Services for those experiencing homelessness

Q&A with Dr Juergen

Can you share a bit about your background in medicine and what motivated you to work as the resident doctor?

Dr Juergen: I have always wanted to be a general practitioner.  I started my career in Inala servicing a very disadvantaged patient group, but I also had amazing mentorship that focussed my skills not just technically, but also to consider the whole person in front of me.  As a GP it is a great privilege that people allow you into their lives and often tell you things that they haven’t told another soul.  You are able to support them though their lowest points and challenges, but also celebrate their successes.

Could you walk us through what a typical day looks like for you as a doctor here?

Dr Juergen: The only thing predictable about being a GP at Emmanuel City Mission is that it is unpredictable.  The bread and butter is treating infections and directing people to other services such as housing or dental.  However, it is these interaction that lead patients to open up and reveal the reasons behind their homelessness, their addictions and their mental health struggles.  This is the aspect which keeps me coming back to Emmanuel City Mission because I as an individual can now help direct another person, often in their darkest point, towards a better way. The caring and safe environment that the Emmanuel City Mission team have worked hard to create means that the patients come to me with many of their defences already lowered as they are in a safe place.  They trust Emmanuel City Mission and so they are more likely to trust me.

What are some of the unique challenges you face in providing medical care, and what are the most rewarding aspects of your work?

Dr Juergen: The greatest challenge I have initially with patients is winning trust.  Reassuring people that I will not judge them and that I will listen.  Our visitors, often heavily tattooed, get turned away from regular medical centres or are judged and dismissed when they do present for medical care.  The other challenge of being at ECM is the lack of resources for their healthcare.  I would love to be able to follow up my patients more closely, but from a healthcare perspective I am an army of one.

I would love a team of trauma counsellors as ultimately, trauma is where the issues for our visitors inevitably stem from – whether that be abuse as a child, an abusive partner or a life event that led them down the wrong track.  The most rewarding part for me is being able to provide a bit of mentorship and have people step up out of homelessness.   Having someone who was sleeping rough come back to visit me, dressed in high vis, and tell me they have kicked their addiction, and that they are working now – that gives me a buzz.

Can you share a particularly memorable or impactful patient story that highlights the positive impact of medical care at Emmanuel City Mission?

Dr Juergen: There are so many success stories that I see through the healing that ECM provides, it is hard to narrow one down.  I do reflect though on one individual who when I first met him he had poorly controlled diabetes, was drinking litres of wine a day, injecting drugs, had hepatitis C, numerous previous suicide attempts, but none of that he was concerned about as he was under the impression that his death warrant had already been signed and time was the only variable.

The health system had essentially given up on him as he doesn’t respond to offers of appointments (that he doesn’t receive as he has no phone nor address) and they state that he doesn’t want to engage.  By being able to connect with him in a place where he feels comfortable, in conjunction with all the others who supported him at ECM, he is now clean from drugs, only has the occasional beer on a weekend, has been successfully treated for hepatitis C and his diabetes is almost perfectly controlled so that he can start back at work again (which he is super keen to do).

He is also reconnecting with his daughter who he hasn’t seen for years. The medical improvements I was able to help him with was only possible through the hope he received from others at ECM and the morale boost of not just being treated as ‘just another addict on the streets’.

Looking ahead, what are your aspirations for medical services at Emmanuel City Mission, and how do you envision the role of healthcare evolving in this community setting?

Dr Juergen: Going forward, I am really keen to further help those recently released from prison and help them avoid going back to old ways.  Unfortunately I believe that we as a state are failing those who often don’t want to reoffend by offering them little guidance upon release.  An ounce of prevention really is better then a pound of cure!

Emmanuel City Mission is a community, not a service provision centre.  I think I get more out of Emmanuel City Mission personally then what I give.  As mentioned previously, medically it is much easier to engage with the visitors at Emmanuel City Mission as they already feel safe and valued there.  There is always laughter around the room, which has people coming to me in a better mood.  That energy also transfers to me personally and I always leave a day of consulting at Emmanuel City Mission on a high, even though I have often been dealing with some of the most complex and traumatic cases I have ever faced as a GP.