SINCE 2007, SAFETYNET Ireland has been providing free healthcare to both the homeless and sex workers of Dublin, Cork and Galway.

The brainchild of Dr Austin O’Carroll, a GP from Dublin, the service operates on a shoestring budget and an abundance of goodwill from various groups.

This goodwill was further put to the test when the decision was made the take the free service on the road – literally.

Formally launched last year, the group’s mobile health clinic is now bringing treatment to Dubliners who otherwise wouldn’t get it.

Speaking to TheJournal.ie, O’Carroll says his main driving force was to identify the gaps in Ireland’s existing health service, and help fill them.

We wanted to bring services to where homeless people actually were. While the homeless have high levels of illness, they have poor access to services. Even when they have a medical card, they move around a lot and typically aren’t good at keeping appointments.

With support from the Health Service Executive, volunteers at all levels continue to make the service a reality on Dublin’s streets.

Trainee doctors offer their time for free, along with their fully-qualified supervisors. The ‘rough sleeper team’ from the Dublin Simon Community do the same, with the Order of Malta providing an ambulance on standby to make sure that should a case warrant actual hospital treatment, the nucleus of the operation – the mobile health clinic – remains available.

The Chrysalis Community Drug Project rounds out the collaborative process, where the goodwill even extends to Topaz, who provide the petrol for the mobile unit for free.

O’Carroll believes that for the doctors who give their time, getting to treat people on a one-to-one basis away from the hustle and bustle of a hospital’s A & E is beneficial to both parties.

The doctors develop a new relationship when they get to treat people in this environment. There is a problem in casualty, especially with alcohol and drug dependencies, and especially if they start to get withdrawals. They leave to fuel that addiction and more often than not, they don’t come back.

Currently operating three nights a week, the mobile clinic can be found at St Stephen’s Green in Dublin’s city centre at 7.30pm on Tuesdays and Thursdays, from where it travels to hostels and various other locations.

On Wednesdays, the clinic operates on the city’s northside.

Documenting the work

Hoping to highlight the work being done by the service is photographer Hugh McElveen, who has been spending his Thursday evenings with the group since last November.

Having worked with Amnesty International as a photographer for 10 years, he first came to know of the service through his brother-in-law, who was a trainee doctor with O’Carroll.

A longtime human rights advocate, McElveen believes that health is a fundamental human right. “Health is a very basic human right,” he says.

Unless you can satisfy these primary rights – these low-threshold rights – all other rights are secondary, such as the right to education. If people are sick they can’t avail of things like education.

Seeking to document the doctor-patient relationship, he admits that while he didn’t initially have concerns for his safety, his wife did. In the 11 months that have passed, however, he hasn’t experienced anything to stop him from coming back.

Documenting the people who avail of the service has been a slow process, and always on their terms.

Speaking of the success so far, O’Carroll says that while he initially had some reservations, they have long since disappeared.

We soon found out that homeless people like to tell their story, so it’s been really positive.

“It’s a slow process,” McElveen says. “I’d start by taking pictures outside [the van] and would then come back again with the pictures and show them to them. Bit by bit, people let me take more and more.”

I’ve never gone out to photograph peoples’ wounds. It isn’t an expose of vulnerable people. When I feel there is a situation where someone is vulnerable, I put the camera down.

Sometimes people do want to be photographed, however, regardless of the personal nature of their complaint

One man came to the clinic with an abscess on his groin. I went to put the camera down but he said ‘I want people to see what the bus does’ and so I took the picture. He saw the camera as a way of empowering him and helping him to advocate for the bus and what it does.

McElveen plans to release a book next summer which details the work of the service, with all monies raised going to Safetynet Ireland, which he believes is going to keep getting busier and busier.

When I started shooting last November, most people had either mental health or dependency issues. This year it has changed. More and more are homeless purely because they are poor. That proportion is becoming more and is a reflection of the times.

Please note that readers may find some of the images in this slideshow disturbing.