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BOLD VISIONARIES

THE REVOLUTIONARIES of healthcare WORDS SHIRLEY SINCLAIR

HEALTHCARE PROFESSIONALS NOVA Evans and Sonia Martin were frozen in their cinema seats, speechless after the documentary they’d just seen.

The life-changing moment snuck up on them, hitting like a lightning bolt, just as everyone else moved on to the canapes and champagne.

The fi lm at a palliative care fundraising event told the inspirational story of a doctor who created a hospice after seeing poverty-stricken sick and elderly people dying on the streets of India. Stripped of dignity, these people had no one to hold their hands at the end of their lives.

The doctor’s voice reached through the big screen and seemed to speak directly to Nova and Sonia: “Are you helping those who are most in need?”

“We just sat back in our seats and went ‘Are we? Are we really?’,” Nova remembers, as a tradesman continues working on their newly opened Sunny Street Community Healthcare Centre in Maroochydore. “We got goosebumps because we knew that if people make it through the doors of a hospital, if people make it through the doors of a general practice, they’ll get good care. But then the doctor challenged us – what if they don’t make it through the doors?”

Sonia takes up that thought: “The hospital system is fantastic,” she says. “But what about the people experiencing homelessness? They’ve got nowhere to sleep, they may have drug-use issues, living in poverty, mental health issues, with no support. In our roles, we saw people consistently move through

emergency departments back out onto – wherever – and then re-presenting in hospital.”

Their ‘Geronimo Moment’ – the point of no return – happened two weeks later. They resigned on March 19 from secure positions with Queensland Health at Sunshine Coast University Hospital – Nova as the hospital in the home program medical director and Sonia as the complex discharge coordination team nurse unit manager. The two friends, who had met in 2017 while working at Nambour General Hospital, considered an aged-care project or starting an orphanage overseas, but their energies soon turned to the homeless.

“We did try within our roles to explore different ways of providing healthcare to people sleeping rough but unfortunately we hit an innovation ceiling and so we literally started to think outside the box, outside the system,” Nova says. “We wanted to help the system, but we thought it would be more productive, fl exible, easier, more nimble to go outside the system.” A revolution in healthcare thinking was needed.

Both mothers-of-four and their families’ main bread winners, Nova and Sonia picked up part-time work where possible, writing and actioning their plan for Sunny Street after hours over the following four months. The launch was brought forward to July 28, coinciding with the Maroochy Neighbourhood Centre inaugural Hair and Pamper Day for vulnerable people.

“I had two medical students with me. Sonia had fi ve RNs [registered nurses] with her and then we had three admin people in support roles, and the university placed 13 nursing students

The opening of the Maroochydore clinic. PHOTO: Cade Media

Mayor Mark Jamieson helps open the new clinic. PHOTO: Cade Media

with us,” Nova recollects. “We geed up the team at the start and said ‘All we’ve got to do today is let people know Sunny Street exists. Wear the pink and yellow. Have a cuppa.’ “I thought we’d be sitting down and just talking amongst ourselves. But no. In four hours, we looked after 48 people. And it was at that launch that we thought, ‘We’ve stumbled across a true need here’. “Originally we thought we’d be two chicks and a medical truck and we’d just go out and deliver healthcare, but then we very quickly realised that that wasn’t the greatest need of people experiencing poverty and homelessness.”

The greatest need was much more basic: someone to talk to. Conversations develop trust – the fi rst step towards helping other problems. From there, Nova and Sonia ran two clinics a week at Maroochy Neighbourhood Centre for three months, then reviewed the data before expanding to nine a week with the help of family and friends who were also clinicians. By Christmas, they were exhausted and took two weeks’ break from the clinics and each other.

Sitting with takeaway coffees on a sofa in the furniture section of IKEA North Lakes, Nova and Sonia wondered: “Do we keep going?” The answer was yes. In three years, Sunny Street has developed nurse-led outreach clinics throughout Queensland, offering more comprehensive care through paid doctors and allied professionals, and providing help wherever needed, from gutters and parks to community centres and buildings at night.

The Maroochydore centre in Baden Powell Street, opened by Sunshine Coast Mayor Mark Jamieson in October 2021, is now the epicentre of operations – the “sun” to the outreach clinic “rays” in the logo on the unmistakeable pink and yellow Sunny Street T-shirts. These headquarters offer the full range of primary healthcare you’d expect from a GP for free to members of the public.

“We are committed to being Australia’s fi rst nationally co-ordinated healthcare service for people experiencing homelessness and vulnerability. And we believe that we are all vulnerable,” Nova says, looking up from her pencil work on a 100 Ways to Colour Kindness book, part of the social prescription therapy supplies available.

“This is a healthcare system for Australians. We are determined to change the way healthcare is delivered because it’s not working for anyone. It’s not working for clinicians working in the space and it’s certainly not working for patients. We’ve got to do things differently. We’re demonstrating how it can be done differently.”

