Winnipeg health authority turns down mobile clinic plan

The Winnipeg Regional Health Authority has turned down a proposed free mobile health clinic, citing the ongoing upheaval of provincial health system changes.

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This article was published 02/08/2019 (1214 days ago), so information in it may no longer be current.

The Winnipeg Regional Health Authority has turned down a proposed free mobile health clinic, citing the ongoing upheaval of provincial health system changes.

Doctors of the World operates mobile clinics in Montreal and Victoria, and argued Winnipeg could benefit from one, too — as the meth crisis deepens and rates of sexually transmitted diseases soar, especially among those experiencing homelessness.

The Montreal-based organization had funding lined up to cover the purchase of a van (about $145,000) and annual operating costs (about $160,000), as well as doctors and nurses ready to volunteer, said executive director Nadja Pollaert.

RUTH BONNEVILLE / WINNIPEG FREE PRESS “People are dying out there, and we’re not doing our job to look after them. This is one way we could really be successful, said Al Wiebe,chairman of the Lived Experience Circle advisory committee.

The non-profit came to Winnipeg in November to assess gaps in the health system. “There are a lot of needs,” Pollaert said.

A Doctors of the World report said the local health system is "doomed to fail" vulnerable patients, citing rising methamphetamine-related deaths and broad swaths of the city without supports for the homeless.

Medecins du Monde needs assessment for Winnipeg

However, when the WRHA declined to support the project, funding and supporters fell through, director of national operations Veronique Houle said in an email.

The WRHA cited "significant and revolutionary change" in the Manitoba health system; in January, Phase 2 of the plan to consolidate six city emergency rooms to three was well underway, culminating this summer. Work on a broader clinical and preventative services plan continues.

A letter from the WRHA to Doctors of the World, dated Jan. 30, said: “In the absence of a provincial co-ordinated plan, we cannot commit to a solution and we are not in a position to support this project at this point in time.”

WRHA letter to Medecins du Monde, Jan. 30, 2019

“I think that’s a cop out,” said Al Wiebe, chairman of the Lived Experience Circle advisory committee. “People are dying out there, and we’re not doing our job to look after them. This is one way we could really be successful."

Wiebe knows firsthand how difficult it is to get medical care when on the streets — he said he was turned away from Health Sciences Centre multiple times while homeless, prompting him to attempt to end his life.

“If you’re on the street, you need help from somebody to turn your life around. This (clinic) would have been the idea way to do that.”– Al Wiebe

Syphilis rate up 560 per cent

An outbreak of syphilis continues in Manitoba, with a more than fivefold rise since 2014.

The most recent data from Manitoba Health shows gonorrhea infections more than doubled by 2018, as well.

An outbreak of syphilis continues in Manitoba, with a more than fivefold rise since 2014.

The most recent data from Manitoba Health shows gonorrhea infections more than doubled by 2018, as well.

The Winnipeg Regional Health Authority began sounding the alarm about the syphilis outbreak last June, and numbers only continued to rise — 791 cases in 2018, compared to 253 in 2017.

In January, the WRHA said almost half of those infected with syphilis reported using drugs, mainly meth, and almost two-thirds lived downtown or in Point Douglas.

Overall, rates of sexually transmitted blood-borne infections are up nearly 60 per cent.

HIV rates have stayed relatively flat at around 100 per year.

Organizations such as Doctors of the World make STI testing a big part of their work — among 1,817 mobile clinic visits in Montreal last year, 294 included testing — but paying for lab tests became a sticking point with the WRHA for their proposal to provide a mobile clinic in Winnipeg.

“Sure, there’s changes (to the health system). But this was a freebie… Somebody just didn’t want to step up.”

Main Street Project’s success with an outreach van shows how much benefit a project like this could have, said executive director Rick Lees. More than two years in, its van now responds to 311 calls and transports people to hospital, but can’t provide care on-site.

“It’s been proven in other cities, the evidence is there, that if you bring the care to them, you actually reduce the demand on emergency rooms, Winnipeg fire-paramedic services and police,” Lees said.

"We think it’s pretty neat, and we don’t think that the door should be closed."

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Another innovation: each shift on the mobile Doctors of the World clinic would have included a peer support worker.

Wiebe said including such lived experience could help a project build rapport in a way not possible in a traditional hospital setting.

“If you’re on the street, you need help from somebody to turn your life around. This (clinic) would have been the idea way to do that,” he said.

While Siloam Mission offers free health services from 10 different types of volunteer providers, from doctors and nurses to foot specialists and optometrists, communications manager Luke Thiessen said there’s still a big need.

“(The mobile clinic) looked like a great idea,” said Thiessen, "because potentially it could serve people who weren’t being served."

Because health providers volunteer their time at Siloam, patients don’t need Manitoba health cards — which helps avoid a potential roadblock to health care, as many experiencing homelessness don’t have such documents available. It would have been the same for the mobile clinic.

But Doctors of the World needed support from the WRHA to get lab testing paid for without health cards, Pollaert said.

About one in four visits to the Doctors of the World mobile clinic in Montreal is for sexually transmitted infections, its annual report states.

“The testing can be quite expensive, and a lot of people don’t have only one test, they might have two or three — so it’s easily a couple of hundred dollars per person,” Pollaert said.

“We need an external partner to take care of this. So this is a non-negotiable… It has to be in place.”

tvanderhart@freepress.mb.ca

Twitter: @tessavanderhart

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