Newsletter No. 13, July 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
I took a week off and went up north to spend time with friends on an island in the North Channel of Lake Huron, about a 20-minute boat ride from Whitefish Falls. I spent a week swimming, canoeing, making pies and exploring the island. Towards the end of the week, I learned that back in Toronto things were heating up, literally. I admit it; I took my Blackberry with me and periodically climbed some of the higher rocks on the island to get a signal and news from home. That’s how I learned about the oppressive heat back in Toronto and the heat related death of Richard Howell, who lived in a boarding home. I also found out that his death was having a huge impact on the PARC drop-in and Toronto Disaster Relief Committee members.
It was a very sad reminder to me that people who are homeless and poor, hardly ever have opportunities to get refreshed. The “hot spots” I have often talked about (infections like tuberculosis, homeless deaths, shelter conditions, and heat and cold emergencies) were becoming quite literally true with these recent southern Ontario heat and smog waves.
Within 14 hours of being back in Toronto from my holiday, I was sitting with PARC members in the drop-in observing a press conference that the Toronto Disaster Relief Committee had organized in response to Richard Howell’s death.
Richard Howell was well known to PARC drop-in members. Bob Rose, a PARC staff member described how Richard had written a country song with him called “You’ve got the Key to My Heart.” PARC members were clearly affected by Richard’s death. They listened attentively to the speakers, including Glen, one of PARC’s members. The PARC members clapped periodically. They know, too well, the risk they also face.
Seventeen years ago when I began working as a Street Nurse, I would never have dreamed that hot weather and smog would be a health risk that I would have to focus on. As Dr. Stephen Hwang reminded us at the press conference – let’s learn from what happened in France, where they saw so many heat related deaths. “It’s that single room that’s not ventilated and not air-conditioned that’s a death trap in the severe heat wave,” he said. He suggested that hundreds of Torontonians could die if the City does not come up with an effective plan.
Ironically, the previous month a Toronto Public Health Report was released reporting on a statistical review of deaths in Toronto from 1954-2000, with the conclusion that there have been an average of 120 heat-related premature deaths annually in Toronto, with another 822 premature deaths due to smog (which is often associated with heat alerts).
Although the City’s heat plan was implemented - an Extreme Heat Alert was declared by the Medical Officer of Health (for some of the days during that June-July heat wave) the Chief Coroner of Ontario still announced 3 heat related deaths.
Most front-line workers and homeless people scoff, quite rightfully, at the City’s Hot Weather Response Plan. The plan has 2 components or levels: a Heat Alert and an Extreme Heat Alert.
In conditions of very high temperature and humidity, the City’s Hot Weather Response Plan is initiated by the Medical Officer of Health, who will usually declare a Heat Alert. In this situation mostly nothing happens except for public service announcements:
These are not satisfactory options for people who are poor, homeless, or living with chronic debilitating illness.
When the weather conditions indicate that there is a period of “sustained excessively hot weather and the likelihood of weather-related mortality exceeding 90%” - then an Extreme Heat Alert is declared. It is only at this point that the City opens 4 former civic buildings as cooling centres, only one of which is open 24 hours. There are no full meals served in these cooling centres nor are there cots for a sleep – just a rest. During both the Heat Alert and the Extreme Heat Alert, there are no additional funds made available for drop-in centres or seniors programs to stay open longer or do extra outreach. Unlike the City’s Cold Weather Alert, there are no bus tickets provided to these agencies to assist people to get to the cooling centres or even a cooler place, nor is there free or relaxed access to public transit. In fact, I personally witnessed a streetcar driver try to prevent a man with a walker from boarding on one of the hot days recently (arguing it was too wide, even though it had been folded). Fortunately, passengers insisted he be allowed to board.
To make matters worse, access by homeless people to water, blankets and food throughout the entire summer is tenuous. We now rely on the volunteer organization ‘Project Water’ to obtain corporate donations of bottled water for distribution by agencies. Many of these agencies are no longer funded or allowed to provide the same level of core outreach services (food, blankets, sleeping bags) which have helped them support and connect with homeless people in the past.
For me, this heat emergency highlights how critical it is that we work on the local issues, the local emergencies, and the local needs of people who are homeless, underhoused or living in poverty. It may well lead to important public policy changes that could affect thousands of people in the future, and prevent discomfort, worsening health and even death.
Over the course of 6 days, TDRC and PARC staff were forced to develop a policy response that should have been articulated by public health officials who work in these areas.
Here are some of the actions and policy changes that are now being presented to the City by community activists. I share these with you knowing that this hot spot – hot weather and smog in the City of Toronto – is undoubtedly an issue in your community too.
