The Freedom House Ambulance Service, courtesy University of Pittsburgh
Issue #332: American History May 30, 2023
Although ambulance-type transportation has been around since the 15th century, ambulance services to transport people directly to the hospital began in the 19th century. The first known hospital-based ambulance service was based out of Commercial Hospital, Cincinnati, Ohio in 1865.
In 1869, Dr. Edward Dalton, who was a former surgeon in the Union Army, created the Bellevue Hospital in lower Manhattan and started an ambulance service to bring patients directly to the hospital. Dr. Dalton's ambulances carried medical equipment, morphine, and brandy, and the horses were kept in their harnesses to be ready for a call.
The first gasoline-powered ambulance was the Palliser Ambulance, introduced in 1905, and named for Capt. John Palliser of the Canadian Militia.
After doctors were pressed into services during World War II, ambulance services quickly degraded, and other vehicles, including civilian and police cars, were used to transport patients.
During the Korean War, the US Air Force produced a number of air-ambulance units for use in forward-operating medical units, using helicopters for rapid evacuation of patients. These helicopter ambulances were featured in the famous TV show “MA.S.H.” M.A.S.H. is an acronym for Mobile Army Surgical Hospital.
The H-13 Sioux helicopter and the Medical Air Evacuation Squadrons were also used with much success during the Vietnam War.
In 1966, a medical white paper was published stating that accidents were the leading cause of death for people aged 1 to 37, which led the Department of Transportation and the National Highway Traffic Safety Administration to develop a more modern ambulance service nationwide.
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Dr. Peter Safar, who is credited with pioneering cardiopulmonary resuscitation (CPR) and the establishment of the first intensive-care unit (ICU), initiated the Freedom House Enterprise Ambulance Service in 1966. He was inspired by the untimely death of his 12-year-old daughter from an acute asthmatic crisis.
Additionally, the former Governor of Pennsylvania and former mayor of Pittsburgh, David L. Lawrence, suffered a heart attack and was transported to a local hospital by police. Lawrence had no brain activity when he arrived at the hospital and died after being removed from life support. Dr. Safar, who treated Mr. Lawrence at the hospital, believed that death could have been avoided with adequate pre-hospital care.
The Freedom House Enterprise Ambulance Service was the first dedicated pre-hospital emergency medical service (EMS) in the United States. Along with Dr. Nancy Caroline, Dr. Safar developed the standards for emergency medical technicians (EMTs) and for mobile intensive-care ambulance design and equipment.
After being approached by leaders in the predominantly-Black community around Presbyterian University Hospital in Pittsburgh who wanted better medical transportation options for their residents, Dr. Safar trained mostly low-income and formerly "unemployable" Black people to transport critically ill or injured patients as EMTs and medics.
The trainees for Dr. Safar's program had previously held low-paying or menial jobs and many did not even have a high school diploma.
The all-Black Freedom House ambulance project, which provided 24/7 medical services in two districts around Pittsburgh, ran from 1967-1975 and helped establish the national training model as the gold standard for creating, training, and staffing emergency medical service programs.
The Freedom House EMTs were so well-trained that they were often requested to the scene by police officers, and several members of Freedom House went on to establish successful careers in EMS and public safety.
The Freedom House Ambulance Service was the first emergency medical service in the United States to be staffed by paramedics with medical training beyond basic first aid. With its all-Black staff, it broke medical ground by training its personnel to previously unheard-of standards of emergency medical care for patients en route to hospitals.
The paramedic training and ambulance design standards pioneered in the Freedom House Ambulance Service would set the standard for emergency care nationally and even internationally.
The Freedom House EMS/EMT Program became the pilot course for the U.S. Department of Transportation and the White House intra-agency Council on Emergency Medical Services and set the national training model for EMS programs in the United States.
Unfortunately, Freedom House had to shut down in 1975 after losing much of its funding due to resistance from white suburban fire departments, whose leaders understood that an expansion of Safar's goals would eventually force them to retrain their crews.
As Freedom House was phased out, Pittsburgh launched its own ambulance service that was predominantly white.
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Fascinating and inspiring story!