the essential
In Tarnn-et-Garonne, the mobile health and precariousness team (EMSP) goes to structures specializing in emergency reception and reintegration to care for the most vulnerable populations in a context of medical desertification. Report in Montauban.
No one is anymore unaware of the growing difficulties of access to care. But when you are a foreigner, undocumented, homeless, illiterate and rejected from the common law system, consulting a doctor can be an impossible mission. Faced with this harsh reality on a daily basis, the “Promotion, autonomy, health” association (Apas 82) founded a mobile health and precariousness team (EMSP) which travels to meet the most vulnerable. Made up of three nurses, an educator of young children, a coordinator and a general practitioner, the EMSP organizes health hotlines or interventions on demand in emergency accommodation centers (CHU) , reception centers for asylum seekers (Cada) and associations specializing in reception and reintegration such as Emmaüs, Escale Confluences or Amar in particular.
“I have always been sensitive to the misery of others”
This week again, the entire team is taking over the premises of the day reception of the Relience 82 association, in Montauban, to monitor the people already in care and guide new arrivals. “The Relience team sometimes provides us with a list of people to see as a priority, which helps simplify the work upstream. We are also working with them to increase their skills on these health issues in order to prioritize them accurately. And depending, we either meet the person to make an initial diagnosis, or we work to coordinate care. We therefore make an appointment for the patient and we even provide physical support in the place of care, if necessary,” explains Pauline Pettré, the coordinator of the EMSP, a system which saw the light of day in April 2023 with the support of the Regional Health Agency.
Interpreting, a job in its own right
People who consult the mobile health and precariousness team (EMSP) sometimes come from all over the world. And they do not always master French, particularly when it comes to medical terms. Of course, Google Translate helps on a daily basis. But for more specific needs, the EMSP works with three interpreter firms: Tradilibre, ISM Interprétariat and an independent for the Pashto language in particular. “A common law general practitioner does not have the time to carry out such mediation work,” remarks Pauline Pettré. Recently, a lady from Eastern Europe had to be told that she was suffering from an incurable form of cancer. An interpreter was therefore mobilized to tell him the terrible news in complete confidentiality.
In 18 months, nearly 700 people were able to benefit from professional medical care to treat cancer, diabetes, and other heart problems. Fortunately, Dr. Marc Vironneau is able to issue prescriptions and refer his most vulnerable patients. “I have always been sensitive to the misery of others and these interventions are in line with my thinking. Many are on the street and yet, they are followed by specialists from the Montauban and Toulouse hospital centers for serious illnesses,” says the one who can also rely on the immediate care medical center (CMSI) of Montauban, to emergencies, or the Giraffe 31 dental practice, in Toulouse.
The precious support of the hospital center
During its hours, the welcome given to members of the EMSP is always warm, sometimes even too warm. These people who have sometimes lost everything are so delighted to find an attentive ear that they cling to it “like a lifeline”, notes Pauline Pettré who remains vigilant in being available to everyone. “We meet a lot of depressed people, people who no longer have housing. They need to talk,” confirms Dr. Vironneau.
Indeed, psychiatric and addictological problems. The EMSP, whose core business remains somatic pathology, can then count on the mobile psychiatry and precariousness team (EMPP) and the permanent access to health care (Pass), supported by the Montauban hospital center which deserves a special mention for its unfailing support. Without forgetting Epices 82, Addiction France or the Addiction Care, Support and Prevention Center (CSAPA).
“Without this, many would have given up on care, particularly those over 75 who are no longer able to get by despite their retirement,” notes Pauline Pettré. It’s great that this type of team exists, especially given the context of medical desertification. But we lack resources given current needs. »
Relience 82, a sprawling structure
The history of Relience 82 is as rich as it is old. Originally, it was the chaplain of the Montauban remand center who founded a home for former prisoners undergoing reintegration and homeless people. Upon his death, the Association for the Protection and Promotion of Persons (ASPP) took over and in 2010, association 82 was created, still with the objective of helping the most vulnerable populations. People on the street, in precarious or unsanitary housing, those with health problems but also evicted families, young people without resources, women victims of domestic violence or single mothers in difficulty can benefit from attentive listening and individualized support. In fact, Relience 82 is divided into four areas (social monitoring, integration, childhood and family, precarious health). Day reception, accommodation and social reintegration center (CHRS), emergency accommodation for mother-child (HUME), health care drop-in beds (LHSS) or medical reception beds (LAM) are all systems implemented service of the most precarious.
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