jack Preger, who was doing similar kind of work in
Kolkata. “He had been doing this since 1979 and I wanted get a chance
to interact with him; learn from his experiences. But as I was on my
way to call on him, on a whim, I decided to take a slight detour to
Mother’s Home. At the door, I told the nuns the work I was trying to
do and about street medicine and asked if the administrator would be
able to take out time to meet me and share the work being done at
Mother’s Home. To my immense surprise they invited me to meet with
Mother Teresa! I was able to spend nearly an hour with her during
which I found her to be a brilliant and forward-looking woman. Even
though she was in her eighties, she did not dwell on the past, but was
focused on the future. Her clear commitment to her principles
reinforced my own values. I saw how sending a clear, simple moral
message could have a global impact. Street medicine, I believe, is
having that same kind of impact,” explains the good doctor who
received CNN’s Top Hero Award last year.

Talking about homeless women he shares that “the percentage of women
living on the streets in the US has gone up in the last two decades –
it’s nearly 30 per cent today. Most of them have experienced some form
of violence and the majority has actually escaped domestic violence”.
According to him, homeless women generally battle with “depression,
post traumatic stress disorder, mental illness and addictions”. “All
of these issues are inter-related and cannot be addressed in
isolation. By ‘going to the people’, street medicine allows us to
become a part of their lives and gain their trust. Relationships
forged among those living on the streets are very complicated. As a
rule, I never force anyone to do what I think they should but simply
provide them with a consistent, loving support system so that they can
reclaim their own self determination,” he points out.

Gender violence, Dr Withers believes, has multiple, far-reaching,
physical and emotional consequences on the survivors living on the
streets. He says, “Denial and silence are the real enemies in such
cases. Nonetheless, I have seen how reaching out can result in
positive action. I have a dear friend who went through a lot before
she was able to get her life back in order. Lois had a long history of
unstable living circumstances, violence by those she trusted and
homelessness. I was called in to see her one winter; she was sleeping
next to a church in the snow. From that freezing night when we rescued
her it took her a long time to first trust us enough to help her and
then to get back on her feet. Her recovery has been a remarkable
lesson to us all.”

Having firmly established the efficacy of his programme Dr Withers is
hopeful that he would be able to take it to countries, especially
India, where it can truly impact the lives of those in dire need of
assistance and competent medical care. “Having street medicine in
every community transforms us,” he says, “We begin to see that we’re
all in this together. You can’t solve difficult problems if you can’t
get close enough to see them. That’s why I insist on ‘going to the


Women Featrure Service –

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Meet the Campa Cola homeless: CEO to diamond merchant, MD to Editor

Written by Alison Saldanha , Tanushree Venkatraman | Mumbai | June 24, 2014 8:31 am
Phase-1 of the demolition of illegal Campa Cola flats started on Monday with BMC officials disconnecting power, gas and water connections.( Express photo by Amit Chakravarty)Phase-1 of the demolition of illegal Campa Cola flats started on Monday with BMC officials disconnecting power, gas and water connections.( Express photo by Amit Chakravarty)


The Indian Express takes a closer look at 10 of the 89 illegal flat owners affected by the turn of events.

As the Brihanmumbai Municipal Corporation (BMC) begins phase-1 of its demolition plan for the allegedly illegal flats in the Campa Cola Compound, Worli, The Indian Express takes a closer look at 10 of the 89 illegal flat owners affected by the turn of events.

Five of these 10 flat owners are members of the core committee of the Campa Cola residents association and have been at the forefront of a year-long fight to protect the compound from demolition. They have been the faces of the ‘Save Campa Cola’ campaign, which has frequently appealed for sympathy over the past 13 months. The 10 flat owners either run successful family businesses, occupy high positions in private firms or are prominent personalities. In total, they own 23 flats.

PHOTOS: MCGM starts disconnecting supplies at Campa Cola compound

The Mehtas: 2 flats
Nandini Mehta, a member of the Campa Cola core committee, is the founder of a tea brewery business. Her husband Ajay Mehta is the joint managing director of a family-owned steel company based in Worli, involved in import, supply and manufacture of boiler quality steel plates. The company’s clients include Gulf Oil Corporation, the Aditya Birla group and Godrej. The Mehtas own two flats on the 10th floor of Midtown Apartments.


The Srinivases: 2-level penthouse
V Srinivas, a urological oncologist, is a consultant at Hinduja Hospital. He and his wife Vidya, a journalism professor at Xavier Institute of Communication, stay in a two-level penthouse apartment on the 19th floor of Midtown Apartments, overlooking Worli Sea Face. Their two flats have been merged to accommodate a large garden on one level and an open space to entertain guests on the second level. They are members of the Campa Cola core committee.