· The Province of Ontario should immediately convene a Coroner’s Inquest into the death of Richard Howell in order to allow a full exploration of all the issues, including the physical standards and operating requirements of the mental health boarding home system and the use of psychiatric drugs and other medication and the provision of air conditioning. The purpose should be to determine practices that will prevent future deaths of a similar nature.
· Toronto Public Health should launch a city-wide drug education campaign to inform psychiatric survivors, people with disabilities and the elderly, of the serious health risks of psychiatric drugs and other medications. This campaign should include tenants in rooming houses and boarding homes, residents of group homes, nursing homes, homes for the aged, supportive housing and those in long-term care facilities, psychiatric hospitals, clinics, as well as community agencies such as shelters and drop-ins.
· Community health providers / agencies / shelters and housing providers serving psychiatric survivors must develop and implement a protocol to inform clients / tenants / users of psychiatric drugs, about the risks during hot weather conditions and ensure that safety precautions are taken.
· The City of Toronto should work quickly to improve safety conditions, including:
1) Legislate a maximum temperature in the city’s Municipal Code as a parallel provision to the current cold weather requirement that landlords provide minimum temperature from September 15 to June 1;
2) Assist those most at risk during heat alerts by developing a community-specific response that considers the conditions and needs of people. This must provide for geographically-accessible cooling centres, including a west-end location, with transportation to assist those in need.
· The City of Toronto should immediately implement a community protocol to deal with maximum temperature in housing and also in Toronto's existing heat alert protocol and its emergency response protocol for rooming and boarding houses (this can be tied into ss.13 to 15 of Ontario’s Health Protection and Promotion Act, which gives the Medical Officer of Health extensive powers to deal with health hazards). As part of this initiative, there needs to be additional financial and staff resources to cover everything from additional TTC tickets to assist people to get to cooling centres and additional community workers to assist in emergency relocation or other measures to assist people during heat and smog alerts.
The immediate development of a retrofit
program to bring existing rooming and boarding houses, and other dwellings,
up to the new maximum temperature standard. This can be done by expanding
and enhancing the existing Residential Rehabilitation Assistance Program,
which is funded by the federal government and administered by the city.
The words of Bob Rose best sum up this current dilemma:
“We have a population of people in this city that are very compromised because of their poverty and because of their housing conditions and because we haven’t been building any decent housing for the last ten years. You better pay attention to that!”
For CBC coverage of the heat press conference go to:
For more updates on this issue and steps you can take, visit the TDRC website www.tdrc.net
Now to some good news.
There were zero dollars in the February 2005 budget but with the passing of the Layton-Martin budget there is now $1.6 billion allocated for affordable housing (both aboriginal and non-aboriginal housing), with no matching funds required from the province (a barrier that had prevented previous spending in Ontario). A lot of work from people all across the country helped to accomplish this.
“When we look at the expenditure on housing, I certainly think back to Eugene Upper, who lost his life one block from my house when he froze to death. It was a statement of shame that Canada was not providing housing to its citizens. Since that time, groups across the country have formed and have urged all of us in all parties to take action and to get back to building affordable housing again.
It was a great tragedy when the best affordable housing program in the world, as recognized by the United Nations, was cancelled in the mid-1990s and we saw homelessness grow. Now we are seeing a turnaround. We are seeing an investment that brings federal dollars to the construction of affordable housing.
We must thank organizations such as FRAPRU that have long demanded investments in social housing. We now have funding that in no way requires matching funds. So this is important.
Organizations like the Toronto Disaster Relief Committee, the Co-operative Housing Federation of Canada and the Federation of Canadian Municipalities, all of these organizations, have pressed us to take this kind of action.” Jack Layton, June 23, 2005 in Hansard
Our work now is to make sure we see that money allocated as soon as possible, to truly affordable housing options. I admit that I am skeptical that this money will flow easily, even though it could and it should. I expect that roadblocks, loopholes, bureaucratic hand wringing and even a federal election could get in the way. In fact, I have just learned that the federal housing Minister’s office has said that the money will only be allocated at the last minute if there is sufficient federal surplus dollars, and it will have to be committed (i.e. – off the federal books) very quickly.
This means that we need to plan how this money is spent during a narrow window of a few days in late March of 2006. One strategy will be to have a significant presence in Halifax where it is rumored that housing ministers will be meeting in early September. Hopefully by then, the promised federal strategy entitled “HOPE” (Housing Opportunities for People Everywhere) will be unveiled and this country can return to building new and truly affordable housing.
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|Picture: courtesy of Minister Joe Fontana and CMHC|
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