I was on a conference marathon, attending 3 prominent international conferences in the area of Public Health (QHR2016, APHA2016 & HSR2016) and an intense training program (EV4GH) across several cities of the U.S. & Canada. It was during my visit to these places that I found numerous homeless people sitting along the street side with notes saying ‘hungry’, ‘need money for food’, ‘any money for food will help’. I saw several people sleeping on the roadside under the shed of a restaurant or in a corner against the pillar or at the store entrances, squeezing themselves into as little pieces as possible to fight against the chilling winter. They had created their own little covers from cardboard boxes or their tiny tents from scrapped materials, hoping that it would protect them from the outside world. I was deeply pained to see these homeless people struggling with the cold weather and an empty stomach every few hours.

Photo Source: http://www.povertyinsights.org/wp-content/uploads/2015/10/3667770124_781f5874a9_z.jpg

Following which, I went on a trail of thoughts imagining how it would feel to be in a situation like this, taking me back to the state of homeless people in my own country, India. Something seemed different. I was wondering what was driving them into such a situation. U.S., Canada being developed countries with per capita GDP and per capita welfare spending among the top 20 across the world and better social security mechanisms, I could not rationalize the extent of homelessness there (even if, in Vancouver for example, I got some explanations from public health experts on why the city struggles with a serious homelessness problem).

My own country is still a developing nation grappling with extreme poverty issues, hence, it is common to find homeless people even in the urban areas. The primary reason for homelessness in India is extreme poverty, while in the west, several other individual and relational factors like family break-up, domestic violence, mental illness, addiction challenges etc. are found to contribute to homelessness –  coupled with migration recently.

However, I noticed a difference in the way these homeless people approach others for help. In India, a poor homeless person is likely to be an illiterate and cannot read or write even in his/her own local language. Generally dressed in unkempt clothes, these people find it difficult to convey their message and have to largely rely on nonverbal gestures. Unlike them, at least some homeless people in the west appear better dressed, and are able to communicate their circumstances well through written messages. The latter manner of seeking help is less intrusive, provides clarity on their situation and reason for seeking help. One can even find people explicitly asking money for drugs or alcohol. Recently, a prankster carried out a social experiment in New York to find out who would receive more help: a homeless drug addict or a homeless father, and to everyone’s surprise, the former was able to get a good sum of money in an hour with messages like ‘stay high man’ & ‘get a big bottle for yourself’.

This cultural aspect reflected by their behavior and mode of communication is just one bit of the entire story. If we try to understand this at a macro level, then there are several structural and systemic factors reacting with their individual circumstances making them land in situations like these. Failure in the state’s social security system to address the needs of this section of population – too many holes in it, certainly in the US? –  coupled with several structural factors like poverty, increasing unemployment, lack of affordable housing and access to other welfare services makes the situation even worse. As reasons are rooted across several political and social welfare dimensions, tackling homelessness actually needs a multi-pronged approach.

My observations from the streets in Northern America made me think of how such conferences are successful in bringing out the voices of the neglected homeless people living on the streets endlessly. APHA has a specific caucus dedicated to homelessness (for every annual meeting) with sub-themes such as: housing as a human right, impact evaluation of interventions targeted to homeless people, severity of multiple health conditions experienced by them etc. Also, these conferences (especially HSR2016) emphasize the role of civil society organizations and community engagement as an important mechanism to promote active citizenship among the community members. A key question for HPSR researchers is perhaps this one: how are communities to be engaged if many citizens are (too often) desensitized to issues of power and privilege in their own local settings? Somehow, our social justice antennas seem to be triggered more in faraway lands…

The United Nations Commission on Human rights estimated a 100 million homeless people worldwide in 2005; and over one billion for people living in any sort of insecure, temporary or illegal housing. A recent global poll conducted by GlobeScan in 24 countries found a significant increase in perceived seriousness of poverty and homelessness as national concerns. Hence it becomes essential to see how the learnings and ideas generated through such conference discussions get translated into reality. At least if we’re serious about ‘leaving no one behind’…