After three years on Union Street, the Auckland City Mission is moving back to Hobson Street. We spoke to the mission’s healthcare team about what changes are on the horizon.
Gilli Sinclair, the health services manager at Auckland City Mission, remembers meeting a man with severe burns outside the New Beginnings Court. A judge had begged him to see a doctor. “I went up to him and said ‘we can organise all of this for you?’ and he said ‘yeah, I’ll be there’, and I said ‘you won’t really, will you?’ and he goes: ‘nope’.”
With more funding, he might not need to come to the mission; medicine can come to him, instead. A new redesign of the Hobson Street premises could bring new medical services to Auckland’s homeless.
For more than a century the mission has brought respite to the city’s homeless community. For 13 years its healthcare centre – named the Calder Centre, for mission founder Reverend Jasper Calder – operated out of the Hobson Street location. After three years’ sabbatical on Union Street, it’s time to return home.
Homeground, the new Hobson Street building, will officially open in November. It has 80 apartments to house the homeless; both those chronically so and those on the social housing register. It has a large community kitchen to serve more than 250 people, as well as provide takeaway lunches. It will have a community garden to grow both food and traditional Māori herbs to make salves. It’s a $110 million transformation.
“It’s a home for all of Auckland,” says Ra Pope, the mission’s former communications manager. “A community within a community.”
While much of the redesign is focused around providing new services, thought has also gone into how best Homeground can make its community comfortable. “We’re making sure we’re representing the people, our street whānau who are going to be using it,” says Pope. “We want people to go and see there’s some tapa cloth there, or te reo Māori there, and it feels like a bit of home.”
Sinclair manages the healthcare and detoxification services offered by the mission, and has been key to the redesign of the Calder Centre. To her, Homeground is an opportunity to expand their work outside of the building. “It’s thanks to projects like this that we can do the work in expanding from a normal medical centre to more of a nurse-led model,” she says. “We can take services to people rather than just having people pop in.”
Outreach nurses are those currently spending time out in the community, thanks to recent funding from Southern Cross Health Trust. They visit people in emergency and transitional housing, and conduct “wellness assessments” designed to delve past years of absence from the medical system.
“One of the things that’s really important with our street whānau is that they’ve been sick for so long they don’t know they’re sick any more,” explains Sinclair. “If I’m sick I go and see someone, but if you’ve been sick for years and years, you stop feeling that you’re sick and it becomes your new normal – you stop fighting.”
Southern Cross Health Trust CEO Terry Moore says the trust has been proud to sponsor the mission for the past three years. “The essential health workers at the Calder health centre and all those at the Auckland City Mission do incredible work every day and I’m proud our trust is able to support them to continue their work,” he says.
“When the Auckland City Mission opens its new building, Homeground, its ability to provide additional wraparound health services to people doing it tough will take a fantastic step forward.”
In one transitional housing location, James Liston, homeless people are around for about 12 weeks. The Calder Centre is taking advantage of this to get out of the mission buildings and give health assessments. “Even if we don’t see them after this, we’ve had 12 weeks to work with them and it’s really nice,” says Sinclair.
Those who access the Calder Centre generally, she says, come in around four or five times as often as a standard patient would. “The Auckland PHO is great and every time they can help us, they do. It’s still a government process and the trouble is for a lot of our street whānau it’s never been a good mix; they’ve never found a system that does work for them, so with our outreach we hope it works a bit more.”
Funding from Southern Cross means the centre can do things differently. Moving outside into the comfort zones of their patients means the people they see are less afraid of losing time and money on a doctor’s visit.
“If you’re homeless there’s still bills to pay,” says Sinclair. “Health isn’t high on people’s agenda.” It’s a hard choice, but immediate needs often outweigh a medical itch that’s been tolerated for months, she says. “Why would you get that leg ulcer that you’ve had for the last three months checked when you could go and get something nice to eat?” The Calder Centre costs $2 per week, which means the patients are never slapped with a big bill.
Pope says there’s always more than meets the eye when it comes to homeless health. “People say, ‘she keeps missing her appointments’, and the reason is she’s a grandma who has 12 mokopuna and she has to look after them. We judge, saying ‘she can’t even look after herself’, but there’s a lot more going on.”
Moving forward, Pope and Sinclair would like to continue to scale up and serve these hard-to-reach people. “I would love to have a van where we could take a key worker and a nurse out to see people on the street,” says Sinclair. “The more resourcing we have, the more we can go out and access the harder-to-find group.”
The Calder Centre has around 1,700 enrolled patients, but they’d like more – about 3,000. The most recent count puts Auckland’s homeless population at around 20,000. While Covid-19 lockdowns took many off the street, they’ve since drifted back. “Homeless doesn’t necessarily mean sleeping on the street,” says Pope. “There’s cars, there’s couch surfing, there’s ‘I just don’t have anywhere permanent to live right now so I’m staying with friends,’ there’s a lot of different types.”
Sinclair believes everyone is just a couple of accidents away from being homeless. “You make a mistake here, your life deteriorates, you lose your job,” she says. “Covid-19 was a prime example of that. We’re all this close to losing our jobs, really.”
In Auckland, those most at risk of becoming homeless are people with mental health issues, drug or alcohol addictions, and people experiencing family violence. “You wouldn’t wake up in the morning and think, ‘I think I’ll leave my comfy home and bed,’” says Gilli. “Nobody says that. It’s a rough set of circumstances.”
She believes a move back to Hobson Street will attract more of those 20,000 people into the mission. In particular, she has high hopes for a potential dental service that would bring even more people and money into the centre. “We’re trying to have a good business model as well as having a kind outreach model,” she says. Ideally, the centre would develop – alongside dental clinics – podiatry clinics, diabetes clinics, and hepatitis C clinics.
When Homeground opens in November, Sinclair and her team will have more nurses and funding than they’ve previously had at Hobson Street. The homeless community will have a hub where more of their needs can be met, and more long-term change can be affected. “It’s lovely,” says Sinclair. “It’s really neat to see homeless people being treated with respect. That’s what this is, really.”