An introductory hello, delivering healthcare in the absence of infrastructure

I am very excited to have stumbled upon your community to hear more about open access health care. I am a junior doctor in the UK, currently 3 years out of med school, with an MSc in Humanitarian Studies. Coming from an academic angle I am very much aware of the limitations and formalised structures of my knowledge and learning so far.

I am taking a couple of years out of formal training to take part in the wider world of health, healthcare and healthcare delivery. I have recently returned from Belgrade, Serbia supporting an unofficial camp of around 800-1200 migrants, majority Afghan, all male, squatting in the city centre. I teamed up with a creative and passionate trauma nurse practitioner from the states, who had a lot of involvement in the squat clinics in Athens, and together we built a small clinic tent (literally gazebo and tarpaulin) and set about delivering health care to the community. One of the earliest challenges we faced was how to deliver healthcare where there was no infrastructure in place, not even a basic clean, safe and private space to consult or examine patients. In this setting the lack of infrastructure allowed us to be more creative and fluid about the way we delivered healthcare. Challenging the limited view that healthcare intervention revolve solely around the quick consolation, examination of patients and distribution of pharmaceuticals. In fact these are the last stages of healthcare and may only be offering a quick fix to a much broader problem. I think it is so important to be a part of the wider community outside of clinic walls.

The second interesting thing for me was the recognition of environmental factors and how significantly they affected peoples health. We had serious problems with poor sanitation and hygiene and the inevitable infestation of scabies and body lice. Tackling these issues wasn’t about treated their medical symptoms (although hopefully we try to achieve that too), it was about recognising the source of the problem and working out ways to overcome or improve the problems. Work such as this prompts you to talk to different voluntary groups and communities about the work they’re doing, the infrastructure they’re building and their impact on the “camp”. Bringing a collective ethos to the action and work that everyone was participating in. We also delivered or tried to deliver public health information and education to the community about why they were suffering and how they may be able it help themselves to overcome it (ie. itching and washing). Breaking down the perception that you can solve everything with a pill and encouraging people to recognise the environmental, social and political factors that have an impact on their health. Hoping to encourage peoples independence, knowledge and agency in self care.

Having spent the majority of my life so far in school, I haven’t had much opportunity to take part in activist or anarchist action. As a beginner, newby or a novice as yet I can’t define myself by either of the above. The world at times feels like a dark place, as the planet heats up, the weather fluctuates to greater extremes, there is an increase in natural disasters, war, famine and draught still devastate and kill it is easy to feel overwhelmed. I would love to take part in a community where, despite the heavy dose, cynicism does not prevail. Where in the face of adversity we hope to find some cooperation, creativity, and compassion. To talk about events, learn develop and evolve my own understanding and hopefully share some of my knowledge, experience and thinking too.

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What you wrote is an inspiration @Georgie , am glad you found edgeryders.

Many stories of people coping with refugee crises - from many angles (@aravella_salonikidou 's backpacks with basic aid, solidarity businesses, and also this story which I highly recommend about working in the camp - @alex_levene wrote it.

What were the resources you had, in the midst of running the clinic? Is it still going?
I’d love it if you joined us for OpenVillage festival at the event - we’ll be up to 60-80 people gathering to share the different kinds of work we are doing to deliver care in mostly less seen and informal ways. You can read about it in the Festival page (see menu above), but coming up is a draft schedule. There is however a lot of space for new ideas and projects: is there something which you would like to do, or people you’d like to meet in such a gathering?

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Great to meet you @Georgie! It does seem there is a good match between you and this crowd. :slight_smile:

It’s a great story you have here. It’s intriguing how a trauma nurse played an important role. In the context of OpenCare we have been following @ybe and her Trauma Tour. She is a trauma therapist herself… is there a pattern there?

Hi folks thank you so much for your welcome response. I feel the open village festival is calling me :slight_smile: I shall have a little look at the links you have sent me as well as take a tour through some of the interesting comments and reflections people have made.

We were fairly resource poor in terms of medical equipment and medical supplies. Pharmaceuticals were relatively easy to get out hands on, we relied heavily on donations of gloves, swabs, betadiene, tape, scissors, sterile fields and other small practical equipment from visiting healthcare providers from nearby Spain and Italy. They were sporadic, but on reflection it would have been very difficult without them or at the very least very expensive trying to source them over the counter. Unfortunately the whole area was destroyed and the migrants were gathered up and packed off to camps! :frowning: the clinic was also bulldozed. It would be interesting to hear if any one had any bright idea about supply chains and resource/ equipment management in these “pop up” type clinics. I know @michael_dunn is doing so work on emergency mutual aid of which supply chains may be a small but important feature.

I also really liked the Health Autonomy at the End of the World, written by @woodbinehealth. They paint a rather bleak picture of the breakdown and cut backs in healthcare structures within America. I whole heartedly agree that we need greater health autonomy for the individual and population at large. I shall do some further reading and comment on the writing there.

Many thanks for your warm welcome. Ill look into booking some time off for the festival :slight_smile:

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We ought to put that as a banner across the front door: Here cynicism does not prevail.

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Amen to that, brother.

@Georgie thanks so much for your post and sharing your story. And I agree that it is so easy to fall into the cynicism of everything is “fucked” or what not. There is a courage in being able to look into the bleakness and not try to cover it up with some corporate blank “positivity” but rather seeing the world as it is and finding the beauty in the process of building a new world, together. Glad you found this community! We’re hosting the “Revolutionary Care: Building health autonomy” theme at the Opencare festival. I’d be interested in hearing more about your story and ways we can collaborate. Maybe we can set up a voice/video call in the near future? Message us through this platform or email woodbinehealth@gmail.com. Be well and take care!