The Jayakars: 2 flats
Devyani Jayakar is the Consulting Editor of Inside Outside, an architecture and design magazine under the Business India media group. Her husband Tibrewala is a child specialist, while her son Niall Sadh is a TV anchor with Pogo channel, which is part of Turner International India Pvt Ltd. The Jayakars own two flats on the 12th floor of Orchid Apartments.

The Vermas: 1 flat
Sunanda Verma is the founder of a family-managed footwear business and a member of the Campa Cola core committee. The Vermas own two footwear stores in Mahalakshmi and regularly host footwear exhibitions around the country. “We built this business from scratch and have worked hard for many years. Today, if I have to invest all that I have earned on a new house, we can’t live the kind of life we wanted. We have to start all over again,” said Sunanda.


The Jalans: 2 flats
Ashish Jalan, the chief executive officer and director of Concept PR, a top public relations agency, owns two flats — on the third and eighth floors of Esha Ekta Apartments. His firm has been campaigning for the cause of the residents for more than a year.

The Sethias: 2 flats
Diamond merchant Suhas Sethia owns two flats on the sixth floor of Patel Apartments, where he lives with his family and three domestic helps. His son Karan Sethia, a member of the Campa Cola core committee, has been at the forefront of the campaign to save their flats. “We have lived here for over 22 years. I got married while staying here and had my first child here. Today, I can’t imagine what will happen to my parents and my brother but we will keep fighting till the end,” said Neha Sethia, Suhas Sethia’s daughter.

The Hirawats: 4 flats
The Hirawats own four flats in the compound. While Vinaychand Hirawat, who resides on the 16th floor of Midtown Apartments, has retired, his son Atul Hirawat is a stockbroker. Their cousins also own two flats in the same building. “If they ask us to go out, where will we go? There have already been three deaths in this compound due to the stress we are living under. I can’t believe we are living in a democratic country,” said Vinaychand, who has been a prominent face of the campaign to save the flats.

The Danis: 3 flats
The Dani family owns all three flats on the 16th floor, from where they have an unfettered view of the sea. Ashok Dani, the family head, who recently suffered a heart attack, is a manufacturer and exporter of readymade garments. His son Aatish Dani is the director of a consumer products testing laboratory, which has branches in four Indian metros. “We are thinking of shifting all our belongings to Bhiwandi. After living so comfortably, it is difficult for us to suddenly change everything. The civic body should help us find homes if they are ready to destroy whatever we own,” said Chanchal Dani, wife of Aatish Dani.


The Sanghvis: 3 flats
The ten-member Sanghvi family owns three flats on the 10th floor of Orchid Apartments. Tapan Sanghvi manages the family’s export business along with his father from an office in Mahalakshmi. “Now that we have started packing our belongings, we remember the trouble we took when we were building the house. Who would have thought a day would come when the state turns against its own citizens? We feel so vulnerable…we have been targeted for no mistake of ours,” said a member of the Sanghvi family.

Lata Mangeshkar: 2 flats
Singer Lata Mangeshkar, who recently pleaded with the state government through Twitter to not demolish the illegal flats, owns two flats on the eighth floor of Esha Ekta Apartments.

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‘India Under the Stars’- A new campaign for homeless #mustread


An uneasy sanctuary

  • The homeless survive on pavements, outside parks, at crossings and any place big enough for them to rest their heads. (From the top) Homeless people sleeping outside the Bhopal junction, the Hanuman temple compound in New Delhi’s Connaught Place and on a pavement in Allahabad on the eve of Gandhi Jayanti.— Photos: A.M. Faruqui, Monica Tiwari
    The homeless survive on pavements, outside parks, at crossings and any place big enough for them to rest their heads. (From the top) Homeless people sleeping outside the Bhopal junction, the Hanuman temple compound in New Delhi’s Connaught Place and on a pavement in Allahabad on the eve of Gandhi Jayanti.— Photos: A.M. Faruqui, Monica Tiwari

A new campaign seeks to shatter the stigma attached to the homeless

It is the eve of Mahatma Gandhi’s birth anniversary. Barely 50 metres from the magnificent compounds of the Allahabad High Court, Ram Chander is preparing to sleep. His bed is a thin rag spread on the concrete pavement; his roof the sky and the shutter of a law bookshop is his wall. Next to him, a frail old woman presses her husband’s tired legs. A couple of stray dogs are rustling to find space among the row of people, who flank Ram. Each night, he shares this space with 40-50 other homeless people, including women and children.

It is easy to spot a young runaway girl as she gets off a train at Bhopal junction, vulnerable to a nexus of porters, shopkeepers and pimps in the area who recruit young runaway girls into the flesh trade.

