Hill District ambulance service revolutionized healthcare, establishing a model for emergency medical services emulated nationwide.

In the blistering summer heat of 1968, the first ambulance of its kind wailed down the street, and as it came to a screeching halt, out hopped emergency medical service professional John Moon. Like the ambulance, Mr. Moon was also a first: one of the first professionally medically trained men to serve the Hill community of Pittsburgh, Pennsylvania. As an Emergency Medical Service (EMS) member, Mr. Moon provided lifesaving emergency medical care en route to a hospital in the back of a moving vehicle. He did all this in the name of serving his community, The Hill District.

Not only was an ambulance equipped with an EMS professional a sight to see in 1968, but even more surprising was that the EMS professional was a Black man, at a time when America was torn by racial strife. The ability of Mr. Moon to attain such an important job and give back to his community would not have been possible without the Freedom House Ambulance Service.

Freedom House Ambulance Service emerged in 1967 as a response to the Hill community's desire for self-reliance. Before Freedom House, the Hill community - and all Pittsburgh residents - had limited access to emergency medical services.  Ambulances were driven by police officers, firefighters, or even mortuary workers, all with little or no medical training. There was no on-site or in-transit treatment, only an effort to get the patient to the hospital quickly.

John Moon describes the experience of emergency medical transportation in the 1960s as "swoop and scoop...which meant you'd call the police, and they'd pick you up, throw you in the back of a paddy wagon, and rush you off to the hospital. They could do little more than offer patients basic first aid, a canvas stretcher, a half-empty oxygen tank, and a pillow, which often only served to choke off your airway."

"And on top of that," recalled Moon, "both officers got up front. The patient was left to fend for themselves in the back of the police van. If you stopped breathing in the backseat, there was no one there to assist you."

In addition to the limited medical care, police ambulances often failed to respond to emergency calls in a timely manner, especially in poorer, Black-majority neighborhoods like the Hill. The Pittsburgh Courier regularly reported cases which resulted in serious harm or death due to police negligence or lack of response.

Freedom House Enterprises, Inc. was an organization initially aimed at fostering Black-owned businesses and creating jobs in Pittsburgh's Hill District. Headed by James McCoy, Jr., the program was a part of Lyndon Johnson's "War on Poverty" initiative.

In 1966, McCoy connected with Philip Hallen, a former ambulance driver and president of the Maurice Falk Medical Fund, a local foundation. Hallen's experience as an ambulance driver made him sympathetic to problems faced by Hill residents, and he decided that if Freedom House could sell produce out of a truck, then they could easily shuttle members of the Hill Community to the hospital in lieu of city police ambulances.

The impact of the Freedom House Ambulance Service reverberated beyond Pittsburgh. Recognizing the importance of Freedom House's work, other cities and communities across the country began to adopt similar models of EMS training and integrate advanced life support systems into their ambulances. The Freedom House Ambulance Service thus became a catalyst for change, racial equality, and community strength, inspiring the development and advancement of EMS throughout the nation.

But this success, unfortunately, came at a cost to Freedom House. Political squabbling and racial inequality cut down Freedom House Ambulance Service in its prime. As improved standards of emergency medical care were taken up by the state, local community services like Freedom House lost their funding.

The Hill community now had to use the same state-run emergency medical programs that underserved them in the first place once again. The closing of Freedom House reflected politicians' unwillingness to employ or allow African American folk to engage with their communities in a meaningful way.

In 1975, Mayor Pete Flaherty struck one final blow. He announced that the city would roll out its brand-new paramedic service. Not only was the new service showered with the resources Freedom House had long been denied, but none of the new recruits were African American. Dr. Caroline got the city to hire Freedom House's staff, but most of them were quickly reassigned to non-medical or non-essential duties, and even as late as the 1990s, Pittsburgh's EMS program was 98% white.

Despite this, the legacy of the Freedom House Ambulance Service showcases the extraordinary impact a single African American community can have on transforming emergency medical services. Their efforts raised standards and expectations for EMS, inspiring change, challenging barriers, and leaving a legacy of hope, progress, and community empowerment. The paramedics of Freedom House inspired generations to believe that they too could be effective and create positive change in communities like the Hill.

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Set atop a scenic hill on Bedford Avenue, this beautiful property was home to the ugly reality of tuberculosis.

During the first half of the twentieth century, tuberculosis posed a grave threat to public health in the United States. The disease was easily transmitted through actions as simple as coughing, sneezing, singing, or even speaking and caused symptoms such as weakness, fever, chest pain, and, at worst, death. For people who lived in cities, the risk of tuberculosis was especially high; poor air quality combined with people living in close proximity to one another created an ideal breeding ground for infection.

