Saturday, 31 March 2012

Homeless sevice users and Sexual health

Yesterday a tutor from Dublin AIDS allowance came to the housing project on North Circular Road to give a talk on sexual health to the service users there. It was fascinating to say the least, not least from my own point of view.

The tutor was excellent, very professional and thorough while managing to be entertaining, approachable, relaxed and open at the same time. You quickly felt at ease and her manner inspired confidence and trust. You knew immediately you could ask her anything without embarassment or fear of being judged. Considering that there were approximately 28 people in total living in this house, I was surprised at the low turnout for the talk, considering the subject matter! Only 4 service users in total attended,one awfully obese lady had to be almost literally dragged from bed (where I understand she spends most of her time) and one reluctant gentleman sat in on the talk halfway through the presentation, just at the point where the tutor was demonstrating the symptoms of syphilis on the screen. Nasty viewing! I almost thought I was going to lose my breakfast and could barely look at the screen!

I observed the ladies who had attended the talk throughout the presentation and one thing that struck me was how streetwise they were in many ways, yet how naive when it came to their own sexual health. I guessed that none of them had ever had ever had any sort of talk about sexual health as a child or teenager and their knowledge was gained from pieced together anecdotes, gossip and chat and from painful personal experience. Many of the facts about the various STDs including AIDS were news to me and I had questions of my own but it was obvious from the questions that one lady asked that many myths still abounded such as the possibility of catching an STD from a toilet seat.

I noticed the girl I'd seen the last time I had been there-the girl who had the awful, weeping sore on her leg. She was looking much better than the last time I'd seen her and looked alert and "with it". Incidentally, her leg was much improved although still incredibly swollen looking. She must have been to see a doctor in the interval between my first visit to the home and today. She seemed interested in the presentation and participated actively asking questions. Of the 3 ladies who attended, she was the youngest and seemed to have the most knowledge of some of the STDs. As it turned out, she was speaking from personal experience as she informed the tutor that she herself had Hepatitis C. I know next to nothing about Hepatitis C but from my Google research, it seems it primarily is spread by blood-to-blood contact associated with intravenous drug use.  The same girl  matter of factly referred to the fact that she'd had an abortion at one point but it seemed from what she said that she hadn't really understood what had happened to her or what the doctors had been doing to her at the time.....it also appeared from what she was saying that she had also undergone a smear test but hadn't understood what this was or why she'd had one.

The ladies were polite and interested and particularly enjoyed the practical demonstrations, especially when the tutor showed them how to put a condom on properly (things have moved on from bananas it seems, she had a dildo for the occasion!) and passed around a female condom (which I'd never seen myself) and some scented mouth guards for use when  performing oral sex! There was plenty of eye rolling from the gentleman who attended, some lewd (but harmless) jokes directed his way and lots of laughter.

All in all, an interesting day.....



Wednesday, 28 March 2012

What Dublin Simon is really about.....

Last Friday (16th March) I started volunteering in the Dublin Simon office as part of the Learning and Development team. Since I don't work Fridays anyway, I figured I might as well do something useful with my time and that it might assist with this blog in order to get a greater insight into the services available for the homeless in Dublin.

It was a varied and interesting first day. I was introduced to the other staff in the office, sent on an errand down to "Eason's" on O'Connell Street, made a few phone calls to service users who had registered for a course and attended a "team meeting" which consisted of my new boss, another girl in the office and me. I learned a new acronym which was much bandied about the office- SLI (pronounced SLEE). It stands for Support to Live Independently which is a large part of what Dublin Simon Community is about.....helping those who are homeless to get off the streets and enabling them to make that transition to living independently. I learned also about a number of the education projects that Dublin Simon are providing for homeless service users.  Naturally, all courses are provided free of charge to service users and are aimed specifically at them so as well as getting the opportunity to learn a new skill, they have the opportunity to engage with other homeless people in a supportive, non judgemental environment.  One  of the courses was a course in Creative Writing, another was a Coaching and Life Skills course (which I think involved some aspects of CV writing and job skills) and another was centred on Health and Wellbeing and involved teaching participants about basic health and fitness. The first 2 classes would as well as teaching participants about the importance of looking after their health and fitness, allow participants to learn how to use some of the machines in a gym and have  a fitness class.

