· CBC News ·
For a few hours each week, local shelters become a clinic for Dr. Jennifer Bondy.
During a visit, she might dress a patient’s wounds or assist them through a mental health crisis. At the same time, she’s also attending to their chronic conditions, such as getting their high blood pressure or diabetes under control.
While these are health issues that anyone can experience, oftentimes when a shelter user sees Bondy, their condition has progressed because they don’t have easy access to care.
In Windsor-Essex, some people experiencing homelessness haven’t seen a doctor for 15 years, according to the Windsor-Essex Ontario Health Team, which runs a mobile medical clinic. That’s something Bondy hopes to change.
She’s leading the charge on a shelter health initiative, which involves providing health care directly to people who use shelters in the city.
“In Windsor, this is a need that I saw and this is something that I wanted to do, along with all the partners we’re working with,” said Bondy, who is the lead doctor on the initiative and sits as co-chair on the shelter health steering committee.
Other partners on the initiative include the City of Windsor, Hotel Dieu Grace Healthcare, the Windsor-Essex Ontario Health Team and the Canadian Mental Health Association Windsor-Essex Branch.
“We want to take care of everybody and this is a good way of doing that,” she said.
Across the province, municipalities like Toronto and Hamilton already have similar initiatives in place.
Right now, Windsor has a bare bones version of a shelter health initiative — two doctors and a nurse practitioner.
Bondy spends a couple of hours two days a week at the Homelessness & Housing Help Hub (H4) and the Welcome Centre Shelter for Women and Families, while Dr. Ross Lepera sets aside three hours at The Salvation Army Centre of Hope.
Bondy has been at the H4 since summer 2021 and the Welcome Centre since last summer. Lepera has been at the Salvation Army for about four months.
Shelter users might not have a physical OHIP card, despite being a resident of Ontario, Bondy said. As a result, she said they end up going to the emergency department, when they don’t always require urgent care.
People experiencing homelessness also face extra barriers to accessing a health-care professional such as transportation, staying organized with appointments or mistrust with the health-care system.
This is more than a passion project for Bondy; it’s also addressing a gap in service.
A 2021 review of the city’s H4, completed by OrgCode Consulting, recommended that health services be expanded because of the conditions people have and to help them access the Ontario Disability Support program.
But it also found that there were a lot of people living with a brain injury and that many were using emergency services.
According to the review, since there is a “remarkably high level of vulnerability” among people using these services, resources are needed to meet their needs and support a growing demand.
And as of February 2023, Windsor-Essex’s By-Names prioritized list — which breaks down everyone in the community experiencing homelessness — identified 512 households.
Downtown Mission executive director Rukshini Ponniah-Goulin told CBC News that its clients need more access to health care.
“We have definitely seen an increased need for more medical support and more medical help from professionals than what we are able to provide ourselves,” she said.
For about a year, the Downtown Mission has been relying on medical services through the Windsor-Essex Ontario Health Team, and since September, the team has been operating a mobile site at the Mission, Rukshini said.
The Downtown Mission doesn’t currently have medical staff on site, but Ponniah-Goulin said she’s talked to Bondy and hopes to get these services in the future.
“Trying to bring that access to them or reducing the barriers to these services will hopefully help overall in the community with reducing the strain and the drain in the emergency departments or in the hospitals,” she said.
Bondy said an application was submitted to the Ministry of Health about a year ago to make this service more permanent.
Funding will allow the initiative to expand to other shelters and operate more consistently.
“Just last week at H4, unfortunately we ended up having to turn away a number of people, which really doesn’t feel nice, you never want to have to turn anyone away … there was just a lot of demand,” she said.
Bondy stresses that this service will save taxpayers money, because emergency services won’t have to be called in as frequently.
Part of this initiative is to also allow shelters, community organizations and health-care providers to create a network of supports for people living on the streets.
“People experiencing homelessness often times have very high rates of what we call comorbid conditions, a lot of health problems — physical problems, mental health problems, often a lot of social problems going on — and so we need to take a really wide angle approach,” she said.
Bondy also hopes that this service can help people learn to trust medical professionals so that they can eventually find permanent family doctors once they are housed.
“By engaging with people and showing them that they matter and that they are every bit as worthy of our publicly funded health-care services as the next person, that allows them to engage and become active and advocate for themselves, so that when they’re feeling a little bit better then they’re able to engage in the health-care system more fully,” she said.
“When they’re going to walk-in clinics or the emergency department, they’re seeing different people, they’re not really establishing that relationship,” he said.
“Bringing these services [to shelters] it’s going to help establish that rapport, have familiar faces, and that makes you more willing to open up — to talk about the things you might not have wanted to talk about with someone else.”