Building Back Better

Written by: Paul Young, Environmental Health Promoter

We are part of the earth’s connected system and on April 22, we celebrated Earth Day in order to raise awareness about how our health depends on clean air, water and soil. SRCHC remembers its past battles to reduce pollution and make South Riverdale a healthier community. However, we still need to work on reconnecting with the planet. Both the United Nations and World Health Organization found that pandemics result from the destruction of nature, including livestock production and illegal forestry. Human health relies on the health of the planet.

Covid-19 has taught us many hard lessons. We learned that lower income groups suffer more deaths and sickness from Covid-19 than other, more well-off groups. Factory, frontline and service sector workers are especially vulnerable. And we learned that governments make a huge difference in pandemic recovery. For example, New Zealand has been back to normal since May of last year.

In Canada, governments introduced unique initiatives like basic income programs, quick-start housing/shelter projects, and expanded networks for walking and cycling. The importance of parks and streets to physical and mental health, especially for people living in apartments, became more obvious. Advocates had asked for these changes for many years and now we see how quickly governments can respond in a crisis. It’s important to let decision makers know that these changes are worth keeping and expanding in order to keep people healthy, housed and independent. We need to “build back better” with a “just recovery.” We can’t solve our problems by repeating the same mistakes of the past.

Reference

https://www.theguardian.com/world/2020/jun/17/pandemics-destruction-nature-un-who-legislation-trade-green-recovery

Drugs: Legal and Regulated!

Written by: Rhiannon Thomas, COUNTERfit Program Coordinator

Did you get excited reading that? If you did, you are among the many harm reduction advocates and people who use drugs who have been calling for years to decriminalize all drugs. Cannabis was finally legalized in Canada on July 1, 2018, and the story of marijuana legalization can tell us not only what is possible when there is political will, but also a lot about what legalization does to change attitudes about different substances.

For people who have been using cannabis (or other illegal substances) for many years, legalizing weed seems like a no-brainer. Although any substance can be harmful, marijuana has widely been used safely for hundreds of years or maybe even longer. When you think of the “reefer madness” movies of the past and all the supposed dangers of marijuana, it seems ridiculous when you now consider that the biggest danger to consuming cannabis might be not being able to reach the chips.

But for people who use substances that continue to be criminalized (and for those in criminalized communities who have been serving their communities for years by supplying weed without access to legal market status), looking at public attitudes towards marijuana says a lot about how drugs are seen. As a kid in the “Just say no” era, we learned that all drugs are evil and lead to after-school PCP and jumping off roofs. Acid, weed, coke, heroin – these were all equally dangerous (or so Nancy, Tipper and crew would have us believe). Anyone who does these drugs, or looks at scientific facts about them, would know that wasn’t true. You can’t really overdose on acid (though I wouldn’t recommend taking more than a hit or two unless you have lots of experience and a guide). You smoke too much weed and most likely you’ll just fall asleep. Coke and heroin, though – different story. Too many days up doing coke and your nervous system will be a jangled mess, or too big of a hit and you can stop your heart. Too much dope and your breathing slows until your heart stops.

This kind of information would have been useful to a lot of young people experimenting with drugs. The problem wasn’t the drugs, it was the lies told about them, falsehoods based on moral judgement, and systemic attempts to control and incarcerate Black, brown, Indigenous and poor people, as well as anyone who powerfully criticized patriarchal capitalist power.

And then what happened when weed became legal? Not much except that, within three years, it’s legally widely available, in every form, colour and flavour you could ever want. More importantly, every dose you could want. And the stigma around marijuana use seems to have continued to dissolve.

One major downside is that those people who made a living from selling weed have either lost business or are now even more heavily criminalized. This situation could be remedied by expunging all marijuana possession and trafficking charges from people’s records, and offering small business support and loans so that people who have experience and expertise (and probably a client base) could have options to open shops or delivery services without as much risk of policing. Similarly, we could seriously improve the health and economic status of thousands of people in this country if we followed a similar path for stimulants and opioids. There are already many types of opioids and stimulants that are legally regulated for quality and dosing, we just have to make them available with or without a prescription as we did for cannabis.

“But what about the children?” say the usual suspects. Well, there are legal sanctions in place to prevent access to marijuana, alcohol and tobacco for minors. We know that young folks can still access, and this has happened for substances that are both illegal and legal. The legality of the substance has nothing to do with young people accessing it. You know what does make a difference to the health and safety of young people? Knowing what they’re taking, what the dose is and getting access to factual information. And more importantly, just like weed, the stigma around using these substances will diminish so that talking about using drugs gets easier. And that benefits the rest of us, too.

Virtual Acute Primary Care

Written by: Serena Menezes, Family Physician

The past eight months at SRCHC have been both challenging and highly rewarding. I have had the privilege of working with and learning from skilled colleagues to help deliver care to Toronto’s most vulnerable.

I am relatively new to practice, having graduated from my residency program in 2019. Thus, more than half of my career as a primary care provider has been within the context of the Covid-19 pandemic, and I have been impressed by our clinical team’s dedication to providing comprehensive care during these challenging times. Although this pandemic has been difficult, an opportunity emerged to provide virtual primary care in an unprecedented way.

