In day two of the Death on the Street series Corazon Miller looks at how surviving on the streets is causing people to die young.

THE SERIES

Today: How they're dying

Tomorrow: Measuring homelessness

It's 8:30 on the morning of March 30, 2017. A pedestrian walking beneath the Howe St motorway bridge, in Auckland Central, stumbles across a body.

It is a man in his forties, lying under the bridge with a pool of blood around his head. Police are called, and that same morning a full forensic post-mortem examination is done on the body.

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Coroner Morag McDowell's report names him as Paulo Taito, 49. He's described as "itinerant" having lived near the same spot where he died for some years.

Taito had a condition where the arteries were getting clogged and impacting the flow of blood to his body, but the coroner says it's not clear if this contributed to his death.

Instead she rules he died as a result of asthma.

Asthma is a common condition, with some risk, but is not a frequent killer. The latest report that looked at the condition's mortality showed in 2013 there were 70 deaths nationwide linked to it.

Taito is one of at least seven homeless people who died on the streets of Auckland in 2017 - all of whom were years away from the 8th decade most Kiwis expect to live to.

Just over 10km to the south of the central city sits an empty bench, with a lone surfboard attached to its back, surrounded by cracked gravestones in the yard of an Anglican church in Onehunga.

It is here, just weeks after Taito's death, that Keith Johnson, 57, is found dead on "his" bench in the early hours of Saturday July 1, 2017.

Fellow streetie Carrie Allen, 49, recalls finding him dead on that cold, first of July night. It is sad, he says, but at least his suffering is over.

"The streets were cruel to Keith and he had gone too far in his life you know?"

Homeless man Carrie Allen with his dogs, at Onehunga, he lives in his van, with his dogs. Photo / Brett Phibbs
Homeless man Carrie Allen with his dogs, at Onehunga, he lives in his van, with his dogs. Photo / Brett Phibbs

Coroner Brandt Shortland's findings into Johnson's death were released in February 2018. They showed he had died of complications related to alcohol abuse.

Church vicar, Petra Zaleski, says she spoke to so many social agencies to try to get Johnson help, but all were struggling to keep up with demand.

"These guys have nowhere to go, there is no night shelter in Auckland. No one with the skill set to deal with those who have deeply entrenched mental health issues.

"At the moment there are 10 people sleeping outside a public toilet in Onehunga."

When Johnson's death was followed so soon after, by another streetie in South Auckland, she was left feeling sad, angry and powerless.

Petra Zaleski vicar at St Peter's Church, Onehunga, Auckland, sits on the bench at St Peter's Church where homeless man Keith Johnson died aged 57. Photo / Brett Phibbs
Petra Zaleski vicar at St Peter's Church, Onehunga, Auckland, sits on the bench at St Peter's Church where homeless man Keith Johnson died aged 57. Photo / Brett Phibbs

Haami Manahi, 59, was found lifeless outside the Manurewa Methodist Parish on July 11. Fellow streeties said he had a brutal cough before he died.

The Coroner's Office is yet to release the findings into Manahi's death.

Zaleski says the situation is akin to life in the "colonial Victorian slums", a description she says is at odds with what many see Auckland as - a world-class city that's among the best places to live globally.

"There's a real sense of shame among the community… a sense we don't matter."

The following month, in another part of South Auckland, another homeless person dies.

Cherryl Fay Bolton, 63, is found dead on the grey concrete steps of the Anglican Church in Otahuhu - her cause of death bronchiectasis - also not a frequent killer.

While there has been an increase in deaths related to the respiratory condition, from 42 in 2000 to 96 in 2013, death usually happens in those aged over 65, the latest respiratory report shows.

Reverend Margot Postlewaight says Bolton's passing was distressing for her family and the local community who had tried to help her.

"Everybody had tried to get her help. The police had come to help her, but she said no."

The only "blessing" she says was police were able to get in contact with Bolton's family.

"We offered closure for the family, they knew what had happened to her. I think it was a healing thing for them to have that opportunity."

As for what more can be done for the homeless? Postlewaight is not sure.

