A special broadcast from Musquodoboit Harbour, N.S., about access to health care and mental health resources, including in smaller, more rural communities- Part 1

Guests: Jamie Stewart, Dr. Lisa Bonang, Lana Wood Hayden, Ronald Hayden

MATT GALLOWAY: Hi, I'm Matt Galloway, and you're listening to a special edition of The Current, I am in Musquodoboit Harbour, Nova Scotia. This is a beautiful part of the country, but it has a big problem. And that problem is health care.

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MG: Karen?

KAREN: Hi.

MG: I'm Matt. How are you?

Very well. Thanks for having me.

MG: I'm visiting Karen Bake. Karen is about to become one of more than 71000 Nova Scotians on the wait list for a family doctor. And across this country, this is a familiar story. There are about five million people without a family doctor. And you have a family doctor, but you're about to lose your family doctor.

KAREN: Yes. Yes. She's retiring in December and she takes on a lot of veterans. She I think her caseload, she told me one times over almost 2500 or more, but she can't say no. And that's why she's retiring, because she's tired and she's in her 70s. So... Overwhelms me sometimes. And I get upset and then have to go sit in the emergency room, which is not going to happen.

MATT GALLOWAY: Musquodoboit Harbour is about an hour outside Halifax, it's pretty easy here to find people who have a story about the care they can't get. This community, as I was saying, is not unique, though. Health care systems across the country are buckling under yet another wave of covid-19. That's prompted politicians federally and provincially to talk about what they do to fix things, to do things differently. Where do you even start, though?

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CRYSTAL: What I love about this community, number one, is its resilience.

MATT GALLOWAY: I met a community member, Crystal Tobin, last year outside the local hospital, a hospital where the emergency room is closed all day on Monday because there was no doctor to actually run it.

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CRYSTAL: It's causing a lot of stress and worry and anxiety and with the state of mental health and wellness. And in this province right now, you know, I've gone through five or six nurse practitioners in the near seven years that I've lived here. So there's a problem. You know, people are coming into our health care system accepting a one year contract and then moving on or into more urban centred services. And so where's the draw here for rural health?

MG: Well, we've come to Musquodoboit Harbour to hear about all the issues that you've laid out. Hopefully there'll be some solutions that people will get into as well. Just down the road, we're hosting a community forum on health care. Crystal , see you there soon.

CRYSTAL: Awesome looking forward to it.

MG: This is a really neat spot, the old school is a community centre right in the heart of the village of all but harbour in Nova Scotia. We have a small and mighty crowd here with us in the old school. And I want to say thank you for being here and thank you for welcoming us to your community. It is, as I was saying earlier, a beautiful part of Canada. We were down to Martinique Beach yesterday, which is just gorgeous. And I would have been happy to spend the whole day there. But we have things to do and things to talk about, including issues of health care and why this community in particular is front and centre in many ways when it comes to the issue of trying to get a family doctor and of the struggles around rural health care. Lots to talk about. So let's get started. In August, Ronald Haydon had a heart attack. He's 53 years old and he lives in this community with his wife, Lana Wood Haydon. And they are both here with us at the old school. Thank you both for being here.

LANA WOOD HAYDEN: Thank you for having us.

MG: How are you doing, Ronald?

RONALD HAYDEN: Not so bad.

MG: Not so bad.

RONALD HAYDEN: Yeah, pretty good.

MG: Tell me what happened. This was only just a few weeks ago. What unfolded?

RONALD HAYDEN: Yes, I was. It was Friday morning. I was actually on my boat sailboat. I was getting it ready to sail to Halifax alone, and I was just getting provisions down and in stores and down in the bulkhead. And when I went down inside, I started losing my breath. I couldn't catch my breath, so I thought I would sit down for a bit and it didn't seem to be getting any better. So I started hyperventilating and I kind of felt that I was going to black out. So I immediately called my wife here and told her I wasn't doing so good. And that's the last thing I got. And I when I came to I heard sirens in the background and my wife was standing over me. Bit of a panic and how it could have been a lot worse, I guess, if I had left already by myself.

