Alison McGrory

4 minute read

Walking through Edinburgh city centre last year

On a warm spring day last year, I walked up George Street in Edinburgh, filled with hope that I would spend a day with like-minded souls envisioning a better Scotland. One where our citizens live a good life and where we all have an equal chance to thrive and flourish and fulfil our potential.

As a west coaster, I find my way east now and again and our capital city. still fills me with excitement. I remembered the last time I was in this exact place at the Christmas markets – happy memories of friendship and laughter bring lightness to my heart adding to the warmth from the sun on my face.

Heartache

Catching the eyes of a woman sitting in a wheelchair yanks me from that place of contentment. She sees I have spotted her and holds my gaze while I grapple with what to do. I could walk on by, there are certainly too many homeless people to stop and talk to them all; I could give her some money; or I could stop and spend a few moments with her. It doesn’t feel like a conscious choice to stop and say hello.

A sorry sight greets me. She has no front teeth and has had a leg amputated above the knee. She tells me she is 7 months pregnant. You might wonder if this is actually true or could I be exaggerating for effect? I look at her belly wondering myself if it is true, she is wearing a hooded blanket so it’s impossible to tell.

She has no reason to lie to a stranger she will never see again. I feel bad for thinking she might have made up a baby for more sympathy, for more money. The unconscious biases we all have swirled in my head, despite working in public health my whole career, and I feel shame that they are there for me in this moment.

I ask what support she has and she said her social worker is helping and she has a meeting later in the day. I tell her I am visiting Edinburgh and I wish her well. I give her the £4.50 in my pocket and we say goodbye.

I will never know how that women came to be begging on the streets of Edinburgh but it’s highly likely childhood trauma led her to find solace in illegal drugs to numb her pain. It’s also highly likely intersecting poverty and inequality conspired against her – in her family circumstances, the school she attended, and a permeating lack of aspiration and potential to achieve her dreams.

Touchstone

In the year since, I have thought about her often, almost as if that briefest of interactions is a touchstone for my public health practice. In an ideal world her social worker will have worked hard to let her keep her baby, linking her in with recovery support, ensuring a warm roof over her head, “maximising” her benefits, and be looking at childcare options then pathways to paid employment in the future.

In theory this is currently within reach for people in Scotland.

But the odds are stacked too high. My head tells me the baby is in foster care on the road to permanent adoption and the woman is still on the streets of Edinburgh. Begging for money that in this increasingly cashless society must be very hard to come by. Or worse – she might be dead – another heart breaking addition to Scotland’s drug death shame.

Hope

My heart knows a different outcome and future is possible. We can create a Scotland where everyone thrives and women don’t end up pregnant and homeless on the streets of our capital city. A Scotland where we are not numb to pain and suffering in front of our eyes.

When I feel overwhelmed and powerless, I revisit the concept of salutogenesis or the creation of health i.e. what keeps us well and able to live a good life. Coined by Aaron Antonovsky following his studies of people who survived the holocaust and went on to live well – inspired in me by the great Professor Sir Harry Burns during his time as Director of Public Health in Glasgow.

Let’s be brave and unleash ourselves from complex improvement frameworks and data reporting. Let’s dream big. Let’s bring love, heart and soul to our public health practice and inspire a country wide approach to realise the potential of everyone living a good life. Let’s inspire a whole society approach to health, from brave legislation, to filling all our young people with hope, to empowering citizens that a better future is possible, to building the foundations of a fairer and more sustainable wellbeing economy.

On my way back to the tram at the end of my day in Edinburgh last year, I looked for the woman in the wheelchair but I couldn’t find her.