The poster presents an image of a snowman with the legs of a person who has died in the streets of Moscow is part of the 2003 MSF campaign to raise awareness of the people, 90% homeless, who die or suffer from exposure in Moscow streets each wintertime.

Starting from 1992, MSF has operated a program of medical and social aid to homeless in Moscow. During this time MSF provided more than 180,000 medical and 55,000 social consultations, organized the vaccination of more than 10,000 people and assisted in the hospitalization of 11,000 patients. The chief purpose of the MSF activities is to broaden access for the homeless to the possibilities of prevention and treatment in the health care system, as well as to assist the reintegration of the homeless into society.

MSF has repeatedly warned Moscow authorities about the urgent necessity to provide shelters for the people that are living in the streets. MSF considers the indifference of the authorities and broad layers of the public to the daily plight of the homeless living in Moscow to be unacceptable. In winter, such an indifference turns out to be mortally dangerous.

In order to do everything possible to prevent high mortality caused by the cold in this winter, MSF decided to initiate a campaign to attract public attention to the issue. Hoping that this action will prevent the predictable death of hundreds of people, MSF asks all interested parties to support this campaign.

In Moscow today (January 10), MSF launched a key wintertime campaign to raise awareness and provide treatment for the thousands of homeless people living in severe winter conditions. The campaign is titled 'Indifference - Murder'. Each winter, hundreds of homeless people, called 'bomzhi', die on the streets of Moscow. Thousands of others suffer illness, frostbite or are permanently disabled from the exposure to temperatures that regularly fall below minus 30 degrees celcius. More than 90% of those affected are homeless. No less than four people die on Moscow streets each and every winter day. So far over 210 people have died of exposure.

The associated press conference is being hosted on the streets of Moscow next to one of the MSF homeless medical points. Temperatures are expected to be near minus 15 celcius, with snow, during the press conference.

The launch will be initiated with a letter to the mayor of Moscow asking for more direct action to be taken to care for the homeless. In addition, a leafleting campaign shall be started to bring essential information directly to Moscovites so they will know what to do should they come across a person in the streets who appears to be suffering from exposure. The advice is founded on a simple starting point. Call for an ambulance.

MSF has printed 10,000 leaflets which have our 'snowman' (click on images to see larger vesion) with the legs of a corpse sticking out one end. The leaflet gives the address of hostels where people can find refuge during the winter.

One week later, the campaign shall be augmented by a bus that shall be parked in strategic locations throughout Moscow. On one side of the bus shall be the temperature. On the other side shall be the number of people who have died of exposure so far this winter.

Annual death toll

The toll each year is severe. Every year about 3,000 people in the city suffer from hypothermia. More than 200 of them freeze to death in the street. The same number of people die in the first 24 hours after hospitalization. Hundreds of people have become disabled because of effects of the exposure.

The statistics are no surprise. The death toll is always in the hundreds. Over the past four winters 1,667 people have perished in Moscow. In October-November 2002 there were 1,002 people who suffered from hypothermic traumas. Of these 154 of them died (77 died in the street, 25 on their way to the hospitals in ambulance vehicles, and 52 died in the city hospitals within the next 24 hours).

According to official data, 90% of those dying from hypothermia are the homeless.

Reactions in other European cities

In other European countries, where the conditions are not as severe, authorities have often installed immediate facilities to care for the homeless.

In November 1998, when temperatures in most of France suddenly dropped close to zero, the Paris authorities decided to leave one metro station, "Bonne Nouvelle", open for several nights, making it into a homeless shelter. The Paris city council decided to provide 3,000 additional beds for the homeless due to the overcrowding of the city overnight shelters.

In Holland the Salvation Army and the Red Cross operate night shelters but, with the approach of the cold season, police allow the homeless to spend nights in police stations, in open cells.

In Moscow, there are no easily accessible and widely known warm shelters for the homeless. In the cold season, access to the metro and train station halls is closed. For more than 100,000 homeless living in the city, there are eight night shelters and hostels able to accomodate 1,500 people.

Unknown changes

There have been changes to the conditions in Moscow, but the information is not being widely dispersed and so the very people who would best benefit do not know about the change. Since November 15, 2002, Moscow night shelters have been open for everybody.

In addition, this winter, everybody who applies for help should be able to get a place in a night shelter, including people without Moscow registration. The Moscow committee for the social protection of the population issued the resolution "to organize the accomodation for homeless citizens, including those from out-of-town, who happen to be in a situation that is threatening to their life and health".

However this information is not being disseminated. Nobody knows about it except those in charge of the social aid agencies. Despite the lack of visibility, Moscow authorities have heralded the changes and emphasize the concern of the authorities to the homeless, as seen in recent quotes from Russian authorities.

"The Moscow agencies of the interior ... continue to take necessary measures to prevent hypothermia among citizens, including 'bomzhi', in streets and places of public presence". - Chief Interior Affairs Department of Moscow.

"The dispatchers of regular shifts at the emergency ambulance stations have been given instructions about the absolute priority of calls regarding hypothermia". - Moscow Health Committee.

From the MSF-Moscow website

The MSF website is providing additional information in the hopes of changing the perspective of Moscovites who may come across homeless struggling in the conditions. In their weakened state and poor shelter and clothing, it can take only 30 minutes at temperatures below 2 celcius for a person to die.

The chief cause of death of the majority of those frozen is the indifference of the people around them. Without a humane attitude to each other, no administrative measures will lead to a radical change of the situation. Unfortunately, it has become a norm to pass by a person who has fallen unconscious.