In Vaulx-en-Velin, a community health center explodes the codes

Since October 2018, Health Common has moved to the ground floor of a building in a Vaulx-en-Velin district.Constituted in association, caregivers (general practitioners and midwives in particular) welcome each year between 2000 and 2,500 people in this “place of medicine and life”.A watchword: go to the inhabitants and give them a central place.

A room with beautiful fresco, a sign "Serve" with coffee available, messages of all kinds that cover the walls ...

It is the "common health" reception room, close to the Grand Mas, in Vaulx-en-Velin.In the multitude of wall messages, information on vaccination against COVVI-19 is written in "FALC" (easy to read and understand) with drawings.On the teapot, the word "tea" is written in several languages.To address everyone.

Lost in the midst of buildings in a district of Vaulx-en-Velin, this place of life has a nurse, a midwife and three general practitioners.It is quite far from a classic medical center.It is located near people, at a door of the apartments of the building.

In Vaulx-en-Velin: “We are actors in our health”

The common health team

Common health is made up of ten members.On the medical aspect, three general practitioners, a nurse and a half-time mid-time are mobilized.On the "social" side, the association has a pair mediator, two "welcoming" and a project manager.The team is supplemented by a management coordinator.

Since October 2018, the young woman has participated in the life of the places that welcome the inhabitants of Vaulx-en-Velin and vulnerable audiences (suffering from disabilities, public from the reception center for asylum seekers, etc..) By her side, she presents two Vaudais, accustomed to the premises."Users", to resume its words, much more invested than classic "patients".

Mother of three children, this adopted vaudaise crossed the common health door six months ago, to meet a midwife.

In the meeting room, where practitioners and residents meet to talk about the future of the center, she returns to a strong point of the premises: the medical secretaries renamed "the welcoming".Public reception officials, the latter speak several languages including Arabic and English.A plus that facilitates communication and gives confidence to certain inhabitants, in difficulty with French.

During consultations, interpreters can be mobilized by videoconferencing to make the translation between patient and doctor.The consultation time is also doubled in relation to a classic session, to take the time with the sick person.In the same spirit, the third -party third party is always done complete in order to facilitate reimbursements, for people in difficulty.

The inhabitants of Vaulx-en-Velin at the heart of the common health operation

Community health: what is it?

Like the work done by common health or by the association of assistance to sex workers Cabiria, community health goes in the direction of a participation of the "community."It implies it in the priorities to be implemented, the actions to be taken, etc..In the case of Cabiria, this translates, in particular, by the presence of sex workers in the operation of the association.In France, some community health centers have appeared in addition to that of Vaulx-en-Velin in recent years in Marseille, Échirolles or Saint-Denis.

In the neighborhood, an aging and isolated population, which tends to feel abandoned.Little at ease with the Internet, sometimes experiencing difficulties with French, the latter can quickly find herself lost in the face of steps to do or faced with the technical language of doctors.

Convinced by the premises, she regularly goes to 14 avenue Voltaire to see her doctor, give hands and set up projects.Recently, she launched an initiative on menstrual precariousness with the team.Boxes will be installed to collect, in particular, hygienic towels.“Proof that ideas often come from residents,” comments Camille Salmon.

This summer, Kheloudja will come to lend a hand, seconded in particular from Touhani Kenzari, another resident accustomed to the places, to create a "relaxation space" for people in high precariousness, even without-abris.

At the entrance, it has set up a space with classified ads of all kinds.Inexpensive hairdresser, social grocery ... "Obviously, it is a question every time to help those who do not have the means.", Specifies the" almost "retired 63 years old.

"A power relationship based on knowledge and experience, but not on domination"

Far from sanitized, overloaded hospitals, common health wants to be a place open to residents as well as their inspirations.The Center claims an operation in which the doctor has as much weight in general decisions as the welcoming or the health mediator, responsible for welcoming patients.

A symbol ?All the tables in the place are round."I want to," adds Camille Salmon.It avoids face-to-face.»Decisions are always taken at ten, collegially.

In this way, common health responds to a double need: that of being accompanied in the care and that of being taken care of.

In Vaulx-en-Velin, a significant lack of specialists

Like what can happen in Tonkin, Villeurbanne, Vaulx-en-Velin, suffers from a lack of doctors.Suffering from a bad image, the city is struggling to welcome specialists, preferring the neighboring city.

In a neighborhood where single-parent families occupy an important place, blocking entire afternoons to have their children treating is difficult.

Recently, the Suffering Children's Collective of Vaulx-en-Velin launched an alert message to the authorities.During their last event, the collective reported 178 children without taking care of a medico-psychological center.200 children are awaiting a place in speech therapist and 87 children are waiting for space in SESSAD (specialized reception structures for children in difficulty).A serious lack in a city of 50,000 inhabitants where the means of transport are not always.

To overcome this lack, common health seeks to recruit a speech therapist and a psychologist.A first step, of course, but which will remain insufficient in the face of the extent of the shortcomings.

Common health: what economic model?

In common health, the two medical and social centers have their own sources of financing.The medical section is self -financing through medical acts and approved lump sum remuneration.The social part (mediation in particular) is financed, it, via subsidies allocated according to its actions."We do not pool our medical recipes, common health note.This allows us to maintain our care activity with 30 minutes of consultation as a base.In 2020, payment by the act (reimbursement of care) represents 35 % of finances.“Approved lump sums” remuneration specific to ambulatory medicine, the health center and salaried medicine make up 35 % of the resources.Subsidies represent 25 % of the budget.We note a participation of the ARS, the regional and departmental directorate of youth, sports and social cohesion (DRDJSCS), another from the State via the policy of the city and the Foundation of France.