The ‘un­de­sir­able’ spi­ral

Ally Cen­tre says health-care sys­tem fails to treat poverty and ad­dic­tion

Cape Breton Post - - Front Page - BY CAPE BRE­TON POST STAFF

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.”

Emily Dono­van

CAPE BRE­TON POST PHOTO

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.

Dono­van

Bick­er­ton

Porter

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