"To us, where we are sitting [someone passing away on the streets] is not the right thing. I really don't know what the answer is for them."

There are also similar stories of death in the winter of 2016 - Penisione Sionepeni was found dead by a member of the public on June 17.

Coroner Katharine Greig rules his was a "natural causes death" that happened on one day between June 9 and June 17, 2016.

The direct cause, she rules in her finding dated October 4, 2016, is hypothermia after spending the night beneath the Neilson St Overbridge in Onehunga Mall.

Historic weather data shows temperatures overnight in the city dipped to as low as six degrees centigrade on June 13 and 14, with overnight lows remaining in the single digits over all, bar one, of the following evenings until Sionepeni was found.

He was just 47.

If, as the World Bank said, the average life expectancy in New Zealand is 81.6 years, Sionepeni could have had 35 years more.

People are progressively living for longer, according to Statistics New Zealand data.

Someone born in the 1950s could expect to live until at least 86.7 years; for those born in the 1980s this figure rises to at least 89.6 years and for someone born in 2016 it rises to at least 91.6 years.

But not if you are homeless.

No one tracks mortality among the homeless at a national level, but a Herald analysis of coroners' reports shows of the homeless deaths in the past seven years - the average age was 45.6 years.

The youngest was 25 and the oldest was 71.

Calder Centre medical statistics show of rough sleepers in Auckland's inner city it recorded as having died in the last 10 years, the average age was 55.

The coroners' reports from 2012 to 2018 show deaths were caused by drug use, suicide, violent beatings, obesity, cardiac and respiratory issues, hypothermia, accidents and pneumonia.

They died in caravans, in friends' houses, parks, by public toilets, garages, cemeteries and public parks.

In January this year, Paul Errol Brookie, 58, was found dead in the small tent he called home on the side of the Hataitai Park southern walkway in Wellington.

He'd covered himself with two blankets, and used a navy blue jacket as his makeshift pillow, the coroner's report details.

Coroner Christopher Devonport rules his death is due to a heart-related "medical event" that would have happened in his sleep.

He says it is likely Brookie was dead days before he was found dead on January 20.

For Morehu Te Wharekoto Hema, 66, it is weeks after his death when his body is found.

Coroner Morag McDowell rules his death happened in the 2016/17 summer, on a date between December 21, 2016 and January 14, 2017, from pneumonia.

He is found by a passerby in his usual spot on a bench in Puhinui park, Manukau, having been "clearly deceased for some time".

Doctor Richard Davies, who works at the Calder Centre, where many of the rough sleepers go, says rough sleepers faced a myriad of issues, including many that no longer affected the general population.

"Scurvy, that's from lack of fruit and vegetables which in New Zealand is almost unthinkable.

"Trench foot ... people used to get that in the First World War from standing in the trenches, but we see that in our rough sleepers.

"Those are things that I'd never seen before in our medical practice."

He says the constant cold, the lack of sleep, the inherent danger of life on the streets, and the challenges accessing healthcare took a toll on a person's body and could ultimately lead to premature death, be it from a chest infection, hypothermia, trauma or suicide.

"It's very difficult to improve health while sleeping rough, it's not always the highest priority when you are wondering where you are going to be sleeping next."

For Anthony Moran, 45, genuine hardship in the weeks leading up to his death certainly put his health on a back foot.

He had lost his accommodation in the weeks prior to his death and had been living in his car, Coroner David Robinson writes in his report. Moran reportedly had not taken his medicine for three months and not eaten for a week before his death from a pulmonary embolism in December 2017.

Official Information Act requests to the Auckland District Health Board [ADHB] gave further insight into the health of some of the city's rough sleepers.

The data shows each year typically 50-60 people, seen by medical staff in the ADHB catchment, were registered as having the Auckland City Mission, 140 Hobson St, as their home address.

In 2017, 43 of 56 patients were seen by the emergency department (ED) a total of 110 times.

The largest number of reasons (42), for going to the ED, were due to miscellaneous conditions that included bleeding during pregnancy, low iron levels, low blood sugar and the flu.

