Medecins Sans Frontieres Fights Poverty, Officials

Braving a drizzling rain and a long walk from the nearest metro station, the homeless were lining up outside the clinic of the Belgian charity Medecins Sans Frontieres.


Viktor, a former inmate who now sleeps in Kazansky train station, demonstratively rolled up his trousers to show the bleeding ulcers on his leg that required bandaging; another man, diagnosed with dysentery, waited patiently for an ambulance; Olga, a young woman from Tver, said she came to get warm clothing and free pills for a disease she was too embarrassed to name.


"Nobody else is willing to take us in," said Olga. "They are good people."


The doctors at Medecins Sans Frontieres offer free medical care each working day at this clinic in northern Moscow and in a converted camper-van outside Paveletsky train station.


Before winter hits the city, they hope to have a larger bus that will allow them to help homeless people at other stations as well. But unless Moscow's stations re-open their doors to the homeless, their patients may stop coming this winter, the doctors say.


"If the stations stay closed for the winter, where will they sleep at night?" said Christopher Stokes, coordinator for MSF in Moscow. "Our fear is that they'll be dying in the different corners of the city and there will be nothing we can do for them."


The organization last year ran walk-in clinics at both Kursky and Paveletsky stations, then the most popular sleeping spots for the homeless. But station officials closed their doors to homeless people in December and forced out MSF as well, accusing the doctors of attracting unwanted visitors.


Many of the homeless tried to find shelter in nearby apartment buildings, hugging heating pipes in basements and stairwells. Others froze to death outside. The director of Paveletsky station, Nikolai Kharitonov, said he would not allow MSF or the homeless back into the station this winter.


"The station is not for bums, only for normal passengers," he said. "They're a matter for Moscow city."


City plans for construction of shelters have yet to move beyond the planning stage, while private charities offer space to only a handful. Meanwhile, the city has closed many of its overnight detoxification centers, which were little more than holding cells but at least offered a roof for hundreds of homeless.


Eager to stay within reach of the homeless, MSF improvised by parking a van just outside Paveletsky station. Stokes said all parking space near Kursky station was controlled by the station, but said he would try to find a space in or near one of the other stations.


With funding from the European Union, MSF's 10 part-time doctors and nurses offer basic medical care such as bandages, antibiotics and vaccinations against diphtheria and tetanus. For the seriously ill, mostly suffering from tuberculosis or dysentery, the doctors try to find a hospital willing to provide care.


In addition to providing medical care to the homeless, who numbered about 1,500 in September, the mostly Russian doctors hired by MSF also tell their patients they can get a free meal at the French charity Equilibre, free clothing at the Salvation Army and disinfection at a city sanitary center. One doctor doubles as a social worker, trying to help homeless people find temporary work, for instance at a farm outside Moscow.


For most homeless people lacking a city residence permit, required by hospitals, MSF is the only place for treatment, Stokes said.


Viktor said he was sent away by the doctor at a city train station, where medical offices are equipped only for emergencies and doctors are loath to deal with homeless. Others said they were turned away from hospitals because, they were told, they were too dirty.