Last updated:

Homelessness: tackling public perceptions

An escape from the moment, and a chance to challenge public perceptions – Peter Blackburn meets the doctors and participants at the Homeless World Cup

On the day the NHS came into being, in 1948, Nye Bevan said: ‘The eyes of the world are turning to Great Britain – we now have the moral leadership of the world.’

Some 70 years later, the life stories of the people gathered at Cardiff’s Bute Park – a short stroll from the city’s watchful statue of the man who founded the health service – might have left Bevan questioning where that moral leadership had gone.

A few minutes in the company of players from the home nations’ sides revealed all kinds of personal tragedy and ill fortune – and in many cases the powers-that-be in government, and indeed the NHS, had done relatively little to provide a safety net or comfort blanket during times of serious need.

It is this vacuum that the Homeless World Cup aims to help fill. Where society fails, it’s an invaluable chance to bring rough sleepers and the vulnerably housed together with charities, campaigners and those who have experienced homelessness but have managed to make better lives.

The Doctor
Issue 13
Football  article

Speaking to The Doctor at the tournament, actor Michael Sheen, who funded the event, explains: ‘People come down to get involved in the football – it gives them an escape from what is going on in their lives at the moment, they form connections, they become part of a team and rather than the stigma and the judgement they are getting [in everyday life] they feel like they belong somewhere, like people actually care about them… and they get a bit of self-confidence and self-esteem as well as a bit of motivation about wellbeing.’

The World Cup is first and foremost an event: more than 500 players representing more than 50 countries, with recent experience of homelessness, all joining together to compete – and to share experiences. But the initiative itself is wider and includes 74 different projects around the world which utilise football as a ‘tool for social change’.

The tournament, and the wider projects, aim to inspire homeless people to make positive changes in their lives and brings together people who have the experiences and contacts to make changes while challenging public perceptions of homelessness.

Jack Badu (pictured below), manager of the England team at the event and engagement officer for the charity Centrepoint, says: ‘The biggest thing for our team is that this is an opportunity to showcase something that they can have a sense of achievement about.

The Doctor
Issue 13
Football  article

‘A lot of the time the narrative based around young people at risk of homelessness is that they are a burden on society. It’s really important to give them a chance to show how brilliant they are and for them to feel like they are everyone else.’


Beautiful game

Players taking part in the competition feature people who have been homeless within the last year, asylum seekers, people who sell street papers and those in drug or alcohol rehabilitation.

The games are four-a-side and last for two, seven-minute halves.

Mireia Salinas (below), the goalkeeper for the England women’s side, is a shining example of the power football – and charities and campaigners who act where society fails to – can have.

The 41-year-old moved to Derby in her 20s from Barcelona in search of a ‘new language and culture’. Ms Salinas fell into an abusive relationship and drug addiction and after 12 years ‘trapped’ she fled – the only viable option after losing touch with her friends and family was to sleep on the streets.

‘It was horrible – you are on your own. I wasn’t asking for money or anything, I just wanted people to talk to me, to notice that I was there. I understand people sometimes think you are there because you are a druggie and you deserve it, but people get in very bad situations after having very bad luck in their life.

Maria Salinas, homeless world cup

‘I have seen things with my own eyes – I have experienced horrible things. Women being raped. Young lads with a drink abusing people. I saw friends and people I care about going through horrible things. It is very, very horrible.’

But Ms Salinas found help through Derby County Community Trust’s active choices programme, which aids the recovery of substance and alcohol misusers and helps with access to accommodation – and then joined up with the scheme’s football team, which plays in a league against other similar projects. A call-up to represent the England national team at the Homeless World Cup followed, which means she has gone from sleeping in Derby’s Arboretum Park to representing her adopted country on the world stage.

It might be a cliché but football truly has saved Ms Salinas’s life.

‘A lot of the time the narrative is that they are a burden on society’

‘It has given me a purpose to wake up – I wake up with a smile on my face and I know something amazing might happen rather than waking up in a park at 7 o’clock in the morning and thinking, what now,’ she says. ‘Being able to help people now would be the very best thing ever. If I help one person that would be great.’


Pride restored

Rhodri Martin, team doctor for the Welsh international football team – volunteering at the event – saw the power that Ms Salinas describes, first-hand.

