The Western Line'''

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The Western Line...
Portland
NSP
NSP
NSP
Western Line Portland to Auburn Primary
Secondary
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Structural problems in NSP?
SMH, SATURDAY 12TH MAY (World News)
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THE LOCAL CATCHMENT AREA
Western Sydney sister streets
There is a hospital at the end of Hope Street
coincidental or what?
Western Sydney high-rise
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Where are yers?
Beer Garden - St Marys

• Monday, 9.30am
• Um.is there anyone there? Umm, theres some
  of us at the station, can you come out as soon
  asyacan?
•  
• Monday, 9.32am 
• Please, areya there yet? Well wait for ya,
  can ya hurry up, please. Can ya call me back,
  are yas comin?
•  
• Monday, 9.35am
• Umm, please, is anyone coming out? Some of the
  others have gone, theres a few of us still here.
  Umm, can ya call me back? Are ya comin out?
  Can ya call me back? Umm, oh, I dont have a
  phone.

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Mount Druitt 1800 354 589
Where are yers?

• Saturday, 2.30am 
• Umis there anyone there? Im in Whalan.
  Can you bring me a fit? Is there anyone there?
  Dont worry, Ill ring someone else.
• Saturday, 2.33am
• Umwhere can I get a fit? Can I get a fit in
  Whalan? Im gonna have to get AIDS nowthe guy
  Im with has got AIDS, weve only got one fit.
  Is there anywhere in Whalan?
• Sunday, 10.05 pm
• MMMM errrrr mmmmm hungry!

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South Court NSP
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Enhanced services And would
you like

• your blood screened
• a Hep B vaccination
• a sexual health screen
• a pregnancy test..
• wound consultation
• counselling
• to see Dr Eva
• to talk Steroids with Richard

Do a wee for Doctor E Free wee testing here!
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What services are in demand?
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Case Study 1. Dogs are the best people

• Presentation to NSP
• Homeless
• Penniless
• Mentally ill
• Using drugs
• Isolated
• Caring for two large dogs
• Sleeping under our ramp with dogs

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Structural / Organisational Issues

• Multiple agencies involved with client no
  co-ordination of services
• Correctional Services
• DA Methadone
• Mental Health
• RSPCA
• Centrelink
• Department of Housing
• Indigenous Health
• NSP
• Service exclusion practices - you cant bring
  those dogs in here
• Transport
• Poverty
• Indigenous
• Limited education formal and life

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Strategies

•  dont panic no freaking out
• Acceptance and active engagement - conversational
  style of work
• Help client meet basic needs warm clothes, food
  for herself and dogs, shower
• Liaison with other services take active
  co-ordinating role
• Help client make decisions and collaborate on a
  plan
• Arrange for care of the dogs
• Assist client to find emergency accommodation
• Provide equipment and education regarding safe
  injecting

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Case Study 2. Limping lady

• Presentation to NSP
• Long term NSP client
• Poor physical health leg ulcer etc
• Massive drug use
• Cognitive impairment
• Homeless
• Street sex work
• Victim of domestic violence
• Child protection issues 4 children in out of
  home care 1 in clients care

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Structural / Organisational issues

• NSP equipment butterflys and large barrels
• Service co-ordination multiple agencies
  involved with little co-ordination
• Transport client and child
• Access to prescription and non-prescription meds
• Poverty
• Poor education
• Gender issues cycles of abusive relationships
• Lack of suitable stable housing
• Parenting early intervention

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Strategies what we did

• Proactive outreach
• Wound care and emergency health care
• Helping to access rehab with child
• Helping to develop safe parenting behaviours
• Referral and notification statutory obligations
  to DOCS
• Co-ordination of services
• Education, support and practical assistance to
  escape from domestic violence
• Involvement and support of broader family network

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NSP service issues

• NSPs are in no position to directly influence
  macro issues of discrimination.
• History of invasion, discrimination and
  repression of Indigenous people.
• Inequalities of opportunity related to finances,
  housing, transport, education etc
• Recent developments in public sector bureaucracy
  make it increasingly difficult for staff to
  remain active in the political process other than
  as individuals.

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At a micro level NSPs can work in ways that
reduce the impact of discrimination for clients.

• Open door policy
• Non-judgemental client centred approach
  positive attitude
• Pro-active engagement interest in clients and
  their story
• Enhanced NSP services Multi-disciplinary team
  work
• Suitable physical environment and staff numbers
  to engage clients
• Service flexibility
• Creation of good will with other health service
  providers

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The irony is that the position of NSPs at the
bottom of the health food change allows some of
the freedoms often enjoyed by NGOs to actually
work creatively with and from the framework of
clients.