Harm reduction in an emergency response to homelessness during South Africa’s COVID-19 lockdown

dc.contributor.authorMarcus, Tessa S.
dc.contributor.authorHeese, Jan
dc.contributor.authorScheibe, Andrew
dc.contributor.authorShelly, Shaun
dc.contributor.authorLalla, Sasha X.
dc.contributor.authorHugo, Johannes F.M.
dc.contributor.emailtessa.marcus@up.ac.zaen_ZA
dc.date.accessioned2020-10-09T12:17:36Z
dc.date.available2020-10-09T12:17:36Z
dc.date.issued2020-08-24
dc.description.abstractBACKGROUND : Caledonian Stadium, the main mass temporary shelter for homeless people in the City of Tshwane, was created as a local response to the imperatives of the novel coronavirus disease (COVID-19) National State of Disaster lockdown in South Africa. This is a case study of the coordinated emergency healthcare response provided by the University of Pretoria’s Department of Family Medicine between 24 March and 6 April 2020. METHODS : This study uses a narrative approach to restory situated, transient, partial and provisional knowledge. Analysis is based on documented data and iteratively triangulated interviews on the operational experiences of selected healthcare first responders directly involved in the shelter. RESULTS : The impending lockdown generated intense interactions by UP-DFM to prepare for the provision of COVID-19 and essential generalist primary with partners involved in the Community Oriented Substance Use Programme (COSUP). With approximately 2000 people at the shelter at its peak, the numbers exceeded expectations. Throughout, while government officials tried to secure bedding, food and toilets, the shelter was poorly equipped and without onsite management. The COSUP clinical team prioritised opioid substitution therapy using methadone and COVID-19 screening over generalist healthcare to manage withdrawal and contain tension and anxiety. COSUP and its partners helped the city plan and implement the safe re-sheltering of all Caledonian residents. CONCLUSION : The Caledonian shelter is an account of organisational resilience in the face of homelessness and substance use emergencies triggered by lockdown. Through community-oriented, bottom-up self-organisation, a clinically led team navigated a response to the immediate needs of people who are homeless and/or use drugs that evolved into a more sustainable intervention. Key lessons learnt were the importance of communicating with people directly affected by emergencies, the value of using methadone to reduce harms during emergencies and the imperative of including OST in essential primary healthcare.en_ZA
dc.description.departmentFamily Medicineen_ZA
dc.description.librarianam2020en_ZA
dc.description.sponsorshipTshwane Metropolitan Municipality, Republic of South Africaen_ZA
dc.description.urihttp://www.harmreductionjournal.comen_ZA
dc.identifier.citationMarcus, T.S., Heese, J., Scheibe, A. et al. 2020, 'Harm reduction in an emergency response to homelessness during South Africa’s COVID-19 lockdown', Harm Reduction Journal, vol. 17, art. 60, pp. 1-8.en_ZA
dc.identifier.issn1477-7517 (online)
dc.identifier.other10.1186/s12954-020-00404-0
dc.identifier.urihttp://hdl.handle.net/2263/76420
dc.language.isoenen_ZA
dc.publisherBioMed Centralen_ZA
dc.rights© The Author(s). 2020. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License.en_ZA
dc.subjectHarm reductionen_ZA
dc.subjectHomelessnessen_ZA
dc.subjectOpioid substitution therapyen_ZA
dc.subjectNational state of disaster lockdownen_ZA
dc.subjectEmergency shelteren_ZA
dc.subjectCOVID-19 pandemicen_ZA
dc.subjectCommunity oriented substance use programme (COSUP)en_ZA
dc.subjectCoronavirus disease 2019 (COVID-19)
dc.subject.otherHealth sciences articles SDG-03
dc.subject.otherSDG-03: Good health and well-being
dc.subject.otherHealth sciences articles SDG-16
dc.subject.otherSDG-16: Peace, justice and strong institutions
dc.titleHarm reduction in an emergency response to homelessness during South Africa’s COVID-19 lockdownen_ZA
dc.typeArticleen_ZA

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