In this piece Paul talks about the effect of environmental factors on the health of people who experience homelessness. He uses his personal experience to highlight the failure of services to take environmental factors in to account, which can often exacerbate his CFS.
When talking about homelessness and health, I think the most important aspect that is always omitted is environment. I recall talking to a researcher some years ago when he was doing some research into sleep deprivation, and I said, “all of you focused on looking at the impacts for those experiencing homelessness”. And he said, “Oh well, why would they be considered?”. And it was like “because that’s the one group of people that never get to sleep properly, ever”.
You always have one eye open. You never hit REM sleep or you never go deeper than REM sleep. But again, it was that classic moment of, ‘oh, the homeless’ inverted commas. ‘You know, they don’t need research done because, you know, well, frankly, they can’t do anything about it.’
And I’m sitting in the Airbnb accommodation that Westminster Council are currently providing me with and threatened me constantly with eviction. And I can’t help but think how bad this environment is compared to where I was when I was sleeping at Terminal Five in Heathrow Airport. And often people say, ‘Oh, isn’t it better to have a roof over your head?’ and you’re like, ‘Yeah, no, no,..’
That is not a straightforward equation as people often conclude it is. So, for instance, where I’m located, my wheelchair can’t get out of the flat. It is too narrow. And I remember the adult social worker coming to do my assessment, coming in, having to move sideways to get in through the corridor herself and then asking, ‘Oh, you know, just do people take you out in a wheelchair?’. I’m like ‘how, how could that be possible?’.
You have literally just slid him through a corridor sideways because you couldn’t walk down it normally. The floor is grubby. I’m on a main road, so all the exercise I used to do on the floor in my previous accommodation, I can’t do. You just end up being completely black from the pollution that comes in from the window. The shower, the most terrifying space for anybody, generally speaking, but specifically for somebody like myself who suffers with chronic fatigue syndrome.
There is a corner unit directly opposite the opening of the showers. If you slip, there was no chance you’re not going to end up dead. It’s not disabled access. They place me on a ground floor, so I’m vulnerable. But the reason that here is less safe than Heathrow Airport Terminal Five is because at Heathrow, there are people around you 24/7.
If you get into trouble breathing, which I do quite often, and there are people that sort of go, “Oh, you’re OK? Can we help?”. There are wheelchairs accessible, there are trained first aiders. There are security running around every hour on the hour. So you feel comfortable you you feel that you’re in a space that if you do get into difficulties, there are going to be people there to help you. Whereas here I don’t get seen for weeks, if not months, in fact, I have not seen my adult social worker for seven months.
I’ve never seen a housing officer for two years since sort of being taken in under the ‘Everyone In’ scheme back in April 2020, which is insane. But the worst was August last year where I had an MECFS crash, which meant that I couldn’t move or talk. My focus had gone, so I couldn’t even type to send out an email asking for help. And my water that I usually keep by the side of the bed ran out and I’m lying there for day, literally.
It was four days before I thankfully was able to function again enough to send out a message to get someone to come and help. But I was literally dehydrating to death in the 21st century. That was insane. And worse still, having been notified of this by many organisations, social worker has done nothing to appease – no carers, no care system. Again, that’s part of the problem. They go, “Oh well, we can provide you carers between 8:30 and 9:30 in the morning” and I’m like, “Well, that’s not how my life works. If I’m functioning, I’m going to be out and doing stuff. I’m not going to hang around for someone.”
But equally, if I’m not, you know, you need to be able to reach out. “Oh, that’s not how our system works. Oh, but we can offer you this payment scheme, right?”
Great. But then you need a bank account and then you need this and then you need that. And then you basically got to become a self, you’ve got to become an employer. So you have to monitor these people. You have to employ them. You have to pay their wages and pay their national insurance. And you’re like, “if I wanted to do that, you should be paying me as an employer. You don’t give me little pennies and then expect me to run a business”. And they are the two alternatives that work and if neither of those work they go, “Oh, good, right? We’ve offered, you now, off we go”.
And have no concern actually by the fact that they’ve not addressed the problem and this is public sector en masse in the 21st century? “Oh, we’ve offered you something. Oh, here’s a flat with mice and black mould on the wall and broken windows on it is upstairs, even though you can’t leave your wheelchair. But you know, we’ve offered you something. No, we’re not going to do anything.”
We want human beings back in this process. Ladies and gentlemen, human beings. People that go, “No i’m following a tick box and I can block you. Hahahaha,.” But actually, there’s a problem. Let’s find a solution. Let’s move on and make life better for everybody.
So, environment, I think it is the most important aspect that gets left out of the health question. I have no table and chairs to be able to eat, which screws up my digestive system and puts crumbs in my bed because it’s the only place I can eat. And by definition, those crumbs cause sleep disruption.
And we all know sleep is the most important thing for health. Poor sleep causes poor health. Full stop. There’s no debates about that. It is emphatic in all medical journals and medical research is that the lack of sleep does not give your body time to recover and therefore makes you prone to a plethora of illnesses, including Covid and makes you constantly stressed, which is incredibly bad.
This is where heart attacks come from only, you know, high blood pressure, diabetes and all this kind of thing. No kitchen means you can’t cook, so there’s no notion of having a healthy diet unless you’re wealthy.
And this is the irony if you’ve got £3, you’re going to go for a Tesco meal deal of crisps and a sandwich and a drink. Now, fortuitously, Tesco’s in recent months has actually brought in a whole new range of £3 meal deals, which are actually relatively healthy options. But for years, that was it. It was like a chocolate bar, a drink and a sandwich, or a chocolate bar or crisps, a drink and a sandwich.
But that’s not a diet to live on. That’s a diet you survive on but go to sort of Marks and Spencer’s and look for a poquet bowl and you’re talking £6? Well, that’s two days’ food under the Tesco meal deal. And these are choices that you’re not really making yourself, because if you have no money coming in when your benefits have stopped again, this is all part of the environment, then your choices are zero.
You don’t have choices when you, you know, you go to get food and it’s often it’s high sugar, high fat content. Now, actually, in some regards, that’s useful for warmth and energy, but terrible for a whole bunch of other things. And it’s all about balanced diet. But again, we’re back to environment.
The wrong environment: you can’t exercise, the wrong environment: you can’t cook healthily, the wrong environment: you can’t sleep properly. These are all health issues. And if we’re going to talk about health and homelessness, that environment has to has to be top of the list.