In DR1’s documentary series on inequality within health, the focus is on the difference in the health of the rich and the poor, as we have already reported, we know a lot about the special conditions of the socially vulnerable people, who are also homeless. People who are homeless are also diverse and have varying conditions of life. The people with whom projekt UDENFOR are in contact, are the homeless living on the streets with a very isolated life. How is their health situation?
In 1999, we initiated giving these homeless a street-health opportunity, “Nursing on Wheels”. Through this, we encountered more serious and untreated conditions such as tuberculosis, heart disorder, hypertension and less serious, but also untreated conditions such as chronic wounds and other skin conditions, bad teeth and gastric discomforts. The individual homeless had grown accostumed to the state of affairs and lived with the symptoms for better or worse even though they must have been very bothersome. Those with serious conditions were quite well received by the health system but had to have help finding their way round the systems and the subsequent treatment failed time and again. Those with less serious conditions were left to themselves by the health system. “Nursing on Wheels” was terminated after four years. Since then, a voluntary and a local authority health project have taken over.
We are still watching over the health related situation of homeless on the streets through annual making up of our records. Consequently, we know that at least twothirds of the homeless living on the streets are either alcohol or illegal substance abusers or a mixture of both. Besides, half of the homeless living on the streets have a serious mental illness and at the same time, half of these are substance abusers. Finally, at least every third homeless on the streets has one or several physical ailments of lasting and stressful nature and that various, concurrent health issues, both small and large, are quite frequent.
We are all subject to illness. Slight illness passes by itself with a little care and help from relatives; in case of serious illness, we know that each one of us can cope with the services of the health system. That is the situation when you have got a residence and an adequate network. In order to understand illness of homeless people, you must understand that they have not got a good bed to lie in or friends and family to care for them. This is a distant luxury to the homeless, constantly or occasionally living on the streets, with casual friends or at shifting shelters – and it is an important barrier when it comes to treating their conditions.