MG: Let me ask you, Lana. I mean, he's out prepping the sailboat. How did you hear that? He's, you know, in distress. How did you get to him?

LANA WOOD HAYDEN: Well, when I got the call and it was just short and sweet, he just said, help me. And I was a little annoyed because I didn't want him sailing to Halifax by himself anyways. So my answer was like, help you with what? And then he just managed, Help me. And then the line was gone. So I knew there was a problem. So our sailboat is just across the road from our house and over a hill. So I hopped in the car and drove down to the shoreline and I saw the boat there, but he wasn't on deck. So I thought maybe he cut his hand or something. So I knew it was pretty serious. So I jumped on my paddleboard, paddled out of the sailboat, found him collapsed and unconscious and at that point, not really breathing at all and grey colour. And I know what that colour looks like and means. So I didn't kind of said, are you OK? But n911 was what I was doing because that was the only thing at that point in time to do so. I managed to kind of get him up on his hands and knees and up to the side of the boat. And then I checked him out in the rowboat and almost tipped that over. That would have been a whole other problem. So then I jumped in to counterbalance that. And then I rode all the way to shore and by then the paramedics and the ambulance were there.

MG: You can laugh about it now, but it is quite something to go through.

LANA WOOD HAYDEN: It was a pretty surreal situation. Yeah. And, you know, you kind of think you would be freaking out, but it was like something you see on TV how the paramedics would do it. It's like you just know what you have to do and you just you just do it.

MG: You mentioned the situation at the hospital. You get in and you're treated and here you are. You've been stabilised, you're sent home. Describe what happened when he was discharged

LANA WOOD HAYDEN: that day that he was discharged, they were still monitoring him for his weak heart rate, his weak heart. But they needed the beds. And they said we could follow up with our family doctor and get additional tests and diagnosis and treatment later. And I said, we don't have a GP and I'm not really comfortable taking him out of here. Like we don't have a GP. What do we do? And they just said, come back to emerge.

MG: What was it like, Ronald, going home? They say, just check in with your GP. Without it, I mean, what was that like?

RONALD HAYDEN: Yeah, it is a little disconcerting just knowing I have nowhere to go right now. The doctor asked me if I had a family doctor and I said no. Where would they send these all these paperwork so they can follow up? And I said, well, we had this other doctor that we saw once at the walk in and we knew his name. So we just went with that and he sent the paperwork there. But when we called him to try to get an appointment, couldn't there was no chance of getting in to see him even as a walk in. That's as it is now. Nothing's changed.

MG: And this has become a bit of a mission for you, Lana, right. To try to find him a family doctor?

LANA WOOD HAYDEN: Yeah, that's my new full time job. It took me about two weeks of Googling and researching his paperwork to realise what his situation was. And we realised he's got a dilated aorta and his heart. So that's an aortic aneurysm and the next step after that could be an aneurysm rupture and tear. He's in denial. It's only a little rupture.

MG: Just a little ruptured. What do you is most frustrating about this whole thing, Lana, given given what you have been through in the last few weeks?

LANA WOOD HAYDEN: Thirty years ago, my father was 43 and he died of a heart attack. Medicine is a whole lot different 30 years later. And I still can't get help for my husband, you know, 30 years later after losing my father. So it's just mind boggling how our health care system can be in such messed up shape in this day and age. Like the doctors are there. There are doctors. There are treatments that could help him. But the resources are so poorly managed. It's it really does seem like I'm stuck in the twilight zone trying to get doctors and talking with everyone. They've been very compassionate and caring. And they know and I tell them all like he's walking around like a ticking time bomb and you can't take him on. And everyone has said, no.

MG: I'm glad you're here. I'm sorry for what you've been through. But I really this is the kind of story that sets the table for what we're going to talk about over the course of the next little bit and talk really about what's at stake in situations like this. So thank you very much for for being here and sharing your story and take care of yourself and good luck.

