When Donald Morehead first came to Seattle in February, he needed a safe place to spend the night. He found one at a bed in a local homeless shelter, but he got more than he bargained for. During his stay, he contracted a flu-like illness that made him sick for more than two weeks and sent him to the hospital twice.
The next time, Morehead says, he’ll think twice before staying in a shelter.
“You hear people coughing all night,” he says. “I don’t think I’ll go back.”
But shelters aren’t the only service facilities where low-income and homeless people are at risk of contracting disease; the evidence is mounting that hospitals and clinics are dangerous places to be. A recent government study detailed how one bacteria, Methicillin Resistant Staphylococcus (MRSA), killed more than 18,000 people in 2005, a quarter of whom became infected while in the hospital.
MRSA (pronounced mer-sah), like other drug-resistant bacteria, is believed to have been created by the improper prescription and misuse of antibiotics. When antibiotics are prescribed for viral infections, against which they are ineffective, they kill some, but not all, of the germs with which they come into contact, leaving alive those germs that are drug-resistant. A similar process occurs when patients fail to take the entire course of an antibiotic prescription.
MRSA’s initial symptoms, small red bumps, seem fairly innocuous. If left untreated, the bumps become deep, painful abscesses. The bacteria can also burrow deep into the body and create life-threatening infections in the bones, joints, and lungs.
The emergence of drug-resistant bacterial infections is particularly distressing for the homeless, who often lack the proper sleep and nutrition to maintain a well-functioning immune system. And a shelter, a crowded room full of surfaces that come into contact with dozens of hands nightly, is a good incubator of disease.
“The best way to avoid getting sick is to wash your hands a lot, especially before you eat, go to the bathroom, or come in from a public place,” says Heather Barr, a public health nurse. “Of course, homeless people don’t always have that option. They live in public places, and there aren’t enough public bathrooms.”
Of course, for Morehead and many others in his circumstance, the alternative to shelters is spending the night on the street, an option with health risks of its own. After one night on the street, Morehead says, he woke up with his back and shoulders burning and was covered with red bumps that, after two visits to the emergency room, he discovered to be bug bites.
Shelters are well aware of the limited choices for the homeless and are taking steps to reduce the incidence of infection. Barr advises that any frequently touched services, such as counters, doorknobs, keyboards or sinks be wiped down with a bleach and cool water solution once every four hours. “One of the best things to do, and one that a lot of shelters have done, is to put hand sanitizer near the entrance. That way, people leave their germs at the door,” says Barr.
“Hand washing is important not just for yourselves, but for others as well,” Barr says. “Health is communal, and when you take care of your own health you help the people around you.”
But for Morehead, health conditions in shelters aren’t so much a matter of what happens inside, but out. “We can’t get to the doctor, we don’t get health care,” he says. “Without that, of course we’re going to get sick and get each other sick.”