Around lunch time, myself and Joanne (*not her real name) who like me is also working on a voluntary basis in the office, left the office and took a bus to one of the housing projects on North Circular Road. This was one of the "supported housing " projects where a number of homeless service users lived with members of the Dublin Simon team who were there to care for them and support them.  It was a mixed housing project with men and women sleeping in separate buildings in their own rooms but with communal areas such as the kitchen and an outdoor area with tables and benches. I guessed there were perhaps only 15-20 service users in total living there.  All of them appeared to have addiction problems and/or mental health issues. As soon as we walked into the reception area, we met with a guy who seemed to be in charge of the building who was talking to a teenage boy in the corner and trying to persuade him to see a doctor about something.  The boy seemed very reluctant and didn't say much .As it turned out, it wasn't a boy at all but a girl!  Her face was quite small and very pale and drawn looking. She looked to be almost anaemic and she was wearing a hoodie with the hood up over her head which obscured her features and made her look quite masculine.  At one point, she lifted up her trousers leg to show something to the guy who was talking to her and I got quite a shock. Her whole lower leg seemed to be swollen and contused and to my inexperienced eyes, it looked as if she had gangrene setting in. At any rate, it was obvious that she had a wound of some sort that had become severely infected and it was for that reason that the man in the reception was trying to persuade her to see a doctor. Later on, I asked my colleague what could possibly have caused that awful wound on her leg and she told me that it sometimes happened as a result of injecting- wounds then sometimes became infected.

 Our reason for being there on that day was to meet a tutor who was running a cookery class for the residents. None of them appeared to have signed up for this course but  it was a way of trying to engage with some of the residents through cooking and teaching a life skill at the same time. The lady who was running the class seemed experienced and sensitive to her clients needs. Her approach was quite gentle and patient and if someone didn't want to help chop vegetables or stir the bolognese ingredients in the saucepan, well then, that was perfectly alright. Only 4 or 5 residents showed any willingness to participate in helping cook at all and it was immediately obvious to me that motivation was a significant problem amongst the residents, probably due to the fact that so many of them were battling much more significant issues. The girl with the contused leg seemed to be very unwell- she admitted as much herself and was pale, reticent and showed an aversion to chopping garlic. The smell of it seemed to be putting her off and she refused to eat any of the dinner afterwards saying that she had no appetite despite having eaten nothing all day. Another thing I noticed was that for some of the participants, it seemed to be their first time ever cooking anything as they seemed to have no idea how to peel carrots or chop vegetables and their hand movements were slow and clumsy. As a teacher, I immediately thought " fine motor problems"! It made me wonder what they had eaten all their lives and how they had come this far without learning such basic skills that the average person takes for granted. There was a good chance a couple of fingernails landed in with the bolognese ingredients so there was no way I was sampling it afterwards!!!! Observing one resident eat his dinner later, I thought to myself that his movements were that of an old man's. It took an age for him to bring his fork up to his mouth and he seemed to have a tremor in his hand. According to my colleague, the slow movements and poor coordination are often a side effect  of shooting up heroin and when I saw the same guy's face, it confirmed that theory as his eyes were practically rolling around his head and he couldn't focus at all. As we were leaving later on that afternoon, he was staggering in the hallway and attempting to stand up straight but was unable to and two of the staff had to assist him. Two or three of the residents did show some interest in cooking and one of them, a sweet lady who was an alcoholic,seemed to have some experience of cooking and seemed willing to chat about food. She soon got tired however and went up to her room for a lie-down as she too wasn't feeling very well and had a bad coughing fit which led to her having to be helped up to her room by a staff member. Before we left, I noticed a guy in the kitchen whom I recalled meeting when I was working on the Soup Run a number of years ago. He didn't seem to recognise me but I recognised him as he was quite a memorable character and I recalled chatting to him about books as he was always reading anytime you met him when he was out tapping. He appeared to have lost a leg in the interval and was in a wheelchair but I was glad to see that at least he was no longer on the streets and sleeping rough.

Wednesday, 7 March 2012

Homelessness and Drug Addiction

I recently attended a course with Dublin Simon Community on drug addiction and homelessness which was fascinating. A lot of the homeless in Ireland have drug or alcohol addiction problems of one sort or another but that is by no means the case for all homeless people you encounter on the streets. Some people inceredibly, manage to avoid going down that route which always amazes me as I'm sure if the positions were reversed and I was to wind up homeless, I would resort to whatever means of temporary escape was available to me.

The temptation must be overwhelming at times as there are no shortage of drug users staying in the hostels and on the streets and drugs are readily available if you want  them.

Anyway, the talk was given by a man involved in training who had worked in homeless shelters in the UK and as such, he had plenty of first hand experience of dealing with people with drug and alcohol addictions. One thing that struck me from what he had to say, was how difficult it actually is to come off a drug like heroin in this country. Seemingly, once a person makes the decision to go off heroin, it can take up to 6 months to be admitted to a detox programme . Six months!!!! What use is six months to someone whose life has fallen apart and who genuinely wants to get off the drug? For economic reasons, methadone  which it seems is an equally addictive drug, is generally prescribed to users trying to come off heroin.
According to what the trainer said, once a user is admitted to a detox programme,  the first criteria is that he or she has to test positive for opiates. This is done by means of  3 (supervised!)urine samples. Users are then generally prescribed methadone. Contrary to what I thought, some people can remain on an 80 ml dose of methadone for ever, as the drug is so difficult to come off that this may be what is required to keep them stable and capable of living a somewhat "normal"life. If a user comes off it too quickly, they can easily relapse.