LANA WOOD HAYDEN: Thank you.

MG: Lana Wood Hayden and Ronald Hayden, they in many ways, as I say, capture what we're here to talk about. The shortage in many ways are family physicians, but also beyond that, what that shortage leads to. Lisa Bonang grew up just down the road from here and head of Chezzetcook. She's been a family doctor here for 26 years and works in the emergency room at Twin Oaks Hospital, just up the road. Doctor, hi.

DR. LISA BONANG: Hello.

MG: How often do you hear stories like this and you get calls from people like Lana and Ronald asking to be your patient?

DR. LISA BONANG: Not every emergency shift, but pretty much every emergency shift.

MG: And can you take on any new patients?

DR. LISA BONANG: I am not.

MG: If I was your patient and I want to talk about why you can't take on patients, but if I was your patient, how long would I have to wait to see you for an appointment?

DR. LISA BONANG: Unfortunately, now you're waiting about two months.

MG: two months.

DR. LISA BONANG: To get in to see me for nonurgent visit.

MG: And so what happens if somebody needs to get in? And that time? Two months is a long time. A lot can change in two months. What happens?

DR. LISA BONANG: So our clinic does have some same day appointments. So if something more urgent, if not, then they present to our emergency department for care.

MG: We know that there are many thousands of people in this province who are looking for family doctor, close to five million people across the country who are looking for a family doctor. In this community, why is it that there aren't more family doctors practising today?

DR. LISA BONANG: Was Lana said, is a lot different than when I started 26 years ago. Patients are more complex, the system is more complex, and the pressures on the system are more complex. Work life balance is something that's influencing how many people we have or how many people that want to do what we do.

MG: Work life balance and that there are so few doctors and so many patients who are looking for doctors that doctors are stretched in every different direction and that that is unappealing. Is that part of it?

DR. LISA BONANG: There's no question. You know, the days where you had 4000 patients and you're working from seven o'clock in the morning to seven o'clock at night is not appealing necessarily to all physicians. We're all working very, very hard. It's not easy to keep up that same pace like we could 20, 30, 40 years

MG: ago when people don't have a family physician. What are the problems that that can lead to down the line? I mean, we just heard from Ronald. He has a heart attack. He's discharged. The discharging note says follow up with your family physician. What does that lead to

DR. LISA BONANG: if you're going to have a healthy population, healthy persons, you need to have continuity of care, you need to have coordinated efforts both in promotion, prevention and helping people through these events that happened in their lives. If they have no one to turn to, perhaps, you know, the outcomes may not be as good as someone who has a family physician or another primary provider that can lead them through that journey.

MG: And without a family physician, often if people need care, they would go to an emergency department like yours. Just give us a sketch as to what a typical day in the E.R. is like for you in this community.

LANA WOOD HAYDEN: Well, our shifts here are from 8:00 in the morning until 8:00 at night. So we did 12 hour shifts here before we might see eight people. Now we're seeing regularly 20 to 30 and occasionally closer to 40 persons a day in that 12 hour shift.

MG: And are those largely people just from this community or are people coming from other communities still looking for care?

DR. LISA BONANG: People are coming from other communities looking from care. And we have situations where we have persons that come from Stewy. The first part, they come and go to grab it, their clothes. They keep going to Musquodoboit Harbour. We have persons that come in from Dartmouth, from the city, you know, because they have 12 hours a wait time attorney general. They come to our facility to be seen because they know the wait list or the wait times are going to be shorter.

MG: You just talked about some emergency departments being closed. I mean, your emergency room is often closed. We just got an email from the hospital saying, unfortunately, we will be closing our ER department on September 17th, 18th and 19th and 24th. This is due to the inability to cover the physician. Shifts during this period will be opened overnight on each of these nights. Sorry for the inconvenience. Can you tell me more about why an emergency room would be closed?