“The porters approach her offering her a home and the hope of a job. They give her mobile numbers of prospective employers, who are actually shop owners around the station. When you are desperate, you will call one of these numbers. There is usually an autorickshaw waiting with a female pimp as soon as the girl leaves the station. Once she gets in, she is lost to the flesh trade,” says Jamuna Farkale of the National Institute for Women, Child and Youth Development who has worked with the homeless for the past eight years.

In Delhi, violence is an overarching feature of the daily struggle of the homeless, who suffer both at the hands of criminal elements and the police. “The police just lift their batons and bam! Hit anybody who is trying to catch some sleep and escape the day’s drudgery. There is no respite even at night,” says Gopal, a homeless man living on the roof of a shop at the periphery of Hanuman Mandir. The temple teems with devotees during the day and is taken over by monkeys at night.

It is a dangerous life. “The government should do something before we all die like flies,” says Shyam.

The criminalisation of the poor and the homeless must be stopped immediately, says Tarique of Koshish — Tata Institute of Social Sciences, who works with the destitute. While there are 65 shelter homes in the Capital, there is need for twice as many.

In Allahabad, a city glorified for hosting the Maha Kumbh Mela, there are around 11,000 homeless people. They survive on pavements, outside parks, at crossings and any place big enough for them to rest their heads. Despite the struggle on the streets, the homeless are averse to the idea of shifting to a shelter home. While they hope to get some form of shelter, they are not sure of their treatment at government-run shelter homes. Out of the 11 shelter homes in Allahabad, only three are functioning. However, these can accommodate only 400 people and are in a pitiable conditions. Bhopal has 10 permanent shelters run by the municipal corporation, temporary shelters that come up during winter and a few private charities. They can collectively shelter less than a 1,000 people, at the most.

“We need shelters for 100 people for every one lakh people. Bhopal has 20 lakh people and there is no accurate estimate yet on the homeless ones. Even anganwadis used to refuse homeless children. Currently, health centres attend to underage mothers by falsifying their age in the records, lest they be pulled up for child marriage in their area,” says Sanjay Singh of Bachpan.

In an attempt to shatter the stigma attached to the homeless, an ‘India Under the Stars’ campaign was organised by close to 200 voluntary organisations in several cities, where people who have a roof over their heads were asked to come and spend the night with the homeless. In a society that deeply discriminates along the lines of poverty, class, caste and community, the destitute face the deepest forms of discrimination and are ostracised from all processes of civilised life.


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July 25, 2012


Shri Tarun Gogoi
Hon’ble Chief Minister of Assam



Dear Sir,

We, citizens of India committed to its deep secular and peace loving ethos appeal to you as head of the government in Assam to take all steps to ensure that violence stops, security is given to all displaced and dishoused by the violence so that they may return to their homes forthwith; adequate reparation for the lives lost and homes and other properties destroyed is paid and more than anything else a Fair and Time Bound Judicial Investigation by a Sitting HC Judge is conducted into the build up and fallout of the violence.

What concerns us deeply is the divisive discourse that seeks to create legitimacy for the violence by words and phrases like “infiltrators.” Since the mid 1990s tensions have simmered between the majority Bodo Councils and Muslim settlers despite the fact that the latter status was recognised in the Assam accord. Yet under the guise of discriminating between the two a small skirmish blew into a full blown communal conflagration; while the ethnicity of the 32 persons who lost their lives does not matter, the fact that the five persons who lost their lives to police bullets are from the minority has generated fear. There are already 1,70,000 persons in relief camps and they must be assisted with due security to return to their homes immediately. Dialogue must begin between the majority Bodo villages and the Muslim settlers for integrated rehabilitation.

Respecting your commitment to intra community peace we appeal to you to respond to this anguished appeal.
Teesta Setalvad, Mumbai
Javed Anand, Mumbai

Dr Asghar Ali Engineer, Mumbai
Ram Puniyani , Mumbai

Irfan Engineer, Mumbai
Hasan Kamal, Mumbai

Zafar Agha, Mumbai

Kamayani Bali Mahabal, Mumbai

MM Tirmizi, Ahmedabad

Rupa @Tanaz Mody, Ahmedabad
Sairabehn Salimbhai Sandhi, Ahmedabad

Salimbhai Noormohammed Sandhi, Ahmedabad
Tanveer Jafri, Surat

Rajendra Prasad, SAHMAT, Delhi

Ram Rahman, Delhi

M K Raina, Delhi

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Homeless in Silicon City, India

As the city prepares to welcome the monsoon, its poor are left to battle it out in the streets. In 2010, the Supreme Court ordered state governments to set up shelters for the homeless people. The October 2011 deadline has long expired and the work is yet to show good progress in many states. Karnataka, as usual, is a laggard state and Bangalore, lags many other cities such as Belgaum, in helping the lot of its poor. The city may need 80+ shelters, but only seven have been built so far. The majority of the homeless poor do not seem to be aware of them.

