When I was living in Japan, I volunteered at a soup kitchen for homeless day laborers in a neighborhood in Osaka. The men who came to the soup kitchen for hot meals each day were the invisible of Japan. Most of them were Korean Japanese, burakumin (the "untouchable" class of Japan) or Ainu (the indigenous people of Japan); all three groups are heavily discriminated against, and because of that, they tend to be underemployed.
Much like our immigrant workers in the United States, the men stand in groups on the street in the morning, hoping that a truck will stop and take them to a construction site or other location for a day of work. When they do get work, they take their cash from the day and come back to this ghetto neighborhood, spending the money on alcohol and pachinko (a Korean gambling game), and a night's stay in a boarding house. When they don't work, they sleep on the streets, and spend the few dollars they have buying hot sake out of vending machines. Those who are aging or sick are the most vulnerable, because not working means not having food and shelter.
The soup kitchen was a project provided by a group of Japanese Catholic nuns and priests, affiliated with an order from France. I learned of their existence when I met a young Japanese woman who was Catholic. In my own Osaka neighborhood, only four train stops away, no one had ever heard of this ghetto, and all assured me that there were no poor in Japan, and also that there was no discrimination.
On weekends in the winter, I sometimes went out on night patrol, driving through the streets in a van. We stopped whenever we found a group of huddled forms in the darkness. We offered rice balls and hot miso soup, and handed out extra blankets. On the coldest nights, it was not uncommon to find a corpse among the living, someone whose poor health could not sustain them through the extreme chill on the concrete.
There was one particular older man who I grew to know well. He was aging, and sick, and rarely able to work, and he sought comfort in sake and the friendships he had with other men in the area. He was always good humored and friendly. Once I accompanied him to a medical clinic as an advocate. He was having circulation problems, and one of his legs was turning black. His rough, rambling speech was incomprehensible to most. I found myself in the ironic position of serving as a translator, a white American woman rendering his slurred expostulations into meaningful Japanese for the attending physician and nurses.
As the weeks wore on, his condition worsened. He began to be incontinent, showing up in soiled clothing. Finally, the priests decided he needed to be taken to a hospital to be treated, and cared for long-term. When he had been gone for several weeks, I asked if I could visit him.
One of the priests took me to see him, at a hospital clear on the other side of the city. They had taken him there, instead of to a nearby hospital, because he kept trying to escape and return "home." Now he was so far away, that if he had wandered into the streets, he would have had no idea how to make his way back to his friends at the soup kitchen.
He was in bed in a dorm-style room that could house a dozen men. He was clean, shaven, and in a hospital gown. But his wrist was tied with a length of sheet, secured to the side of the bed. They were trying to prevent him from running away. He was distant and mostly unresponsive. I had brought him a small radio as a gift, because I knew he liked to listen to the baseball games. He barely acknowledged it. I was shocked when I saw him. He looked nothing like the smiling, happy man that I had become friends with at the soup kitchen. I left the hospital in tears. And I never saw him again.
I know that those who put him there thought they were doing the right thing. He received needed medical care, a warm place to sleep, and regular food. He was safe. But he was also absolutely miserable. They had saved his body, but killed his spirit.
I often think of that old man. Good people want so much to help. And yet sometimes helping can be so complicated. What was the right thing to do? In the best of worlds, we would have been able to provide local care for him, and housing in his own neighborhood. And then, it seems, that allowing him to stay outside all day and drink sake with his buddies, even though it was ruining his health, would have been his decision. Those of us with more money get to make choices like that - but too frequently, poor people and mentally ill people are stripped of their right to decide how to live out their lives, in the name of charity.
There are no easy answers. But seeing his vacant eyes in that hospital bed, with all of the joy gone - that was no solution.