Student Reflection: Where the UN and medical students meet

Homelessness is a reality of our world. In September 2018, the Secretary General of the United Nations reported on the global housing crisis to reveal almost 25% of urban populations, 833 million people total worldwide, live in overcrowded, unsanitary and often dangerous "informal encampments."[i] Upgrading these slum-like settlements is an imperative of the United Nation's 2030 Sustainable Development Goals.

The United Nations report speaks to the inhumanities of homelessness -- a self-perpetuating entrapment. Nonetheless, political efforts lack the energy to meet or solve the challenges at hand. In a recent New York Times article, former New York City Council member Christine Quinn called the opposition to initiatives for the homeless a "fear-fueled ignorance."[ii] Aptly named, this piece asks a crucial question: through our public service efforts and local governance, are fighting a war on homelessness or a war on the homeless?

A separate New York Times profile on a homeless man named Mark-Steven Holys further elucidates this issue. Mr. Holys is a previous sommelier who is as genuine in his passion for wine as he is in his responsibility for those choices that perpetuated his homelessness. In this piece, he observes there is a lack of understanding regarding who lives in highway-adjacent encampments:

“You’re going to find the criminals, prostitutes and the malefactors.... But you’ll also find people who are saving money wherever they can and who are trying to get out of the homeless quicksand.

“I’ve met a stockbroker and former athletes on the street... Once you’re deeply tattooed by this thing it’s very hard to get the ink out of your life.”[iii]

A compassion deficit is a bleak explanation for the mismatch between the obvious injustices of homelessness and our inability to sustainably and sufficiently react to it.

When speaking with the individuals who seek healthcare through TBSM Street Runs and at our Community Clinic, it is hard to ignore the infrastructural, social and political systems that perpetuate homelessness. Solutions to these issues appear elusive. I often wonder how we, as future physicians and change-makers in healthcare, can we reconcile that health-related activities often occur in non-clinical spaces that do not forward our patients' wellbeing. As important as building our clinical and scientific aptitude, we must prepare to care for and empower our patients, and provide conscientious, culturally-aware counseling.

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[i] United Nations, General Assembly, Report of the Special Rapporteur on adequate housing as a component of the right to an adequate standard of living, and on the right to non-discrimination in this context, A/73/310/Rev.1 (19 September 2018), available from https://www.undocs.org/A/73/310/rev.1.

[ii] Bellafante, Ginia. "Are We Fighting a War on Homelessness? Or a War on the Homeless?" New York Times. [New York, NY] 31 May 2019. <https://www.nytimes.com/2019/05/31/nyregion/homelessness-shelters.html?auth=login-email&login=email>

[iii] Fuller, Thomas. "How a Tuxedoed Sommelier Wound Up Homeless in California." New York Times. [Oakland, CA] 28 Sept 2019. <https://www.nytimes.com/2019/09/28/us/homeless-san-francisco.html>