Saving Lives, Fighting Racism: The Black Influence on Emergency Medical Services

The Freedom House Ambulance Service was created out of necessity and innovation. In 1960s Pittsburgh, the first person someone would call in a medical emergency was the police department. For African Americans, calling the police is not always the most reliable and safe option now and especially during that time period. 

To meet the needs of Pittsburgh's Hill District, a predominantly Black community, a group of people created the United States' first advanced life support and ambulance service, staffed with predominantly Black men and women.  

Historical Context

Before the establishment of the modern standard for emergency medical services, care was provided through a patchwork of unregulated systems shaped by lessons learned during the Civil War. Some services were provided by fire departments and, in some cases, funeral homes. After WW2, municipal laws authorized police departments to provide emergency medical services to people. The pre-hospital care provided by these groups was inadequate and lacked basic training.

The New England Journal of Medicine said, “At the time, police officers and morticians without medical training supplied most prehospital ‘care’, generally providing transportation without medical treatment. Even Pennsylvania Governor David Lawrence’s 1966 death, which was partially attributable to inadequate emergency medical services (EMS) care, failed to galvanize improvements in emergency care.” 

The quality of EMS care was worse in Black communities. Many were even denied service. The 1964 Philadelphia Race Riot and the York Race Riot of 1969 marked the social and racial climate of Pennsylvania. The social and racial climate of Pennsylvania was marked with the 1964 Philadelphia Race Riot and the York Race Riot of 1969. 

The Philadelphia Race Riot was caused by an altercation during a police stop while the York Race Riot was caused by a false report that a white gang had set a group of Black youth on fire. Lack of trust in law enforcement and government officials to accurately help the clear health disparities in underserved Black neighborhoods bred the Freedom House Ambulance.  

Founding of the Freedom House

Freedom House Enterprises (FHE) was originally a non-profit organization that specialized in organizing voter drives and supporting Black-owned businesses within the Hill District. The Freedom House Ambulance Service was established in 1967. 

A key figure is Dr. Peter Safer, an anesthesiologist from the University of Pittsburgh who helped train the members. His 11-year-old daughter tragically died of an asthma attack, and he believed that many lives like hers could be saved if the emergency transportation at the time turned into mobile treatment centers. 

Another figure, Phillip Hallen, a former ambulance driver and chairman of the Office of Equal Opportunity (OEO) Health Committee, made a big impact on the development. He helped garner support for the program and signed a contract with the city of Pittsburgh. 

Black men and women were recruited to train to become EMS staff for Freedom House. The mission was to address healthcare disparities, empower communities, and create an efficient emergency response. 

Training and Innovation

Most of the first members of Freedom House were unemployed. When they first began, there was nothing they had done that interested people in joining. In the first year, some recruits who were convinced to join were Vietnam vets struggling after the war or people from the streets. Over time, the applicant process became more competitive. 

Training began in local hospitals, emergency rooms, morgues, operating rooms, and radiology departments. Freedom House was the first to use modern cardiopulmonary resuscitation (CPR), intubation, defibrillation, and Intravenous therapy (IV) in the field—a technology unheard of during that era. The trainees were trained under pressure to learn in the best way possible, while Dr. Safer used his expertise to train them extensively.  

John Moon, former Freedom House technician and retired Assistant Chief of Pittsburgh Emergency Medical Service, recalled an experience during training, “He [Dr. Peter Safer] would go into an operating room. An anesthesiologist would be sitting at the head of the patient, ready to intubate. The surgeon was there, all gloved up, ready to do his surgery. Safar would come into the OR, move the anesthesiologist out of the way, sit me at the head of the patient and say, ‘Intubate this patient,’ while the patient’s physician was standing there waiting.” 

A true standard was set for EMS training, emphasizing high-level medical training, hands-on experience, preparedness, and inclusivity. 

Legal and Systemic Challenges 

During the 1960s and 70s, no laws ensured the right to emergency care for all individuals, regardless of their background, making community-based efforts like Freedom House susceptible to changes in the political climate. White neighborhoods grew indignant that Hill District residents were receiving better care than them. 

Fire and police departments strongly opposed the ambulance service, as they believed it was a threat to their institutions. The mayor of Pittsburgh at the time, Pete Flaherty, slashed its budget and publicly called for the return of the ambulance service to police departments. 

Freedom House Enterprises initially benefited from funding at the local, state, and federal levels. However, Pittsburgh’s administration later pushed to scale back support for social welfare programs and pointed to Freedom House’s costs as a reason to withhold continued backing. Despite this, the city went on to establish a more expensive, predominantly White city-wide “superambulance” service, indicating that funding was likely not the real issue. 

On September 22nd, 1975, board and city officials voted to dissolve the organization. John Moon said in an interview with UCSF, “Despite a written agreement that our previous training would be accepted, it was not. As a result of constant belittling and additional needless class sessions, a great number of Freedom House personnel were systematically eliminated from employment with Pittsburgh EMS. When you eliminate the history makers, you essentially eliminate that part of history.” 

Impact and Legacy

Throughout history, the contributions of African Americans in the United States have not only been overlooked but also often deliberately obscured. The creation of Freedom House, born out of necessity, marked a pivotal moment in the development of modern emergency medical services. 

Freedom House persisted even with severe political pushback from its founding in 1967 till 1975. During its first year, they responded to 5,800 calls, transported 4,600 patients to the hospital, and saved an estimated 200 lives. Without its groundbreaking work, the trajectory of EMS care could have been drastically different, potentially resulting in many more lives lost. 

Time and again, the legal system has undermined the positive contributions of Black Americans, often excluding them from recognition and celebration. Both the medical and legal institutions in the United States have been shaped by deep-rooted racism and bias. Yet, despite persistent discrimination, the work and legacy of Freedom House remain monumental and enduring.

Image Source: WQED