The biggest single factor was related to the use of synthetics, with 17 of 21 drug-related admissions in the year related to synthetic cannabis.

This was followed by trauma, with nine of 22 trauma-related admissions in the last year due to an assault - four of these culminated in a serious brain injury.

International research reflects a similar picture of the homeless people's health and their rates of death.

One published in The Lancet, in 2017, showed the homeless, prisoners, sex workers and individuals with substance-use disorders were more likely to fall seriously ill or die than the general population.

Dr Robert Aldridge, a researcher at the Farr Institute of Health Informatics in London, says across all health conditions, marginalised groups, including the homeless, were up to 12 times more likely to fall seriously ill or die compared to the general population and marginalised men were five times more at risk than those in the armed forces.

"It is therefore much more dangerous to be in one of these socially excluded groups than it is to be a soldier serving in the UK armed forces."

The three main causes of death broadly speaking were unnatural deaths; those caused by accident, suicide or homicide; cardiovascular diseases and cancers.

Another study, published in the European Journal of Public Health this year, shows the homeless in Rotterdam were overall more at risk of dying and had a 15-fold higher risk of dying from unnatural causes than its general population.

Moira Lawler, chief executive of social services agency Lifewise, says synthetics has been a new, and growing issue among the homeless clientele.

She believes two clients died after taking synthetics in the past year.

"For me it's really the impact of poverty and disadvantage. People use synthetics because its cheap ... it's absolutely a question of poverty.

"People don't choose synthetics because its a drug of choice, it's because they can afford that."

One of the members of the street community to die in 2017 was Cinderella, a full-figured woman with a soft smile, who was a regular presence on Karangahape Rd.

In September, the month before her death, New Zealand Police and the chief coroner put out a public reminder of the dangers of the drug after what was estimated to be 20 deaths so far that year linked to synthetic drugs.

Former homeless woman and community elder Rose Greaves saw Cinderella a few days before she died and recalls her cheerful personality.

"I remember Cinderella, with her ukulele, singing, usually on K-Rd and she always greeted me, she never asked me for anything."

Ex-Homeless woman Rose Greaves is a member of the City Mission Homeless Committee. Photo / Brett Phibbs
Ex-Homeless woman Rose Greaves is a member of the City Mission Homeless Committee. Photo / Brett Phibbs

She says synthetics was a nasty drug that was doing a lot of damage to the street community.

"I tell people don't go there. I tell people that it's killing us."

Doctor Richard Davies says "before we judge too quickly, it is very, very difficult sleeping rough, very stressful. Those who are sleeping rough aren't all addicts before they start by any means".

He says drugs gave them an escape from reality.

Auckland City Mission chief executive Chris Farrelly says a need to escape was often what led people to the streets in the first place, despite the risks that came with it.

"There is a theme emerging, one of trauma, serious trauma. Sometimes pre-birth, sometimes as a child, physical and mental and sexual trauma at a very high rate.

"Add this together to a life where there is much deprivation, nutritional deprivation ... the health status of these people is very, very, very poor."

Street facts and figures

• At least 45 homeless people died in the past seven years
• The youngest was 25
• The oldest was 71
• Average age was 45.6
• Average life expectancy in New Zealand is 81.6

They die from:

• Drugs
• Violent assaults
• Respiratory diseases
• Hypothermia
• Suicide
• Obesity
• Cardiac diseases
• Accidents

They died in:

• Caravans
• Friends' houses
• In parks
• Public toilets
• Park benches
• Garages
• Cemeteries
• Under bridges

THE DEATHS

David Crawley, 53
- Living in a car in Auckland
- Death related to obesity in 2012

Robert Stanley, 44
- Transient, and known to the Auckland City Mission
- Self-inflicted in 2012

Mackereth Ihaka Hireme, 71
- Living on Auckland CBD streets
- Died of a heart condition

Catharina Maria Antonia de Goey, 58
- Living in a caravan
- Accidental drowning by a creek in 2012

Tama Laurence Murray, 25
- Living in his car on the Hamilton streets
- Complications related to schizophrenia in 2012

