Newly kitted-out mobile clinic runs twice each week and offers GP services to homeless people and sex workers, writes CLAIRE O'CONNELL
‘I DON’T know where else I would go, to be honest.” That’s the verdict of one homeless woman attending an out-of-hours mobile health clinic at Stephen’s Green in Dublin recently, and it reflects the views of many of the patients who came seeking medical services that night.
The clinic, which today officially launches its newly kitted-out bus, runs twice each week and offers GP services to homeless people and sex workers.
The mobile health clinic grew out of a need to engage with homeless people who may otherwise not access primary healthcare services, explains GP Dr Austin O’Carroll, who has been a driving force behind it.
O’Carroll is the founder of Safetynet, an initiative supported by the HSE that links a number of fixed clinics for the homeless. “Homeless people can find general practice inaccessible,” he says. “That’s usually because they don’t make appointment times and they may not have telephones, and they find surgeries intimidating.”
O’Carroll was offered a bus that was going spare, and the idea was born of running a mobile health clinic to bring primary healthcare services to the people who may otherwise not access them.
Safetynet joined up with Dublin Simon Community, which has a rough sleepers team, and Chrysalis Community Drug Project, which supports street sex workers. And with a grant from Pobal and money donated through fundraising activities, the bus was refurbished.
During that makeover, the Order of Malta, Ireland provided an ambulance to get the clinic on the road, and it has been going out twice a week for about a year.
So how do patients get to know about it? “It’s about making phone calls and being down on the streets, meeting people,” explains Martina Bergin, a member of the Dublin Simon rough sleeper team.
As well as ringing around hostels and letting them know the clinic is on, the team goes out onto the streets to spread the word too.
“Where people are begging or sleeping on the streets we would go up to them and say the clinic is up and running on a Thursday night if you need to see a doctor,” she says.
“We get details from them and say we can come back and collect you and bring you up to the at 7pm when it is set up, or else they can make their own way up. And if they can’t come to the clinic, then we try to go to them.”
The evening I see the mobile health clinic in action, around half a dozen patients visit it at St Stephen’s Green in the first hour, and they have consultations in the ambulance – the new bus is not out that night.
Most of the patients have asthma, one man is suffering anxiety attacks and needs medication for a chronic viral infection and others have ongoing problems with alcohol. And they all talk openly about how the mobile health clinic can help them.
Patients can be in substantial need by the time they access the service, according to O’Carroll. “A lot of them have chest infections and they have no way of getting treatment,” he says, adding that the marks of self-harm and violence may also feature.
“One woman had been almost strangled – they wouldn’t report it but they would come to us.”
As well as offering GP services, the clinic also looks to link patients with other supports such as accommodation and social welfare, explains O’Carroll, and the newly refurbished bus has a separate room for keyworking.
“One guy had been 14 years on the street,” says O’Carroll, recalling one of many success stories from the last year. “The clinic went to visit him a few times and he’s now in accommodation full-time.”
But it’s not all a one-way street. O’Carroll hopes that the clinic will also help doctors increase their understanding of homeless patients. “I have always felt one of the problems is there can be a difficulty with GPs and the homeless, and I think it is based on fear and not understanding homeless people,” he says.
“But all the evidence shows that if you expose people to groups, it breaks down barriers and stigma. So we are creating a capacity – when go out and work in general practice, I think they will be more open to working with homeless people.”
Meanwhile, those who visit the mobile health clinic on that chilly Thursday evening in Dublin show their appreciation. As he is leaving, one man calls out: “Thanks for all the work you are doing.”
For information on volunteering, email: austinoc@hotmail.com