DR. LISA BONANG: That can be nursing shortages for a good portion of our closures, which are particular facility has had has been mainly nursing. However, as you heard, we also have physician shortages or physician absences that caused cocoa's occasionally, but not often. We also can have paramedics that aren't available. So that would be a closure as well.

MG: I mean, give us a sense for people who don't know this community, they're listening across the country. If they go to the emergency department at Twin Oaks Hospital Musquodoboit Gadabout and they're not able to be treated, how far would they need to go to find some treatment?

DR. LISA BONANG: Our closest facility would be Dartmouth General.

MG: Yeah, but there again, there's an eight to 12 hour wait because there are a lot of people there who are looking for care.

DR. LISA BONANG: That's correct.

MG: What frustrates you the most about this situation is you're describing it.

DR. LISA BONANG: I don't know if you have enough time when you're in the situation. You have someone like Ryan coming in to emergency room and they're asking you and, you know, they need follow up care and, you know, they need a primary care provider. It's difficult to say no to them. We go into this profession, all health care providers, to do our best and to take care of people. And when you're not able to take care of them. It doesn't make you feel good.

MG: It's really emotional for you to have those conversations. What do you say to somebody when they call and they're in a crisis situation and they say, I need a family doctor, I need somebody to take care of my health, and you can't you can't help them out. What do you say to them?

DR. LISA BONANG: You apologise. And, you know, most people understand. They understand that you're busy. They understand that you have a lot of patients and that you're working as hard as you can. And in the moment, we tried to do the best that we can.

MG: But as you say, you didn't get into this profession. People talk about being a doctor as a calling. You didn't get into this because you wanted to say no to people. He wanted to treat people. That's right. You're going to stick around with us, we have some other things that we want to bring up with you, so I appreciate you being here, Dr. Lisa Bonang. We'll come back to you in a few moments. We're going to go to our audience for a moment for a different perspective on this. Jamie Stewart is a registered nurse. He works in the emergency department at Cobequid Community Health Centre, which is not so far from here. Jamie, hi. What are the things like for you and other nurses right now in your ear?

JAMIE SATEWART: I see people like Ronald every day that come in and are waiting to be offloaded and our eyes are so busy. I mean, I can give an example of just Monday night and I'm the clinical leader there. And you come in, there's 44 people not seen in our departments, the 30 bed unit that's already full and you have eight aimlessness waiting to be offloaded.

MG: So we run through those numbers again.

JAMIE SATEWART: Forty four waiting to be seeing the department's already full. It's the 30 bed unit and eight ambulances. Are those some of those 44 waiting to be seen?

MG: What is when you see that, what goes through your mind,

JAMIE SATEWART: you, while you're in you're panic mode, in survival mode, trying to provide the, you know, some care to everyone. So you're just scrambling to make room for everyone to provide some semblance of care to people, you know, that need it first.

MG: And how do you do that if space is I mean, at a premium isn't even a sharp enough phrase in some ways, but there's no space at the space is taken up, what do you do?

JAMIE SATEWART: So that's where triage comes into. OK, so it's the sickest get seen first and even then you're triaging the triage patients. So it's it's it's it's a vicious cycle. You know, the staff are like, I would call it, almost like morally like injured because we want to provide the best care we can to people. But we can't. We're just mandating everybody.

MG: Is it getting worse, do you think?

JAMIE SATEWART: Yeah, I've been doing this for 27 years and this is probably the worst year I've seen.

MG: How do you cope with that?

JAMIE SATEWART: Are we coping with it? I mean, I've never seen my co-workers so anxious and just worried. And I mean, they're just trying to find any avenue to try to get some self-help, some self care just to try to distract from they know what the workplace is going to be when they get there.

MG: You use the phrase moral injury, which is something that I've heard a lot over the course of this pandemic from people who are on the front lines. They're caring. You're carrying a lot and it's been 18 months and you're fried. We hear from a lot of nurses who are leaving their jobs totally fried, burnt out. They are unable to continue doing that. Are you seeing that as well?