Craig James Scott, 36
- Living in a tent after having withdrawn from society
- Self-inflicted in 2012

Danny Mokotupu, 47
- Sleeping rough in Papatoetoe
- Died after being hit by a car while he was drunk in 2013

Grant Stoner, 53
- Transient, but was staying in a Waikato motorcamp at the time of his death
- Self-inflicted in 2013

Edwin John Linder, 41
- Sleeping rough on Mills Lane in Auckland CBD
- Died after an assault in 2013

Jason Wiremu Henare Nuku, 42
- Sleeping in a vacant lot in Christchurch
- Died related to a respiratory condition in 2013

Simon Garrick, 41-42
- Living in a holiday park
- Substance-related death in 2013

David Hartley, 50
- Living transiently in Palmerston North
- Unknown cause of death in 2013

Bruce Dwan, 63
- Living in a campervan
- Died of a heart attack in 2013

Maqbool Hussain, 49
- Homeless in Auckland central
- Died after being assaulted in 2014

Michael Oliver, 58
- Transient around Auckland
- Died of hypothermia in Beach Haven in 2014

James Kendrick, 56
- Homeless in Auckland
- Morphine overdose in 2014

Brendon Cotterill, 34
- Transient in Auckland
- Self-inflicted in 2014

Michael Daley, 58
- Homeless
- Hypothermia in 2014

Dawson Delamere, 40
- Homeless
- Substance-related death in 2014

Stuart Kingan, 36
- Living in his vehicle on a campsite
- Self-inflicted in 2014

Gaynor Broadhurst, 53
- Homeless in Christchurch
- Died of a cardiac condition in 2014

Roslyn Keith, 49
- Homeless in Hamilton
- Died of pneumonia in 2014

Gail Gunnell, 57
- Had been living in a campervan
- Substance-related death in 2014

Daniel Gilbert, 61
- Living in van on side of road
- Accidental carbon monoxide poisoning in 2014

Sarah Bromley, 37
- Transient living arrangements
- Run over in Auckland, in 2015

Eric Searle, 41
- Transient living arrangements
- Self-inflicted in 2015

Courtney Gamble, 36
- Living in a car
- Self-inflicted in 2015

Teina Wharawara, 42
- Homeless living around Outhwaite Park
- Died after an assault in 2015

Taiki Talagi, 59
- Living on the streets for several months
- Died on the streets of heart disease in 2016

Daniel Bindner, 40
- Living on the streets for a few months
- Crushed in a recycling truck in 2016

Penisione Sionepeni, 47
- Had been living homeless in Onehunga, Auckland
- Died of hypothermia in 2016

Warena Thompson, 27
- Homeless around Christchurch
- Self-inflicted in 2016

Jane Palmer, 52
- Homeless in Christchurch
- Self-inflicted in 2016

Wendy Allen, 52
- Living in a caravan
- Died from respiratory issues in 2016

Te Wharekoto Hema, 66
- Living on the streets of South Auckland
- Died of pneumonia on the streets in 2017

Anthony William Deighton Moran, 45
- Had been living in his car
- Died of a pulmonary embolism secondary to a DVT in 2017

Cherryl Bolton, 63
- Living homeless in Otahuhu, Auckland
- Died of bronchiectasis in 2017

Paulo Taito, 49
- Living homeless in central Auckland
- Died of acute asthma in 2017

Rangi Carroll, 57
- Formerly homeless in Auckland
- Internal bleeding secondary to pancreatitis in 2017

Haami Manahi, 59
- Homeless in Manurewa, Auckland
- Found dead by the Manurewa Methodist Parish in 2017
- Coroner yet to release findings

Keith Johnson, 57
- Homeless in Onehunga Auckland
- Found dead on his bench outside St Peters Anglican Church in 2017
- Internal bleeding related to alcohol abuse in 2017

Brian Allan Harris, 50
- Sleeping in public places
- Died from complications related to heart and liver disease in 2017

Paul Errol Brookie, 58
- Living in a public park
- Died in his sleep from a heart condition in 2018

Source: Ministry of Justice, Coroners Reports from 2012 to 2018