Newsletter No. 11, May 2005

I've been a street nurse in Toronto for 15 years. In the spring of 2004 I received the Atkinson Economic Justice Award which permits me to pursue, for up to three years, my passions for nursing and working on homelessness and housing issues.  In this newsletter I hope to report on my activities, create a link to a broader group of individuals who care about these social issues and encourage critical debate.

Further information about subscribing to the newsletter is found below.  I want to hear from you - about the newsletter, about things that are happening in the homelessness sector (what a sad term!), and about good
things which will provide inspiration for all of us.

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Nurses Week

This week marks Nurses Week in Canada.  As a Street Nurse, over the years my career has increasingly moved from working one-on-one with people who are homeless to working on bigger picture issues, like lobbying all levels of government for better social conditions, income and housing.  For anyone doing this work, it’s been a struggle, sometimes like banging your head against the wall.  That’s why I want to highlight some of our recent successes in this newsletter.  As you will see, our work has started to result in victories at the municipal, provincial and national levels.  Since this is Nurses Week, I hope you will indulge me when I make special mention of some of the creative work being done by nurses today and share with you some of my own thoughts on nursing.

Toronto Emergency Shelter Win.

In April the Street Nurses Network, the Canadian Union of Public Employees, the Ontario Coalition Against Poverty (OCAP) and the Toronto Disaster Relief Committee sponsored a joint press conference, rally and a meal outside of Toronto’s City Hall.  One of the demands was that the City reverse its decision to close the emergency shelter at 110 Edward Street in May.  The City finally saw the light and we now expect this shelter to remain open at least until the end of the year.  Photographer John Bonnar captured the spirit of the day: http://johnb.smugmug.com/gallery/500962

Sign OntariO Now!

For many months, federal and Ontario housing ministers kept promising that “soon” the housing agreement would be signed. Intense lobby efforts by Ontarians included hard to obtain meetings with Ontario Housing Ministers Gerretsen and Caplan, and an appropriately named letter/email campaign called Sign OntariO Now (SOON).  These efforts resulted in SOON becoming NOW.  The housing deal was signed April 29 and includes a total of $602 million dollars directed towards the creation of 15,000 new units, 5,000 rent supplements, and an affordable home ownership program.  Details are still sketchy and with 160,000 Ontarians on social housing waiting lists this is only a beginning.  The deal is good for momentum, both federally and provincially. At the national level, the affordable housing program had become critically stalled largely due to the logjam in Ontario. Excitement about housing will hopefully fuel people’s energies to fight for the passing of the federal Liberal-NDP budget deal that includes an additional $1.6 billion for housing.  It is not quite the 1% solution but it’s definitely closer!

Federal Liberal-NDP Budget Deal

In my last newsletter I wrote about my huge disappointment with the federal government’s February budget, which despite promises, had no new money for housing.  In early May, Federal NDP leader Jack Layton negotiated a budget deal with Prime Minister Paul Martin that calls for $1.6 billion in new housing spending. There is no requirement for matching funding from the provinces, which eliminates a major barrier in a number of parts of the country, including Ontario.  If the deal holds, then Layton will have secured more money for new social housing in one day than the current federal government has delivered over the past dozen years.

The NDP budget deal also calls for new spending in other priority areas, including childcare and the environment.  The new social spending - which most Canadians support, according to recent opinion polls - will be funded through a reduction in corporate tax cuts.  Canadian corporations already pay a lower rate than corporations in the United States, so the budget deal is a fiscally responsible package that makes sure that there is revenue to pay for this critical spending.

However, there is plenty of work to be done to make sure the deal sticks and the budget is passed.  In early May, I moderated a press conference sponsored by People Before Politics, where both Toronto Mayor David Miller and Vancouver Mayor Larry Campbell called on all parties to pass the federal budget so that important action on the environment, housing, child care and infrastructure can continue.

The situation in Ottawa is volatile and who knows what will have happened by the time you read this newsletter.  Please contact your networks, Member of Parliament, and local media and urge that the deal be passed as quickly as possible. Use the example of local projects and local needs to support the call to immediately commit the $1.6 billion in new housing funding.

Nurses Play Key Role in OCAP’s Diet Campaign

Nurses know that poverty is the foremost social determinant of poor health.  For years, the cuts to social assistance rates and the stripping away of social programs have left social assistance recipients with immense health challenges.  I still remember the day about 8 years ago when a patient of mine, an elderly Native man, was admitted to St. Michael’s Hospital.  His primary diagnosis was malnutrition.  Current social assistance rates force people to choose between paying rent and buying food.  In response to this most basic human need, as part of The Raise the Rates campaign, OCAP initiated Special Diet Clinics.  Their goal is to see the Ontario government raise social assistance rates by $250 per month!  See www.ocap.ca for more details.

Nurses, like Kathy Hardill and Pat Larson are playing an important role in these special diet clinics.  In health centres and at outreach sites they assess people and assist them to obtain what is known as the Special Diet Allowance, which they are eligible for.  Clinics are taking place in community settings including drop-in centres and in social housing buildings.  Although primarily in Toronto, the diet clinic work has expanded to other communities including a small Native community near the base of James Bay.

