LEARNING FROM AN EMERGENCY THE TERRITORIAL RESPONSE MODEL IN ROME

The new Report about the INTERSOS territorial response model 9 months after the start of the intervention to combat COVID-19 in Rome

About nine months ago, the first patient affected by COVID-19 in Italy was identified, the so-called patient zero. Shortly thereafter, infections in our country began to increase exponentially, making Italy one of the countries most severely affected by the SARS-Cov-2 epidemic.

In the large number of ministerial decrees and procedures aimed at containing contagions, however, there is no sign of indications aimed at protecting the health of homeless people, of people in reception centres, neither of operators working in centres. There is no sing even of an adequate and effective reorganization of the territorial assistance system aimed at implementing home surveillance and management of less serious cases (just an extremely reduced extent compared to what is necessary). Instead, emergency and unfair visions and measures prevailed, without a socio-health approach and, therefore, fragmentary. The Special Regional Assistance Continuity Unit (USCAR), for example, born with the vocation of implementing home care, if in some regions (such as Veneto and Emilia Romagna) they have managed to intervene in a virtuous way since March, in Lazio they were in late, with different practices, objectives and resources in the area, as well as with a very poor coordination capacity with the communities, general practitioners and various departments. Without tools for a detailed reading of the needs of the territory, their use seems in fact limited to the administration of tampons at home, outside the logic of integrated home care.

INTERSOS activities

In these nine months, the INTERSOS teams active in Italy have completely recalibrated their activities, focusing on the implementation of anti-COVID-19 measures aimed at the most marginalized populations, not included in the measures adopted by the institutions.

In Rome, in particular, since March 2020 the INTERSOS24 project (active since 2016, thanks to the partnership with UNICEF Italy) has focused on the implementation of anti-COVID-19 measures aimed at the homeless population or in conditions of social exclusion. in order to guarantee the protection of their health and support the Lazio Regional Health System.

Two mobile health teams have been organized which still carry out health surveillance, health education and health promotion activities in organized spaces used for residential purposes (“housing squats”), informal settlements (spaces adjacent to the main railway stations) and reception centers for Italian and foreign people in conditions of fragility, for asylum seekers and for unaccompanied minors (UASC).

The constant and versatile presence on the main places of interest, as well as the presence of a physical space recognized and known by the target population and by the institutions has undoubtedly represented an essential premise for the ability to provide, even in emergencies, concrete and equitable answers to needs. primary. This type of territorial and integrated intervention has made it possible to include people otherwise excluded from health surveillance in diagnosis and treatment paths for COVID-19, to manage less serious cases at home, avoiding improper use of first aid and to fill institutional gaps by enhancing and systematizing the resources of the communities themselves.

From the beginning of the intervention to today, the mobile teams have intercepted and supported 1,583 people through medical visits and health education sessions; managed at home in coordination with the ASL of reference more than 150 positive vulnerable people or in fiduciary isolation; included in diagnosis paths for COVID19 about 250 people with barriers to access to treatment for administrative and bureaucratic reasons; accompanied around 42 people without resources to drive-ins.

In this sense, the work of the INTERSOS mobile teams in Rome can be read as a pilot experience of integrated territorial assistance (public-private social), cross-cultural (involving both Italian and foreign populations in marginalized conditions), multidisciplinary and based on community involvement. This integrated and territorial organizational approach has proved to be particularly effective and necessary if applied to more marginalized populations, and would be generally desirable for the care and health practices of the general population.