Street medics are defined as people who provide medical support at protests and demonstrations. They have varying levels of training from Wilderness First Responders up through physicians - though most of them have the skills of EMTs with some supplemental knowledge of herbalism. They are "basically radical activist medical professionals." Contemporary street medics often identify as anarchists, even more often as "radicals," though being an anarchist or a radical is not a prerequisite.
Street medics trace their lineage back to the Civil Rights Movement. In 1964, the Medical Committee for Human Rights (MCHR) started the Medical Presence Project (MPP). MCHR was a Civil Rights Era integrated group of medical professionals who, among other activities, traveled to the South in the "Freedom Summer" of 1964 to provide medical care for low-income Blacks. MPP was established due to the observation that "just the presence of ... health ... personnel has been found extraordinarily useful in allaying apprehensions about disease and injury in the Civil Rights workers." They cared for those injured and jailed in protests. MPP worked under the assumption that medical knowledge can be a form of self-defense, an assumption that has become a major contemporary street medic tenet. In the 1970s, street medics avow involvement in the work of Black Panthers and the American Indian Movement, among others. Street medic activity was sporadic in the 1980s and limited in the early 1990s.
The contemporary incarnation of the street medic movement traces its inception / revival to the 1999 World Trade Organization (WTO) protests in Seattle, Washington. During those protests, small cadres of street medics were highly visible and very helpful when police used tear gas and pepper spray against protesters. This alerted activists of the necessity of acquiring training to deal with protest-related injuries. Thousands of street medics were trained in preparation for further anti-globalization protests. Street medic training became more standardized and specialized - they learned how to care for pepper spray, tear gas, and taser injuries, as well as hypothermia, dehydration and other likely complications of protests. While some see street medic work as "just a hobby" others take it on as an identity. There are currently dozens of street medic organizations/ collectives across the U.S. and in ten countries. In virtually any picture of someone dying in a protest in the last five years - especially in the United States - a street medic is visible tending to their wounds.
Contemporary street medics employ a philosophy that combines elements of anarchist philosophy, conservative medical ethics, and a structural determinacy approach to poor health. The guiding principle - "the only bit of street medicine ideology that is consistent" according to one person interviewed - is "do no harm." This is also the guiding principle of the Hippocratic oath, but it has a specific interpretation among street medics. It means "in the theaters of street medicine ... the person you are treating, if you do anything to [harm them] you put that person into immanent danger, more than they were before." Street medics work under the assumption that their patients might not be willing to seek care in a hospital - because they can't afford it, fear legal ramifications, and so on - so if there is a possibility that a street medic's treatment will make someone sicker, they will not do it. Street medicine's emphasis on prevention and wellness rather than treatment also results from the "do no harm" ethic. Street medic protocols emphasize preventative measures such as "dress warmly," eat protein," and debriefing afterwards if something emotionally stressful occurs. There is also a sense of crisis in the way "do no harm" is described. Street medics see their work - when it is responding to medical problems rather than preventing them - as occurring in dangerous of high-pressure situations. They lack the privilege of "back-up" from police or hospitals that a paramedic enjoys. Thus, they see an increased potential for them to commit harm with no additional resources to repair it.
"Do no harm" also implies an emphasis on patient consent. As one Common Ground Health Clinic founder put it ; "taking into account patient consent, informed consent: giving your patient a realistic rundown of, if they should go to the hospital, why." The operative word is realistic, from the perspective of the street medic. Conventional EMTs are trained to recommend patients go to the hospital under almost any circumstance "just to be safe." Street medics, on the other hand, believe hospitals may be more harmful, or just unnecessary, to patients than taking care of themselves. This faith in self-determination and the value of self-care is evidence of anarchist philosophy's influence on street medics.
Running parallel to "do no harm" as a recognition of their limitations, street medics also believe that basic healthcare is not overly difficult to teach or learn. This tenet hearkens back to the Black Panther Party's emphasis on demystifying healthcare. Many believe that the bureaucracy and rules currently associated with both the training for and implementation of medical care in the United States are excessive and at times counter-productive. One long-term Clinic volunteer and street medic described this as approaching medicine "without all the anxiousness and all that bureaucracy." Street medics view street medicine as portable, because it is neither bureaucratic nor difficult.
The last aspect of street medic philosophy, which is a commonality between anarchists and street medics, is a "structural determinacy" approach to health. Both groups believe that "oppression" (racism, sexism, economic deprivation, etc.) causes poor health, rather than genetics, biology, or personal choice. To this extent, street medicine is political, because it implies that social change will go further to improve health than individual healthcare.