Funding helps mobile GP clinic treating ‘forgotten’ patients roll on

For many Australians, going to the doctor is simply not an option.
 
Sometimes they cannot afford it, sometimes they do not trust the system, they feel embarrassed or unwelcome, it clashes with cultures, they live unpredictable lives, have no way to communicate, or it is just too far away.
 
For those people, 360 Street Doctor has been a lifesaver.
 
The mobile GP clinic began in Perth in 2001, aiming to improve the health and wellbeing of homeless, transient, and disadvantaged people.
 
Today it provides free healthcare to more than 3000 people each year, through its onboard GPs, registered nurses, outreach workers, Aboriginal health practitioners, and pharmacists.
 
The truck travels across the suburbs on a regular timetable, no bookings are taken, and it is all free.
 
From immunisations to blood tests, pregnancy support, mental and sexual health assessments, care plans, and wound care, it functions the same as any other medical centre.
 
Onboard GP Dr Catherine Civil describes the truck as an ‘Aladdin’s Cave with a phenomenal amount of equipment’, all cleverly organised to offer the highest possible care.
 
‘We do ECGs, minor surgeries and simple dressings, iron infusions, we have point of care syphilis testing, cryotherapy and more,’ she told newsGP.
 
‘We provide pathology and serology collection from the truck and have couriers collect them at the end of each clinic.
 
‘We even dispense some prescription and over-the-counter medicines to those that experience barriers to accessing them.’
 
As well as healthcare, the truck has teamed up with a range of social services to provide basic human rights some patients have been forced to go without.
 
‘The outreach workers triage clients wanting to see the clinical team and give support and advice about housing, drug and alcohol services, food access, legal access and all the other social necessities, in a very supportive way,’ Dr Civil said.
 
‘We also work alongside other visiting services that provide alcohol and other drug support, meals, legal advocacy, mobile showers, and laundry services.
 
‘We are lucky to have specialists who work with us on the trucks regularly, which is invaluable in managing complex medical problems in people who are unable or unwilling to access mainstream services.’
 
The service comes at the same time as Australians are battling through a cost-of-living crisis, with the number of patients delaying or not seeing a GP due to cost doubling in recent years.
 
At the same time, rates of homelessness are rising, with an especially concerning spike in young females left with nowhere to live.
 
Dr Civil said it is these people, the patients who would otherwise be left with no options, which make the job the most rewarding.
 
‘I love the fact that I am treating people who have a real need and who are often forgotten,’ she said.
 
‘We offer a safe space outside the trucks which is also an opportunity to encourage a bit of yarning. The clients get to know and trust us.
 
‘There are many people who don’t feel comfortable, and may not feel welcomed, in the mainstream medical system.
 
‘Maybe they can’t negotiate the appointment systems because of their chaotic lifestyles, or they can’t bear to be inside hospitals because they are considered places that you go to die.’
 
This month, Street Doctor added another vehicle to its fleet, with the new truck complete with diagnostic equipment, the latest technology, and access to telehealth services. 

The demand for Street Doctor’s services has only increased in recent years, and no one knows that better than GP of 56 years, Dr Wence Vahala, who recently retired after a decade-long tenure with the service.
 
He has seen it all.
 
‘Life is so difficult for Street Doctor clients, that a number turn to substance use – alcohol, cigarettes, marijuana, and methamphetamines,’ Dr Vahala said.
 
‘Negotiating our health system is challenging for my cohort of patients and they often miss a specialist medical appointment at the hospital. Why? Sometimes the notification never reaches them because they have no fixed address.
 
‘Other times they miss the appointment because of more pressing needs, such as finding a meal, a funeral or attending an appointment for housing.’
 
Dr Vahala described the job as a privilege and said he was sad to leave at almost 80 years old.
 
‘Street Doctor provides essential medical services for the most disadvantaged patients,’ he said.
 
‘Even before the patient gets on the truck, the outreach worker outside has chatted and created a trust between the patient and our service. 
 
‘As much as I enjoyed working as a part of a team, it is the inspiration I got from the patients that made my day. Despite their challenging circumstances, they are resilient, they bring humour and laughter.’
 
Street Doctor is not alone in its mission, with similar services available across Australia, all aimed at helping to get those most vulnerable patients back on their feet.
 
Ultimately, Dr Civil said Street Doctor has been nothing but a positive experience, for the healthcare staff on board and their patients alike.
 
‘I think that we fill a gap in services for a very low cost for what we offer,’ she said.
 
‘We assist vulnerable people to stay out of hospital and that has to be a positive for all.’
 
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alcohol and other drugs homelessness mental health vulnerable populations