Olallo House, an intermediate care service in Central London, created in response to multiple tuberculosis (TB) treatment failures and preventable deaths among people experiencing homelessness , has been shortlisted for the awards on October 14.
The project was set up in 2008 by the charity SJOG Hospitaller Services, in partnership with the convent Poor Servants of the Mother of God.
While the project provides holistic support to homeless people who have experienced trauma and face multiple disadvantages, its origins can be found in the rise in prevalence of TB in the city in the last decade.
In 2012, London was declared the European capital of TB, with more than 8,750 cases recorded. As the charity points out, TB is a social disease - finding its niche among populations at the margins of society where delayed diagnosis leads to uncontrolled community transmission.
Any preconceived idea of TB as a relic from Victorian times is dispelled when learning about the guests who depend on the project to support them through their long-term treatment.
As PaweÅ Zabielski, Service Manager at Olallo, highlights: “Those who come to the house are often those with No Recourse to Public Funds, and have been sleeping rough.”
“They will often be discharged with big bags of medication set to last them 6 months, the minimum treatment time for the disease. When we started people were stopping their treatments too early. They simply lacked the space to store and take their medicine. Hospital treatment at home is designed for the general population, but we work with those most vulnerable on the fringes of society.”
Despite the increasing prevalence of homeless Londoners suffering from TB, and the difficulty they have in accessing sufficient outpatient treatment in the community, Mr Zabielski is keen to stress however that there is no typical journey through the service.
“What our intermediate support looks like depends on the needs of the person. When they arrive at the House they are allocated one of our dedicated support workers, who between them can speak 12 languages. After an assessment, they are offered specialist support depending on the problems they face.”
One case study that Mr Zabielski likes to use to demonstrate the range of disadvantages a guest might face is that of a man who came to the House at 24 years old. “He had drug resistant TB, which meant he needed multiple injections a week over the course of two years. To deliver this treatment, our key workers had to negotiate his anger management issues and substance abuse.”
If the guest had been engaging with mainstream services, or had been left to fend for himself on the street, he may not have survived. As Mr Zabielski explains however, “he completed his two year treatment with us, and now has a job and is TB free, no longer spending nights on the street.”
The story reflects the widespread success the project has had since its founding. An independent evaluation of the project undertaken by UCL found that TB patients cared for at Olallo between 2010 and 2019 were three times more likely to complete TB treatment when compared to all other TB cases diagnosed in London during this same period.
Mr Zabielski believes this success is underpinned by the principle that at the House it is “not us and them … it is all of us together”.
“We respect the choices made by the individuals, even if at the time they might not seem the wisest choices, such as discontinuing treatment for substance abuse for a period of time. By giving them more of a say and treating them as equals we try to empower them, so that they can ultimately dream again of having a better future.”
While Covid was the greatest disruption for most homelessness in the spring of 2020, the team at Olallo House had to deal with another emergency - their building being flooded.
As CEO of SJOG Hospitaller Services Paul Bott explains: “due to a water mains failure our basement and kitchen were turned into swimming pools. It took about a year to get things dried out and sorted. Within a day however all guests were provided with accommodation and a hotel, due to the hard work and commitment of our brilliant staff.”
Going forward, the charity hopes that its successes can serve as a template for growth in other hotspots for infectious diseases around the UK. As Jamie MacKrill, Director of Opportunities at the charity says, “Olallo serves that specific need for people with No Recourse to Public Funds, and who suffer from TB and other infectious diseases. We have a unique delivery model operating in London, but this needs to happen all over the country. Replicating the service in the right context would be something we want to do.”
As most of the projects shortlisted for the Awards have demonstrated, the innovative and transformative nature of the projects is combined with great modesty on the part of service deliverers. Mr Zabielski, who has worked at Olallo House for 10 years, says “my manager once called it a bus stop. We show the people at Olalllo that homelessness is not permanent, they are simply waiting for the correct bus to jump on so that they can get on with their lives.”
The London Homelessness Awards, taking place on 14th October at Union Chapel, is being run in partnership with the Evening Standard’s Homeless Fund. To find out more visit: https://lhawards.org.uk/