An emergency room physician is among front-line workers calling for more shelter space and the collection of data after seeing more amputations in Edmonton's homeless community.
Dr. Sandy Dong, who has practised medicine in the Edmonton for two decades, says he has never seen more amputations due to frostbite than he did last year.
"The vast majority was because they were houseless and did not have access to a warm place," said Dong.
He said he hopes to see better decisions this year "because we have a situation where the outcome and the injury is preventable."
In an email, Alberta Health Services said it does not track amputations from frostbite and had no further information.
The health department does not track deaths, or causes of death, among Edmontonians living homeless, either.
Dong said an official count should be kept of mortality and amputation rates to better understand the scope of the problem.
The Alberta government announced last month that it would spend an additional $63 million over two years to reduce homelessness province-wide.
Of 450 provincially-funded additional shelter spaces, 260 spots at Hope Mission and Herb Jamieson Centre are already open.
Forty additional overnight spaces are expected to open November 23 at the Mustard Seed Trinity Lutheran Church.
The Hope Mission is working toward opening up at least 150 more spaces at an off-site location near Argyll Road and 77th Street by mid-December.
With roughly 2,700 Edmontonians now living homeless, the Edmonton Coalition for Housing and Homelessness says at least 1,550 additional shelter spaces are needed.
Dong said investment in shelter and housing is relatively inexpensive compared to the required acute care, treatment, surgeries and rehabilitation.
Amputees are often discharged back to homelessness where healing and getting around are even more challenging, and many can no longer work.
"Now they have no income and then they're back into the cycle of poverty," Dong said.
'Four walls and a roof'
While handing out supplies on her regular patrols, Judith Gale, local chapter leader for the outreach group Bear Clan Patrol, said she is seeing more people who have lost their fingers and toes due to exposure.
Gale recalled some of those heartbreaking circumstances: a double amputee stuck in a snow pile while trying to cross the street in a wheelchair; a homeless refugee who escaped war in Somalia only to lose all of his fingers on Edmonton's streets.
"It's a life sentence," Gale said. "It's a life sentence of not being able to work with your hands again, not being able to walk shoulder to shoulder with your peers and society. It's a life sentence and it could be avoided so easily just by four walls and a roof."
Elliott Tanti, a senior manager with Boyle Street Community Services, said collecting data would show whether the rate of amputations has gone up or the number has increased because more people are experiencing homelessness.
He noted that earlier in the pandemic, daily updates were provided so that appropriate health decisions could be made.
"So how as a society, how as an agency, how as a health-care provider, are we able to make effective decisions around public health if we don't have effective information, whether it be deaths or amputations?"