The ‘undesirable’ spiral
Ally Centre says health-care system fails to treat poverty and addiction
Emily Donovan knows what it’s like to be one of Cape Breton’s “undesirables.”
At 25, the Sydney woman is a recovering opiate addict who continues to struggle with mental illness. She’s also seen first-hand how the health-care system fails people in her situation, like when she went to the hospital complaining of pain and doctors instead tried to treat the symptoms with pills.
“I told them, ‘I don’t want you to treat my pain, I want you to tell me why I’m in pain. Fix it,’” she recalled during a public meeting held by the Ally Centre at the James McConnell Memorial Library in Sydney on Tuesday night. “It would go months until I passed out and rushed into surgery because nobody wanted to hear me because I’m a drug addict.
“Once you get that label, that’s all they see. They don’t see you as a human anymore.”
That experience is far too common according to research conducted by the Ally Centre and Cape Breton University. The study by CBU sociologist Margaret Dechman involved 21 service providers — everything from food banks to correctional facilities — and 52 of the so-called “undesirables” — people who are dealing with mental health problems, addictions, poverty and run-ins with the law, or in many cases, combinations of all those factors.
Yet the overriding theme in most cases was what Ally Centre’s community development consultant Janet Bickerton called a “profound sense of hopelessness,” something she blames on a health-care system that is far from universal for the marginalized and excluded.
“You can add 100 doctors or 1,000 doctors, the situation for these people will not change,” said Bickerton, a registered nurse. “This population are the undesirables, and sadly you will hear people refer to themselves as that at the Ally Centre — a little black humour, you know, goes a long way when you’re living that kind of life,” she said.
Bickerton said the biggest barricade is the fact that most doctors are essentially operating a private business in which they exchange their services for a fee. That means most doctors aren’t interested in taking on patients with the “complex issues” that often lead to addiction and other health issues.
“I don’t know if people really understand that,” she said. “I often wonder when I hear people talking about how we’re going to fix the system and how we’re going to make it better for all these people — especially undesirables — because nobody wants them in their practice.
“We cannot decide who we want to care for. We need to care for whoever is in front of us in all of their complexity, and as we struggle in our communities and end up with serious health consequences, because of many things that are outside of their control, we need to provide compassionate care free of stigma and discrimination. It’s not happening now.”
That’s something the Ally Centre hopes to change with the outreach health model it hopes to adopt. The first step was the study presented Tuesday, and in the future executive director Christine Porter hopes the Sydney-based centre can expand its health clinic into New Waterford, Glace Bay, North Sydney and Sydney Mines.
“It’s going to the people and seeing what their needs are because obviously you could put 100 more doctors there and 50 more hospitals and the folks that we’re talking about, they don’t go there because of the stigma and transportation and poverty and other issues,” she said.
The centre, which also provides anonymous blood testing and operates a clean needle exchange, is busier than ever said Porter, who noted Cape Breton has extremely high rates of hepatitis C and overdoses.
“When I first started here 18 years ago we were giving 20,000 syringes out; now we’re giving out 650,000,” she said of the number of needles handed out each year. “We’ve got issues — we’ve got big issues — and all of these, really somebody’s got to answer to it.”
Donovan, who is about to graduate from a Nova Scotia Community College social services program that will allow her to help people in her situation, says the Ally Centre outreach health model is desperately needed. “Big time, especially if they’re getting people involved who are stigma-free and nonjudgmental. That’s a huge issue for people, because once you’re judged, you lose all trust with that person and you don’t want to ask them for anything. And they often battle these things alone and they do all of this alone because they don’t trust anybody,” she said. “It was the people at the Ally Centre who didn’t give up on me and who gave me a voice when I didn’t have one. For the first time in my life I had a voice and I mattered to somebody, and that was the first step for me starting my life over — it was a fresh start for me.”
“It was the people at the Ally Centre who didn’t give up on me and who gave me a voice when I didn’t have one. For the first time in my life I had a voice and I mattered to somebody, and that was the first step for me starting my life over — it was a fresh start for me.”
About 40 people attended a public meeting held by the Ally Centre at the James McConnell Memorial Library in Sydney on Tuesday night. The centre and Cape Breton University presented a study that calls for an outreach health model that would see the Ally Centre offer health services in Sydney, New Waterford, Glace Bay, North Sydney and Sydney Mines.