
“Medieval” Diseases Flare as Unsanitary Living Conditions Proliferate - spking
https://www.scientificamerican.com/article/medieval-diseases-flare-as-unsanitary-living-conditions-proliferate/
======
awakeasleep
After learning about hep C (diarrheal, can survive in an infectious state for
up to 6 months outdoors) the issue of sanitation became very 'real' to me.

I had the idea of starting a charity to rent port-o-potties for the homeless
encampments near our office. For context, my company is filled with
_completely_ woke people, super concerned about social justice and stuff like
that...

But when i pitched the idea everyone universally shot it down, in disgust and
with a dismissive attitude like it wasn't even worthy of consideration.

It messed with my head. It's a symptom of our fucked up country where
"wokeness" is a separate idea from kindness, where disgust about the poor
crosses all colors of skin, and it's worth keeping the poor in misery even
when that decision threatens your own health.

~~~
DoreenMichele
I was homeless for nearly six years. I did my level best to never use a port-
a-potty. I think they are generally gross.

I think the only exception was one set up permanently in a park as the only
bathroom there. It was not as gross as the ones set up on city sidewalks,
apparently usually for homeless individuals.

I really dislike most solutions aimed at helping the homeless. They are often
solutions no middle class person would accept.

If you wouldn't want it for yourself, please think about why you think this is
a good thing to do for the homeless population. It probably isn't. It's
probably part of the pattern of societal behavior that helps keep this issue
entrenched.

~~~
cco
I use portapotties all the time, they're not unicorns and rainbows but
assuming they haven't been defaced, i.e. poop or urine all over the inside and
not in the receptacle, they're just fine.

I don't see them as a dehumanizing thing. Shoot, nearly all construction
workers use them as their office toilet, is that unacceptable?

~~~
DoreenMichele
When you are homeless, you tend to wear the same clothes for days or weeks at
a time. You may be unable to shower for long stretches.

Construction workers are going to go home, shower, change clothes, wash the
clothes they wore all day and worked hard in.

You seem to be taking it for granted that one can get cleaned up again after
being exposed to a port-a-potty. This is not a given for homeless individuals.

If you are in good health -- which many homeless people are not -- and have
regular access to showers, laundry service, etc, using a port-a-potty may be
no big deal. But this is generally not the case for people on the street.

~~~
username3
The solution is public showers for the homeless.

~~~
DoreenMichele
Yes, let's just leave them on the street and give them lousy port-a-potties
and shower access. That's the humane approach.

(Do I need a sarcasm tag here?)

That still leaves them wearing the same filthy clothes. It doesn't remotely
solve the problem. Furthermore, homeless showers tend to be as horrible as
most homeless services.

Either you have no privacy -- because why the hell should your dignity matter
when you are homeless? -- or it has mold issues, etc.

All services specifically designed to service the homeless population tend to
be really, truly terrible in a "you would get sued if this were aimed at
middle class people" kind of way. The general attitude is "beggars can't be
choosers" and "don't be so uppity -- show a little gratitude for the shitty
service you are getting for free, you ungrateful whiner."

So, no, that's not the solution. Missing Middle Housing is The Solution here.
Or one part of it.

There is no single cause of homelessness. There is no single solution.

~~~
lisper
> There is no single cause of homelessness. There is no single solution.

This is really important to emphasize.

I've never been homeless, but I did spend two years hanging out with homeless
people while making a documentary film. The range of people on the street is
almost as broad as the range of people off it. I met homeless people with
Ph.D.'s. I met homeless people with florid schizophrenia. I met homeless
people with substance abuse issues. I met homeless people who were perfectly
ordinary but had some bad luck (ranging from losing their job to losing their
entire family in a car crash). I even met homeless people who chose to live on
the street (or in their car) because they wanted a nomadic lifestyle.

But no matter how you slice it, the only real solution to homelessness is
housing.

~~~
DoreenMichele
You made an excellent movie about the issue. I highly recommend it:

[http://www.graceofgodmovie.com/](http://www.graceofgodmovie.com/)

~~~
lisper
Thanks! :-)

------
kylehotchkiss
I've spent some time living in a third-world country and one of the things
I've observed is that even the poorest people are still living in some sort of
structure that is capable of providing a limited amount of protection from the
elements, a small bit of privacy, and a place to come back to at night. Even
in villages, these small homes have electricity and satellite TV. They're
often built with low cost materials like bricks and tin roofs, but they allow
people who can't afford a brick-and-mortor home the opportunity to have some
stability in life.

