Oral Health Programme for the Homeless in Sydney - Assignment Example

Community Profile and Assessment Plan Oral Health Programme for the Homeless in Sydney Introduction Homelessness is a pervasive social problem affecting many societies, including affluent nations. As expected, an immediate casualty here is the health condition of an individual. Oral health condition is one pressing issue that needs urgent attention and action from the society in general and community in particular. This paper outlines its proposed community assessment plan that seeks to assist in identifying different types of homeless people with varying degree of oral health problems. Sydney, which is one of Australia's Central Business Districts, is an important setting and home to at least 700 homeless individuals in 2009, according to a statistics prepared by the Australian Bureau of Statistics. The challenges posed in responding to identified health problem will be addressed by coming up with a policy programme geared to get actual number of the homeless people in Sydney. After doing so, this bring us to the community project of launching a mobile health assistance to render oral health solutions and to conduct health awareness campaign. To do so, the proponents identified it will tap inter-agency support and cooperation, appealing to institutions to assist in the community health intervention programme. Under the plan, an evaluation will be conducted before and after the implementation of the plan. Research Purpose This research aims to map out ways to conduct an effective community profile of the identified setting for a proposed community intervention programme. In effect, this research will present a health intervention programme geared for the homeless in Sydney through the conduction of mobile missions for homeless people with oral health concerns. Community Profile Homelessness is a complex global problem facing most nations. Though a first world country by economic standards, Australia is not spared of this persistent social or economic dilemma, which requires urgent attention and intense action. In a 1989 Australian Bureau of Statistics study, it showed that there are around 70,000 homeless people, comprised of children and young people. By the end of 2000 in New South Wales, there were 96,500 people who are waiting to be accommodated in the government's public housing programmes. In a policy paper titled, “Counting the Homeless: Implications Policy Development,” Chris Chamberlain reported that there are up to 105,000 homeless people across the country. Based on existing classification system of the homeless, it was indicated that most at risk are the mentally-ill, victims of domestic violence, substance abusers, and the like (Chamberlain, 2009). Meanwhile, the report categorized the homeless as follows: from between 60-70 percent are homeless for six months or more while 46 percent are considered temporarily dwelling with other households. Twenty percent were in improvised dwellings, tents or sleeping out, and another 22 percent and 12 percent were staying in boarding homes and SAAP-funded homes , respectively. SAAP stands for Supported Accommodation Assistance Program. Based on reports about this survey, the study was made during the coldest months of the year, which experts said underestimated the exact true figures of homeless people in the said area. For this community assessment plan, we will look into the homeless community in Sydney's Central Business District. In one survey, it was reported that a quarter of homeless people in Australia live in NSW, where the City of Sydney is one of the 152 Local Councils in the said region. Around June to September of 2005, there are 311 to 455 reported cases of homelessness in Sydney's Business District alone, based on the Australian Bureau of Statistics (Marquette, 2009). A more recent survey in 2009 revealed that in February 2009, there are up to 791 homeless people in the Local Government area (Marquette, 2009). The many challenges that this dilemma pose include matters pertaining to decisions to be made in coming up with a policy programme about getting the true number of the homeless, including data on the geographical spread of the population. The same proves to be true with ways needed by the proponents in mapping a plan to provide oral health promotions in order to assist the homeless people in Sydney, Australia. Through this proposed assessment plan, a health intervention programme can be used to respond to the outcomes expected and outlined by the Ottawa Charter for Health Promotion. The same suggested that said health promotion may be defined as “a process of enabling people to increase control over, and to improve, their health” (Ottawa Charter for Health Promotion, 1986). From the actions alone about the gathering of the population of homeless Australians and how much the health sector are responding, the actions seems slow. Thus, with this proposed action plan to assist the homeless with their oral health problems, it is assumed that this will afford a small yet significant impact on the community that can soon be viewed as model for future undertakings. (Paul, 1996) Community Assessment and Engagement Plan a. Goal To increase inter-cooperation awareness among various sectors in Sydney to help the community of homeless with oral health problems through the conduction of mobile oral health missions. (Ottawa Charter, 1986) b. Project Aims To strengthen policy programmes in rendering oral health-related assistance for the homeless in the Central Business District area of Sydney, Australia. (Ottawa Charter, 1986; Paul, 1996) To hold mobile health missions to assist the homeless in Sydney with oral health problems with timeframe of of six months. (Ottawa Charter, 1986; Paul, 1996) c. Objectives The conduction of mobile missions to assist the homeless with oral health problems is aimed at strengthening health intervention support or assistance, particularly oral health care support, given to the homeless community in Sydney, which in effect can help raise awareness of need for inter-cooperation among different sectors of the community. (Ottawa Charter, 1986; Paul, 1996) d. Settings The location is the Central Business District of Sydney, which is part of North South Wales, Australia. Communities or areas targeted include the following – Temporary dwellings or emergency accommodation places Refuge Homes (Youth, women) Homeless living in streets, parks, derelict or abandoned buildings, etc. Schools and Campuses. e. Project Partners Oral health associations – Expert advice on problems encountered or their experiences in dealing