Maintainer: Oltalom Charity Society,
Name of the institute: Oltalom Hospital,
Leader of the institute: Dr. OLASZ, József,
Address: 1086 Budapest, Dankó u. 9.,
Phone number: (+36-1) 210-5400/ extension 116., 118.,
E-mail: korhaz@oltalom.hu
The 30-bedded hospital –originally planned with 20 beds – was established with the considerable help of the Inter-Europa Bank and the competition support of the Ministry of Health. The Capitol sponsored the equipping and the Chief Mayor himself performed the inauguration before the Christmas of 1994.
We received the first patient in February 1995. The hospital was extended with another 21 bed in 2003. In this rehabilitative ward, we attend to homeless with psychiatric diseases.
Financing:
In the first year we operated the institute with competition budget, but before that we started the procedure of acceptance with the National Health Insurance Office (OEP).
By New Years’s Eve of 1990, OEP has accepted the financing of 30 beds and by today (apart from some hitches) it’s funding 40 beds. The remaining 11 beds are sponsored by donations and we hope that one day the sponsoring will be done by OEP.
Fellow-workers:
The doctor-team of 13 is composed of well-educated professional individuals (they have special examination of internal medicine, pediatrics, psychiatry, neurology, surgery, vascular surgery, plastic surgery, anaesthesiology, intensive therapy, radiology, dental and oral affection, dermatology, bacteriology, pathology, public health and medical science. The nursing stuff and the other colleagues (social workers, psychologist, and physiotherapist) perform high-class, outstanding work.
Turn over facts in the 1. Yearly reports
Difficulties:
Repeatedly our patients arrive in a neglected condition, infested with parasitic. Unfortunately most of the time they are under alcoholic influence with a diminished mental ability, often having no self-control. Our conscientious nursing personnel are not only exposed to the danger of infections but physical peril too. Beside the parasitic, the biggest threat is the pathogenic of tuberculosis since tuberculosis cases among our homeless are above average. Some of our patients cannot be rehabilitated “fit to street” and it is almost impossible to hospitalize them safely. In order to operate smoothly we need financial aid and donations in kind (clothing, medication, food, etc.)
Typical diseases:
There’s a very appropriate expression that goes: not every sick is homeless but every homeless is sick.
We have experienced that they are not only sick but most of them have several sicknesses. In the view of our examinations (928 cases) it came to light that more than 50% of our patients (480 person) are massive alcoholic. Not more than 5 of our patients declared themselves abstinent.
With the massive alcoholics considerably increased enzyme values, hepatic enlargement, pre-delirium and delirium are observed. With large number (173 cases) skin diseases broke out because of deficient hygiene, insufficiency of food and chronic disorder of absorption. We treated 169 person with traumatic injury; the cause of almost all of them was alcohol. There is a large number of patients with cardiovascular sicknesses (163). Among them there were patients with valvular sufficiency (waiting for surgery); after coronary-bypass surgery; and embolism (waiting for surgery) where the exciting agent was smoking. No doubt that their condition was corrupted by the vicissitudinous way of life (many of them were forced to spend the coldest winter days on the street).
There were 115 patients with respiratory illnesses possibly they were precipitated by smoking. The most frequent sicknesses are emphysema and chronic bronchitis. Since we treat male patients in our hospital, with the exception of gynecological diseases we deal with every sort of sicknesses. We would like to highlight that we treated 7 hypothermal patients although there’s a special medical division in Budapest for hypothermal cases. Last but not at least the most important problem is the fate of people with tuberculosis. Out of 642 there was 73 infectious cases (11,4%). These patients should be sent to pulmonary wards but their transfer almost always run into difficulties. It is hard to screen and follow up the wandering homeless. It is well-known that tuberculosis is increasing all over the world, not just among homeless but inadequate social environment, insufficiency of food and chronic consumption of alcohol make the homeless an endangered circle. Still, to transfer them into pulmonary wards is quite difficult and even if happen, they are expelled at the first given opportunity or their treatment is shorter than of a “normal” citizen. The no longer infectious homeless disappear, his regular intake of food is not assured, his intake of medicine is not controlled and most of them never reach complete recovery. No wander that we meet more and more therapy-resistant cases.
The number of psychiatric cases is increased and patients with acute psychotic episodes are sent to special wards of hospitals. On the basis of our personal observation we think that 70-80% of the homeless show symptoms of some sort of psychiatric illness (personality disorder, neurosis, dependency problems, etc.).
Repartition by their age is the following: the majority (40%) is between 40 and 50; they became homeless because of the reductions at their workplaces and also divorces. Similarly high is the proportion of the age group of 50 to 60 (27%) and in the latter times the number of homeless above 60 has increased (13%). Only a smaller part of them irresponsibly wasted their home, but the greater part has become a burden to their family or was not able to support a flat from their pension. The youngest age-group has also appeared with an increasing number, they are – for the most part – without a family background or psychiatric patients.