I'm a big fan of safety regulations for construction but after time living
abroad, I'm beginning to see a case for loosening some construction rules to
make true low-cost housing available to more people. I don't intend to say
bricks and tin, nor so dense it becomes a large fire risk, but some simple
allowances that would let people build theirselves a small place to call home
without city regulators barring it. Perhaps this could help with the
increasing amount of health issues occurring like typhus.

~~~
DoreenMichele
It likely can't. Structures of the sort you are describing only work decently
in small villages where people all know each other, etc. They tend to not work
in more developed areas with a higher population density and different social
fabric.

If you are interested in addressing the housing aspect of this in the US, look
into "Missing Middle Housing" and ways to promote more of it in your
community. These are more affordable forms of housing that were common at one
time in the US that have been largely zoned out of existence while we promote
ever larger single-family detached homes and suburban sprawl.

That's the crux of the issue in the US. It doesn't have to be that way.

~~~
freddie_mercury
> Structures of the sort you are describing only work decently in small
> villages where people all know each other

This hasn't been my experience at all. I live in a developing country. I've
also spent significant amount of time in two cities: one with a population of
13 million and one with a population over 1 million.

In both cases, there is lots and lots of housing just like the OP describes.
It works fine in a big city. It doesn't require a village.

There's an old lady who lives down the street. Her "house" is about 1 meter by
3 meters and is two levels. She sleeps upstairs and cooks downstairs.

~~~
DoreenMichele
I seriously doubt that.

I would bet that you tend to see a lot more theft and other crime committed
against people who have flimsy, unsecured shelter in more dense populations.

In developing countries where people routinely still use a field to relieve
their bowels and bladder in spite of the fact that you have city-style density
levels, women get routinely raped and murdered while trying to pee or poop.
This is such a widespread and common phenomenon that if you search on the term
"rape, murder and lack of a toilet" you will find no shortage of articles on
the subject.

So I seriously doubt it works just fine. It probably doesn't work just fine.

~~~
jacobolus
Shanty towns slowly developing into established neighborhoods with permanent
houses is the normal way cities have been built throughout history, and still
dominates throughout the developing world. A significant proportion of all
people alive today live in shanty towns.

Of course urban shanty towns can be dangerous and have plenty of problems. So
do rural villages.

~~~
DoreenMichele
I would very much love, love, love to see US zoning regulations (etc) loosened
up to allow for smaller spaces with fewer amenities.

But I am loathe to say "Yes" to shanty towns per se as a thing we allow in the
US as official policy on city property.

But thanks for chiming in. Have an upvote.

------
blendo
From the SciAm article: “The hygiene situation is just horrendous” for people
living on the streets, said Dr. Glenn Lopez, a physician with St. John’s Well
Child & Family Center, who treats homeless patients in Los Angeles County. “It
becomes just like a Third World environment where their human feces
contaminate the areas where they are eating and sleeping.”

My son gave me an eye-opening book this Christmas: "Righteous Dopefiend"
[https://www.ucpress.edu/book/9780520254985/righteous-
dopefie...](https://www.ucpress.edu/book/9780520254985/righteous-dopefiend)
"This powerful study immerses the reader in the world of homelessness and drug
addiction in the contemporary United States. For over a decade Philippe
Bourgois and Jeff Schonberg followed a social network of two dozen heroin
injectors and crack smokers on the streets of San Francisco, accompanying them
as they scrambled to generate income through burglary, panhandling, recycling,
and day labor. Righteous Dopefiend interweaves stunning black-and-white
photographs with vivid dialogue, detailed field notes, and critical
theoretical analysis. Its gripping narrative develops a cast of characters
around the themes of violence, race relations, sexuality, family trauma,
embodied suffering, social inequality, and power relations. The result is a
dispassionate chronicle of survival, loss, caring, and hope rooted in the
addicts' determination to hang on for one more day and one more "fix" through
a "moral economy of sharing" that precariously balances mutual solidarity and
interpersonal betrayal."

Personally, I'm now convinced the most practical short term solution is for
the city of SF to a) allow use of IV drugs without fear of arrest, and b)
provide a clean, dry place to shoot up and nod out.

------
minikites
At the Hubert Humphrey Building dedication in Washington, D.C. on November 1,
1977, Humphrey spoke about the treatment of the weakest members of society as
a reflection of its government: “the moral test of government is how that
government treats those who are in the dawn of life, the children; those who
are in the twilight of life, the elderly; those who are in the shadows of
life; the sick, the needy and the handicapped.”

------
argd678
How come you don’t see homeless in Europe to the same degree like in the US?