JAMIE SATEWART: Oh, for sure. People are like, why would you stay somewhere where it's like a war zone where you can go to work and maybe a public health clinic and get immunisations and screening. But just make sense. People are retiring early just because they just they can't last a few more years. They're going to take their pension now and be done.

MG: And that's only going to make the situation worse.

JAMIE SATEWART: You're losing all your experienced nurses.

MG: What would you say to people who are listening about the urgency of the situation? I mean, we've heard stories about this and we'll hear more, but what would you say about the urgency of the situation right now?

JAMIE SATEWART: This is our new state of emergency, is what I would say about it, is not the pandemic anymore here, it's their health care.

MG: I appreciate the work that you're doing to take care of yourself in addition to all of your patients. And Jamie, thank you very much. As Jamie Stewart, he's an emergency nurse in Lower Sackville, Nova Scotia. We are here in Nova Scotia talking about health care. Your CBC News is next. And then we'll take a look at the pressures on ambulance service and emergency rooms. We've been talking a little bit about what happens when those ambulances arrive in the E.R.. We're continuing our special on health care with a focus on rural Canada.

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VOICE 1: If we do not properly fund the system, if we don't come up with a national human resources plan to staff the system, if we don't have standards that ensure that everyone across the country is getting equal access to care. We will essentially be abandoning public health care. And in that sense, we will also be abandoning the promise. And I, quite frankly, do not want to live in a society where we say that whether or not you live or die is based on whether or not you can find a doctor and pay for it out of pocket.

VOICE 2: The day before he died, I took him to a clinic and he was diagnosed with a UTI. And I thank God that's all it was. It was a yachtie doveish show concept. Doctor called in the prescription. I picked it up. He took the two pills that day. Well, overnight he took a turn. You have to get on the ground and see what's happening and listen to what is being heard in community. So I'm really excited for you guys to be here to have your ear to the ground, to be a part of the listening.

MG: for Nova Scotia, speaking with people in this community about the barriers to care and some of the solutions that we could offer. My name is Matt Galloway. You're listening to The Current on CBC Radio One. Stay with us.

A special broadcast from Musquodoboit Harbour, N.S., about access to health care and mental health resources, including in smaller, more rural communities- Part 2

Guests: Tanas Sylliboy, Mike Parsons, Anne McPhee, Simone Harker

MG: Hello, my name is Matt Galloway, you're listening to a special edition of The Current. We are here in Musquodoboit Harbour, Nova Scotia, gathered with people from this community and we are asking what happens when people can't get quality health care when they need it? My column could tell you that in January he had two heart attacks but drove to the hospital himself because he did not trust an ambulance would come in time. And then.

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When I got up to ICU in the cardiac ward, exceptional care, exceptional care. But down below, you're just you're, just you're just nothing on a goddamn slab. I mean, I thought emergencies were for poor care not to store people and ignore them, like for almost three days. I'm sorry, the emergency care is busted.

MG: The system was busted for Mike. And you will hear similar stories across rural Canada, stories about emergency care, about care for the elderly and about mental health care. Every party in this federal campaign is promising money and a plan to tackle the issue. Here in Nova Scotia, a new provincial government was just elected with a promise to fix health care. My guests here today have some ideas about the problems and what needs to change. And we are grateful that they are willing to tell us their stories. Simone Harker is sitting beside me this summer. Simone's husband, Keith, died in the waiting room of the emergency department at the Covequid hospital. Simon, hi. Hi. I'm sorry for what you've been through.

SIMONE HARKER: Thank you.

MG: How are you doing?

SIMONE HARKER: I'm mostly holding it together, but it's not even seven weeks. It's close to seven weeks, so it's still pretty rough with me.

MG: I'm really, really grateful that you're here with us. It's really important that you're here. I know. Do you mind? And only say what? What is comfortable? I know this is difficult, but do you mind telling us what happened that day? Mm hmm.

