The plight of homeless men

Mention the homeless or people who live on the street and we think of cocaine addicts and the mentally ill. However, I had reason to question this view recently when I assisted with a medical clinic for these people. Most of these homeless people are middle-aged or elderly men. They live on the streets or 'cotch' at somebody's place.

One man told me he had been 'burnt out' so had nowhere to live. The majority came into the examination room holding all they owned in one or two 'scandal bags'. I felt moved when two men entered the room, the older guiding the younger because the latter was visually impaired. Both men were homeless but they tried to care for each other.

One man told me that they were sometimes ignored at the public clinics or were considered a nuisance so they appreciated this free clinic at the church. I was struck by their knowledge of the public-health system, since they named health practitioners at the health centres in Kingston. Several had been inmates of the mental health services. A few admitted to absconding from treatment for HIV/AIDS.

Acute problems

Several had acute problems, such as wheezing, which required urgent care. One individual complained of passing urine frequently and being incontinent. On testing the blood for sugar, this was found to be exceedingly high. This person was sent immediately to the hospital. Another man complained of vomiting frequently, when I looked in his throat, I could see evidence of yeast infection. This was certain to be caused by AIDS infection. He was referred for treatment.

Some of the men complained of itching all over the body or in the pubic area. This was discovered to be caused by scabies in one case and crab lice in another. Many had chronic problems such as hypertension, diabetes and arthritis. They came to the clinic to obtain prescriptions.

Almost all the men were slim and anaemic-looking, suggesting that they ate little protein. Their legs were striking in revealing the ravages of street life. Often, the feet were dirty, sometimes showing a scaly skin condition due to poor venous circulation.

Depression

Some admitted they were depressed about their way of life. However, others were cheerful and made no mention about their state. All were very appreciative of the care offered. I was impressed by these people who live on the fringe of society. It was heart-warming because they struggled under very difficult circumstances to maintain their dignity and preserve their most important asset - their health.

Dr Pauline Williams-Green is a family physician and past president of the Caribbean College of Family Physicians; email: yourhealth@gleanerjm.com.