~~~
swerner
Can’t speak for other countries, but in Germany there is a social security
safety net that will pay rent up to a certain apartment size and just barely
cover living expenses.

It doesn’t eliminate homelessness entirely, a lack of affordable housing in
cities is a problem here just like anywhere else, but it makes it much less
likely.

I know the narrative from some, especially in the US is a “why would anyone
work when the state will pay for you”, but the standard of living you get in
welfare is just basic survival and most if not all desire more than just that.

And there is of course mental health, a much lower rate of opioid
prescriptions and therefore addictions, etc.

~~~
refurb
Hmmm...

Rates of homelessness: Germany - 0.50% USA - 0.17%

[https://en.wikipedia.org/wiki/List_of_countries_by_homeless_...](https://en.wikipedia.org/wiki/List_of_countries_by_homeless_population)

~~~
swerner
Interesting. The difference in homelessness between EU and US may just be
perception and not reality?

~~~
mercutio2
Most countries, and for that matter most urban areas in the US, routinely
force the homeless off the streets pretty systematically.

California (and especially the Bay Area) get a lot of criticism for their
homelessness not because SF is especially cruel to the homelessness, but
because in the Bay Area it’s _not_ generally considered acceptable to sweep
the homeless out of town.

For instance, New York City (at least in Manhattan) was aggressive for many
decades about rounding up the homeless and forcing them out of town.

This doesn’t mean the Bay Area is doing a _good_ job with homelessness, the
root of US urban homelessness does genuinely seem to be a combination of
missing middle housing and a shortage of affordable and accessible
mental/physical health care.

But the mere presence of visible homelessness is more about (direct) police
tolerance, and (indirect) municipal political tolerance for visible
homelessness.

------
onetimemanytime
In other words: take away soap + water + disposal of you-know-what and...

------
rsln-s
Yet another reason to support higher taxes and more wealth redistribution.

~~~
dsfyu404ed
Homelessness and the problems that go along with it is only a serious problem
in certain cities on the west coast.

Don't get me wrong, every city has some homeless but cities in the rest of the
country seem to be able to keep the problem at bay without increased "wealth
redistribution", many of those cities even exist in states with far less
"wealth redistribution" than the cities that have the biggest homeless
problems. I see no indication that increased wealth distribution will fix the
problem. There does not seem to be any substantial correlation.

I think the problem lies elsewhere. Problems like this don't tend to have
single sources and single solutions anyway.

~~~
UI_at_80x24
Yes because it's the regions fault people don't want to freeze to death on a
sidewalk in Minnesota.

The first thing I would do if it looked like sleeping on the street was my
only option is start walking south.

The problem is wealth disparity; not drugs, not geography, not 'life-style',
not 'poor choices'. These "certain cities" on the West coast are prime
examples of the wealth gap, people are homeless because they can't afford to
live there. Nothing more. The wealth-gap is CAUSING the problem.

The wealth gap was less at the start of the French Revolution then it is now.

~~~
bluGill
Most homeless have mental issues. Minnesota has a good welfare system. However
the cold in MN means that those who generally don't trust government (meaning
that they will run away from any help the government tries to give unless
restrained in an often inhuman way) either freeze to death or make their way
south. Thus the poor in MN have a house of some sort. There are a few who
migrate north for the summer and back south for winter.

No amount of safety net helps when your mental illness makes escaping the
notice of the safety net a priority. It is a hard problem and I don't think
anyone has a good solution.

