Housing Would Help

Cathy Crowe, Street Nurse, Atkinson Economic Justice Fellow

c/o Sherbourne Health Centre

365 Bloor St. East, Toronto, ON, M4W 3L4

416-324-5069 ccrowe@sherbourne.on.ca

Thanks so much for this invitation. This is probably my first time visiting a Housing Help Centre. That says something about how unique you are. Can you imagine if the right number of Housing Help Centres existed to meet the demand in this province? How many do you think we would need?

The Hardest Job in the World

I can well imagine that the work of the Housing Help Centre is particularly challenging, especially when there is such a lack of affordable housing.

The City of Toronto recently hired 2 housing workers to very specifically work with some of the people who are homeless and who had suddenly become very visible and in the press - the young people under the Gardiner Expressway near Spadina and Bathurst and the more than 100 sleeping outside our City Hall. I think those two workers probably have one of the hardest jobs in the city right now. I don’t know where they think they will find housing for people.

The homeless disaster and the campaign

Many of you will know that in 1998 we formed a group called the Toronto Disaster Relief Committee, declared homelessness a National Disaster and began a national campaign which called for 2 solutions.

The first – emergency relief to be channelled into the inner cities where the crisis was severe – that is, in essence, the origin of the ‘SCPI’ monies. Secondly, we called for a national housing programme and the 1% solution – a reinvestment of an additional 1% - the average amount all levels of governments used to commit to social housing when they were building it. We haven’t gotten that one yet, that’s why I titled my speech Housing Would Help the Housing Help Centre.

I want to say a couple things regarding the notion of disaster because it still applies.

Hurricanes. Hurricane Hazel – McCallion that is. I saw her interviewed on TVO the other night. She came to fame for doing what a politician should do in a disaster. During the Mississauga train derailment, the largest evacuation in Canadian history, she toured the site, she witnessed the damage and worked to ensure people were safe and rehoused as soon as possible.

Hurricanes of another sort such as the recent ones in Florida and Haiti leave very obvious destruction and homelessness. They are also situations that beg for politicians to be leaders, to witness the damage and to come up with immediate solutions and it always takes money.

Homelessness in our country wasn’t caused by a hurricane, it was and continues to be a man made problem, a structural problem and we should expect it to be dealt with.

Over the years I have taken a number of politicians on a tour of the homeless disaster. It can range from several hours to all day or night. Most recently I took Toronto Mayor David Miller on a tour at night to meet people sleeping outside and to visit several emergency shelters. I believe that first hand witnessing can make a huge impact and I’m happy to say that this year, for the first time ever, our city is planning ahead for winter and has promised to open an additional emergency shelter.

My focus during the Atkinson fellowship is to work towards realizing a fully funded National Housing Programme.

Work on the ground

My first priority is to stay connected to the people and to the issues. It is important for me to be in close proximity to the people and it’s why I relocated to the downtown east side of Toronto to be near what I call the epicentre of homelessness. Because I am a nurse, and that is always how I have approached the issue, I chose to stay connected to a health centre so I have an office at the Sherbourne Health Centre. It is essential that I know, that I see, that I be able to witness, respond and act on issues at the street level. You might call this community organizing or community development, or health promotion (if you’re a nurse), or capacity building. To me, it is nursing.

Let me give you some examples of the issues I am working on: I call them the hotspots.

1) Shelter conditions – our shelters are by and large overcrowded, under funded, long-term congregate living situations for people. In some cases emergency shelters, including the Out of the Cold programme, do not meet the UN standards for refugee camps. This is a pattern repeating itself across the country. It’s only logical, as homelessness increases, shelter needs increase. There are huge stresses on this system and the people in them.

2) Outdoor sleeping – people are now sleeping in parks, ravines, tents, cars, subway grates, in front of city halls, in abandoned buildings, squats, tent cities. Tent Cities and squats are new forms of survival and they are occurring everywhere, from Halifax to Vancouver.

3) Reliance on the third sector – for example, the Out of the Cold program. I want to mention this program again because it is faith based, charity based and municipal governments have allowed this third sector to replace adequate shelter. SARS must change our thinking and I’ll come back to this.

