July 14th, 2019 by Steven Duncan

Every Monday afternoon I go to a homeless shelter to help with patient consultations. We take blood pressures and reapply bandages to wounds, often listening to complaints of chronic pain and worries about reinfection. We disperse a fair amount of over-the-counter pain medications and eye glasses that have been donated by Agape. A doctor is employed full-time by the facility and we recommend patients to him if they are complex.

I’ve been told things run slower at the facility during the summer because seeking shelter is less urgent in the warmest months. Many residents are amputees because becoming homeless in Russia during the winter is a serious threat to life and limb. Untreated frostbite, on top of undiagnosed diabetes in some cases, is extremely dangerous and the consequences are long lasting.

Problems with limited mobility are also very common in this population because of trauma related to alcohol abuse. I remember on my first day we helped bandage a man’s leg after he hurt it from jumping off a bridge while drunk. I was surprised to hear the opinion that acute injuries resulting from inebriation are a bigger problem for the Russian homeless than chronic cirrhosis and subsequent liver failure. It seems that most individuals who don’t require a wheelchair have gait abnormalities. Treating substance abuse disorder seems to be the highest priority as it remains the root cause of many patients’ troubles.