Top doc focuses on poverty and addictions

The new president of the Canadian Medical Association is bringing a northern perspective to Canada’s debate about homelessness, mental health and addictions.

The new president of the Canadian Medical Association is bringing a northern perspective to Canada’s debate about homelessness, mental health and addictions.

Dr. Anna Reid was in Whitehorse Friday for the Yukon Medical Association’s annual meeting, one of her many cross-Canada duties as the CMA’s new top doctor.

“It’s busy, challenging, a big learning curve, all those things. But I love it. It’s all about going out and meeting people. That’s what I like to do,” said Reid.

Reid has made a career out of meeting and working with people in isolated communities.

After doing her family practice residence on the B.C. coast, she worked in Nelson for many years before ultimately landing in Yellowknife as an emergency room physician. It was the five years in that city’s ER that she said really opened her eyes to the North’s health challenges.

“I’ve worked my entire career in remote parts of the country, but when I first moved to Yellowknife I was immediately struck seeing people in the emergency department and how desperate their lives were. I’d seen pockets of it before, but it was almost like a kick in the face when I got there,” said Reid.

She tells troubling stories, including one of a patient in western Nunavut going through her pregnancy while living under a house because of overcrowding. She has seen ER waiting areas packed with homeless people on plastic chairs because there was nowhere else to send them when the temperatures dropped to –40 degrees C.

Her biggest concern, she says, is addressing the costs – in lives and in dollars – of health inequalities often related to poverty and historic-cultural trauma, such as the legacy of residential schools in the North.

Intertwined with social status is the complex mess of mental health and addictions services, which Reid knows are a huge challenge in the North.

“In general, I think it should be treated as a medical issue, not criminal. But it’s not just a biological medical issue. You can’t treat mental health and addictions without looking at it in the cultural context in which these people live. You have to have a huge holistic look at it,” she said.

She sees her role with the CMA as one of advocacy.

“Physicians, we’re not experts in how to build low-rent houses, we’re not experts on education, we’re not experts on how to change the tax structure for low-income people. What we are experts on is the downstream effects of what we call health inequities. We see the impacts on the lives of people in these terrible circumstances. I think our role really in many ways is to add that powerful voice to the debate,” she said.

Her envisioned solution follows in the footsteps of one of her predecessors – former CMA president Dr. Jeff Turnbull.

Turnbull pioneered a harm-reduction program for hardcore alcoholics at inner city shelters in Ottawa, giving them a few ounces of wine every three hours and allowing patients to stabilize and have access to shelter even when under the influence.

In 2010, Whitehorse doctor Bruce Beaton visited Turnbull in Ottawa as part of his research for a report he co-authored with Champagne and Aishihik First Nation Chief James Allen on the territory’s “acutely intoxicated persons at risk.”

That report was largely ignored when the Department of Justice built a new detox centre at the Whitehorse Correctional Centre, and many of its other recommendations have yet to be implemented.

Allen said he hopes giving the job of the country’s top doctor to a physician with years of experience in the North will bring those issues back into the national spotlight.

“It’s great to see that because the one thing I’ve noticed since Dr. Beaton and I did our report … that the medical staff (in emergency rooms) have treated people with dignity and respect … they are treated seriously. It is a disease and I noticed that they are treated with respect now. That has changed,” Allen said.

As daunting as the issue may seem, Reid said she sees hope in programs like B.C.’s tripartite agreement on health, which gives aboriginal communities the power to deliver their own primary-based health care in collaboration with the federal government.

“It’s a huge problem, but there’s always hope. I’ve seen people who drank on the street for 20 years get the help they need and stop drinking. Things get better. I never believe things can’t get better. I couldn’t do my work if I did,” said Reid.

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