Survivors of torture and trafficking, asylum seekers, homeless people and exploited domestic workers are just some of the people who seek help at humanitarian health charity Doctors of the World's clinic in Bethnal Green, London.
Three days a week, the clinic's volunteer GPs, nurses and caseworkers support those facing barriers to healthcare in the UK – even though everyone living in the UK, no matter their status, is legally entitled to see a doctor.
Access for all
The clinic has been running for a decade and has grown significantly in that time, with more than three times as many people now using the service compared with when it opened in 2006. The work has expanded beyond Bethnal Green, with one clinic established in nearby Hackney and one in Brighton. In 2015 the charity also launched a 'pop-up' clinic, sending medics to treat people at other organisations helping refugees and migrants across London.
While the number of patients attending Doctors of the World's clinic may have increased in the last 10 years, the types of problems they face are strikingly similar. Barriers to basic healthcare in the UK stubbornly persist – be those administrative and legal barriers, a lack of knowledge and understanding of the UK healthcare system, or fear of being arrested.
A report published in April by the charity exposed the fact that at least two in five vulnerable people are being wrongly refused GP registration, with the biggest barrier being people's inability to provide paperwork.
A sad situation
Doctors of the World's UK Programme Officer, Phil Murwill, began working for the charity three years ago and now helps to run the Bethnal Green clinic. He recalls one recent case which illustrates the impact that not accessing healthcare can have:
'We saw a man who was hearing voices; he'd heard them for years, and as a result his friends and family had abandoned him, calling him crazy. He'd been too scared to see a doctor about it.
'It was desperately sad. If he'd been able to access appropriate care in a more timely way, he could have been well supported and maintained his social network, but instead he saw his friends leave him one by one. We helped him to register with a GP, which we hope will be the first step on his road to recovery.'
Photo credit: Credit: Luke Johnston
The majority of the clinic team consists of volunteers who are essential to the continuation of the programme, and at least 30% of these are students.
'The clinic wouldn't run without them,' says Murwill. 'They are the first point of contact for new service users. They carry out assessments to identify the person's needs and they have a responsibility for identifying indicators of trauma and abuse, and concerns of safeguarding or exploitation, so we can work in an appropriate way to keep people safe.'
Students can volunteer with Doctors of the World as support workers or office-based caseworkers. These roles enable students to gain experience helping vulnerable service users and learn more about advocacy. The charity requires clinicians to be fully qualified GPs or nurses with at least two years' experience, but for other roles volunteers simply need to have good people skills and be empathetic and resilient, as they will be dealing with some distressing cases.
'An incredible eye-opener'
Seb Casalotti is halfway through his medical degree and volunteered with Doctors of the World for 12 weeks after finding the role on the volunteering website, Do It. He says that his experiences with the charity have reaffirmed the importance of policy and advocacy in providing access to healthcare and improving public health.
'Social activism is a part of medicine that is considerably overlooked in medical training. Working with vulnerable migrants is also an incredible eye-opener. It made me ask myself important questions, like how does one best empathise with people who have experienced things that you could not even imagine?'
For those who don't have a medical background, there are also opportunities for students to help raise awareness and funds for the charity by organising a university group. Such groups have already been established at universities including Oxford and Queen Mary.
It made me ask myself important questions, like how does one best empathise with people who have experienced things that you could not even imagine?
As the clinic celebrates its 10-year anniversary, Murwill reflects on what the next decade will hold.
'Unfortunately, the clinic will be in high demand as current government proposals to restrict healthcare for migrants will mean more people don't access care when they're not well.
'We'll need to expand to meet this growing demand and any work we do will have to include advocacy. It's important that we can talk about what we see to the Department of Health and provide evidence to help them better understand the reality of the situation for people being denied healthcare in the UK.'
To find out more about how to get involved with Doctors of the World please visit their website.