Maintainer: Oltalom Charity Society
Name of institution: Oltalom Hospital,
Leader of institution: Dr. Olasz József
Address: 1086 Budapest, Dankó u. 9.
Phone: (06-1) 210-5400/ extention 116., 118.
The 30-bed hospital – in space originally planned for 20 beds – was established with the considerable help of the Inter-Europa Bank and grant support from the Ministry of Health.
The city of Budapest sponsored the equipment, and the Chief Mayor himself performed the inauguration just before Christmas of 1994.
We received the first patient in February 1995. The hospital capacity was increased by another 21 bed in 2003 to provide services to the homeless with psychiatric diseases.
In the first year we operated the institute with grant funding, but we also started the procedures for support by the National Health Insurance Fund of Hungary.
By New Year’s Eve of 1996, National Health Insurance Fund of Hungary accepted the financing of 30 beds and are currently (apart from some hitches) funding 40 beds. The remaining 11 beds are sponsored by donations although we hope that one day the sponsoring will be undertaken by the National Health Insurance Fund of Hungary.
The team of 13 doctors is composed of highly competent professionals with certifications in internal medicine, pediatrics, psychiatry, neurology, surgery, vascular surgery, plastic surgery, anesthesiology, intensive therapy, radiology, dental and oral care, dermatology, bacteriology, pathology, public health and medical science. The nursing staff and other professionals include: social workers, psychologist, and physiotherapist. All of our professionals provide high-quality, outstanding care.
There’s a very appropriate expression that goes: not everyone who is sick is homeless but everyone who is homeless is sick. We have found that they are not only sick but most of them have several sicknesses. Examinations of 928 cases show that more than 50% of our patients (480 persons) are chronic alcoholics. No more than 5 of our patients declared themselves to be abstinent. The chronic alcoholics we serve suffer from considerably increased enzyme values, hepatic enlargement; pre-delirium and delirium tremens. With a large number of the alcoholics (173 cases), skin diseases are also present because of deficient hygiene, insufficient food and chronic disorder of nutrient absorptionand malabsorption due to chronic alcohol consumption.
We treated 169 persons with traumatic injury; most of them were related to alcohol consumption.
There are also large number of patients with cardiovascular disease (163). Among them there were patients with valvular insufficiency (waiting for surgery); coronary artery disease; and embolism (waiting for surgery) where the primary cause was smoking. There is no doubt that their condition was exacerbated by the difficulties of their lifestyle (many of them were forced to spend the coldest winter days on the street). There were 115 patients with respiratory illnesses possibly precipitated by smoking. The most frequent sicknesses are emphysema and chronic bronchitis.
Since we treat mostly male patients in our hospital, we don’t see many gynecological diseases. However, we deal with every other sort of illness. 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 cases examined, there were 73 infectious cases (11,4%). These patients should be sent to pulmonary wards but their transfer is almost always difficult. It is hard to screen and follow up with the wandering homeless. It is well-known that tuberculosis is increasing all over the world, not just among homeless but in other inadequate social environments. Insufficient food and chronic consumption of alcohol make the homeless an endangered population. Still, transferring them into pulmonary wards is quite difficult and even if it happens, they are expelled at the first given opportunity or their treatment is shorter than of a “normal” citizen.
The no longer infectious homeless persons disappear, their regular intake of food is not assured, their intake of medicine is not controlled and most of them never reach complete recovery. No wonder that we meet more and more therapy-resistant cases of tuberculosis.
Demographics are as follows: the majority (40%) is between 40 and 50; they became homeless because of the reductions at their workplaces or divorce. The age group of 50 to 60 (27%) is nearly as high and in recent times, the number of homeless persons above 60 has increased (13%). Only a very small portion appears to have irresponsibly wasted their home security. The greater part has become a burden to their family or cannot support a flat with their pension. The youngest age-group has also appeared with an increasing number; they are – for the most part – without family support and/or have psychiatric problems.
Turn over facts in the 1. Yearly reports
Repeatedly our patients arrive in a neglected condition, infested with parasites. Unfortunately, most of the time they are under the influence of alcohol 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 parasites, the biggest threat is infectious tuberculosis cases which are higher than average among homeless persons. Some of our patients cannot be rehabilitated “fit to return to the 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.)