Every day on my walk to and from school, I pass through a lovely park. Usually, I walk at a fairly quick pace so as not to waste time or be late for class, ignoring those around me and avoiding eye contact. One afternoon on my walk through the park, a dishevelled-looking man on a bench asked me for money. This was not unusual – the park is frequented by the city’s sizeable homeless population. On most days, I would pretend I didn’t hear him or make an excuse like “I don’t carry change”. But on this particular day, I decided to chat with the man and listen to his story. He told me his name was J* and that he was a missionary from Vancouver. When I asked J what brought him to Kitchener, he revealed that he initially travelled here to see his mother, who had recently suffered a stroke and was very sick. Nonetheless, upon arriving, with no income, he found himself begging for money and sleeping in shelters.
We then chatted about astronomy, medical specialties (by this point I had already told J that I was a medical student), and nutrition. During our conversation, I glanced down at his legs and noticed what seemed like severe cellulitis. Upon questioning, he admitted that he had contracted MRSA due to his poor living conditions and was unable to pay for the medications he was prescribed. That’s when I understood the plight that this individual, and many others like him, have to endure every single day. Prior to this encounter, I seldom stopped to consider the health of people I saw on the street. But now I realize there is a large population in our Canadian cities that is constantly neglected when it comes to health. For example, homeless men in Toronto have a mortality rate 3 times higher than the mean.[i] Also, homeless adults often develop certain conditions earliery on that, which do not appear in non-homeless populations until old age.[ii] They suffer from preventable illness and death because of factors often out of their control, such as extreme poverty, cognitive impairment, and difficulties accessing health care. The problem is worse in some cities. In the Waterloo Region alone, there were almost three thousand people who experienced homelessness in 2017[iii]. Three thousand people at risk of diseases and illnesses last year that most of us can easily avoid by virtue of our clean homes and running water. This made me think: what am I doing to help?
I gave J some change so he could buy himself a meal, and a few cough drops to relieve his sore throat. However, this issue is much more complex than just food and illness. In order to make change, we need to address everything includingfrom basic necessities like food and housing, to community-level programs, government and healthcare policy, and societal beliefs. Unfortunately, I don’t possess the knowledge or power to effect change in all of these domains, but what I can do as a medical student and future physician is advocate. I can advocate for J and others like him who are disadvantaged in our health care system. That’s why I wrote this piece – to expose the difficulties that homeless individuals experience in health care and to advocate for change amongst my peers and fellow health professionals.
Change can be as simple or as involved as you want it to be. I invite my peers to start by questioning their own beliefs and behaviours towards homeless people. I know that from now on, whenever I encounter a homeless individual I will make an effort to challenge my own attitudes and stop to chat with them – because you can’t fully understand what someone else might be going through unless you hear their story.
*Name changed for privacy
[i] Hwang SW. Mortality among men using homeless shelters in Toronto, Ontario. JAMA 2000:283:2152-7.
[ii] Gelberg L, Linn LS, Mayer-Oakes SA. Differences in health status between older and younger homeless adults. J Am Geriatr Soc 1990;38:1220-9.
[iii] Waterloo Region. (2017). Retrieved July 30, 2018, from http://homelesshub.ca/community-profiles/ontario/waterloo-region