Throwing a lifeline to those without OHIP
Public health nurse helped create free clinic for uninsured patients
Every Tuesday and Thursday evening, dozens of people arrive at a small building in Scarborough in desperate need of medical care. They come here because they have nowhere else to turn. They are among the most marginalized members of society, people who have somehow managed to survive in Ontario without a health card — refugees, recently landed immigrants and those without status.
They have come to one of the only clinics in the GTA offering free health care.
For 13 years, they have all been greeted by Jennifer D’Andrade when they walk through the door.
What the uninsured don’t know is that D’Andrade, a nurse with Toronto Public Health, will likely become their advocate, their lifeline and their source of support, as they try to manoeuvre through a healthcare system not designed to serve people like them.
D’Andrade is one of the pioneers of the clinic, which opened its doors in 2000. For them, the work is not just a job; it’s become their lives.
“Joy in life is knowing exactly what you are meant to do. This is it for me,” says D’Andrade, 57, who received honourable mention for this year’s Nightingale Award.
D’Andrade became a nurse decades ago, simply because she wanted to work with people. She joined Toronto Public Health in 1980, and spent the first few years working with seniors, new mothers and children in daycares. But when she started working with women in shelters, she realized that many did not have access to basic medical services. She spent years listening to their tales. One day, a mother who didn’t have money to pay for care, shared her story about waiting in the hospital emergency ward with her child who was having an asthma attack. D’Andrade felt moved to act. “It happened one time too many, it seemed to me,” she says. She connected with Dr. Paul Caul- ford. With a group of volunteers, they started a makeshift free clinic, seeing patients in basements and community centres twice a week. They would bring in tackle boxes filled with gauze, needles and syringes. Eventually, office space was donated to them. The clinic now sees more than 1,200 patients per year. And with drastic cuts to the Interim Federal Health Program for refugees, the clinic has seen a 300-per-cent increase in the past year. The sudden jump would overwhelm most people, but D’Andrade takes it in stride. “Jen is the soul of this place; it wouldn’t be here without her,” says Caulford, one of the people who nominated her for the Nightingale. She continues to do what she can, often going beyond the limits of her job description. In more cases than she can remember, she has driven patients to and from the clinic, bought them medicine, taken them to the bank, helped them find stable housing, taken them to deportation hearings, and just been their advocate when they had no one else.
“Somehow, the bus ticket will find its way into the pocket of the patient. Somehow, the food from a food bank will find its way to the home of the pregnant woman. Jen will go to the hospitals to argue with them to lower their bills,” says Caulford. “Who does this stuff?”
D’Andrade doesn’t mean to go overboard, but she can’t help it.
“When you are trying to help someone, what’s the point of saying, ‘I can’t do this one thing because of the rules,’ ” she explains. “At some point, you stop being a robot and become a human. I just don’t know where to stop.”
She also can’t take “no” for an answer, which serves her patients well. She will go to great lengths to get them medication, referrals to specialists, life-saving surgery — often begging doctors to take patients who can’t guarantee payment.
There are days when she worries what will happen to the clinic when she finally retires a few years from now. Ever the optimist, she’s hoping there may not be a need for it by the time she decides to go. “I’m hoping this issue is solved by then.”