Walk in their shoes

Tom* was limping badly as he shuffled into the Mission looking for a bed for the night. He couldn’t walk properly.

Our duty social worker asked him to take his ill-fitting shoes off - they were obviously too big for him - and he had no socks.

“His feet, they were so bad. His skin was raw from here down (pointing at his ankle) and it was broken and inflamed,” she remembers.

“Then I said, ‘flip your feet up’ so I could see the soles and it was terrible. He had dead pieces of skin all over them on the pressure points. I called in one of the nurses and she cut off the dead skin to give him some relief.”

Tom had been sleeping on the streets and luckily our shelter had a place for him that night and we could take him in. He was with us for two weeks and along with dealing with all the other problems he had, we treated his feet, cleaning them, bandaging them, giving him clean dry socks and properly fitting shoes.

Bad feet are a significant symptom of poverty and homelessness. We see this in many of our clients and sometimes the damage can be quite horrific - up to and including infected feet which have become black and gangrenous

It’s a cruel injury for people who are often on their feet all day and trying to survive winter days. Just shuffling along a footpath can be an immensely painful journey.

Because bad feet can indicate other problems, at the City Mission we look beyond that damage to find out what else is going on that we can help with.

Our nurse will check the damage, clean and dress the feet and we can prescribe antibiotics if infection is present. Then we might dig further as to why the client’s feet are so bad.

 A blood test might check for diabetes and if that is an issue then we will check why the client isn’t on medication or, if he is, find out why he isn’t taking it. We might find out he has an alcohol addiction and is drinking a lot, which has put sugar levels up even higher, so he needs a referral through to our alcohol and drug services.

 He’ll be fed, washed, sleep safely, live in dry clean clothes, have medical care, and we will start working on a plan for him to move off the streets and to be housed when he leaves us.

Our rough sleepers have feet problems all year round – with deep painful cracks in summer – but winter brings its own special problems caused by feet being in damp socks and shoes all day combined with poor hygiene. That can cause infections, fungal outbreaks, cellulitis and painful swollen feet with long toenails and can create joint problems as victims are unable to walk properly.

It can be even worse for people suffering from mental health issues who often walk long distances during the day. That’s a common activity because walking – sadly along with substance abuse - is a way of calming the mind.

Constant dampness and not being able to afford to be warm and dry affects many of our clients in winter – including many who do have a home to sleep in at night.

The rising cost of living has badly affected the vulnerable people who need our help and the increased petrol costs will force more of them to walk in the wet to schools, to casual work, to shop, to socialise.  They go home to places which they struggle to afford to heat so they can’t keep warm or dry out their clothes. They might lack a change of clothes, or only have one pair of shoes, so the dampness continues into the next day. (On top of this their homes are often mouldly from the ever-present dampness.)

The alternative for those who don’t have to leave home is what one person described to us as the cheapest winter heating solution, stay in bed with a hot water bottle or electric blanket on. That’s not living, that’s just surviving and it’s not healthy.

In the past we have talked about how for many Christchurch people it is a case of pay the power bill, or pay the food bill, but this winter you can add the petrol bill and food bills on to that.

Winter is an annual crisis for many families we look after. They dread it because of how it exposes the weaknesses in their day-to-day lives. Seasonal work dries up and illness strips families of income earners.

What can follow for the most vulnerable is hunger, humiliation, mental health issues, addiction problems, family violence and break-ups, children’s education failing ...

That’s where our more than 20 integrated and complementary services become so important. We heal feet, but that is just the start.