Story and photo by Lara Pickford-Gordon
Last year, within one week on three separate days I saw men with skin trauma. The first, was a man with a swollen hand that looked scalded. He asked me to buy something to treat it. Another day a young man was sleeping outside the doorway of a pharmacy on Independence Square with what appeared to be burns on the back of his leg— there were blackened edges where the skin was gone and red exposed flesh.
The third was a tall man with a swollen leg but on the day I saw him, one leg had a gash. Apart from these, there is the man nursing an open, odorous wound. Sometimes he wraps it in dirty rags.
I chatted with him one day when he asked for something to eat and realised he may have a mental illness. I wondered how he endured the pain. I got the answer one day when walking across Queen Janelle Commissiong Street—he was ingesting something in a piece of foil.
We have grown accustomed to passing these homeless individuals but when we stop and look closely there is unease and anger. What are the authorities doing?
I decided to find out and conducted an interview with Executive Director, Social Displacement Unit, Loraine Reyes-Borel on December 13 at the Ministry of Social Development and Family Services, Port of Spain.
The unit is familiar with the regulars on the streets from “outreach” done during the year offering the services of rehabilitation, access of grants and a facility for elderly homeless.
The engagement with street dwellers is done by one field officer to cover the entire country; there are five contract positions.
Help was offered to the man with the wound on his leg but he left treatment. Another man who constricted his fingers and circulation until the tissue in his fingers died was once in a rehabilitation facility in Piparo. He chose not to stay and was discharged.
Reyes-Borel said, “He abandoned the programme and came into Port of Spain, eventually, settled in Barataria. We have been in contact with the Barataria Mental Health and Wellness Centre to get assistance.”
The man however, cannot be taken into treatment for mental health until his medical issue is treated first. “You cannot forcibly give medical care to this gentleman on the streets so we are in a catch 22,” Reyes-Borel said.
She explained, “When you speak to him, he is quite lucid. He says he does not want any help. We have gone twice, and another occasion, a gentleman went to him, with us; we had a mental health nurse. [We] engage him with a vehicle waiting but he does not want to go to the hospital.”
T&T has a “chronic homelessness” problem. At a glance the number of street dwellers seems to be increasing however, Reyes-Borel stated that there isn’t a “population explosion”.
Mental health issues
In the 18 years head counts have been done the number has not exceeded 1,000, “and if you want to include capacity at shelters, the capacity at rehab shelters that admit our clients, the highest figure we have come up with in estimates is 1,500”.
Reyes-Borel said the homeless population migrates to particular areas at certain times of the year—they flocked to the nation’s capital on public holidays like Divali and Christmas. Their visibility was less at Carnival time.
Reyes-Borel said, “Carnival is not safe for a street dweller so you tend to see lower numbers in Port of Spain…at Carnival people are not looking to give money…they would probably then migrate to the other areas, Arima, Chaguanas.” Street dwellers go to places where they will receive money and food.
From the information gathered at the Centre for Socially Displaced Persons (CSDP) Port of Spain and Court Shamrock, the CSDP in San Fernando, mental illness and substance abuse were the “most significant”.
It is a “major challenge” to respond to the needs of these clients. The Health Ministry has the Arima Rehabilitation Centre, a mental health and wellness centre.
Reyes-Borel said, “The Mental Health system and rehabilitation programmes need to be expanded significantly.” The law does not compel family members to take care of relatives with mental health issues and families unable to cope may rely on the state institution, the St Ann’s Hospital.
The predominant mental health issue of the homeless population is schizophrenia; it impacts social interaction and makes living within a household difficult. “It is really easy to go to the streets and stay on the streets,” she said.
There are homeless persons receiving government grants—disability, public assistance. An address must be given to access them. “In some cases, the family is accessing the grant. They give them $25, the family has the income and that works for the family,” Reyes-Borel said.
She noted in T&T street dwelling has a specific kind of behaviour. “In Trinidad we are particularly good at sitting down and doing nothing whole day, beg alms, go get your drugs.”
Reyes-Borel further explained, “T&T citizens are kind; they will give you money. When you are on the [Brian Lara] Promenade, you can get Hosein’s [roti], KFC, doubles, burgers. Why are they going into a facility where they will serve bake on Monday, bread and cheese on Tuesday…the street can be comfortable. We may not appreciate it, we may think ‘how could you stand it’ but there is something working for them.”