In the calculation of real disasters homelessness has easily won its
Graeme Bacque (gbacque@idirect.com)
Fri, 30 Oct 1998 07:16:21 -0500
October 30, 1998 The Toronto Star
In the calculation of real disasters homelessness has easily won its
place
By Cathy Crowe
I am a ``street nurse.'' My specialty, if you will, is homeless health
care. This should be a perverse concept because I am a community health
nurse - in Canada.
1998 has been a turning point in the way I engage in my nursing. You
see, I experienced a nursing epiphany - that homelessness is in fact a
national disaster. How I reached this understanding of homelessness is
significant. I have nursed, researched, and written in the area of
homelessness for many years. For myself and my colleagues, our
perspective is that homelessness is intolerable and at the same time
solvable. We move from battle to battle, fighting to get health cards
for homeless people, fighting tuberculosis, fighting to have trailers
installed as shelter, even fighting in the coroner's court to produce
recommendations that would stop further homeless deaths.
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All the signs of an acute disaster are evident: clusters of infections,
a rise in over-all morbidity including malnutrition, and a rapid rise in
the number of deaths
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Yet, it took the gruelling 1998 ice storm in Eastern Ontario and Quebec
to shock me into realizing that homelessness is a national disaster.
Glued to the television coverage of the ice storm, I seriously
contemplated going to Kingston or Montreal to help in the relief
efforts. Despite having never worked as a nurse in a recognized disaster
zone I was convinced I could contribute. I had 11 years' experience
working in crowded drop-ins and shelters providing health care to
homeless people in emergency conditions - often working alone and
without running water, proper supplies or adequate light. I was
adaptable and good in a crisis. I worried though - was my French good
enough to get by? Would I be able to get time off work to go? These
questions plagued me daily. Yet, the more I followed the ice storm
coverage, the more I was convinced I must go.
As soon as I made the decision to go, I was hit with a wave of emotion -
my gut told me something was seriously wrong. I realized that to go was
to deny that homeless people here were living in a disaster!
I realized that the images on television that had moved me were the
daily circumstances of homeless people's lives. I was overcome with
grief and nausea as this truth hit home.
The comparison to the ice storm was a painful reminder to me that
homeless people, no matter where they are in Canada, quite simply have
no home, no central ``heart'' of support or base. Many have had no home
for years.
All the evidence pointed to an enormous national problem. All major
cities facing escalating numbers of homeless people, many forced to
migrate to cities like Toronto.
With my new insight, I realized that all the signs of an acute disaster
were evident: clusters of infections, a rise in over-all morbidity
including malnutrition, and a rapid rise in the number of homeless
deaths. At the same time there was evidence of suffering and exhaustion
of both homeless people and workers.
For homeless people across Canada in this disaster:
The electricity is not going to magically turn on, giving them the
freedom to ``go home'' or back to work or school.
The emergency shelter stay is not temporary. Many people - women,
families, children even - have been in shelters for five to 20 years.
Hostels are overcrowded and intolerable. The homeless are forced to stay
in temporary emergency shelters such as church basements or school
gymnasiums. Each night homeless people follow the path of a forced
migration to whichever temporary facility happens to be open that night.
Then the spring comes and the program shuts down. Once again alleyways,
grates, squats, parks and under bridges become ``home.''
For couples who wish to stay together, sleeping outside is often the
only alternative for intimacy and companionship.
There will be no compensation for suffering and loss - instead,
government officials say that welfare cuts are good for homeless people
and will help them get off the street.
To be homeless is a daily life and death situation. To be homeless is to
risk tuberculosis infection. In Vancouver, the spread of HIV infection
or AIDs is due to the consequences of homelessness. In Toronto,
front-line workers report two to four deaths of homeless people per
week.
There will be no relief efforts that include public health nurses in
emergency shelters doing early case identification of serious health
problems; or crisis intervention teams to deal with the emotional trauma
of congregate living; or hospitalization of those who are elderly or
very ill and unable to tolerate the shelter conditions.
Surprisingly, few complain.
The tensions apparent on televised accounts of ice storm victims' faces
after two weeks in shelters triggered me, reminding me of the tensions,
anger, frustration, grief and sadness that I see every day on the faces
of homeless people.
People who have spent three hours in one drop-in before it closes,
forcing them to move on to the next centre. People who are forced to
sign up and line up for showers, to see the nurse, to see the lawyer, to
get a bus ticket, for food, for the bathroom.
And then there's the nighttime - uncertainly about where you will find
shelter, or who you will be sleeping next to. To be homeless is to risk
one's mental health and feeling of self-worth. Not surprisingly, severe
depression emerges.
In June, 1998, a group of front-line health and community workers, AIDs
activists, formerly homeless people, housing experts, academics, church
people, came together to write a declaration, calling for all
governments to view homelessness as a national disaster. We call
ourselves the Toronto Disaster Relief Committee. On Oct. 8, we released
a public call.
The report calls for immediate short-term ``rescue'' measures as well as
the 1 per cent solution, adding an additional 1 per cent of government
budgets to housing. After all, in a real disaster, people are returned
to their homes.
To date, 300 organizations and 700 individuals have endorsed the
declaration, including, this week, Toronto City Council.
As professor Ursula Franklin eloquently said, ``This is a man-made
disaster and we have the legal and technical means to end it.''
There are now at least 200,000 people homeless in Canada. Many of these
people will suffer an experience which will harm them for life -
children particularly. The Anne Golden report says that 80,000 people in
Toronto are at risk of becoming homeless. The Toronto Disaster Relief
Committee report says, ``The homeless situation is worsening daily at an
alarming rate, as the factors creating it remain unchecked.
``Any delay in firmly and massively responding will only contribute to
compounding the present crisis of suffering and death which is already
an epidemic which no civilized society can tolerate.''
If there was a flood in Toronto, would the city send officials to house
only the people who were affected by the flood and leave behind all the
rest who were affected because they were poor? If I was a city official,
no amount of money would be enough to accept that job. Delay in action
means long-term consequences.
The Canadian winter is coming.
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Cathy Crowe is a nurse and member of the Toronto Disaster Relief
Committee.
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