He says: ‘I thought it would be a worthwhile thing to do especially given I am working in football. I thought it would be beneficial to give something back to people using football to try and get their lives on the straight and narrow.

‘I’m not used to dealing with homeless people in my work – not since I was a junior doctor. It was refreshing for me to be working with other colleagues and trying to help give people a second chance in life.

‘You get a sense of the importance of the event and the pride of the individuals – they had something to be really proud of and it gave them a real sense of purpose and worth. Walking out and listening to a national anthem and representing your country was clearly a huge sense of accomplishment of the individual. They can be superstars and that can only be beneficial.’


Maintaining hope

While Ms Salinas’s story is one of hope, many of the 500 footballers at the tournament return to life on the streets or in temporary accommodation when the final whistle blows.

Makumbi Abdallah (pictured below) fled Uganda last year after his father was murdered and lives in immigration hostels while his permanent right to asylum is being processed. While his future is still up in the air, Mr Abdallah – who plays for the Welsh men’s team – says the feeling of being around people with similar experiences, and those who have made better lives, is inspiring.

The Doctor
Issue 13
September 2019
Home Hero images

He says: ‘At this moment I can’t even remember that I am homeless because of the huge number of people around you who like to have conversations with you – you forget the situation that goes behind your life.

‘I have not got a place to stay so I have to go back to the immigration hostels. But I don’t lose hope – in time things can change.’

The link between homelessness and health is inextricable – and it’s of growing significance.

Figures collected by The Doctor through a series of Freedom of Information requests reveal that the number of recorded visits to England’s emergency departments by patients classed as having no fixed abode has nearly trebled since 2010-11. The effects are significant for patient care, workload and balance sheets.

Yet when The Doctor looked to assess the provision of homeless care to tackle this growing need, services around the country were remarkably patchy: only 20 CCGs (clinical  commissioning groups) reported having clinical leads for homelessness – a position of responsibility for overseeing care for homeless patients recommended by some experts; just 15 areas said they specifically hire or contract staff to work in homeless care; and in 77 CCG areas there were no specific services for homeless patients reported, whatsoever.


Care improvements needed

Swansea emergency medicine consultant Katy Guy (pictured below) was on hand as the medical director for the tournament – and has been inspired to take her experiences back into the day job.

‘This has really opened my eyes,’ Dr Guy says, the sights and sounds of the festival of football echoing in the background.

The Doctor
Issue 13
September 2019
Home Hero images

By day four of the tournament, Dr Guy has already had time to muse on the treatment given to homeless patients in the NHS. While life on the front line is tough – with the stress and strain of a depleted workforce and soaring demand – better care would be an improvement for patients and doctors.

Dr Guy says: ‘When you are really busy and you’ve seen a patient and there’s another waiting to be seen, it’s easy not to get involved in trying to change or improve things.

‘I think we can do more than just say: here’s the number for a shelter that may not have any beds for you. It is something I would like to work on and do more to help with having met all the people here.’


Public health emergency

Doctors at the BMA annual representative meeting earlier this year pledged to be ‘at the forefront’ of tackling the ‘public health emergency’ of homelessness.

Doctors agreed that the association would lobby for medical schools to include the healthcare needs of homeless patients in their curriculums, NHS bodies to explore integrated models of homeless healthcare, and for hospital trusts to provide clinical staff with clear admission and discharge guidelines and procedures.

The motion also urged action from the governments of the UK – calling for additional resources to support the primary medical care of these vulnerable people and to ensure that no person completing a prison sentence is released without having somewhere to live.

For Ms Salinas, who has come through so much and can be a beacon of hope to many, this is the crux: those in charge of policy and purse strings need to step up.

‘I know something amazing might happen rather than waking up in a park at 7 o’clock in the morning and thinking, what now’

She says: ‘These things [the support and guidance provided by events such as the Homeless World Cup] are amazing but they should be provided by the Government. I know it’s a lot of money and it’s a lot of time – but we are people, we are humans.

‘I have met the smartest, the sweetest and the most amazing people in the streets and they are capable of doing amazing things with the right help and the right push. There are smart people, there are writers, these people can do something. If the Government could care a tiny bit more about us it would make so much difference.’

Read Streets of shame – a feature from The Doctor about the tragedy of homelessness

BMA Giving

Photos by Matthew Saywell



Read more from Peter Blackburn and follow on Twitter.