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Service cuts hurting the marginalized
Social and sexual health experts in Cranbrook are warning that a lack of available testing and treatment opportunities in the city is leading to increased rates of sexually transmitted infections (STIs) and HIV for those who fall through the cracks in society.
AIDS Network Kootenay Outreach and Support Society (ANKORS) Care Team director Gary Dalton, former Cranbrook Women’s Centre coordinator Vicky Dalton and Operation Street Angels manager Heidi Hebditch appeared before City of Cranbrook council Oct. 22, asking for assistance in getting the word out about the growing problem, and for the city’s Family and Community Services Committee to begin looking into ways it can help. They also asked for a letter of support.
Gary Dalton said health care system cuts in the past year have slashed into the well-being “of the people who do not have access” to regular medical attention or have a family doctor.
In December 2011 Interior Health (IH) announced that public health nurses would no longer provide testing and treatment and sexually transmitted infections (STIs) and HIV testing.
“This means you cannot go to Public Health to get tested,” Dalton said, noting that the result of the 2011 changes meant “the inability of many citizens in Cranbrook, and in the East and West Kootenay, to receive blood work necessary to test for many STIs, including HCV, gonorrhea, syphilis and HIV.”
Dalton said Interior Health’s announcement memo on why it was re-arranging staffing resources “discussed options for testing in the community including doctors and drop-in clinics. But 20% of Canadians don’t have a doctor and there was even a deficit of doctors in our clinics at that time. Cranbrook does not have a ‘walk-in clinic. Stats Canada demonstrates that up to 34% of men between the ages of 20-34 do not have a doctor.”
Testing by public health nurses was often the only way many of these people could find out if they had a STI, he stressed.
“The importance of increased testing in this community was behind a previous initiative that included pre and post-test counseling as well as drawing blood in sessions at Street Angels and the Salvation Army. Just as testing was becoming less difficult and stigmatized in our community, it suddenly became inaccessible for many,” Dalton told council.
“The nurse practitioner at Street Angel does provide some limited options. The office is opened for a minimal number of hours. Still there is no support for those needing service outside of that time and frame and that location.”
Dalton said IH “are taking steps to address the issue but the community at large needs more. This approach is not always inclusive of those who do not have doctors or of those who find barriers and cannot use resources other family or friends access. There are also those who work up north needing testing here and cannot make their schedules work.”
He also told council that “STIs are on the rise in our community.”
The timing of cuts to providing testing to marginalized citizens was terrible, Dalton said.
“We are heading towards an HIV-free generation” because of the effectiveness of current treatments. “In order to have that treatment you must first be tested to see if you have the virus,” he said.
Operation Street Angel’s Heidi Hebditch concurred.
“I can attest to the undeniable need for additional testing and medical services. However, I am also fully aware of the need for additional funding and the need for greater collaboration between community partners and council. There is an apparent disconnect between local resources, governments and service recipients resulting in the misuse, mismanagement and eventual disruption of services available.”
Working at Street Angel has given her a clear picture of what is needed, she said.
“The current condition of the health care system is failing our most marginalized citizens. The vast majority of clients who access our services are without a physician and though some steps have been taken to address this through the added services of the nurse practitioner, there are still many falling through the cracks. Testing of HIV (and non-testing og STIs and Hep-C) has its difficulties as expressed by Gary Dalton, but in addition to this HIV treatment occurs in Vancouver, which requires the added expenses of medical travel and most often the need for a travel companion, thereby creating barriers to the much-needed treatments available and often resulting in a personal neglect of treatment,” she explained.
The only way a homeless person without a family doctor can see a doctor is by visiting the emergency room at the hospital, Hebditch said, and that’s at best a crap shoot for them.
“I’ve had reports of people going to the hospital and being treated poorly because of how they look,” she said.
Vicky Dalton pointed out that doctors can chose who they wish to add to their client lists, and to keep on them.
“One of the biggest issues we face: is the fact is if a doctor feels you are not complaint, then you can be fired by the doctor as a client,” she said.
Following a brief council discussion, Coun. Angus Davis presented a motion, which was unanimously passed, to have the Family and Community Services Committee consider Monday evening’s presentation and bring recommendations back for council’s consideration.
“It was a real sensitive presentation,” Davis said. “Lots of people are being left out. I think we are lucky to have you folks in our community. You are working your hearts out. Believe me, you are making a difference.”
Several council members noted that Cranbrook would be well-served with a walk-in clinic.
Coun. Denise Pallesen said she agreed with the need but doubted the likelihood of one coming to life any time soon.
“I don’t know how lucky we are going to be with that one,” she said, pointing out doctors own/operate the clinics, not Interior Health.
“It makes an incredible amount of sense” to have a walk-in clinic, said Mayor Wayne Stetski, agreeing with Pallesen. An attempt at a walk-in clinic in Creston ended up failing because “it got in the way of doctors’ (full-time equivalents) FTEs.”
For more on ANKORS: http://www.ankors.bc.ca/
Ian Cobb/e-KNOW