For our clients who have access to a phone and/or internet, virtual care has reduced some of the common barriers to accessing care such as time needed to take off from work for appointments, and mobility issues that often keep patients from having regular follow-up appointments. And thinking about what primary health care could look like post-pandemic, virtual care could continue to play a valuable role. By providing access, especially to our clients who struggle with mobility, have challenges with transport, or need to prioritize their work over appointments, this kind of care remains important.

When we emerge from the pandemic, there might be a temptation to go back to the previous way of offering care. In-person clinical assessments are still essential in certain situations, but we can try to draw from our recent experience and incorporate, when appropriate, these new, virtual tools to help us deliver care.

Supporting Individuals and Families in Coping with Covid-19

Written by: Bernadette Lettner, Registered Nurse

Since November, 2020, the Covid Resource Team (CRT) has been working to support people who test positive for Covid-19. Comprised of nurses, health promoters, social workers, case managers, counsellors, project coordinators, drivers and the infectious disease team at Michael Garron Hospital, the CRT links hospital-based testing to community agencies and supports. Through these links, we can connect with and support people by offering practical resources to manage the unequal burden of Covid-19 infection in Toronto.

The integrated web of people and resources that hold up, and hold together, communities is very apparent when doing this work. Relationships and resources are strained by the physical separation that happens when people must remain at home in isolation or quarantine, but the many places we turn to for help, comfort and care are also revealed.

Through regular phone calls, the CRT provides symptom management, personal protective equipment and grocery deliveries, financial support, counselling, settlement services and a wide array of other services. To be able to do this work, the CRT has developed relationships with many community organizations, including East End Community Health Centre, The Neighbourhood Organization, Health Access Thorncliffe Park, Scarborough Centre for Healthy Communities, and the East Effort Fund. Between November 2, 2020 and March 31, 2021, over 2,695 people were helped and new referrals are accepted daily.

We have seen first-hand that high vaccination rates have an impact. Many long term care, shelter, and group home residents in east Toronto have received at least a first dose of vaccine and have avoided the outbreak conditions seen in so many areas of the city. Other areas have seen the emergence of pop-up vaccine clinics, specifically designed to bring vaccination to areas with the highest rates of community transmission. Every single vaccination makes an impact – perhaps the biggest impact we can make right now.

Throughout the vaccine rollout, we will continue to support people who contract Covid-19, and ensure that we move towards health together. We started with a small team and a big vision, and it has been incredible to see how the CRT has grown and evolved. The connection and mutual support that has developed as a result of listening and responding to community needs will remain strong, and the ripples of these care-filled connections will carry us through this wave and beyond.

COVID-19 and the Mental Health Pandemic

Written by: Stephen Fenn, Social Worker

Since the beginning of the pandemic, almost all of us have been focusing on our physical health and keeping ourselves safe. This should be our focus as we navigate these difficult times of surges, variants and vaccine rollout. However, most of us have also experienced another pandemic, one of mental health.

Mental health practitioners around the world have been sounding the alarm over the increase in mental health challenges many have faced throughout this turbulent time. While we may still be able to access support for our physical health during the pandemic, mental health support, which was difficult to find pre-pandemic, has become even more challenging to secure.

The burden of mental health has also disproportionately affected those most vulnerable as communities living with unaffordable housing found this even harder as they lost income. People with chronic conditions, more vulnerable to becoming sick, were faced with increased difficulty accessing community supports or treatment, and increased isolation due the higher risk associated with leaving home. And for those who face discrimination and unequal access to society, hostility and insensitivity increased. The support mechanisms we used before, such as seeing family and friends, became impossible due to the associated risks.

The challenges of this pandemic will continue. Although a focus has been on bringing ourselves back to “normal,” we also need to account for the mental health challenges and trauma many have experienced. Many of us don’t know how to seek support and how to take this first step. But support is available and, although we have faced the last year alone, we don’t have to do this moving forward. SRCHC and many other agencies have mental health supports available. While our goal this past year has been on protecting our physical health, a focus on mental health is just as important and worthy.

According to the World Health Organization, “There is no health without mental health.”

Pay It Forward

The Pay It Forward fundraising campaign was launched to provide our most marginalized clients with winter supplies and clothing.  

Due to COVID-19, most programs and drop-ins have closed. This winter, people living on the streets have nowhere to go to stay warm and no access to free hot meals. Many of our clients and volunteers live on fixed incomes. More than 50% of our clients live on $25,000/year or less. According to the Toronto Foundation, approximately 30% of people in Toronto are struggling to pay for essentials like rent, food and utilities. The idea behind Pay It Forward is to recognize the involvement of those of our clients who have been volunteers with the Centre’s programs (such as community clean-ups, markets, etc.), and to urge those who can to donate and “pay it forward.”

Between 2013 and 2018, the number of people using Toronto shelters increased by 69% (from 4,806 to 8,134). Some people are waiting for weeks to get into shelters and others are avoiding them, fearful of catching the virus in congregate settings.

