health

Sanitary pads as wound dressings and unimaginable violence: The issues facing our homeless.

“I’ve got a house now doc….what do I do in it?”

“How do I cook meals for one on one cooktop, and what does that look like?”

“How do I lose weight when I live in my car?”

“How do I change my kids’ pathways so they don’t end up like me?”

“I don’t have any money to fill the prescription the hospital gave me. What do I do?”

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These are just some of the questions Dr Nova Evans and nurse Sonia Goodwin are asked at their Sunny Street clinic.

They run a mobile outreach unit in south east Queensland, the first of its kind in the country to treat those experiencing homelessness.

In this capacity, they’ve had their eyes opened to a whole new world of practicing medicine.

Nova and Sonia
Dr Nova Evans and Sonia Goodwin run Sunny Street, the country's first GP and nursing mobile outreach unit. Image: Supplied.

But in witnessing first-hand what it's really like to live on the street, they've realised it's not just proper medical care and housing that homeless people need.

It's normal social interaction. Conversation. Kindness. Access to services. Help in knowing what services they actually have at their disposal. Life skills. The list goes on and on and on.

But the current umbrella that's used to 'help' on a government level just isn't getting into the nitty gritty needed at a grassroots level.

"These people are tough, they're survivor level. But they're also just really ashamed and scared to reach out. [They] come to a Sunny Street clinic for a sense of reality, a dose of perspective and a dose of gratitude," Dr Nova told Mamamia.

Of course, there are people who have been dealt a hard life from the start, like 39-year-old Alison who has been living on the streets on and off since age 11.

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"But we see people who have been CEOs or CFOS and they've owned businesses and done incredibly well. Then they've taken a risk or something's happened and they've lost their business, then their family, and they end up on the street," Sonia told Mamamia.

"I was sitting in a gutter the other evening with a gentleman who'd been hit in the face. He had a degree in community arts and community development. He had been involved in the planning of Brisbane city and now he's sitting in the gutter - injured and a chronic alcoholic.

"It can be so so quick," said Sonia.

READ: Alison was homeless at 11. She's been raped and beaten. She also has 9 children.

Registered nurses, teachers, tradies (lots of tradies) - the list of professionals who end up curled up in parks in Australia is extensive.

In fact, there's more than 100,000 people living rough in this country.

"We've had people come in with sanitary pads on their wounds."

What else are you supposed to do when you don't have money to go to the pharmacy and buy a wound dressing?

They hand out sanitary items at St Vincent's, but what if you can't get access to pads? Or are a man?

Share the Dignity is a company that provides pads and tampons to women on the street. Post continues after video.

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Video by MMC

"They'll come in with their legs wrapped in toilet paper. Or they'll get bags of rags from Bunnings to dress injuries with," explained Sonia.

There's a huge proportion of homeless who have a background of childhood trauma, or domestic violence.

"One woman made an offhanded comment that's stuck with me. She was talking about her childhood and she said she'd been sexually abused for eight years as a child and, 'it is probably normal..but it was really annoying.'"

For many of these individuals, violence is normalised.

Alison estimates she's been bashed on the streets upwards of 30 times over the past three decades.

Alison-Sime
Alison has been homeless since she was 11 and is one of Sunny Street's more than 500 patients. Image: Supplied.

But for Sonia and Nova, it's the children they treat who are the hardest to come to terms with.

They see kids as young as eight who present with injuries to their wrists, ankles and knees after being hit by cars, from jumping off trains and from getting into fights.

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"There's usually groups of them, they hang around in packs," explained Sonia.

Of Sunny Street's 550 patients, 31 per cent are under the age of 25. Their youngest is just five weeks old, born to a teenage mother on the run from an abusive partner.

As well as things like wound care, skin conditions and infections - ailments you might expect from living a life on the streets - one of the biggest challenges faced by the country's homeless is obesity.

"If you think about what they eat and when they eat, metabolically they will just eat the cheapest rubbish they can get and when they do get an opportunity to eat they overeat. So it's just an incredible paradox," Sonia explained to Mamamia.

But most of the time, the questions Sonia and Nova get aren't medical.

"How do you teach someone who has been on the streets for so long how to make a home when they finally get a house? What do you tell them to do in it every day?" Sonia said.

Then there's the challenge of teaching people about self care and calming techniques when they don't have access to luxuries like a warm  bath or a calming Spotify playlist.

"We work out what it is they have in their lives. Some kids like skateboarding. For the adults we might suggest going to the local botanical gardens or just getting out of the space they are in and moving to a new park," said Sonia.

"Just one more night, love."

There's one night in particular that Sonia can't forget.

It was getting late and was pouring with rain, and Katy*, a registered nurse, thought it was the night she'd finally get the call from the Department of Housing.

She'd been promised a roof.

Abstract blurred background of traffic jam on heavy rain
Sonia waited until she hopped in the car to break down in tears. Image: Getty.
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But then she was delivered the news: "Sorry Katy, just one more night love."

Katy's face dropped and started to crumble, a mixture of contorted emotion.

"But then she put her head back up, corrected herself, grabbed her swag and walked out into the rain," said Sonia, who'd been watching from afar.

"To see a woman break like that and just pull it together so quickly. It was horrific," she said.

She waited until she was in the car to break down in tears herself.

"Do you have one of those blue puffers, doc?"

For Dr Nova it's the man who walked into the clinic one day, out of breath and desperate.

"Do you have one of those blue puffers, doc?" he asked.

When she handed him over the asthma medication, he became instantly emotional.

"I thought I was going to die tonight," he told her.

"I didn't have any money to buy a new one."

Breaking down the barriers.

Dr Nova and Sonia's patients repeatedly tell them; "Oh, I'd never see a doctor or a nurse."

"But we're doctors and nurses," they reply.

"But not like those other doctors and nurses," they insist.

Perhaps because they're not in scrubs or walled clinical appointment rooms, it can be easy to forget they're medical professionals.

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But it's probably got more to do with their approach.

Sonia and Nova are pretty quick to ask "how are you?" rather than "what medical condition can I help you with?"

It's as much a friendly chat as it is treatment.

Alison says it's the first place where she hasn't felt judged.

"I didn't go for two weeks and they were asking where I'd been and what I was up to. They greeted me like a friend," she told Mamamia. 

Along with access, transport and cost,  judgement is one of the biggest barriers the country's homeless face when it comes to seeking help.

They're embarrassed, ashamed, and often find it incredibly hard to trust other people.

Dr Nova and Sonia offer the homeless one of the things they crave the most: kindness.

As Alison told Mamamia, "homeless people are down and they're hurt. All they're looking for is a hand up not a hand out... most of them anyway."

*names changed to protect privacy.

Sonia and Dr Nova are taking Sunny Street national this year. You can give them a hand here. 

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