A NEW HOSPITAL FOR THE HOMELESS OPENS IN SAINT PETERSBURG
Great news from Russia! -- by Stephen Wilson, one of our reporters abroad
How we've waited! It's long been anticipated. The first charity hospital catering specifically for the homeless has opened in Saint Petersburg. Here the homeless can obtain free medical care and treatment regardless of whether they have documents, citizenship or medical insurance.
According to Sergei Iyvkov, a voluntary doctor, patients can obtain not only medical assistance for injuries but can be vaccinated against viruses. And everyone can attain this without cash or citizenship. Further, the patients can obtain assistance whether he or she is clean or not.
Now some people might be startled and bemused by this news. They might ask, “Why do we need to open a specific hospital exclusively for the homeless? Isn't it the duty of all hospitals to open all their doors to sick patients including the homeless? After all, doctors are bound by strong moral and civil obligations. All doctors swear the Hippocratic oath to assist the sick without discrimination.”
The spirit of this oath is enshrined in Article 41 of the Constitution of the Russian Federation which states, “Everyone has the right to the protection of their health and medical assistance.” But then after the first sentence you read, “In the government and local municipal institutions of health, treatment must be freely provided to citizens, according to the budget, donations of insurance and other things.”
Notice that while in the first line everyone has the right to medical care, but then this is contradicted by the next few lines stressing “citizens have the right,” but conditional on limitations such as a budget and insurance contributions. This ambiguity might serve as a 'loophole' for refusing to treat some patients because of the lack of resources or insurance donations.
The problem housing advocates get when asking for medical aid is clear. Just try calling an ambulance to assist the homeless in Moscow. Some ambulances won't come. Some refuse to take a homeless person on all kinds of grounds. They might maintain, "He is not really sick but just drunk.." Or they might say, "He is too dirty, and he will infect our ambulance." They might even say, "He is not registered in this locality so we can't take him to our hospital." Too often you hear "No medical insurance, no treatment!"
I personally got into legal arguments with some ambulance staff who were highly reluctant to take a homeless person who could hardly walk. Another ambulance would not take one patient to hospital because they claimed he did not have food poison but "was just drunk". This is despite the fact the man never drank at all! The same patient once asked me to bribe hospital staff to provide him with a bed for the night.
So getting medical treatment for the homeless can be problematic. It is not impossible but can still sometimes entail a feat.
It is worth pointing out not everyone views the opening of this new hospital as positive. They argue a two-tier system is being created; one for those with homes, another for the homeless. Surely all existing hospitals still have to provide medical aid to all patients including the homeless and those without appropriate documents? Though no homeless advocate disagrees with this point. The problem is that refusal to aid the homeless is so widespread and entrenched that it is not going to go away tomorrow.
Any voluntary assistance to help the homeless is welcome even if it is limited, incomplete, and not nearly wide enough.
In addition, the homeless are very vulnerable to countless medical problems such as viruses, heart attacks, skin diseases, and such difficult conditions as trench-foot. Many require urgent psychiatric treatment and support. The homeless have a very low life expectancy.
In Saint Petersburg, one estimate suggests the number of homeless ranges from 50,000 to 60,000. We must also not lose sight of how illness is not only a consequence of living on the streets but an actual cause. As a result of serious diseases and injuries, as many as 8.80% of the homeless lose the ability to work and look after themselves {*Nochlezhka report of 2020, Moscow}.
Much medical aid for the homeless in Moscow and Saint Petersburg is very rudimentary and often basic. For example, there are the special buses provided by charities such as Medicine without Borders, and First Aid nurses dressing the wounds of some homeless and aid provided in heated tents.
We often hear a lot of short-sighted and myopic speeches against tents for the homeless. Yet heated tents have played a significant role in preventing the ill-health of some homeless people.
According to a report by the homeless charity Nochlezhka, “People should not die from the cold on the streets and become disabled from frostbite. Every night spent on the streets takes people further away from the possibility to maintain their health, dignity and self-confidence, and therefore from the possibility of returning to society and overcoming homelessness. If a person has nowhere to go, they can come and stay in one of our heated tents, no certificates or papers required. In addition, they can have dinner and breakfast, receive medical care and primary social counselling” {page 26, of Annual report of Nochlezhka, 2020, Moscow}.
Although warm tents are welcome, hospitals for the homeless are also imperative until the Russian medical system as a whole is transformed into a far more caring and improved service. The new hospital provides aid from all kinds of specialists such as dermatologists and ophthalmologists to name but a few. The hospital currently assists 50 patients a day. Patients can receive treatment, free medical tests, examinations, diagnosis and a free pair of glasses.
Sergei Iyvkov, one of the founders of the charity hospital states, "Nobody here must be cold, hungry and ill."
*Nochlezhka: Oldest charity helping the homeless in Russia, with locations in Moscow and St. Petersburg. For more info, please see: https://homeless.ru/en/