The man in this video earns Rs. 70 per day, almost twice Montek’s gratis to BPL people.
These are the aam aadmi for whom the Congress is shedding crocodile tears and setting up the UID database at a cost of Rs. 20,000/ Crores (as per the Union budget) to prevent “leakages” of LPG and BPL rations.

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When High Court Judges usurp land meant for the homeless, where do the homeless seek justice?

Faiza Khan, Khar East Andolan

Posted on May 6, 2012

When you ask about the court cases in Golibar now, the residents will wrly reply with the famous Hindi film dailogue. “Tareek pe tareek! Tareek pe tareek! “. The hearing on this Monday, the 7th of May, will be 20 months since the Golibar criminal case has been in the Mumbai High Court. In 2009, builder Shivalik Ventures had faked signatures of residents of Ganesh Krupa Society (GKS) in Golibar to claim the 70% consent it needed to redevelop the Golibar slum. On that list of signatories was Sulochana Pawar who had died four years before she allegedly gave her consent. Going by the rules of the SRA, this should have, at the very least, led to the ouster of Shivalik Ventures from this redevelopment project.

Instead, the then Slum Rehabilitation Authority(SRA) chief, Mr. S. Zende (remember this name, it’ll come up again later!) asks the residents of GKS to settle for a compromise. The police had been even more nonchalant and refused to investigate the case until the Court directed them to do so. Once on it, they were so baffled by this seemingly obvious case of fraud that for 20 months, they’ve been seeking extension after extension to complete their investigation. The Court has been very obliging. Meanwhile MHADA’s demolition squads, with police protection continue to break people’s homes.

So the government is clearly not on their side, specially after it backtracked on the GRs last year. The police never was. Their only hope of any justice was in the Courts. Until the Nyay Sagar scam came to light.

Akankhsha tai and other women from Ganesh Krupa are huddled around a copy of Janta ka Aaina, a community newspaper. They burst into cackling laughter. “Yeh toh apna Chandrachud hai!“(This is our Chandrachud!). Apna Chandrachud is Justice Chandrachud of the Mumbai High Court who has been hearing the matter of the Golibar GR case in the High Court. Now he’s on the frontpage, accused in a major land scam, along with Justice Khanvilkar who is hearing the Golibar criminal case (of the forged signatures). There are 13 other Judges and ex-Judges accused.
Nyay Sagar and Siddhant are two multi-storeyed buildings built on a plot of government land that was reserved for the homeless. The judges of the High Court led by then Justice Rebello (now Chief Justice of the Allahabad High Court) formed Nyay Sagar Co-operative Housing Society in 2001 and in collusion with Vilasrao Deshmukh  de-reserved all but 10% of this land and appropriated it for themselves. This change in the Development Plan of this plot, Survey No 341 (Part) CTS No 629 from being reserved for the homless to Residential was facilitated by some very senior bureaucrats, including Mr. Zende (the SRA chief who asked residents of GKS to settle for a compromise). What is shocking though is that the land was handed over to Nyay Sagar CHS much before it was de-reserved.

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Even the de-reserving was a sham. Once it is decided that the reservation of a piece of land is to be changed, there is a notification which is open to the public for 30 days in case they have objections. This notification was made public on 16.6.2004 but just six days later, on 22.6.2004 ,the status of the land was modified. The Ghar Bachao Ghar Banao Andolan has filed a complaint with the Anti Corruption Bureau asking them to file an FIR.

Akanksha tai laughs when she reads the buildings are called Nyay Sagar (meaning Ocean of Justice) and Siddhanth (Principles). But then she asks soberly, “Now where are we to seek justice?”


1. Shri Vilas Rao Deshmukh, the then Chief Minister,
2. Shri Sangeetrao, the then Collector Mumbai Suburb,
3. Shri SS Zende, the then later Collector Mumbai Suburb,
4. Shri RC Joshi, Principal Secretary, Department of Revenue,
5. Shri Ramanand Tiwari, the then P. Secretary UDD,
6. Other Unknown Govt. Official/s.
7. Justice V C Daga,
8. Justice A M Khanwilkar,
9. Justice B R Gavai,
10. Justice S M Ghodeshwar,
11. Justice S Radhakrishnan,
12. Justice S A Bobde,
13. Justice P V Kakade,
14. Justice R Lodha,
15. Justice G D Patil,
16. Justice F I Rebello,
17. Justice D K Deshmukh,
18. Justice D B Bhosale,
19. Justice D G Karnik,
20. Justice J P Devdhar,
21. Justice DY Chandrachud

A letter from Justice Rebello to ex-CM Vilasrao Deshmukh misusing his official letterhead for a non-official matter
More documents will be made public soon.


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