I grew up being told when I was sick I should "suck it up." In my culture (Russian), when people were sick or injured, they had to deal with it silently, and use their sleeve as a bandage. We did not have soft tissues or Tylenol PM. When I get really sick now, I grunt at work and at home, and I watch bad movies while thinking about making chicken soup. I fall asleep under my soft comforter and often don't wake up for 12 hours. I thank God that I have a bed, a DVD player and a roof over my head.
But this isn't about me being sick, it's about those who are sick and homeless.
On Aug. 13, the Glory Hole got a call from Dale Erickson, the managing nurse at Bartlett Hospital's emergency room. Dale asked if the Glory Hole's "handicapped room" was available. The room he was referring to is a 6-by-6-foot unit on the second floor. Unlike the three main dorms on the third floor (completely full at the moment), which are not accessible to people with physical disabilities, this room is accessible by elevator and is reserved for the homeless individuals who cannot access stairs, as well as families who cannot go anywhere else. The hospital had two homeless people sick with the flu (likely swine flu) and in need of bed rest.
I explained the room is reserved for handicapped individuals and that the Glory Hole provides food and shelter, not medical services. Our insurance coverage prohibits offering medical treatment, and we don't have the staff to monitor those who are sick. According to the Center for Disease Control, those infected with swine flu should be isolated from the other people. Many of our patrons already have compromised immune systems, making it easier for the disease to spread. I wished Dale a good day and hung up.
The next morning, the Glory Hole got a call from the hospital and then from the Front Street Clinic (a wonderful and useful affiliate of SEARHC that provides medical care to those who are homeless). They wanted to know if some sick individuals could stay at the Glory Hole. There were now four diagnosed cases of flu. I repeated my reasoning and contacted the Glory Hole's board of directors. Then I got calls from the Public Health Center, Red Cross, United Way and faith-based organizations. People were concerned, offering supplies and advice. I walked downstairs and reminded patrons to wash and sanitize their hands and asked the staff to wipe down everything with Lysol and bleach (twice as often as usual). I also asked them not to let people who look sick into the shelter or the dining room.
A few hours later, a patron discharged from the hospital was standing in front of my office door. His face was swollen and his eyes and nose were running. He was leaning on the door frame because he didn't have the strength to stand. I could feel the heat from his fever from two feet away.
"Mariya, can I go lay down?" he asked. "No," I replied. "You cannot even be in the shelter and have to leave." I was disgusted at my own words.
"Is there any place in town I could go lay down?" he asked. I thought hard, wishing he never left the hospital. "I don't know," I said, feeling like a petty, ineffective and calloused bureaucrat.
"Mariya," he said, "I just want to lay down."
I asked him to have a seat, and in spite of myself, I told him to go lay down in the little room. I didn't know what else to do.
A little later, representatives from the Public Health Center, Juneau's Emergency Response Program, Red Cross and Glory Hole board met in my office. We talked about the possibility of a flu outbreak (with the flu season quickly approaching), of options for housing the sick and homeless, about costs and liabilities, staffing issues and about contacting other agencies. I was thinking about my patron who could not stay at the shelter, about where he will go that night (and the next night) and about other patrons who are sick. After the meeting was over, a generous, local residents got the patron a hotel room for three days. A volunteer brought him some food during the weekend. On Monday, the patron informed us that he could not breathe and was coughing blood. He went back to the emergency room and was admitted but was told he would probably be discharged the next day.
The problems concerning Juneau's sick and homeless is not just about swine flu. The Glory Hole's mission is to provide food, shelter and compassion to those in need, but we are not medical providers. At the Glory Hole, we have two or three people every month who are recovering from surgeries, adjusting to new medicines, experiencing colds and flus or recuperating from significant injuries. These people are discharged from the hospital and told to get bed rest, but they have no place to do it.
Other shelters in Juneau and the rest of Alaska have similar concerns when dealing with people who have contagious conditions and can't be allowed into the shelters. When a homeless person gets sick, they often stay sick for months and develop severe complications. Instead of getting rest and chicken soup, they get rained on and have to rest in the back seat of an abandoned car, a wet tent, a derelict boat or a cave.
I think about the approaching flu season, and I think about "sucking it up" and about the public safety issue. When sick, homeless people without care are "sucking it up" it means they are walking around on the street, coughing in alleyways and public places like libraries, which is an unacceptable danger to others. I also ponder basic respect for human life, regardless of levels of income, personal circumstances, lack or presence of substance abuse, or degrees of mental illness. I do think people whine too much and should be tougher, take responsibility and take care of themselves, but the time to do it is not when someone is so sick they cannot stand. People should have access to a bed when they are sick, and that is not very hard to provide.
I urge the city of Juneau, social service providers, medical providers, relevant advisory boards and the state to find a way to keep Juneau's homeless at the local hospital until they are better, and to not release them onto the street only to re-admit them days later after they contaminate other people and their own illness worsens, possibly leading to life-threatening complications. I strongly believe that the cost of keeping the homeless in the hospital until they are well will not break the bank and that room can be found to accommodate them. I think that homeless patients must be treated differently than patients who have a place to recover.
The solution must be found and implemented quickly. As I write this, I expect sick patrons to show up who have been discharged from the hospital. The flu season is approaching, but I am confident Juneau can deal with this. Let's figure out how.
Mariya Lovishchuk has been living in Juneau since 2000 and is the executive director of the Glory Hole, a homeless shelter and soup kitchen in downtown Juneau. To learn more, visit www.feedjuneau.org.
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