------
ptah
makes sense to just give them free houses

------
freeone3000
Clearly the solution here is to reduce the unsanitary living conditions is to
eliminate homelessness. The easiest way to do that is to close the gap between
the wealth gap between the richest and the poorest, and the easiest way to do
that is to let the homeless die. As diseases become worse, those able to
afford healthcare will live, and those unable to (the "potential homeless")
will start to die in droves. Of course, we'll spend a bit more on cremations,
but perhaps we can get a bulk discount? We'll have people look into that. All
measures state that if the least wealthy people simply stopped being there at
all, we'd be closer as a society to our ideals by every quantifiable metric.
So hats off to typhus, and cholera, and dysentery, for existing in 2019 and
doing what we always wanted to happen but haven't got the stomach to do
ourselves.

~~~
komali2
>let the homeless die

This is immoral and thus not a potential solution, full stop. Others must be
considered instead.

~~~
lisper
The GP comment was satire, modeled after Jonathan Swift:

[https://en.wikipedia.org/wiki/A_Modest_Proposal](https://en.wikipedia.org/wiki/A_Modest_Proposal)

~~~
loudmax
I'm about 90% convinced that you're correct, and about 10% terrified that
you're not.

~~~
lisper
You may find some comfort in the fact that the proposed solution wouldn't
actually work. Humans are extraordinarily robust creatures. Our best efforts
at exterminating them, even using state-of-the-art technology on industrial
scales, have, for better or worse, barely made a dent in the population.

------
harrumph
In this thread: zero mentions of the word capitalism.

Which is very much like a conference about pollution that lacks any mention of
industrial production.

~~~
macspoofing
Because capitalism has nothing to do with the issue at hand.

'Capitalism' is also a misnomer in this context. We live in a market-based
economy with a social safety net and democratic government. This is true
whether you are talking about United States, Canada, Germany or France. Our
governments have all the legal and revenue-generating tools they need to enact
any policy they wish.

Finally, I'm not sure what alternative you're advocating for. Destroying our
current system to adopt a Soviet-style, or Cuban-style, or Venezuelan-style
socialism would be a disaster. Is that your solution?

~~~
harrumph
>Because capitalism has nothing to do with the issue at hand.

Your position is that the unavailability of housing to those suffering
diseases tied directly to their being unable to pay market price for housing
somehow has nothing to do with the prevailing economic arrangement that
utterly defines the housing market these persons cannot participate in. They
don't have and cannot borrow capital, but their suffering "has nothing to do
with" the prevailing system that revolves around / is animated by nothing
but...capital? Total nonsense.

> Our governments have all the legal and revenue-generating tools they need to
> enact any policy they wish.

Your position is that concentrations of wealth -- such wealth's tangible
assets dominated by holdings of real estate -- do not overwhelmingly divert
the attention, priorities, electoral outcomes and revenues of government to
their own ends at the explicit costs of the safety net. You seem to believe
government does not sell political results exclusively to persons who can pay
for those results. Again: total nonsense.

> Finally, I'm not sure what alternative you're advocating for

I'm advocating for merely mentioning capitalism in the discussion! And that
much is too much, apparently.

I suggest you examine your own indoctrination in this economic arrangement if
it is so sensitive that it cannot abide even its naming when discussing the
intensification of suffering caused by lack of capital under the system that
is exactly centered on capital.

~~~
macspoofing
>Your position is that the unavailability of housing to those suffering
diseases tied directly to their being unable to pay market price for housing
somehow has nothing to do with the prevailing economic arrangement that
utterly defines the housing market these persons cannot participate in.

I'm not claiming that at all. In fact, I disagree with that. In this topic
I've stated that chronic long-term homelessness is largely the result of
mental illness and drug abuse. Those issues have different solutions than lack
of income or capital or whatever you're trying push.

>They don't have and cannot borrow capital

We live in a democratic, regulated market economy with a social safety net.
You're arguing a straw man when you imply we live in some sort of
Randian/Libertarian free market capitalist system. We don't. Social welfare
policies are tools already used by modern governments.

>I'm advocating for merely mentioning capitalism in the discussion!

To what end? If you have specific policy suggestions, then argue them. If you
want to argue for a wholesale change to some other socio-economic system then
at least argue for that. As it stands, I'm not sure what a straw-man lob at
our current system accomplishes besides FUD.

