Are Hospitals Helping the Homeless?

Not enough, say some who are learning to fend for themselves

"They told me it wasn't serious enough yet. They wouldn't help me. They gave me some food, but they weren't nice at all."

Hernias such as Allen's typically are deemed emergencies when the distended intestines become strangulated, which in turn can cause a gangrenous bowel, or when the hernia becomes septic, which can be fatal.

"They told me to come back when it got worse," Allen said. But "when this gets worse, I'll be dead."

Another man at the Voice Homeless Shelter said he was discharged from a local hospital with an abscess on his buttocks that was cleaned but not swabbed or cultured to determine whether MRSA was present.

New protocols from the Centers for Disease Control require doctors to test all infected wounds for MRSA, which resists all but a few strong antibiotics. Left untreated, MRSA can rapidly eat through human tissue and prove fatal in just a few days. A small wound can become a condition requiring major surgery overnight. For the uninsured, the cost to taxpayers blossoms along with the infection; a condition that could have been treated immediately and relatively inexpensively early on can quickly become one that costs hundreds of thousands of dollars.

Cononie, who serves on the state's MRSA task force, says some doctors blame ER workers for spreading the infection by not culturing wounds appropriately and not changing latex gloves with each patient; by not changing gloves, a care provider protects himself while putting patients at risk. If the patient is homeless, he might be sent to a shelter, where he is likely to pass the infection on to others. The Voice Homeless Shelter is full of MRSA, Cononie says. He's had it three times himself, he says, even though he's diligent about washing his hands.

MRSA doesn't just come from hospitals anymore, Memorial Regional spokeswoman Kerning Baldwin says. "It's a community problem." Memorial is seeing an increasing number of MRSA cases in people who have not been to a hospital or a homeless shelter, she notes. Baldwin said she could not comment on any specific instances in which homeless people allege they were mistreated at her hospital other than to say that its mission is to treat every patient without regard to his ability to pay. The law stipulates no less, she added, "and we follow those laws to the best of our ability."

Meanwhile, the Voice Homeless Shelter recently bought an ambulance so its workers can go out on the streets and administer care themselves. This way, Cononie says, he can run tests and have blood work done without having to send his clients to an emergency room.

And Cononie says he's arranged for Allen, the hernia patient, to have surgery before it's too late.

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