The result is immediately measurable - additional income for special food needs.  A doctor, an extended class nurse, a dietician or a midwife (for pregnant women only) must fill out the form, and the special diet requests are divided into categories worth different amounts of money.  For example, a diet for iron rich foods provides a monthly increase of $30.00; a diabetic diet is worth $42.00; vitamin/mineral and herbal supplement is valued at $40.00.  The maximum amount of money granted by the Special Diet Allowance is $250.00.  Through their diet clinics alone, OCAP has generated an additional $2 million for people on OW/ODSP.

“Notes on Nursing. What It Is and What It Is Not.” by Florence Nightingale

As I’ve noted, this is Nurses Week and like so many of my colleagues I have a lot to thank Florence Nightingale for.  Over the years during difficult times in my work, when I was campaigning with nurses and non-nurse colleagues for better shelter conditions or for inquests into tuberculosis deaths or for toilets down at Tent City, I would turn to Notes on Nursing and the words of Florence Nightingale to help me figure out if I was on the right track as a nurse.

Ms. Nightingale is considered the originator and founder of modern nursing.  She revolutionized the care of the sick and was considered outspoken on the needs of the sick. She became known as the ‘Lady of the Lamp’, during her period in military hospitals, tending to the injured.  She is widely considered to be one of the most famous healers, who helped to alleviate human suffering in the nineteenth century.

In honour of Nurses Week I again turned to Notes on Nursing, and as I was reading through the pages at the Church of the Holy Trinity, I began to apply the answers she had so long ago to the questions I am still struggling with today.  Please indulge me as I interview one of my great heroes.  

CC:      Ms. Nightingale, last month I heard one of our Canadian nursing leaders, Adeline Falk-Rafael, describe nursing political activism and social justice work using the metaphor of dance. She suggested that justice making is a spiritual act that flows from caring and compassion, the core values of nursing, and that it necessitates what we call ‘upstream work’ which means working on the source of the problem.  What would you say to that?

 

FN:     "Yes, true nursing ignores infection, except to prevent it!  It did strike me as odd, sometimes, that we should pray to be delivered from 'plague, pestilence, and famine,' when all the common sewers ran into the Thames, and fevers haunted undrained land, and the districts which cholera would visit could be pointed out.  I thought that cholera came that we might remove these causes, not pray that God would remove the cholera. Ingenuity and perseverance might save more lives than we wot (sic) of."

 

CC:     We have an enormous problem of poverty and homelessness here in Canada – over 250,000 people homeless and it has been called a man-made national disaster because our senior level of governments cancelled our housing program and made cuts to other programs like social assistance and employment insurance.

 

FN:     “What cruel mistakes are sometimes made by benevolent men and women in matters of business about which they can know nothing and think they know a great deal.”

 

CC:      In fact we now have nurses that are called ‘street nurses’ – but it is really disaster nursing.  It is so hard to provide adequate care where people are situated homeless, in shelters, on the street, in parks or ravines.  You talk about ‘nursing the room’ but I don’t know how we do that when our patients have no room.

 

FN:     “Yes, bad sanitary, bad architectural and bad administrative arrangements often make it impossible to nurse.  But the art of nursing ought to include such arrangements as alone make what I understand by nursing, possible.”

 

CC:     Such as?

 

FN:     “I would say to the nurse, have a rule of thought about your patient’s diet, consider, remember how much he has had, and how much he ought to have today…

 

CC:     Like the special diet forms the nurses are filling out?

 

FN:     “Yes, she must be always exercising her ingenuity to supply defects…”

 

CC:      Did you know that the white plague has returned?  We have recently had a tuberculosis outbreak and there were deaths.  I suppose you would argue that we should also be dealing with the bad air in crowded emergency shelters in church basements?

 

FN:     “Yes, again, a thing I have often seen…the air is stagnant, musty and corrupt as it can by possibility be made.  People lose their health in a dark house, and if they get ill, they cannot get well again in it.”

 

CC:     And the problems we see in some of the rooming houses and high-rises?

 

FN:     “Badly constructed houses do for the healthy what badly constructed hospitals do for the sick!”

 

CC:     That reminds me that I must tell you that we now have hospitals that have carpeting on the floor and it is often so stained!  The hospitals have also cut back on support staff who were responsible for cleanliness.  I know of one hospital that was infested with bedbugs!

 

FN:     “For a sick room, a carpet is perhaps the worst expedient which could by any possibility have been invented.  A dirty carpet literally infects the room!”

 

CC:     Going back to the homeless crisis.  This month we will add 8 more names of homeless men and women to our memorial here at the Church of the Holy Trinity.  No one really knows how many people died this month.  Many are known only as John or Jane Doe.

 

FN:    “It would be very desirable to know how often death is with adults not a necessary, inevitable result of any disease….”

 

CC:     Well – the disease of homelessness.

 

FN:      “hmmm”

 

CC:      Do you have any last words to guide those of us trying to carry on your ‘dance’?

 

FN:      chuckles: “Yes, you must create a public opinion which must drive the government, instead of the government having to drive you.  An enlightened public, wise in principals, wise in details.”

As nurses, and all of us can be nurses, we must continue to drive public opinion and continue to pressure our leaders to build homes, improve social conditions and create opportunities for all. Happy Nurses Week.

Cathy

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