Winter taking heavy toll on people who are homeless, from amputations to freezing to death

The smell of rotting flesh fills the Toronto shelter room where Pat Gallagher lives in the city's north end.

He unwraps bandages that cover his left foot. His toes look like lumps of black coal. The diagnosis: severe frostbite. 

"I pretend that it doesn't bother me, but when you look at your foot and you realize: 'I've seen that at the Royal Ontario Museum, that was on a dead mummy,'" he says. 

"It starts to crawl up into your stomach and you get a little panic in and you feel a little sick."

Gallagher was set to have his toes and part of his foot amputated this week. The surgery was to be preceded by consultations with nurses, doctors and psychologists, followed by a lengthy rehabilitation to learn to walk again.

Health-care practitioners say this is the second difficult winter in a row for those who live outside. Pandemic pressures on an already-stretched shelter system as well as restrictions prohibiting eating — and getting warm — in fast-food restaurants have left many with nowhere to go on cold nights.

Gallagher's case is not unique, says Elizabeth Harrison, a nurse with Inner City Health Associates who treats the homeless.

She's seen a handful of cases of severe frostbite this year and last. Many have lost fingers and toes. 

"These injuries are life changing," she says. 

Warmth is one of the treatments.

"The most important thing for frostbite is to not get frostbite on it again," she says. "It's incredible the difference it makes if someone is able to get into one of these shelter hotels, or anywhere warm, compared to going back out on streets after getting frostbite."

Toronto's shelter system has been full or near capacity for years. This winter, Harrison and others say they have often called the city's central intake office only to be told no beds are available.

Emergency departments have become ad hoc warming centres, says Dr. Stephen Hwang, a physician and researcher at the MAP Centre for Urban Health Solutions at the Unity Health Toronto hospital network. 

He says the network has an outreach worker who calls intake on cold nights in an effort to find spots inside shelters.