Pittsburgh’s infamous smoky air and densely-populated neighborhoods made its residents highly vulnerable to tuberculosis. By 1905, the disease had climbed the ranks to become the city’s third leading organic cause of death, accounting for 9% of all fatalities. Pittsburgh’s eminent public health crisis set into motion a domino effect of responses. In December of 1906, concerned members of the community formed the Pittsburgh Society for the Prevention and Treatment of Tuberculosis, providing community outreach and treatment throughout the city. The city’s first sanitarium opened just two months later, occupying the McConway House, a converted private home, on Bedford Avenue. By 1908, the two groups had joined forces to form the Tuberculosis League of Pittsburgh; that same year, this league would establish the city’s leading sanitarium, the Tuberculosis Hospital of Pittsburgh.

If it were not for a few quirks, passersby could easily mistake the Tuberculosis Hospital of Pittsburgh for a city park. The property sits atop a hill overlooking the Allegheny River, high above the factory smoke of the central city. Wooded areas surround the buildings on three sides, with a grassy lawn central to the property. With conventional medicine lacking the resources to treat tuberculosis with drug therapy, fresh air was one of the preferred methods of care. In the hospital’s earliest days, five open-air shacks accompanied the McConway House. Patients of all ages could take respite in these shacks year-round; even in the colder months, people would bundle up in jackets and scarves to lay in the open front buildings and breathe in the cold, crisp air.

As tuberculosis continued to sweep through Pittsburgh, the hospital quickly outgrew its humble beginnings. In 1909, the Tuberculosis League built a two-story consumption dispensary fitted with two consultation rooms for preventative screenings and skin tests, a treatment room, an operation room, and two recovery rooms. The construction of this building kickstarted nearly two decades of expansion, all with the aim of providing better care for the city’s sick residents.

With each expansion, the hospital became a bit more specialized. In 1917, the League completed construction on the Women’s and Children’s Building, which featured a unique open-air school where ill children were able to continue their studies in the fresh air. The Christmas Seal Building, named after the Tuberculosis League’s annual fundraising sale of package labels, housed infected World War I veterans. Construction on a Men’s Pavilion finished in the early 1920s, followed by the construction of another treatment ward in 1927.

However, the hospital served a broader purpose beyond providing a haven for the sick. Healthcare professionals and medical students also found a home at the Tuberculosis Hospital of Pittsburgh. The Power and Service Building provided an on-campus residence for the men and women who fought so tirelessly against the relentless disease. The building was fitted with amenities such as a laboratory and library. The 1927 ward served as a teaching hospital for medical students from the University of Pittsburgh. Here, at the Tuberculosis Hospital of Pittsburgh, the next generation of doctors and nurses would diligently study the prevention and suppression of the disease. The League constructed a second, four-story residence hall for nurses in 1949, which would be the last structure built on the site.

Before long, the incidence of tuberculosis throughout Pittsburgh began to drop dramatically. By 1925, just 544 people died from the disease, accounting for just over 5% of all fatalities. Ten years later, that number further decreased to 370 people, representing 4% of all deaths and a significant decline from the 1905 total of 9%. With its preventative screenings, tuberculosis tests, and treatment programs, the Tuberculosis Hospital of Pittsburgh was instrumental in this decline.

As understanding of tuberculosis grew, new treatment options emerged. In 1944, a significant milestone was reached when three scientists developed the first tuberculosis antibiotic, streptomycin. This groundbreaking drug reduced the need for extended quarantines and long hospital stays, thus allowing patients to recover in the comfort of their own homes. Outpatient treatment became a priority for the hospital; examinations for these patients grew 21.5% in the years between 1907 and 1946. Ultimately, the rise in outpatient care led to a decline in the number of patients receiving treatment at the hospital. Due to this decline, the Tuberculosis League officially closed the hospital’s doors in 1955, selling the three hospital buildings and Nurses’ Residence to the State of Pennsylvania. These four buildings would later become the Western Restoration Center, a mental health treatment facility.

Unfortunately, the Western Restoration Center also shut its doors in the 1980s. Citizens of Pittsburgh moved for the sanitarium to be memorialized, and in 1993, the hospital was listed on the National Register of Historic Places, in recognition of the site's historical significance. In the time since, the site has been home to a daycare, a city health center, and, most recently, senior living apartments. Despite these changes, the facility’s designation as a national historic site cemented its significant contributions into the city’s history, underscoring its enduring importance in the difficult fight against tuberculosis.

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