Taking healthcare to the streets of Moscow

" We've been living in a constant state of alarm in Chechnya for so long that it ages and exhausts us and our physical health suffers" Chechen doctor

Healthy growth is often interrupted through lack of adequate diet.

Sexually transmitted infections, dermatological and gastric problems, as well as the high risk of HIV/AIDS and other infections are but a few of the many health challenges faced by this vulnerable population. MSF provides primary care and first aid, referring patients on to secondary care for more complex issues.

Over the past ten years, official bodies responsible for the care of minors have attempted to respond to the multifaceted needs of homeless and neglected children, but teenagers living on Moscow's streets are invariably excluded from society. Their access to a full range of health services is fraught with obstacles.

The official system of police - hospital-priut (temporary orphanage) is more focused on coercion than rehabilitation, and does not facilitate access to appropriate healthcare, or include street work.

" We were sniffing not to be frozen over. When you sniff you feel warmer. You are doped and you don't care about the cold."

At the core of MSF's approach is outreach: every day and night, several teams of MSF medical and psychosocial staff walk the streets and visit the areas where street youth gather, treating kids on the spot if possible, and advising and accompanying kids to get more specialised services for treatment. MSF also runs a day centre where kids can participate in a range of therapeutic and educational activities and also shower, wash their clothes and take meals. The MSF multidisciplinary team supports each individual to make a sustained decision to leave the street, encouraging youths to come to terms with the difficulties of their past and take control of their future decisions.

The MSF street children and teenagers project focused much effort in 2005/2006 on developing networks with local organisations, establishing a partnership with a drug and alcohol rehabilitation clinic called NAN. In June 2006 a photo exhibition documenting the lives of the street kids, taken by the kids themselves, was also mounted in Moscow.

MSF believes there are, on any given day, 250 to 500 children living on the streets of Russia's capital. MSF works with an average of 80 kids each month, mostly boys of 15-16 years old.

MSF has worked in the Russian Federation since 1988.