The Role of Universities in developing/developed world: Healthcare for homeless and orphans Vladimir Krcmery St. Elizabeth University, Shelters Bratislava,

The Role of Universities in developing/developed world:

Healthcare for homeless and orphans

Vladimir Krcmery

St. Elizabeth University, Shelters Bratislava, Dolná Krupá, Malacky, Slovakia

and St. Maximilian Kolbe Tropical programes, Cambodia

8.12. 2012 Warsaw

INTRODUCTIONINTRODUCTION

0,2 % of Slovaks are homeless

New phenomenon in Slovakia

The term „homeless“ is not recognized in Slovak law

Health and social care for the homeless is rather the domain of

church and non-profit NGOs

Organizations targeting only homelessness do not exist

DEFINITION OF HOMELESS DEFINITION OF HOMELESS PEOPLEPEOPLE

Lost of housing → lack of „fixed“, regular, and adequate nighttime residence

Social contactsMarginalization

Isolation

„„HELP YOURSELF“HELP YOURSELF“ ACCOMODATIONACCOMODATION

1. „ ON THE STREET“Homeless without any shelter, bus stations2. „ SELF-MADE SHELTERS“ empty houses, tunnels, garden houses

- living in small groups (migration)- specific rules- violence

SHELTERS PROVIDED BY SHELTERS PROVIDED BY INSTITUTIONSINSTITUTIONS

Lodging houses

Hostels

Warming centers

Rehabilitation

centers

- drugs

- alcohol

Food, clothing and possibility of personal hygiene

Health care, social counseling and prevention

Internal rules Limited time Payments

GROUPS OF HOMELESS PEOPLE GROUPS OF HOMELESS PEOPLE IN SLOVAKIAIN SLOVAKIA

10%

26%

42%

22% On the street

In self-madesheltersLodging houses &hostelsOther

SHELTERS FOR HOMELESS SHELTERS FOR HOMELESS PEOPLEPEOPLE

48 homeless shelters, daily stationers, refugee houses,

health centers and hygiene houses in 15 cities in

Slovakia

St. Elisabeth University involved in the field of

homelessness since 2003

Provides

-the only shelter in the capital city available for all

homeless people

-two asylum houses for battered woman with children

SUPPORT OF HOMELESS PEOPLESUPPORT OF HOMELESS PEOPLE PROVIDED BY THE UNIVERSITYPROVIDED BY THE UNIVERSITY OF OF

ST. ELISABETHST. ELISABETH

NAME CAPACITY NUMBER OF PERSON

TARGET GROUP

REMARKS PARTNERS

MEA CULPASHELTERBRATISLAVA

36 BEDS 55 PEOPLE HOMLESSWOMEN/MEN

ZERO TOLERANCE OF ALCOHOL

THE MUNICI-PALITY OF BRATISLAVA

BETHANYASYL CENTRE MALACKY

7 ROOMS 22 PEOPLE MOTHERS AND CHILDREN

40 KM FROM BRATISLAVA

NGOKRIZOVATKY

JOSEPHINUM ASYL CENTREDOLNA KRUPA

12 ROOMS 24 PEOPLE MOTHERS AND CHILDREN

60 KM FROM BRATISLAVA

NGO GOODNESS OF ST. ELISABETH

MEA CULPA SHELTER, MEA CULPA SHELTER, BRATISLAVABRATISLAVA

No tolerance of alcohol Fee 1€ per night Stay: max. 2 months Services: dinner, laundry,

hygiene, counseling, law and social services inc. job search, primary health care

Education: failed primary education up to University

The most frequent age category 31 - 60 years

12% of clients are women

BETHANY, ASYL CENTRE BETHANY, ASYL CENTRE MALACKYMALACKY

Fee 15 USD / month Target group: battered

women with children, released from prison,from orphanages

Maximum 1 year Accommodation,

clothing, food, health care, counseling

PUBLIC OPINION ABOUTPUBLIC OPINION ABOUT

HOMELESSNESSHOMELESSNESS

Homeless people are satisfied with that what they do and do not want to change their life

There are transmitting serious diseases such as bacterial diseases, TB, HIV and hepatitis

WE ARE BREAKING MYTHSWE ARE BREAKING MYTHS

Questionnaire: 634 homeless people during 6 months14% satisfied with their life26% would like to change what they do but they don't know how to do it60% of homeless people decided to change their life

None serious infection confirmed104 homeless → 42 had positive

cultivation of pathogens 21 Staph. aureus 13 Candida albicans 3 Strept. pneumoniae 3 Klebsiela pneumoniae 2 Staph. pyogenes

STRATEGYSTRATEGY OF THE UNIVERSITY OF OF THE UNIVERSITY OF THE STTHE ST.. ELISABETH ELISABETH TO HELP HOMELESSTO HELP HOMELESS

Educate social and health professionals to work with this targeted group

Connection of academic study of social work, nursing and health to support homeless people

Close cooperation with media helps breaking myths about homelessness

HIV PROGRAM PRE SIROTY HIV PROGRAM PRE SIROTY V KambodžiV Kambodži

House of Smile (2006)

Clinic of St. Maximilian Kolbe, House of Family (2003)

Daniela’s House of Family (2008)

Peter Pavol Gojdic Children’s Hospital (2007)

Iniciálne diagnózy u hiv pozitívnych sirôt zaradených do hiv programu (neliečené n=137)

Oportúnne infekcie a koinfekcie pozorované v súbore liečených pacientov, N=137 (2003 – 2011)

61,3%14,2%

10,9%

4,6%3,4% 2,0%

1,4% 1,1%1,0%

Infekcie respiračného systému (pneumónia, bronchopneumónia, TBC,otitis media)Infekcie kože a slizníc (tinea capiliti, orofarengyálna kandidóza)

Gastrointestinálne infekcie (hnačka, parazitózy)

Infekcie močových ciest

Herpesvírusy (herpes simplex, varicella, herpes zoster)

8 ročný monitoring spektra patogénov a rezistencie na antiinfektíva (N = 882 kmeňov)

N=586 N %

Všetky MDR 98 16,7

Gram-pozitívne MDR 88 15

Stafylococcus aureus OXA, ERY, TET 39 6,7Stafylococcus aureus OXA, ERY, TET, CLI,CXM, GEN 3 0,5

Stafylococcus aureus OXA,ERY,CLI,CXM 27 4,6Stafylococcus aureus OXA, ERY, TET, CLI, CXM 2 0,3Streptococcus pneumoniae PEN-R, ERY-R, TET-R 11 1,9Moraxella catarrhalis PEN-R, ERY-R, TET-R 6 1,0

Gram-negatívne MDR  10 1,7

Klebsiella spp. GEN, CAZ,COT 3 0,5

Acinetobacter spp. GEN, CAZ, COT 2 0,3

E. coli AMP,GEN,COT 3 0,5

Enterobacter GEN,CIP,CAZ 2 0,4

Prehľad multirezistentných kmeňov baktérií izolovaných od HIV-pozitívnych sirôt

Potreba edukácie zdravotníckych pracovníkov v oblasti špecifických ochorení a zdravotných potrieb tejto cieľovej skupiny

Prepojenie akademického prostredia a praxe pri tvorbe projektov zameraných na riešenie zdravotných a sociálnych problémov

Záver

Ďakujem za pozornosť!

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