The most important thing Arabella Johnson brought with her on outreach visits with Street Medicine at Pitt was not a medical kit. It was a willingness to listen.
Johnson, an MPH student in Pitt Public Health’s Department of Behavioral and Community Health Sciences, joined the Street Medicine team nearly a year ago as part of her practicum. The clinical outreach program provides care directly to people living outdoors or in unstable housing. She quickly learned that dignity-informed items are just as essential as medical supplies and that community-informed work can shape not only what is distributed, but how others understand homelessness.
Hair ties, a small brush, scented lotion and deodorant were frequent requests. “We are not just trying to give the most basic items to get someone through,” she said. “If we can provide dignity-informed items too, why would we not do that?”
These conversations pushed Johnson to design dignity kits that reflect real needs rather than generic donations.
As she moved through weekly rounds downtown, she noticed that many women experiencing homelessness were difficult to reach. They were keeping themselves safe, often staying close to shelters or away from public spaces that outreach teams regularly visit. When the team did meet women, Johnson saw that feminine hygiene supplies were limited and often not the products people preferred.
She began talking directly with women and created a short survey to identify which products were most useful and why. The responses challenged widely held assumptions. Nearly all surveyed women preferred liquid soap because bar soap becomes messy and hard to store. They also preferred tampons to pads, since pads can cause irritation when worn all day, especially without access to clean underwear.
“A lot of people donate bar soap because you can buy a lot at a low cost,” Johnson said. “But every woman I interviewed preferred liquid soap. Bar soap dries out skin and is hard to store. Once it gets wet in a backpack, it can get everything dirty, so it ends up being single use.”
To build the kits, she began reaching out to companies for bulk donations of underwear, tampons, liquid soap and wipes. She presented her findings at the school’s Public Health Practice Showcase late last year and received the Director’s Award in recognition of her efforts to improve population health.
“Arabella’s presentation on the unmet need for personal hygiene and menstrual health products among people experiencing homelessness demonstrated the impact that one committed individual can make when they begin by centering community voices,” said Tina Ndoh, PhD, director of the Center for Public Health Practice and associate professor of environmental and occupational health.
As the project has grown, Johnson has also begun using it as a way to engage younger members of the community. Through presentations and service activities, students are not only helping assemble donation kits, but also learning about homelessness and public health in ways that challenge assumptions.
During one session with middle school students, Johnson asked how many of them knew what public health was. Not a single hand went up. By the end of the session, one group had decorated their donation box with the words “public health” in large sticker letters, a small but meaningful sign of how quickly awareness can grow when young people are given the opportunity.
“We form assumptions very early about people experiencing homelessness,” she said. “If we can create space for young people to learn, ask questions and better understand the experiences of others in their own communities, that is powerful.”
The project continues under Street Medicine at Pitt, where Johnson has taken the role of co-president, building on both dignity kit distribution and community engagement efforts.
“Arabella represents the very best of public health leadership,” said Anna Marie White, MD, medical director of Street Medicine, director of the Center for Street Medicine at Pitt’s School of Medicine, and Johnson’s preceptor. “She identified a critical unmet need and developed a community-informed intervention grounded in the lived expertise of people who are experiencing homelessness. She then carried out the project with exceptional organization, teamwork and initiative, and it is already having a real and measurable impact.”
-Clare Collins
