Ile-de-France : a day of full immersion in a mobile clinic


Just like in countries such as Nigeria, Lybia and Mali, Première Urgence Internationale set up mobile clinics in Ile-de-France to facilitate access to the healthcare system for the less fortunate people. On this emergency response to COVID19, Première Urgence Internationale intervenes with the support of the ARSthe Sanofi Espoir Foundation, the Abbé Pierre Foundation and the association La Chaîne de l’Espoir. The goal : proposing free medical consultations for the detection of COVID-19 symptoms, heighten awareness about the virus for the most vulnerable who have no direct access to healthcare.

After some time working remotely, the mediators from Première Urgence Internationale were able to get back in the field to raise awareness about COVID-19 among the most vulnerable. Chiara Ciampa, one of our communications officers, accompanied them to cover this action.

«When we went back to the slums where we usually intervene, the people that knew us were very reassured that we were there again. During the first month of confinement, very few people actively mobilised to be physically there for them. There was a great need to discuss the situation, to feel supported», testifies Justine, healthcare mediator.

Since April 16th, the mediators make three trips per week in the department of Val-de-Marne.

The departure

Première Urgence Internationale setup two mobile clinics with, in each of them, a team of two people. Today I am with Justine, healthcare mediator, and Françoise, volunteer nurse. We leave at 10am from the Première Urgence Internationale welcome center, which has been now turned into emergency storage for the kits to be dispensed(1).

The team checks that everything is in the car, and then we start towards one of the squats on our territory today, chosen with regard to the feedback of the associations working in the 94.

Premiere Urgence Internationale fights COVID-19 with mobile clinic in Ile-de-France

«The partnership with inter-asso(2) is very important for having a clear cartography of the slums, an estimation of the people in it and mostly to gather contacts and being able to introduce ourselves before the visits», explains Thomas, manager of Project Health – Slums and Bidonvilles of the French Mission for Première Urgence Internationale.

Today, we are visiting a squat in Sucy-en-Brie (Val-de-Marne), in the southeast suburbs of Paris. The squat is not too far away from the slums in Bonneuil, where Justine usually works for Première Urgence Internationale. «We normally focus on areas we are already familiar with. COVID-19 widens our vision, it’s the chance to cover unfamiliar ground», Justine explains.

Visiting the squat

The first of the families welcomes us. We get into a room warmed by a heater where a man is reading. He stops to listen to us while his daughter and niece fetch us chairs.

«Have you heard about Coronavirus ?», the duo from Première Urgence Internationale breaks the ice. The answer is always «yes», but after we start to talk about it we discover that these people don’t have the correct information, or none at all.

This is why with the aid of examples and tools Justine and Françoise explain the symptoms of COVID-19, the behavior to adopt in case of suspected contamination, the barrier gestures and protection to adopt, the certification to fill to go outside.

The daughter and the grandfather are asthmatic, they show their medication to Françoise. «We often meet vulnerable people with chronic diseases in these places, so it’s particularly important to listen to them», explains the nurse. «A caregiver is not made by their skill. It’s not the fact that I can measure blood pressure that makes me a nurse. It’s listening to others!»

The team leaves room for the questions. Often the people are not afraid of the illness itself, but of the consequences that it can bring to their life : a lack of medical follow up, inability to work, to go to school. COVID-19 has worsened their already difficult life circumstances.

C., 14 years old, is the only kid who goes to school in this squat. «I’d like to be a veterinarian», she says in French. We see the worry in her eyes when we talk about the school closing. She asks herself when she’ll be able to go back. Justine explains to her the government decisions about the re-opening of the school and reassures her.

There’s no electricity in the squat, which is even more isolating for the people living in it who can’t follow the news. «How can I know what’s happening outside? I have no television and no electricity,» concludes one of the residents.

Premiere Urgence Internationale fights COVID-19 with mobile clinic in squats and slums in Ile-de-France

Two sectors to better answer to the needs

The two sectors of intervention of Première Urgence Internationale are healthcare and access to water. Even if COVID-19 hasn’t yet arrived in the squats, due to – or thanks to – the isolation of the population, it’s very important to be vigilant, as the people we meet are in a vulnerable situation.

A girl of 18 years old, pregnant with her second child, explains to us that her medical appointment of prenatal follow up has been cancelled due to the pandemic. Another woman around twenty years old, received eye-surgery but hasn’t had a follow up yet. As she waits, she isn’t able to see. A man who had several strokes shares his feeling : «Me, I don’t believe in this illness.»

«We find all these situations, raising awareness, listening», explains Justine.

Premiere Urgence Internationale fights COVID-19 with mobile clinic in squats and slums in Ile-de-France

Indeed the life and hygienic conditions are not at all up to minimum standards. There’s not even access to running water. It’s easy to imagine how fast the spread of an epidemic could be in these circumstances.

«People try their best to respect the barrier gestures, however it’s worth reminding that inside a squat or a slum it’s very difficult, or even impossible to respect social distancing, and access to running water is not always available», concludes Justine.

«At the moment the people in the Sucy-en-Brie squat have no access to drinking water on their site. We evaluated the possibility to attach them to fire hydrants 250 meters away, fitted to a distribution header close to their living quarters, and eventually a drinking water attachment to their site. But technically speaking this intervention is only possible through the city technical services. We have therefore contacted the municipality of Sucy-en-Brie to obtain an authorisation of access to drinking water as soon as possible, so they can get the essential in this period of health crisis : a right to drinking water which is a fundamental right. Première Urgence Internationale also proposed to make their expertise and teams available to the municipality, so to support the technical services in the city», explains Emilie Sevestre, technical manager for water, hygiene and sanitation for the France mission of Première Urgence Internationale.

Première Urgence Internationale also intervenes in access to basic hygiene for the people, offering the cans for water storage and access to first necessity hygiene products. Soon the organisation will supply them with disposable kits for two months, for their domestic and storing needs of water. This distribution will be backed by an awareness campaign on the barrier gestures against COVID-19.

At the end of the day

At the end of the awareness campaign a man approaches the mobile clinic: «I would like to thank you for giving us your time.» The people the team meets are extremely grateful toward our actions.

The current situation is difficult for everybody, but even more for the people that cannot gain access to basic resources, and that’s the case for the residents of the squats and slums that we meet. A question that is often encountered is: «When will all this be over ?». Despite their precarious situation, however, these people keep their calm and a remarkable resilience.

Since 2012, Première Urgence Internationale has been conducting health mediation activities in the slums of Ile-de-France, Seine-Saint-Denis and Val-de-Marne. Three bilingual mediators provide a regular follow up to dozens of Romanian-speaking families, to assist their access to healthcare and the respect of their rights. With the spread of COVID-19 the slums have been partially emptied, but the vulnerability of these people has worsened.

(1) Mobile clinic kits contain: shampoo, soap, toothbrush and toothpaste

(2) Interasso 94 : Romeurope, Acina, Fondation abbé pierre, Hors la rue, les Enfants du canal

 

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