Can you spare some change?

Issue: BCMJ, Vol. 59, No. 5, June 2017, page(s) 253 Editorials
Jeevyn K. Chahal, MD

I step out of my Audi wearing my Helly Hansen jacket and Maui Jims, and suddenly I’m approached by a disheveled man in his early 40s looking just as worn as his backpack. He asks, “Can you spare some change?”

I feel a moment of panic. Do I give him some change? Do I ignore him? Do I outright say no?

Kamloops has an increasing number of homeless people, and I’ve taken the time to discuss the issue with people from vastly different backgrounds.

The director of a non-for-profit shelter told me his goal was to provide a safe, comfortable place where people can eat, learn, and interact. He feels that physicians need to recognize people who are on the verge of becoming homeless and to complete the persons-with-disabilities forms at an early stage. He also thinks we need to support the housing-first philosophy and not herd people into cheap motels.

From a local builder’s point of view, however, there is no incentive to build low-income housing. And because many people don’t want to live near subsidized housing, mixed housing also becomes a difficult sell.

A local community member is fine with subsidized housing but thinks that community service should be done in exchange for it. 

Another community member said she was spit on and sworn at when she offered to take a homeless person for food and pay for it, instead of providing cash.

A city official said that the city council has focused efforts on adequate housing, but is challenged by the large spike in the homeless population and increasing demands on the system because of the fentanyl crisis. Council also has to deal with pressures from small businesses that do not want the homeless outside their storefronts.

A mental health care worker agreed that lack of housing was the main issue, noting that there has not been a significant increase in social assistance for housing over the last 10 years. The current vacancy rate in Kamloops is approximately 1%, and the average rent for a one-bedroom suite is approximately $600 to $900 a month. He sadly admitted that for many homeless individuals, using substances was a priority over housing and food.

A person from a shelter opined that drug addiction should be treated as a medical issue, not a crime. But a few of my physician colleagues find it frustrating to have their patients with urgent medical conditions competing for medical attention with those addicted to drugs.

An experienced law enforcement officer classifies homeless people into three categories: those who want to live on the street and refuse help, those who are working but can’t make enough to keep up and have nowhere else to go, and those who have mental health or substance-abuse issues. He is on a committee with street nurses, representatives from shelters, and mental health care workers that meets weekly, so he knows that there are many resources available to the homeless that go underused. He disappointingly admitted that the homeless count doesn’t change year to year.

I also had the opportunity to speak with a few homeless people. One lived in a crack house and would rather be homeless again, preferring to sleep in a protected stairwell or a bank-machine kiosk. Another said the problem was corporate greed, with landlords overcharging for inadequate housing. Another said he would like a decent place to stay but he wasn’t willing to work at this time. I also came upon a young man who said he was Martin Luther King and had come back to save the city from corruption. He said, “Home is a place to hang your heart—otherwise, it shrivels up and dies,” and that he had his heart in a “safe box” until he found a home. He admitted to stealing and said that homeless people do drugs to cope.

These conversations have raised more questions than answers for me. We have a challenging task ahead. We need to empower people to change their situation, provide them with opportunities and skills, and above all, give them hope.

I reach into my purse and scrounge for change. I feel a coin and pull out a loonie. I offer it to the man who has approached me, feeling somewhat embarrassed with my small offering. He thanks me with a brief nod and is on his way. Maybe he won’t put the money toward drugs. Maybe he will buy himself a sandwich. There’s always hope.