Health Collaboration Improves Outcomes for Kaewa

Housing First Ōtautahi (HFŌ) has partnered with the Rodger Wright Centre Health Service (RWCHS) to improve health outcomes for kaewa, through a new pilot health clinic alongside outreach services. So far, over 38 kaewa have accessed the weekly health clinics located at the HFŌ office and The Commons.

The partnership seeks to remove barriers to accessing healthcare for people experiencing homelessness. “The life expectancy of our kaewa is between 55 to 65. It’s appalling,” says HFŌ Community Development Worker Jono Kitt. “Being unhoused exacerbates everything. Access to health shouldn’t be a privilege.”

In August last year Leah Higgins, a Nurse Prescriber from the RWCHS, started coming to The Commons with the RWCHS outreach van, a mobile health clinic set up to provide Hepatitis C testing alongside other health services. The RWCHS (also known as the Christchurch Hepatitis C Community Clinic) has been operating for almost 15 years, and has achieved some of the highest Hepatitis C test and treatment rates in Aotearoa. 

The outreach services at The Commons led to the health clinic pilot at HFŌ, where kaewa can make weekly appointments to see Leah or Jo Talarico, a Nurse Practitioner also from RWCHS. Kaewa access the health clinic for a wide range of concerns, often overcoming fear to make it to a first appointment. 

“One man we saw was so nervous at reception, and then he came in and left saying ‘oh this is fine.’ He’d worked himself up all week,” says Leah. “They can sound like small gains – but for the person it’s really huge.”

Leah and Jo are able to build trust with kaewa who may not feel comfortable talking about their drug use with other health providers, as the RWCHS is part of the New Zealand Needle Exchange Programme which has a high level of trust in the community and operates seven needle exchanges across Te Waipounamu.

“Often what they come in the door for isn’t what they end up going out with. They’ve figured out slowly that they can bring up other concerns,” says Jo. “I love it when people walk out and say ‘I feel like I’ve just had coffee with a friend.’ All their worries have been addressed.”

The clinic is already making a meaningful impact, improving health outcomes for kaewa who may otherwise have slipped through the cracks.

“One man we met through The Commons had been sleeping rough for many years,” says Leah. “He shared that he had diabetes but hadn’t seen anyone about it for over three years. We did a diabetes blood test which was really elevated and starting to impact poorly on his health.”

“We could then connect him with Jo to provide support, and recently he became ready to link in with the Māori diabetes outreach nurse who has come down to The Commons. We both completed a support letter which has led to him receiving housing, as there’s no way we could safely administer insulin on the street.”

Kaewa that access the health clinic who aren’t engaged with a primary health provider have often been seen at Christchurch Hospital’s Emergency Department (ED) in the past six months.

“Part of what we hope to achieve with the outreach health clinics is to prevent smaller health issues from spiraling, as they often do, which leads to kaewa ending up in ED,” says Jono.

“It’s a great model. Keyworkers and Peer Support will often be in the consult with their kaewa too, so it’s providing that collaborative care,” says Leah.

The collaboration between HFŌ and RWCHS has opened the door to other health providers getting involved including sexual health and diabetes outreach, and the team is looking to expand the service as the pilot continues.

Comcare Trust
Te Whare Roimata
Emerge Aotearoa
Christchurch City Mission
Christchurch Methodist Church