~~~
harrumph
> I'm not claiming that at all.

You absolutely did. In fact, you plainly used the phrase "nothing to do with".
I'm sorry, but words mean things.

>In this topic I've stated that chronic long-term homelessness is largely the
result of mental illness and drug abuse.

Then I am here to tell you that you have it perfectly backwards. What I've
learned from working with the persons who make up the growing tent settlements
in my giant city is that the perfect reverse is true: overwhelmingly, lack of
capital triggers evictions, which triggers homelessness, and homelessness
triggers mental illness, criminality and drug abuse. Exceptions to this
pattern exist, but nowhere nearly in sufficient numbers to derail the
characterization.

>You're arguing a straw man when you imply we live in some sort of
Randian/Libertarian free market capitalist system. We don't. Social welfare
policies are tools already used by modern governments.

I repeat: Your position is that concentrations of wealth -- such wealth's
tangible assets dominated by holdings of real estate -- do not overwhelmingly
divert the attention, priorities, electoral outcomes and revenues of
government to their own ends at the explicit costs of the safety net. You seem
to believe government does not sell political results exclusively to persons
who can pay for those results...with capital. Again: total nonsense.

I've hung around with way too many homeless people who were working three to
five years ago and were laid off as an effect of nothing but their employers'
capital flight for me to fail to notice that capital allocation is the primary
catalyst in this suffering.

>lob at our current system accomplishes besides FUD.

Don't worry about what I'm accomplishing; through your response, I've already
demonstrated that the role of capitalism in human suffering is commonly and
literally a taboo to discuss. Someone, maybe even you, although it need not
be, will notice this when they hadn't before. That is a good thing.

~~~
macspoofing
>You absolutely did. In fact, you plainly used the phrase "nothing to do
with". I'm sorry, but words mean things.

Yes. Words mean things. You can't distort definitions to suit your argument.
It doesn't work that way.

But I'm fair minded. Let me qualify my statement to your satisfaction: "Your
grossly dishonest distortion driven by some warped ideology is not useful in
either diagnosing the homeless problem, nor coming up with a solution". That
is what I wanted to convey to you. I hope that clears it up.

>I repeat: Your position is that concentrations of wealth ...

You can warp, distort and repeat as much as you want. That is not my position.

>I've hung around with way too many homeless people who were working three to
five years ago

We both know you haven't. You wish you had, but you haven't. You come off like
a disaffected college student who is really excited about Marx.

>Don't worry about what I'm accomplishing

The point is, I wish you were honest. If you're trying to argue for the
replacement of the current soci-economic system, then argue it, instead of
falling back on the eye-rolling "I'm just asking questions ... for a friend"
cliche.

~~~
harrumph
Yeah, if I had nothing to counter with on the topic and had my own
indoctrination demonstrated so clearly, I might go ad hominem too.

~~~
macspoofing
Let me try another way.

I think you have to find a way to manage your expectations in these
discussions. For example, if the discussion centers around the problem of
library fines, suggesting to overhaul the entire socio-economic system to
solve it is not rational. In the same vein, the problem of homelessness in
certain urban areas does not lend itself to a solution based on destroying the
entire system. I understand you're very excited about Marx and every issue is
just another entry to an ideological debate of communism vs capitalism that
you want to have, but it tends to not be very productive and most will just
ignore it.

I know you feel slighted that I haven't answered your objections, but honest
to God, I have no idea what specifics to answer to. You view our modern
society through a specific ideological lens and you can't just expect others
to take on your ideological assumptions. Here's an example of something you
argued: _" Your position is that the unavailability of housing to those
suffering diseases tied directly to their being unable to pay market price for
housing somehow has nothing to do with the prevailing economic arrangement
that utterly defines the housing market these persons cannot participate in."_

To that, I can only say the following:

1) You're putting words in my mouth, that isn't my position.

2) That isn't the system we live in. We don't live in a purely capitalist
system where everything is determined by the cold hand of the market. We live
in a market-based economy, with a social welfare state. We spend inordinate
amount of money on providing a safety net, from government programs to grants
and subsidies. Government social spending is also complemented by non-profits,
private charities, and churches. So no, not having an income to pay rent does
not imply you're going to be homeless.

3) Lack of income isn't what is driving homelessness. Chronic homelessness is
driven by drug and alcohol abuse, and mental illness. That is a fundamentally
different problem, requiring a fundamentally different approach for a
solution. Communist regimes (and I grew up in the Soviet Block)side-stepped
this issue because they would simply forcibly institutionalize a mentally ill
person found living on the street. I actually think that this is the correct
solution in this case as well.

So you tell me, given all that, how do I argue with you? What kind of an
argument do you expect from me, given that I don't share your ideology.

