Driving home from an out-of-hours shift, Dr Zahid Chauhan spotted a man sitting in the middle of the road, clutching his mouth.
“It was a homeless man, and he told me he had just pulled out his own teeth with pliers as he was in so much pain,” Dr Chauhan told HuffPost UK.
He learned the man had walked to hospital and waited hours but hadn’t been seen.
Seeing the plight faced by homeless people in Oldham, Greater Manchester, first hand led to Dr Chauhan founding the charity Homeless Friendly. He now urges medical practices, hospitals and out-of-hours providers to support the homeless and allow people to access services without proof of address.
“Historically, homeless people have always faced injustices,” said Dr Chauhan. “But they are part of our society and have the same entitlements as everyone else.
“I strongly feel these are a group of people who have been marginalised because they are forgotten people who have been left to fend for themselves.”
As the coronavirus vaccination programme rolled out, Dr Chauhan knew it was time to speak up for the homeless again.
Homeless people are not listed among the priority groups for vaccination, but the wording in the Joint Committee on Vaccination and Immunisation (JCVI) allows local health workers some flexibility in who they chose to call in – and mentions the importance of “mitigating health inequalities”.
Dr Chauhan, a cabinet member for health and social care at Oldham Council as well as a GP, agreed with others at the town hall and the local NHS that they would prioritise vaccinating those experiencing homelessness – even if this meant defying the guidelines.
“Common sense is helpful,” explained Dr Chauhan. “There are a comparatively small number of people who are homeless in the UK. So vaccinating them is a small cost but high-impact intervention that will save lives and reduce pressure on hospitals.”
The 44-year-old GP added: “It is also the right thing to do morally.”
Dr Chauhan held the first ever Covid-19 clinic to vaccinate homeless people in the middle of January and with the help and support of the DePaul charity, the jab was administered to 23 people.
Dr Chauhan told HuffPost UK he felt “honoured” to administer the first doses to those affected by homelessness – by personally vaccinating a homeless couple who had been living in a tent in a disused building in a park following eviction.
Since then, a further vaccination clinic for homeless people has been held in Oldham with the support of homeless organisations and many other Greater Manchester authorities have followed suit by offering the vaccine to people who are homeless within their catchment areas.
Dr Chauhan partnered with other campaigners, such as the Homelessness Vaccination Campaign, and wrote to every local authority in the country asking for homeless people to be prioritised for the jab.
His work was praised by homeless organisations and campaigners and taken up by some other towns and boroughs – but he also received abuse.
“I got a lot of backlash from some members of the general public asking me why I wasn’t following the JCVI guidelines,” he said.
“Some even said I should be reported to the General Medical Council and be struck off as a GP. I felt like I had committed some sort of crime.
“But you don’t stop doing the right thing just because some people are criticising you.”
“You don’t stop doing the right thing just because some people are criticising you”
On the flip side, Dr Chauhan received hundreds of emails and letters of praise for his work highlighting the importance of vaccinating those experiencing homelessness.
What’s more, the NHS has now written to all GP surgeries and Clinical Commissioning Groups (CCGs) asking them to address vaccine inequalities and give due attention to groups such as “homeless, Traveller and Gypsy Roma communities”.
As well as giving clear guidance stating homeless people should be prioritised for Covid vaccines, the letter highlighted Dr Chauhan and the work in Oldham as an example of good practice of how localities should develop outreach programmes.
“After all our campaigning and constantly having to defend our decision, this is a victory,” said Dr Chauhan.
Paul Dowbekin, 45, is one of those who has had the vaccine. He had been sleeping rough around Oldham for five years until November, when an organisation called Street Angels found him and helped him get off the streets.
“I was with my partner for seven years and have four kids, but we ended up splitting up and I became homeless as I had nowhere else to go,” he told HuffPost UK.
“I turned to drink as a result of the relationship breakdown and because I was on the streets. The drink blanked everything and took the pain away and I felt normal for a while again.”
Paul admits he was “not a nice drunk”. “I was a nasty drunk and was always getting beaten up and arrested.
“When my ex-partner told me my kids wanted to see me, I knew I was in no fit state. I knew I had to change for myself and my children.”
Paul sought help from Turning Point in Oldham, which promotes recovery from addiction, and he has now not had an alcoholic drink for a year.
Paul was living on the streets throughout the coronavirus lockdown. After being found by Street Angels in November, he was initially put up in a hotel and said if it wasn’t for them he would have “frozen to death”.
In January, he was homed in temporary accommodation in Oldham in a block with other homeless people – and it was here that he received his Covid jab.
“I don’t want to die of Covid, so when I was offered it, I had it,” he said.
“I think homeless people are more vulnerable to coronavirus as they are on the streets and mixing with everyone.
“If you have no fixed abode, you might not have a doctors where you can go to get the jab. Taking the vaccine to them is the answer and what this doctor has done for the homeless is so important and a great idea.
He added: “Some people on the streets think Covid is a government plot. But I think everyone should have the vaccine.”
“I think homeless people are more vulnerable to coronavirus as they are on the streets and mixing with everyone.”
Janey, 56, also received the jab while living in temporary accommodation in Oldham. She became homeless three years ago after fleeing domestic abuse.
A mother-of-three and a grandmother, Janey is studying English and maths at an adult learning centre and also volunteers online to help women suffering domestic abuse. She told HuffPost UK the vaccine has made her feel more protected.
“I feel grateful for the vaccine as it means I can do a bit more and go and do my studies and volunteering,” she said. “But we still need to be mindful and keep our face coverings on and keep socially distanced.
“Homeless people are very vulnerable and not a lot of them have doctors they can turn to and some of them don’t even know how to register with a doctor or dentist.
“I had my jab because they brought the doctors and nurses to the temporary accommodation and we were jabbed one at a time in a separate room in a safe environment.
“Not a lot of homeless people like to go into a doctors because they find it too daunting and claustrophobic.”
Dr Chauhan points out that homeless people already face deep health inequalities – and a much lower life expectancy.
“Homeless people are extremely vulnerable and their life expectancy is only about 44 when the national average is around 80.
“A study in Canada found that homeless people are five times more likely to die of Covid-19 and are more likely to have underlying health conditions.
“Those living on the streets are 20 times more likely to be hospitalised with Covid-19 and the physical frailty of a rough sleeper is around that of a 90-year-old when they are much younger.
“So why should we give up on people who have suffered bad luck and obstructions in their lives such as a breakdown of a relationship which led to them turning to alcohol?
“It is the moral duty of people like me to support and speak up for homeless people.
“We need to give people a chance instead of giving up on them.
“If a person is in a care home or a hospital, we will go and give them a vaccination. So why can’t we do the same for homeless people?
“We need to take Covid as a warning shot as a nation. We need to discuss underlying root causes as to why these inequalities exist.”
He added: “We can’t just discharge our moral obligation to homeless people by giving someone some loose change.”