with different community types, such as the homeless may be an important information that can be obtained from their group. Their experience can be used in formulating an effective policy programmes before rendering oral health solutions to the homeless. Additionally, these associations or groups can be tapped to render at least a full-day equivalent of volunteer work. (Chamberlain, 1996) Media networks – Although their role may be secondary in effecting change, however, the media's assistance in promoting the project will be very relevant, especially in influencing mindset. These establishments can assist and give needed media coverage and exposure of the health promotion project through the mobile mission to areas with homeless people (Chamberlain, 1996; Paul, 1996; Ottawa Charter, 1986). Schools and campuses – The awareness-raising campaigns to promote inter-cooperation among community partners are better held within the confines of the learning institutions. Schools are good grounds to conduct events and health promotion activities to influence attitude and perceptions among the students, who can also be tapped to assist with the project (Chamberlain, 1996; Paul, 1996; Ottawa Charter, 1986). f. Strategies Strategies can be comprised of the following actions: Policy mapping with the different health sectors and finding partners who will assist the project (from non-profit, profit media, to government areas) (Chamberlain, 1996; Paul, 1996; Ottawa Charter, 1986) Create media partnership who can provide needed exposure to boost reinforcements from volunteers and help from outside sources (community, health sectors, etc.) (Chamberlain, 1996; Paul, 1996; Ottawa Charter, 1986) Along with the use of mobile health missions, a foldable mobile learning tents can be used to provide common fixtures to draw attention, curiosity and awareness about the oral health awareness for the target partners (Chamberlain, 1996; Paul, 1996; Ottawa Charter, 1986). Create key partnerships with health professionals in the community and by involving them to support the project by encouraging volunteer support. As a token of appreciation, media coverage of the health intervention programme will credit volunteers' names and organizations in the reports to be published online (Chamberlain, 1996; Paul, 1996; Ottawa Charter, 1986). Development of a web site to promote the activities and generate massive public awareness and interest about the health promotion project (Chamberlain, 1996; Paul, 1996; Ottawa Charter, 1986). g. Evaluation The success of the project can be evaluated based on the following (Jimerson, 2003): Mileage or the exposure the project will generate from the media to the online space (blogs, etc.) Publications citing the project in journals and other forms of creditable media. Database of the recipients of the oral health assistance. Conduct interview with target partners and homeless oral patients who will be rendered the service during the programme. h. Issues Expected to be Encountered School health education is not a cure-all remedy to increase awareness and interest because it is expected that students may receive uneven knowledge about the need to support or encourage participation or cooperation to promote the mobile health missions to the homeless. However, positive attitude may be gained towards the importance of giving urgent attention and solution to such problem. (Bayat, 2000) The proposed strategies for the health intervention programme is more ideal than realistic at planning phase. This means, some projected benefits or advantages may not materialise, and the same may be true to its other implications. Walker and Darling (2007) identified the need for rigorous programme evaluation and challenges programmes in order for the same to became acceptable to the population which may not necessarily be effective. Like health education programme which was intended to influence and change attitudes, information campaigns to promote oral health programme for the homeless may achieve the same. However, some of these ideals, such as changing of attitudes fail. Hymann and Sheatsley (1947) explained that the reason most information campaigns fail is due to the fact that people tend to acquire information mostly about things that they find of interest and tend to avoid information that they have been unavoidably exposed to uninteresting and disagreeable information. Critical Analysis and Recommendations a. Health issue One of the emerging health-related issues posed by homelessness is dental and oral problems of homeless people. Due to their social and economic inadequacies brought about by joblessness, poor health and domestic violence, it is expected that these people would be depraved of sufficient medical and dental requirements. As the world reels in economic uncertainties, it is expected that the number of homeless people will rise, along with other related health problems. (Marquette, 2009) b. Community strength and challenges In certain populous cities and regions like Sydney, it would already be expected that some health intervention projects would be available, which may already be using the basic-needs provisioning model where aid are doled out to support or meet the needs. Such practice can be traced back from the British practice to establish education and social welfare in in some of its colonial territories (Mosher, 1989). The same time when large international organizations, (e.g., World Bank, International Labor Organization, UNEP, UNICEF) bilateral aid agencies (e.g., USAID, CIDA), nongovernmental organizations, and independent development institutes became more involved with community development in 1970s, then also emerged some alternative approaches to community development (Chenery et al., 1974). The practice reflected the basic-needs provisioning that targeted the marginalized or severely under-serviced areas. Support for the cause of the poor it is said are very prominently given by non-governmental organizations and such were reflected in the amount of commitment, size of effort and efficiency. A United Nations study said NGOs have participated in community development efforts even in non-state countries or where social unrest are occurring (Bayat, 2000). Expecting community participation through mobilisation of participants may prove difficult, however, when the area is beset with cultural and structural reasons, as in the case of Libya, and other nations where tensions and political strife are happening (Bayat, 2000) The basic-needs provisioning model for community development has its own limitations that would not be sufficient to address poverty