Sunny Street uses a healthcare model that has tapped into Nova and Sonia’s wealth of experience. Sonia has been a registered nurse for 30 years in private and public health, focusing on aged and community care. The Sunny Street director of nursing was recently named the 2021 winner of the prestigious Health Minister’s Nursing Trailblazer Award.

Nova, who graduated from the University of Queensland in 2004, did advanced training in anaesthetics and pain management at Nambour before completing generalist training at Kingaroy Hospital, where she became senior medical offi cer and director of clinical training. She also feels privileged to have helped remote communities through the Alice Springs Royal Flying Doctor Service.

In a way, Sunny Street embodies the image of the country doctor and nurse with calm, understanding bedside manners.

“It’s one of the sad things that we’ve noticed in our professions,” Nova says. “You go into nursing or medicine because you care, you want to help people and you want to make them better. Unfortunately, the way the system works, over time it beats that out of you.

“Look at the hospital system and emergency medical departments: you’re just under the pump. You’re having to quickly move from patient to patient. In aged care, where Sonia used to work, there’s one RN to hundreds of residents so you just don’t physically have the time to look after people the way you want to. That’s how people’s hearts are forced to shrink because they’re just having to get the job done.

“One of the biggest reasons I started Sunny Street with Sonia is because I wanted to look after people the way I believe they should be looked after.”

Sonia proudly shares Sunny Street’s statistics: 35 staff, 180 volunteers across Queensland who have had more than 30,000 conversations and consultations, and a COVID department, run out of Tewantin, that has vaccinated 18,000 Australians and tested in excess of 16,000.

The volunteers are part of the Sunshine Coast-based outreach department clinics and provide everything from chronic health and wound care to education and prescription information.

At the heart of the healthcare model are kindness, compassion and conversation.

Unlike most general practices, a Sunny Street consultation isn’t time-based. The clinical and non-clinical team approach starts with a simple “hello” and a sympathetic ear. “It’s just someone to sit and listen,” Sonia says.

“We don’t go in as healthcare professionals and say ‘this is what’s wrong with you’. We ask them where they’re at, what’s the one thing they might like to change right now about their life or their health and then we work on that because it’s important for rapport and trust.

“A lot of people we deal with have had really complex traumatic histories and fi nd it really diffi cult to trust people but especially healthcare professionals. So we have the bright T-shirts, we teach our teams to lean in with kindness and love, and just spend the time with people that they need.”

Sunny Street is already a fi ne legacy for Nova and Sonia’s mission to leave the world a better place, with a few laughs along the way. But by this time next year, they hope to be surrounded at the Maroochydore centre by people dropping in for refreshments and a chat, having private conversations in the soundproof communications pod, undertaking consultations with GPs, dentists, psychologists and social workers, taking showers and perhaps grabbing items from the exit lounge pantry stocks.

“It’s about social engagement,” Sonia says, just as a man wanders in off the street, asking politely to borrow a pen and piece of paper. “If we see an increase in appointments, an increase in people just sitting here, then that’s how we know. Our service is entirely run on what patients need.”

The next step in the national plan is to open a Brisbane community healthcare centre. A recruitment drive is also under way for paid doctors and nurses to join the growing team, as well as volunteers from paramedics to non-clinicians.

The corporate fl u vaccination program is a fundraising venture allowing businesses to contribute.

As with anything, many hands make light work. “If you look at it with a global perspective, we are not going to solve homelessness, but we can be a salve for it,” Sonia says.

“It’s one person at a time. One conversation at a time. That’s how we change people’s lives. For me, my grandmother was my best friend growing up and her connection to me, honestly, without it, I don’t think I’d be here today. If one of those Sunny Street people can be the person that is the bridge that doesn’t break for someone, there’s that unconditional relationship which is where we change the power balance. Then we’ve got a good chance of changing one life.”

And opportunities for change through compassion are everywhere. Nova says while Sunny Street has “millions” of patient stories, one is close to their heart: a socially isolated man in his forties, living in poverty, with multiple serious health conditions.

“He was one of our fi rst patients. He was in Sunny Street’s team presence for four hours a week for three years before he felt safe enough to disclose his childhood sexual abuse to me,” she recalls. “We’ve obviously provided him support and care and we’ve now got him into psychology treatments, but his story really refl ects the difference in Sunny Street’s model of care compared to traditional general practice. I think about the team-based approach and the sheer number of hours that the team has spent with him.

There’s no way that he would ever have reached that point of safety in mainstream general practice with 10-minute consults.

“He hadn’t even told his mum. I was the fi rst person he had told. It takes people who have experienced trauma a long time to think they can trust somebody to share their story.”

At the Maroochydore clinic opening with artist Shauna Hill, whose artworks feature in the clinic. PHOTO: Cade Media

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