~~~
harrumph
>Let me try another way.

Okay, no more weak, baseless and condescending ad hominem?

> I understand you're very excited about Marx > I know you feel slighted

That didn't last long.

You ask: how do we argue? We don't, because you've already performed your
function.

Recall why you engaged: I noticed that despite the topic's plainly economic
roots in housing markets, literally nobody in the thread was talking about the
dominant economic system, prompting you to contribute the idea that capitalism
somehow bears _no responsibilities_ for what happens to the steadily growing
population of persons who specifically lack the capital to pay for shelter
under its system.

Effectively, you believe nobody actually lacks the protections of having
capital under capitalism even when they don't have capital. That is a howling
absurdity on its face, available for all to see, similar to a turd worn as a
hat.

I thank you for your help in demonstrating my point: indoctrination tends to
make people believe absurdities and enforce taboos to suppress examination.

Have a good weekend!

------
coldtea
Can't be, Hans Rosling and Steven Pinker had all the good stats for how it's
all ever more perfect in this best of all worlds...

------
macspoofing
Predictable result of modern municipal government acceptance of homeless
encampments. If you try to prune a tree on your front yard you'll need 17
approvals before you can even think about touching shears, but pitch a tent in
the middle of the sidewalk and nobody will ever bother you.

~~~
ceejayoz
I doubt homeless people would agree with the assertion that "nobody will ever
bother you".

~~~
macspoofing
It was colloquial phrasing. The existence of permanent encampments and even
tents on pedestrian walkways (experienced in San Fran, LA and Toronto) shows
me that municipal governments have abrogated any semblance of enforcement of
their own by-laws.

~~~
wbronitsky
I'm curious as to why you are so wrapped up in law enforcement, and not in
common decency. Isn't the issue that these cities don't house their homeless?
If removed from the sidewalk, where would these people go? Fixing this problem
starts with humanizing the homeless and proposing coherent solutions, not
complaining about the lack of law enforcement.

~~~
macspoofing
>I'm curious as to why you are so wrapped up in law enforcement, and not in
common decency

That's a fair interpretation based on my phrasing, but I would like to further
qualify my point that outside of enforcing bylaws, it is also the decent and
moral thing for local governments not to allow people with mental illness and
drug problems to languish in the streets, tents and encampments.

>Fixing this problem starts with humanizing the homeless and proposing
coherent solutions

The problem is that activists have completely hijacked policy. Attempting to
institutionalize a homeless person with severe mental illness leads to
boycotts, lawsuits and FUD from activists. It has gotten to the point that
even immediate families cannot take those individuals off the streets and into
institutional care.

~~~
wbronitsky
I'm not going to respond to these arguments because you clearly are continuing
to dehumanize homeless people, and thus are arguing in what I would consider
bad faith.

I will challenge you to think a bit outside of your current paradigms and
realize that there is more to this than the solutions you have defined. We can
do more as a society than just enforcing bylaws and institutionalizing the
people at the margins. I agree that those solutions don't work, but then
throwing up your hands and blaming everyone else might not be the solution. Do
you want to complain, or do you want an equitable and just society for
everyone who lives in it? Do you want to be right, or do you want the homeless
to be housed?

~~~
macspoofing
>because you clearly are continuing to dehumanize homeless people

That is a patently unfair statement and a gross mischaracterization of what I
wrote. At no point did I even imply something of the sort.

>I will challenge you to think a bit outside of your current paradigms

Fair. And I challenge you to think a bit outside of YOUR current paradigms.

The reality is that we are more OK with leaving our most vulnerable people to
languish in the streets in filthy encampments than providing them with
institutional care and I don't think that's moral.

