05/20/2026
Freedom House Ambulance: The Forgotten History That Shaped Modern EMS
By: Chuck Sista
How many of you have heard the story of Freedom House Ambulance? No? Neither had I — and I am approaching my twentieth year in EMS. I discovered this history completely by chance through an Amazon book recommendation.
Every EMS provider should know and champion the history that was created in Pittsburgh’s predominantly Black Hill District in 1967.
Before 1966 and the publication of the landmark White Paper Accidental Death and Disability, Freedom House was a community resource center focused on helping residents of the Hill District obtain job training. Its transformation from a workforce development organization into the pioneer of modern EMS in America came as a result of the failures of the existing emergency response system in Pittsburgh and the vision of Dr. Peter Safar, widely regarded as the “Father of CPR.”
At the time, prehospital emergency care in Pittsburgh was handled much like it was in many cities across America: victims were placed in the back of police cars or funeral home hearses and rushed to the hospital with little to no medical care being provided en route. This system was ineffective and, in many cases, likely caused more harm than good.
One pivotal incident involved the Governor of Pennsylvania, who suffered a heart attack during a campaign stop in Pittsburgh. A nurse trained by Dr. Safar initiated CPR and continued lifesaving efforts until two Pittsburgh Police “medics” arrived. The officers placed the Governor on a stretcher, loaded him into the back of a police wagon, shut the doors, and drove to the hospital while no medical interventions continued during transport. Upon arrival at the emergency room, the Governor was found to have no brain activity and was later declared brain dead.
At the same time, Dr. Safar was personally affected by tragedy after the death of his daughter, which he believed was worsened by delays in prehospital transport and inadequate emergency care. He had seen enough and was determined to create change.
Dr. Safar was introduced to Phil Hallen, a former ambulance driver who oversaw the Falk Fund, a grant initiative created during the Lyndon B. Johnson administration to expand employment opportunities for African American men in Pittsburgh. Hallen approached Freedom House Enterprises with the idea of recruiting Black men from the Hill District and training them to become prehospital medical providers.
Freedom House agreed, and in 1967 Dr. Safar put 25 Black men through an intensive 32-week paramedic training program that included more than 300 hours of instruction in anatomy, CPR, first aid, and clinical rotations in hospitals and on the streets.
The first Freedom House paramedics began operating in 1968, staffing two ambulances and responding to calls in the Hill District. This was a major step forward for the community. Due to racial tensions and strained relationships with law enforcement at the time, many residents were hesitant to call for medical assistance because they feared police involvement. Freedom House became a beacon of hope during a period of significant social unrest and change.
After several years of both triumph and hardship, Dr. Safar handpicked Dr. Nancy Caroline to become the Medical Director of Freedom House. Before accepting the position, Dr. Caroline had little experience in prehospital emergency medicine, but that did not stop her. She immersed herself in the culture and mission of Freedom House, riding the ambulances alongside the crews and providing care in the field.
During this same period, the City of Pittsburgh began reducing financial support for Freedom House, yet the organization continued to push forward. While serving as Medical Director, Dr. Caroline began writing the curriculum for the newly emerging role of the paramedic.
Together, Dr. Safar and Dr. Caroline introduced technology and procedures to the streets that were once believed to belong only inside hospitals. Freedom House paramedics performed the first successful field intubations by paramedics in the United States. Their innovations, training standards, and dedication laid the foundation for what we now recognize as modern prehospital medicine.
As EMS continues to evolve as a profession and remains an essential function in today’s society, we must honor the history and barriers broken by the medics of Freedom House. We should look back on the challenges faced by the all-Black members of Freedom House EMS and use their perseverance as inspiration to continue advancing the profession.
EMS as a whole does not do enough to recognize and celebrate this history. By sharing this brief overview — which only scratches the surface of the full story — I hope it inspires others to research Freedom House further and tell this story to anyone willing to listen.
EMS providers are a special group of individuals, and it is time that we begin championing both ourselves and the history that built this profession.