alleviation dilemmas. Modern approaches may be undertaken that highlight direct or targeted approaches against indirect and over-reliance on economic growth and trickle-down methods to help the poor. New school of thoughts espousing basic-needs approach are even proposing that popular participation be increased as well. Thus under this new suggestion, organizers of community development programmes must ensure that the poor attain certain level of organization and self-reliance. For experts, the community members’ active involvement with a development project is assumed to contribute to the enhanced efficiency and effectiveness of investment and to promote processes of empowerment (Frances, Cleaver, Institutions, Agency and the Limitations of Participatory Approaches to Development, 2001). With most community development efforts now granted with more autonomy from states to implement programmes, Fuentes and Frank (1989) said such movement are not new yet the approach remains that of a filler by filling the void in what the government cannot do. For people who have lost faith in the ability of mainstream institutions to improve their well-being or defend their rights, popular movements seem to offer a viable bottom-up alternative. From these evolved theoretical frameworks, community development, thus, can be defined in the simplest term possible as a practice that encompasses the processes and tasks needed to achieve the vision of empowering the community to have effective control and responsibilities for the destinies of their community. Thus, the empowerment of the community members is the result of the activist nature of community development (Bayat, 2000; Chamberlain, 1996; Paul, 1996; Ottawa Charter, 1986) Mobilising a community to get involved in a community project is one of the biggest challenges facing community workers today. Michau (2007) noted that in order for change happen, there ought to be an understanding that success of such community development programme may depend on how involved members of the community are in responding to calls to be vigilant and active. This impresses that in order for change to happen, the level of activism must be strong among the members of the community or intended publics. Monitoring and controlling the process in all aspects may prove very difficult, however, for social change to happen, community development organizers must recognize that there is no such as thing as straightforward progress. Furthermore, the principle of establishing a more holistic approaches in community development, as what many activists subscribe to, is hard to translate into practical strategies. In her study on the prevention of domestic violence, Michau (2007) state that activists and practitioners recognize that their aim is geared on modifying the socio-cultural patterns of conduct of men and women and to eliminate prejudices, customs, and other practices centered on the idea of the inferiority or superiority of either of the sexes and on stereotyped roles for men and women’. Yet, these activists map strategies to implement stand-alone campaigns, workshops with specific sectors or the prodction of a campaign collaterals, such as poster or radio programme. Since challenging a deeply-seated value system is complex, a ‘do what you can’ strategy is undertaken to make such manageable on the assumption that doing something is better than doing nothing (Bayat, 2000). c. Recommendations for change We understand and determined that grassroots activisms in community development do have limitations in terms of internal constraints, accounting factors such as how much can realistically be meet, and how such approach may be carried out with or without government support. To resolve our dilemma, social development tasks must not only consider the grassroots level, but also recognising that the state carries a critical role in distribution matters on the wider scale. Hence, it would be too idealistic not to consider the state's involvement. Apparently, it is like daydreaming to imagine changes and improvements in people’s lives without the state’s pressure or direct action (Bayat, 2000) This paper thus recommends that the training for health intervention workers include the honing of one's the civic-mindedness and involvement. Bayat (2000) noted the rise of social-community activism as grassroots non-movement. Such concept illustrates a condition that espouses a non-collective direct actions of individuals and families to acquire basic necessities in life, such as land, shelter, urban collective consumptions, informal jobs, business opportunities in a quiet, unassuming manner. Compared to conventional or traditional activism, new emerging activism is that it seeks direct, individual and informal actions. As a result, there is a “pressure from below” that will inevitably create realities that authorities will sooner or later adjust their policies. Had grassroots actions been totally absent, there would have been no change happening in countries where this new activism emerged (Bayat, 2000). Under the proposed strategy, the mobile health missions while providing oral health solutions to the homeless, can also at the same time provide educational relief that will teach the target publics the importance of inspiring participating partners to get involved and take a more active role in empowering people to be concerned with their health (Bayat, 2000; Ottawa Charter, 1986). d. Conclusion As suggested in the Ottawa Charter for Health Promotion, health promotion is a recommended template that health workers may use as a guiding principle in empowering people to improve on their health (1986). When applied in our subject, the creation of a policy programme for the community of homeless in Sydney, the template protocols of the Ottawa Charter is an important guiding principle. The same, however, may prove wanting in terms of implementation when undertaken per se. Thus, in order for a community assessment plan to succeed, not only specifically for the region of Sydney, there must be consideration to the demographics and economical standing of the area. Involving different institutions, such as the education, media and government sectors, may be a viable proposal to consider, however, there remains some issues that may need to be addressed for a smooth and effective undertaking of the subject. Although projected that the community assessment plan may become successful when implemented, the role of the health workers evaluating the programme must consider the larger scope that the programme will provide the community. 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