Homeless people increase amidst the COVID-19 outbreak: MSF provides temporary shelter and free medical consultations

Six months into the COVID-19 crisis, Hong Kong is facing the third wave of COVID-19 infections; the most severe yet with many of the cases locally transmitted, some from unknown sources of infection. Where public facilities and services have been suspended because of the virus, homeless people have been particularly affected. At the same time, Hong Kong’s homeless numbers have increased due to the economic downturn and increased unemployment rate. Médecins Sans Frontières (MSF) has found that the number of homeless people in Tsim Sha Tsui district has increased by 50 per cent within a month, especially after mandatory suspension on dine-in services. Some are first-time street sleepers due to job losses during the outbreak. MSF is concerned that they are particularly vulnerable and often neglected during the pandemic and has been providing emergency shelter and free medical consultations since June.    
Starting with health education activities with the most vulnerable communities when the outbreak first arrived at the end of January, MSF has extended its COVID-19 emergency response in Hong Kong. The emergency team is supporting a local NGO, ImpactHK, in providing temporary shelter, food distribution and other essential services for the homeless people, including free medical consultations and referrals to the healthcare system to improve their access to medical care. 

Consulting a doctor in Hong Kong could costs more than $300 that is equivalent to two to three days’ expense of a homeless person.  MSF provides free basic medical healthcare to the homeless people in Hong Kong since June 2020. Dr Ryan Ko, MSF doctor, is treating Peter who suffers from backache. ©MSF

“MSF is extremely concerned about how COVID-19 could affect people living in already precarious situations,” said Lucy Lau, MSF field coordinator in Hong Kong. “During a visit to the homeless in Tsim Sha Tsui last week, we saw that the number of people living in the streets has increased from 35 to 55 individuals, compared with what we saw in June.  We have noticed that some of them are in their 30s, relatively young compared to those we have seen in the past who are usually in their 50s. Some of them have been unemployed for months due to the outbreak and it’s their first time to sleep in the streets. The closure of publicly accessible bathrooms, suspension of services by some meal providers and sleeping areas in the midst of the COVID-19 pandemic affected them particularly. Without access to essential facilities and resources, it can be difficult for them to observe proper hygiene and preventive measures amidst the pandemic, and this all increases the risk of infection with COVID-19.”
Since June 2020, MSF has been working with ImpactHK, a local non-government organisation that supports Hong Kong’s homeless and one of the few that has continued its services during the COVID-19 outbreak.  Dubbed as ‘Kindness Walk’, the MSF team together with ImpactHK volunteers walk through Tsim Sha Tsui every Tuesday and Thursday nights for two hours to visit the homeless, distribute food, drinking water and essential hygiene kits such as masks and hand sanitizers to protect people from infection. Our caseworkers will then follow-up where there is a need, such as arranging for temporary shelters and medical assistance. 

Living behind the hustle and bustle of the city are the homeless people, often neglected during a crisis. They sleep in the corners, on the floor, under the bridge or anywhere that allow them to stay at night. ©MSF


“The increase in homelessness has put additional pressure on local service providers and organisations such as ImpactHK. Their existing services and capacity has reached its limits. Therefore, MSF has decided to step in.  Within a month, the MSF team has conducted 27 medical consultations and arranged temporary shelters for 15 vulnerable individuals,” added Lucy Lau.  
One of the people who have been helped is Miyako (alias), aged 29. She had slept in the street for several years and fast food restaurants had been her “home” since the beginning of the year. She used to go to a restaurant at around 9:00 PM and then leave by 6:00 AM before its manager came to drive her out. Until one day in July she heard about the services provided by MSF and ImpactHK and came to ask for help.  
“If I didn’t have the temporary shelter provided by MSF, I would have to sleep in the street. The risk of getting COVID-19 would be higher and it is also impossible for me to afford medical fees.
"Now, I am living in the hostel arranged by MSF where I feel safe and can focus on finding jobs,” she said. “Everyone has their own difficulties. You may have a health issue, he may be unemployed, and I am homeless, but with help, I am sure we all can overcome this.” 
MSF volunteer Jojo joins the Kindness Walk to distribute food, drinking water and hygiene kits for the homeless people in Tsim Sha Tsui at night. “It is important to let them know that we are here if they need our help or just need someone to talk to. It is very good for MSF to provide such services to the homeless people,” said Jojo. ©MSF
“No one should be neglected in a pandemic response. Any single case could develop into a community outbreak if no preventive measure is being taken. The needs of the homeless people must be addressed to support the management of local outbreaks and to reduce the public health risk in the community,” said Eliza Chang, MSF nurse and experienced infection prevention and control health worker.  “Homeless people may have more difficulty in implementing preventive measures and face obstacles in accessing medical care. It is very important to inform people about the protective measures they should take and help them to have the means to protect themselves.”  
Since the end of January 2020, an MSF emergency team has been responding to the COVID-19 outbreak in Hong Kong. Our team has been reaching out to vulnerable groups in the society and has conducted more than 32 face-to-face health education and mental health workshops. This focuses on groups who are less likely to have access to important medical information, such as the street cleaners, foreign domestic helpers, visually impaired people, the homeless, refugees and asylum seekers, and those who are more vulnerable to developing severe disease if they are infected, such as the elderly. Apart from sharing up-to-date, evidence-based medical information, we also listen and answer the many questions that the outbreak has generated. From our long experience serving people in crises, we know that prolonged exposure to uncertainty can cause stresses and anxieties. Therefore, we have conducted workshops to help people deal with these symptoms, and created a website for the general public, offering tips and tools to help cope with these stresses and worries: https://howareyou.msf.hk/en/. It is important to be both physically and mentally healthy to fight against the pandemic. Our team is closely monitoring the development of the outbreak in HK and will adjust our response accordingly. For further information about COVID-19 and MSF’s response and medical support worldwide, visit our website: https://msf-seasia.org/COVID-19.
Hong Kong