Soldiers during World War I were frequently afflicted by an ailment of the skin called “trench foot.” As they crouched in knee-deep mud and fetid sewage, the skin of their feet was never able to fully dry, leading to damage that could reach the bone. In an attempt to help soldiers keep all 10 toes intact, they were inspected often and encouraged to change their socks and clean their feet regularly.
You may have learned about trench foot in your history class. You likely learned that it was a bygone disease, confined to the marshlands of the Western Front. If that’s the case, you were misled. Because people in our community — right now, right at this minute — are experiencing the same physical ailment as GIs in a foxhole.
Among our unsheltered population, illnesses associated with perpetual wetness, cold and lack of access to hygienic necessities, like clean, warm water, are exceptionally common. A review of research on the subject from 2016 found that “foot conditions were highly prevalent among homeless individuals with up to two thirds reporting a foot health concern.” Only a quarter of these individuals received treatment.
The best treatment for trench foot and other foot-related ailments is, most often, prevention. But that is far out of reach. Without a way to keep their belongings — like a second pair of socks — clean and dry, folks living outside experience a revolving door of discomfort and disease.
Tiny homes, despite the ample protest of neighbors who, conveniently, have never known the wrenching pain of nerve damage due to wet socks, are one way to provide this space. Sanctioned tent cities, where tents are kept out of the mud and water by pallets, are another.
Overnight shelters, which offer no storage and few sanitary services, do not. And allowing folks to sleep in doorways or in parks without any kind of coverage do not.
As we consider what it means to serve our homeless neighbors, it’s vital to examine not just what makes housed people feel better, but what will actually help prevent the daily struggles and injuries that unhoused people experience every single day. Instead of prescribing the treatment we think will work, we have to treat the diseases that are plaguing the people in tents and on benches. These are not new conditions — we know what to do and how to alleviate their pain. We just choose not to see it.
Hanna Brooks Olsen is a writer who, after more than a decade in Seattle, recently relocated to Portland, Oregon. Her work has appeared in The Atlantic, The Nation, Slate, the New York Daily News, Pacific Standard and others.
Read more of the Jan. 6-12, 2021 issue.