Yes, citizens. It is often assumed that itinerant individuals have abandoned their rights, along with the roof over their heads somewhere along the series of 'hard knocks' that befell them. That gentle euphemism barely covers some of the life traumas many Downtown Eastside residents have experienced.
Vancouver is a Canadian city where I have stayed for long periods of time with friends and family members. It feels like home whenever I am there, but I am very aware of the contradictions between its great wealth and its immense deprivations.
Jenny Kwan has represented the neighbourhood in British Columbia's provincial parliament since 1996. "We have a homelessness crisis in this community...people with mental health issues, people who are very, very poor. Some suffered tremendous childhood traumas," she says.
Many of the residents struggle with several of these problems all at once. The DTES is said to have the highest rate of HIV infection in North America (about 30%). Statistics show that the DTES has a disproportionately high number of homeless people, of drug addicts, people with mental health problems and the unemployed.
It is thought that about 2000 locals may not have a fixed address, out of an estimated population of about 18,000. The Downtown Eastside has historically been a place of cheap accommodation that suited transient seasonal workers, such as loggers or miners, in between stints in the woods or mines of British Columbia.
These loggers and miners returned to live in the DTES when they could no longer work, and were joined by permanent, low-income residents from elsewhere, who could not afford the more expensive rents of other areas. A pattern was set.
More recent trends also contributed, such as the closing of institutions for mentally ill people in the 1980s, the increase in illegal drugs and the loss of inexpensive housing in other neighbourhoods.
Professor Aprodicio Laquian from the University of British Columbia says the concentration of services in the DTES acts as a magnet to people faced with mental health and addiction problems. "It also conveniently 'saves' other sections of the metropolitan area from dealing with the problems," he says.
Residents of other neighbourhoods fight off proposals for projects for the homeless, addicts or mentally ill people in their areas, as they fear for the values of their properties.
Shortly after the publication of In the Realm of the Hungry Ghosts, I heard Dr Gabor Maté speak in a Vancouver church. His vision of what we may learn about ourselves by helping the most vulnerable among us and connecting with their humanity was inspiring and a reality check.