Street Nurses in times of corona

Only together we can overcome the pandemic. Every element of the health care system has a responsibility, and we are playing our role as a lifeline for an extremely vulnerable target group of people who must survive on the streets.

The current crisis forces us to realize that society would do better to fully invest in the inclusion of the vulnerable. Leaving people behind in inhumane conditions is a sign of bad policy and a major risk factor when something goes wrong in society.

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Our Public and Covid-19

With Street Nurses, we accompany extremely vulnerable homeless people in order to get them off the streets and into sustainable housing. Our patients combine a long period on the street with physical and often mental health problems and poor hygiene.

Even though they live in relative isolation, their living conditions, their often chronic illnesses and their age (52 years on average) make them even more susceptible than others to Covid-19 infection.

They are also highly dependent on all kinds of infrastructures such as day and night centres, social restaurants or shelters. On the one hand, these can become potential sources of infection, but on the other hand, their closure also leads to a lack of access to food and sanitary facilities.

We must therefore do our utmost to prevent these people from becoming infected and, if they are, to ensure that they are treated appropriately.


What is the impact of the corona crisis on our patients?

Patients on the street:

Lack of information: People living on the street do not have the same access to the media as others, so they have little or no information about what exactly is happening, about the corona virus, how to protect themselves from it, what measures the government has imposed.

No access to sanitary facilities: isolation and hygiene measures are also almost impossible for homeless people to apply. This is because they do not have housing where they can safely retreat, and they do not have access to sanitary facilities or soap to take care of their hygiene adequately. In addition, as a result of the measures imposed by the Government, several centres have closed their doors, making access to toilets, showers and washing machines even more difficult. It is therefore almost impossible to protect oneself (and others) against the virus.

No access to medical facilities: homeless people have many physical and psychological (chronic) problems. They are mainly dependent on the emergency services of hospitals or community medical centres to be able to ask for medical help. Due to the crisis, access to these institutions has become much more difficult.

Hunger and thirst: as a result of the crisis measures, social restaurants have closed down, aid organisations have had to stop or reduce their activities, cafés and snack bars can no longer open and the streets have been emptied of people. For people living on the streets, these are their usual food and drink supply channels. The situation has therefore become extremely complicated, and some are suffering from hunger and thirst.

Loneliness: finally, there is the feeling of being completely outside of society. The streets are empty, the loneliness becomes even greater.

The patients in housing:

Isolation: Loneliness is a problem for most of our rehoused patients, even in normal times, and it's even more so in this periode of confinement.  This group of people also does not have all the modern technical means and skills necessary to keep in touch at a distance with the people around them and society in general.

Medical situation: in many cases it is already normalized (presence of a treating doctor, mutual insurance in order, etc.) but this does not mean that the person is autonomous in making appointments or going to his doctor. Moreover, they are not always aware of the seriousness of their condition or sometimes do not take their treatment regularly. With the crisis, the follow-up of these people and access to the medical doctor are even more complicated.


Our mission

In the street

Street work continues, even more intensively.

More than ever, we are paying great attention in our contacts to providing information about the dangers of coronavirus and about the nature and necessity of the measures imposed to protect themselves and their environment. The aim is to contribute to adequate prevention through correct information, continuous presence and medical surveillance at a time when the streets are becoming increasingly empty.

As hospitals must be preserved, we monitor the medical situation of our patients even more closely, in collaboration with a number of general practitioners. We do this both for our patients on the streets and for those in housing.

Our street teams mainly do marauding - rounds without a specific appointment - as it is not possible at the moment to make regular appointments with all kinds of services and institutions. Priority is given to the most fragile patients who are already in our follow up, while waiting for medical services to return to normal.
But we are now also actively looking for all people on the street, especially for whom we never had the capacity before, those who are isolated or who are further away on the outskirts of the city, in order to inform them and to get an overview of their medical situation. To all of them we give comprehensive support: information, prevention, care, food if necessary, hygiene and medical surveillance.

From mid-April, we will be involved in the medical follow-up of about thirty homeless people sheltered in a hotel requisitioned by the municipality of Anderlecht.

In accommodation:

Many appointments for rehoused patients have to be cancelled due to the circumstances. Though all kinds of administrative files can be followed up or prepared by telephone or electronically.
Here, medical supervision is all the more priority as these patients are isolated at home, and problems are therefore less likely to be noticed.
We keep in touch with patients in nursing homes by telephone as much as possible.
This change in work organisation has led to the possibility for part of the housing team to redeploy to reinforce the street team, which is much more solicited at the moment.


Constraints due to the epidemic

Less accessible services: Hospitals need to be relieved, so they cannot be called upon as they normally are. This is why, during this pandemic, we are taking care of the medical follow-up and care of our patients as much as possible. Wherever possible, we do this in collaboration with general practitioners, taking care not to overburden them.

Social distancing from our patients: We must be there for and with our patients, but at the same time we must apply the rules of "social distancing".
We have to make sure that our patients and homeless people in general are not forgotten by society, but at the same time we have to tell them to distance themselves as much as possible from others.
We respect the guidelines on social distancing, also in our direct contact with our patients, and ensure that mouth masks, aprons, gowns, disposable gloves and disinfectant wipes are made available to our colleagues and patients in order to minimise the risks in situations where closer contact is needed.

Social distancing from our colleagues: We must avoid being infected ourselves in order not to reduce our capacity, so we must keep a distance, also between colleagues, whereas we are used to working only in teams and supporting each other.

Lack of protective equipment: We do not have large amounts of protective equipment (mouth masks, disinfectant gels...), neither for us nor for our patients. Thanks to our networks and targeted calls to the general public, we seek out the necessary protective equipment, both for ourselves and for our patients.

How we adapt to these constraints

It's really important to be able to continue our work with our patients and all the people on the street right now. In order to minimize the risk of contamination, which could put our staff and patients at risk, or weaken our operational capacity, the entire organization has adapted.

Support teams (administration, finance, logistics, communication) have switched to working from home. The field teams have been split up and now work very autonomously. What we can accomplish from home (administrative follow-up, phone calls, emails), we do at home. Internal meetings are held by videoconference.

What role for communication and awareness raising in this time of crisis?

Our intention is to help contain the epidemic and to continue to support our patients in Brussels and Liège during this difficult period.

This is why we are also committed to raising public awareness and political lobbying to draw attention to the specific difficulties faced by our patients and homeless people in general in these circumstances and to call for appropriate measures to protect them from the virus.

How do we collaborate with our colleagues from other organisations during this period?

Collaboration is more necessary than ever, both in Brussels and in Liège.
We carry out "mixed" tours with colleagues from other organisations and we can count on logistical support for the purchase and distribution of food.
Several coordination platforms have been set up within the sector to centralise practical material issues as well as to increase awareness and lobbying.

How can the public help us?

In order to be able to respond flexibly and quickly to changing needs, we need to maintain our capacity for action, also financially. On the one hand, we try to maintain our normal activities as much as possible. On the other hand, we must now make new budgets available for the purchase of medical equipment such as mouth masks, protective aprons, hydro-alcoholic solutions, disposable gloves, shoe protectors, etc.

We must also invest more in the purchase of food products for our patients.

In addition, we regularly issue specific calls for medical or other equipment, depending on our needs at a given time.

Finally, we also adapted the capacity of our team to the circumstances and to provide the necessary IT and telecommunications infrastructure to make working at home and at greater distances as efficient and comfortable as possible.

An indirect effect of the crisis is the disappearance of the fundraising events already planned, which has a negative impact on the budget forecasts.

Financial donations are therefore welcome on BE91 0014 6955 7676 or via our online payment platform