4) Plagues – congregate living situations (nursing homes, jails, camps, shelters) all lead to serious health risks. As Florence Nightingale used to say “nurse the room” – well when you have hundreds of people using the same room, whether it’s a day time drop-in, a soup kitchen or a shelter you face special problems. Conditions which stress the immune system (such as cancer, diabetes, lack of sleep, hepatitis) increase the risk of contracting other illness and heighten the risk for tuberculosis and other infections. Every year a new menace occurs. We saw the impact of the Norwalk virus on shelter users who did not have adequate access to toilets. We saw the impact of a TB outbreak that killed several homeless men. We now see the impact of a massive bedbug infestation in our shelter system. Are they in Hamilton yet? I remain astonished at what we have not learned yet from SARS. As a nurse colleague of mine, Barb Craig, has said – what would have happened if the first case of SARS had walked into a downtown hospital like St. Michael’s Hospital? What if homeless people were exposed or contracted SARS, what if they slept one night in a Salvation Army shelter, the next day used a soup kitchen, in the afternoon went to a drop-in centre, in the evening had dinner and slept at an Out of the Cold – which the next day is closed necessitating them to go to the next Out of the Cold!

5) Dying and deaths – there are now huge palliative care needs for this population. Many years ago I knew I was going to way too many funerals for a community health nurse. Today, I now know that we need to deal with a shameless gap in palliative care needs of homeless men and women. Each month now we add between six and eight names to the monthly homeless memorial at the Church of the Holy Trinity beside the Eaton Centre. I was however shocked to learn that the death rate in communities like Sudbury and Ottawa is comparable to Toronto’s. As my colleague Beric German has said “homelessness is a national disaster, but the number of homeless deaths is a national scandal’.

The rest of the country

It is essential I leave Toronto once in a while to see what’s happening in other communities. I am quite convinced that when I visit a community I can see very quickly (especially when I’m meeting with the right people and being taken to the right places), what’s going on – the issues, the gaps, and the creative solutions being developed. This information allows me to remind politicians, the media and the general public that this disaster is menacing and progressive and not just a Toronto problem or one of the individual who they suggest “chooses that lifestyle”.

Social Determinants of Health

I’m hoping to bring to life, in practice, what this means. Are our schools teaching this material or are health care professionals still getting only a few hours on homelessness and it’s about the so called ‘mental patient’ who goes off his drugs and becomes violent?

I’m working with health professionals’ groups to look at practice, policy and their role in advocacy. I’m starting with the nurses and steeling myself for the doctors next.

Book project

I have had so many opportunities to speak out and the media have been extremely important in educating the public about homelessness. However, I know that homeless people want to speak out too. The Tent City people are the most impressive – not only did they allow media into their ‘living room’ for years, no matter what the time of day or night, but after the September 2002 eviction when they won their housing many continued to speak out so others would have the same privilege – the privilege of a key for a front door and a toilet to flush. I want to allow people like this to be what I call standing upright (instead of always being shown lying on grates) – so I am doing a book where they will tell it like it is.

This is usually what people really want to know. Are we getting closer to winning a comprehensive national housing and homelessness strategy? Everywhere I go groups are lining up wanting to do housing in their community.

Remember Prime Minister Chretien appointed a Minister Responsible for Homelessness? I thought that was such a good title – a Minister Responsible for Homelessness. That was Claudette Bradshaw. That was then.

Remember that in 2001 the federal government signed a federal-provincial-territorial housing agreement?

More recently Prime Minister Martin appointed a full-fledged Minister of Housing. Prior to this, housing was an add-on to other ministerial duties such as transportation, environment and public works. The new minister, Joe Fontana, is also the Minister of Labour.

The Prime Minister has joined the federal government’s homelessness programs with the federal housing programs, indicating that he is at least making the link.

In the last federal election, the Liberals promised $1.5 billion over the next five years, on top of the $1 billion over five years they had promised earlier. We have just learned that there will be a federal-provincial housing ministers’ meeting, likely this November. This is a great opportunity for lobbying.

Our main logjam is of course in Ontario with monies being held back. The 2001 federal – provincial housing agreement promised $244 million dollars to Ontario which Ontario would match. Ontario’s February 2003 budget promised another $100 million. There are varying reports on how much Ontario has spent but it is probably between 1.2 and 12 million. Our other problem is that our housing ministers (Minister Caplan and Gerritson) are showing a great deal of resistance in opening their office doors to meet with housing groups.

So now what you can do

Hamilton is a key player in our fight for housing so I urge you to be loud and persistent. I’m looking forward to spending a bit more time in Hamilton today meeting with people and learning more about some of your issues and needs.