By Michelle Read
Writer
Stay at home; wash your hands; remain six feet apart—simple preventive measures to stay safe from COVID-19. But what if a person has no home, has no reliable access to soap and water, and sleeps two feet from the person in the next cot?
Ottawa Public Health has identified people living in shelters as being at particularly high risk of contracting COVID-19, given their living circumstances. As such, they were made a priority for testing soon after the onset of this new health threat.
In the midst of the current pandemic, several faculty members and students at the Faculty of Medicine have turned toward caring for the most vulnerable members of society. As large university with a research-intensive medical school, the University of Ottawa has abundant resources that, applied thoughtfully, can have a huge impact on COVID-19.
“It’s all about pivoting our activities and resources to respond in a nimble fashion,” says Dr. Claire Kendall, the Faculty’s newly appointed assistant dean of social accountability. “The heart of our responsibility lies in working directly with communities to truly understand their health and needs, in order to establish and strengthen the right partnerships.”
Bringing COVID-19 testing to streets and shelters
Dr. Jeffrey Turnbull, former vice-dean of medical education at the University of Ottawa and currently a professor in the Department of Medicine, has been working with vulnerable populations at Ottawa Inner City Health (OICH) for more than 20 years.
The medical director of OICH since 2017, Dr. Turnbull directs a program reaching out to the vulnerable directly on the streets by means of a van, whose purpose has recently pivoted to testing homeless individuals for COVID-19. Turnbull says that uOttawa’s abundance of personnel provides enormous potential resources.
“Contract tracing and testing will be huge issues. Our skilled people can do an awful lot and have already made a big contribution,” he explained recently. He added that homeless people face unique challenges.
“The instructions to stay safe are not for them: they feel excluded from the advice of public health.”
Dr. Kendall, herself a volunteer with the project, agrees that working directly with the marginalized offers an opportunity to hear their needs straight from the source.
“It’s a chance to say, do you need our help, and more importantly, how?” she says. “And, at the same time, we’re building trust and relationships with public health and other community groups.”
Sensitizing tomorrow’s leaders
Even before COVID-19 struck, the Faculty’s medical curriculum was shifting to become more directly responsive to community needs, Dr. Kendall says. The pandemic highlights the wisdom of this shift.
“We ensure our learners are embedded in the community, allowing them to work collaboratively in teams to care for marginalized populations,” she says.
MD student Suzanne Boroumand founded the COVID-19 Relief Fund and Advocacy Campaign for Homeless Shelters in Ontario, where 59 med students have banded together to help the public appreciate the hardships of vulnerable populations during the pandemic.
“We’re expanding people’s thinking from those close to them to those without basic necessities or support systems,” says Boroumand. “Funds raised will help shelters, who are no longer accepting non-monetary donations of food, linens and toiletries that they previously relied on.”
To inform curriculum development, the Faculty is moving beyond simply evaluating learner competencies. The ultimate goal, says Kendall, is to evaluate the impacts that the delivery of our program is having on our communities and on our health system.
The value of research
Social accountability is also percolating into graduate and postgraduate studies and research.
“Granting bodies are asking researchers to consider how their research is relevant to the population? How can I include patients in my research activities so that their perspectives are central?” Dr. Kendall says.
Dr. Doug Gruner, a family physician and associate professor of family medicine, says that robust data is critical in making important arguments for the rights and the needs of vulnerable populations. That data is generated by researchers like Drs. Kendall and Smita Pakhalé, who are exploring the impacts of COVID-19 on marginalized people, such as social isolation and economic hardship.
“Research is a huge aspect of advocacy,” Dr. Doug Gruner said recently.
COVID-19 is exposing systemic issues underlying inequities in population health—and not just during a pandemic. If the disease has a silver lining, it is the opportunity to continue to build on supports for vulnerable populations in their daily lives, not just at a time of crisis.
“I feel positive and invigorated. There is so much we can tap into as a result of this crisis that we will make a better society going forward,” said Dr. Gruner.
Main photo: Fifty-nine uOttawa med students have banded together to help the public appreciate the hardships of vulnerable populations during the pandemic as part of the COVID-19 Relief Fund and Advocacy Campaign for Homeless Shelters in Ontario. Left to right: Kaitlin Endres, Ieta Shams, Mojgan Rezaaifar, Suzanne Boroumand, Ashkan Jahangirnia, Panteha Babelmorad.
