An impactful project in which former homeless individuals assist those living on the street is making a difference in the Cape Town CBD.
South Africa will not be able to address its drug and street-living problems until it starts to focus on people, not their problems. This is the life-changing ethos of a groundbreaking “peer-to-peer” programme which is being implemented in the Cape Town CBD by the Cape Town Central City Improvement District – a private-public company that works to improve the inner city – and its NGO partner, Khulisa Social Solutions.
In the programme, previous substance abusers and street-dwellers are trained as peer fieldworkers to provide multi-faceted support to help people who are living on the street believe that they, too, can change their story.
In Cape Town, thousands of individuals are homeless, and the number is growing. They are chronically overlooked in a very literal sense. There’s an epidemic of eye-contact avoidance; of choosing not to see or engage. Each winter, CCID Social Development department field worker Mark Williams anticipates that as many as 30 of his clients may not survive the bitter conditions. The unyielding rain and wind exact a heavy toll, compounded by the well-documented shortage of shelter beds.
Nevertheless, the City of Cape Town is vigorously striving to address this issue. The 12 CCID peers tirelessly dedicate themselves to supporting their peers around the clock. Their assistance ranges from providing a bed for the night to offering food, arranging clinic visits, assisting with ID applications and SASSA grants, facilitating work rehabilitation projects, making referrals for substance abuse treatment, and responding to opioid overdoses.
Tara Gerardy-Bissolati, CCID Social Development manager, says since the programme’s inception a year and a half ago, “the results have been remarkable”.
City of Cape Town councillor for Ward 115, Ian McMahon, says programmes like this one “are steps in the right direction”. He says, “We need to tackle the prevention aspect, which is sorely not yet enveloped, and I commend Streetscapes and the CCID for this innovative, bold step”.
Gerardy-Bissolati says the programme’s success hinges on the peers’ unique understanding of their clients’ situation. “They have been there and have come through it,” she says, “and with that comes an empathy which is hard for anyone else to emulate.”
Her views are shared by Jesse Laitinen, manager of strategic partnerships at Khulisa Social Solutions and founder of the Streetscapes work-rehabilitation programme, who believes that peers possess a unique ability to revolutionise the homelessness sector “by providing more effective and immediate solutions on the ground”. Says Laitinen, “Their first-hand experience and insight enable us to address critical service gaps.”
POWER OF PEERS
Amy is an example of the power of the programme – and human resilience. Shortly after she lost her husband, her daughter started acting up and losing weight. Two years later, with her daughter confessing to being a chronic drug user and fighting for her life after an overdose, Amy resolved to save her – and other children like her. She went to various NGOs offering to volunteer to help young people on the street. Finally, she joined the CCID peer programme.
Today, her daughter is her greatest cheerleader. Amy is completing her counselling course at the University of Cape Town, and she has helped to rehabilitate many people. She’s proudest of a young boy. She has photos of him on her phone. The first photo is of a skeletal child dressed in an old, torn T-shirt. The day she found him he said he wanted to end his life. She scrolls to the latest picture he sent her. Healthy, well-dressed, back with his family and holding his ID. Eyes looking at her, hopeful, bright. Unrecognisable.
She has photos of another client as well. An old man she encountered outside the police station, unable to move, with cavernous ribs and a pus-filled cavity in his chest. Scroll to the latest photo he sent her, standing, with his family on either side. Another unbelievable transformation.
For her it’s a heart-calling and she won’t rest until she’s helped as many people as she can.
Tyler has a similar story. They were working as an educator at an NGO advocating for the rights of sex workers. Originally from Paarl, they were stressed being in a new environment and in an unhappy relationship, so they started to avoid going home. They began to live on the street and met a new partner who introduced them to heroin. For three years, they felt totally lost. Then a social worker reached out to them, and they joined a work-rehabilitation programme and started doing a theatre course.
Fast forward, and Tyler joined Khulisa Social Solutions’ work-rehabilitation programme, Streetscapes, and the peer field worker programme. They’ve now helped 15 people into shelters and they have a special passion for assisting LGBTQIA+ clients with HIV-treatment adherence. And they’re still acting; an actor and activist.
They say, “I remember how I was approached and how it felt. I had this hope I could find myself again. I felt like I could be born again. This has made me stronger, a better person. I am healing myself first.”
Hillary is another peer, who came from an unsupportive, unloving home. She ran away to the streets as a young adolescent, was raped and abused, and became a sex worker for income. She had two children, who she had to leave with strangers while she worked to earn enough to buy them food. She was determined to change her situation for the sake of her children. So, she joined Streetscapes, stopped drinking, and turned things around. Today, she too, has helped many individuals. She also lives in a house with her children.
The peers’ stories are profound. And rooted in trauma. Which is another key aspect the programme addresses through psychosocial and healthcare training.
THE PEER APPROACH: A MODEL FOR SOUTH AFRICA
Gerardy-Bissolati says the programme provides the peers with skills that field workers have, so they can develop viable careers. She wants to develop a succession pipeline of peers across the Cape Town CBD. The peers work in known “hotspots” across the city centre, helping clients, while also addressing concerns such as aggressive begging and public substance use.
“A big part of the programme is a harm-reduction approach, which is a model of treatment for substance use disorders,” Gerardy-Bissolati explains. “This approach meets our clients where they are at. It is a set of practical strategies and ideas aimed at reducing the negative consequences associated with drug use.”
Laitinen says that the health needs identified by peers played a crucial role in Streetscapes securing a three-year international grant to scale up and support this work. “This shows the power of peers in influencing and guiding decision-makers and directing resources where they are most needed. This ultimately leads to tangible improvements in homelessness and people's lives.”
The peers, who work two days and three nights every week, are trained in several areas, including how to act in the event of an overdose and other medical emergencies. They actively engage with the day clinics, linking clients for chronic medication adherence.
There are two teams who are mentored by CCID Social Development department’s field workers (three during the day and one at night). They meet every morning and afternoon to check in and “debrief”. Says Gerardy-Bissolati: “This type of work comes with a lot of heartache and loss. Every small victory is celebrated.”
The CCID collaborates with multiple shelters, aiming to extend its reach to marginalized individuals. Gerardy-Bissolati is committed to helping those on the fringes of society and is eager to expand the programme's scope to serve a broader audience. For her, each intervention begins with the simple act of making eye contact and asking individuals how they're faring. Aside from the dearth of social and medical services and shelter beds, what missing is humanity. “This is where the peers excel … they have the lived experience. They can ask someone’s story, hear them, and understand.”
TWIN EPIDEMICS
For South Africa to address its twin epidemics of substance use and homelessness, this people-first approach is key. “These kinds of peer-led models are tried and tested worldwide, and they work,” explains Gerardy-Bissolati. “And the country needs to implement more of them.”
To support the CCID's peer fieldworker project, visit the Social Development page on the CCID website for more information. Additionally, the CCID is currently conducting its yearly Winter Readiness programme to aid individuals during the toughest season. Those interested in contributing can donate through http://www.showyoucare.co.za/.
*Peers’ names have been changed to protect their identities
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