The Fallout Report (published by the Toronto Foundation in late-2020) reported that the city’s shelter system was operating at capacity and approximately 2,000 people were living in outdoor encampments. Many people choose to live outdoors due to COVID-19 because they feel it is safer than congregate living settings.

In East Toronto, we know that there are significant health and social disparities among our 300,000 residents and 21 different neighbourhoods. Over the past year, we have seen people come together to support one another in ways we have never seen before. This crisis is not yet over and will impact many people for years to come

For more information or if you would like to donate, click here. 

 

Harm Reduction Satellite Sites

Satellite sites, community access points that provide resources and services at a local level, are a critical resource. Many people think of first responders as Emergency Medical Service (EMS) workers. However, first responders in the opiate crisis are largely other people who use drugs. Satellite sites are usually homes or places in communities, relying on natural networks, that provide people who use drugs with sterile syringes, harm reduction equipment and naloxone kits. COUNTERfit (an SRCHC program started in 1998 by the late drug-user advocate Raffi Balian) employed a number of strategies to deliver a range of harm reduction supplies to our community. One strategy involved asking volunteers from the service-user base to do secondary distribution from their homes. The model worked well and SRCHC was able to get funding to pay people with lived experience for their community leadership.

Satellite sites are informal services where people who use drugs can access safer-use supplies, naloxone, information and training. In some cases, they can access a safer space to use. Since community health centres employ the resident operators, they can link clients directly to other services, including drug checking, primary care, HIV and hepatitis C testing, treatment, counselling and more.

Last year, together with Parkdale Queen West Community Health Centre, we were pleased to release a guidebook about satellite sites called, “Harm Reduction Satellite Sites: A guide for operating harm reduction hubs from the homes of people who use drugs.”

 

Poly-Seniors Project

Medication Safety Ambassadors

SRCHC is implementing the Poly-Seniors Project (PSP), funded by Canada’s New Horizons for Seniors program. The project’s focus is safe medication use for seniors. It aims at supporting local seniors in the community and teaches how to prevent medication errors. Examples of a medication error are, taking a medication at the wrong time or taking too much or too little. Many seniors take five or more medications (called polypharmacy) and this can put people at risk of harm.

The objectives of the project are to promote volunteerism among seniors (and others), expand awareness of elder medication misuse, and support social participation and inclusion of seniors. Supported by pharmacists from the Institute for Safe Medication Practices Canada, seniors are involved in the program’s planning, design and development to help make the information more interesting, relevant and useful. Information about medication safety is available to staff and community members in English and also available in Chinese, Punjabi and Spanish. The senior’s group will be trained (online via Zoom) as medication safety ambassadors, and participating seniors will receive pandemic care packages sent to their homes. If you experience a medication error, click here to report it.

For more information or to book senior ambassadors to speak to your program, contact Shirley Cheng-Kerr at 416-461-3577, ext. 348.

 

 

Harmony Hall Highlights & Looking Forward

COVID-19 did not stop the Harmony Hall communities from coming together. After a shift from in-person events due to COVID-19, some accomplishments included:

  • A variety of virtual programs for seniors such as group dance, fitness, sing-along sessions and technical support services available in English, Tamil, Bengali & Chinese.
  • Celebrations of special events such as Pooja, Diwali & Christmas.
  • The official launch of Harmony Community Food Centre and its new programs, including an affordable produce market, weekly community meal, virtual kitchen programs and youth programs.
  • Emergency support including food access assistance (grocery delivery, hot meals, grocery gift cards).
  • A transportation partnership with Michael Garron Hospital and SRCHC for COVID-related needs such as patient transport and food delivery.

What we’re looking forward to in 2021

Harmony Community Food Centre looks forward to addressing food access needs by connecting with more members of the community and offering additional educational programs. We are also excited about partnering with George Webster Elementary School to set up a pollinator garden and school garden.

As well, the Seniors Active Living Centre will continue to provide virtual programs, including new activities, to keep seniors active and help to maintain health. Whether it’s connecting via telephone or online, our goal is to reduce isolation, increase engagement and stay connected.

 

COVID-19 Case Management Support

Since early November, SRCHC has been providing comprehensive case management support to people recently diagnosed with COVID-19 through Michael Garron Hospital and its pop-up testing sites. With surge funding received through Michael Garron Hospital, existing staff were redeployed and two new nurses were hired to support the project. East End CHC and Thorncliffe Neighbourhood Organization/Health Access Thorncliffe Park are also project partners.

The project’s aim is to provide assistance to people who have challenges with the required isolation and quarantine periods due to their social isolation and/or poverty. Case managers provide clinical support and symptom management, as well as coordinate delivery of fresh groceries, offer system navigation and make referrals to other services. Helping people to cope with the anxiety and stigma of a COVID diagnosis is also a big part of the work, as is support around grief and loss.

From November 2, 2020 to January 20, 2021, the project received 250 referrals and supported 1,067 individuals. Each referral has an average of five other family members who are also supported. Many people live in communities, like Thorncliffe Park, Flemingdon Park and Warden Woods, that have been hard-hit by COVID and referrals are closely linked to new and emerging outbreak or hot spot areas. As a result, the case management team works intensively in many neighbourhoods to provide both support and education.