SIMONE HARKER: My husband being a diabetic, I made sure he got some really good treatment. And we watched his sugars and took the insulin often as as he should. He told me for the last couple of days his sugars were high. And I know that that's usually an infection or he took too much insulin. He swore he took the right amount. He's been a diabetic for a long time. And so I said, well, how do you feel? He said, my body doesn't feel quite right, but he couldn't articulate what it was. So anyway, the day before he died, I took him to a clinic and he was diagnosed with a UTI. And I thought, oh, God, that's all it was. It was a UTI. [unintelligible] his sugar's up. Doctor called in the prescription. I picked it up. He took the two pills that day. Well, overnight, he took a turn. He woke up to go to the bathroom. He said, Can you help me? I can't make it. And I got him out of bed. I said, put your arms around, put your arm around my neck. He said, I'm afraid if I fall, I'll take you down and hurt you. Put your arm around my neck and I'll hold you up. Got him in there, got him back to bed. The next morning, he couldn't feel his legs. He couldn't stand up. And so luckily our son in law was staying upstairs. I called and said, Can you come down and help me? He got we got him to ask, got him in a wheelchair, took him down to the car. He drove us out. I walked in with him and covid. It was a nightmare. It was packed. And as I sat there and looked around, I thought, oh, my God. So they had a system, I think five chairs and five chairs. You waited to be changed. I was sitting in the last chair. I had to make it all around. My husband was vomiting. It took I was over two hours waiting to make my turn around. But in the meantime, I seen a paramedic come out and I went over. I said, my husband is really sick, he's a diabetic. And this just overnight, he's become very, very weak. And I said, I'd like to call 911 to have an ambulance come to Cobequidto take me into town. And she said, you're going to have to wait no matter where you go, you may as well sit and wait here. I went over to the triage. I waited till that patient came out. And then I went in and I said, my husband is desperately sick, he's diabetic. And this came on very, very suddenly. How long before he gets in? She said, I'll do what I can. And at that point he was vomiting. She says, Here, I'll give you a bag for we were not we sat again, I said I tried. After about seven more people went through her triage, she waved to me and said, come on in. His blood pressure was 189 over 73. His shoulders were 19 plus. And so she said, OK, just go over to the next window. So I went over to the next window and again this nurse was talking to me and he was, he was barfing but there was nothing coming out and when I looked in the bag, it was all white and then all of a sudden he was... And I lifted this mask and sadi, Talk to me, he was frothing at the mouth and the skin was changing colours. He died right there at the window in the lobby of the hospital in front of everybody. And then they came running and I ran after them and they each grabbed a limb, four of them. And he was like a rag doll. And they tried and they tried, with CPR and electric shock and he was gone. I couldn't believe that he had a UTI and I took him there to get help. And I had to leave without him.

MG: Oh, my God, I'm so sorry.

SIMONE HARKER: We just had our 50th wedding anniversary a week or two before that, and I lost the love of my life that day and it's still so very, very difficult. I don't blame the nurses or the doctors, I did put a letter in the paper. I don't blame them. I witnessed, but these what they have to do,

MG: you said in that letter that you wrote that you don't blame the nurses or the doctors, they were doing the best with the resources they've been given.

SIMONE HARKER: Right. And they don't have enough resources and they need to do something. They need to perhaps get the students that are taken nursing or something, get them out on the floor and get them this. I don't I don't have the answers for it, but whatever they can do, they could try.

MG: I want to introduce the woman who's sitting beside you who before you started talking, you were holding her hand for support because she has gone through something very similar. Her name is Anne McPhee. Last fall, her husband, Kelly, had a heart attack at home in their Halifax apartment. They waited 40 minutes for an ambulance. They lived three kilometres from the hospital. The ambulance took 40 minutes and Kelly died there at the apartment. And thank you for being here.

ANNE MCPHEE: You're welcome.

MG: Can you tell me more about that weight and whether you got information, three kilometres is not very far.

ANNE MCPHEE: It's not far at all. I'll never forget that. Morning, Kelly, got up and he always had this wonderful smile on his face and he passed me, I was up earlier and I was preparing something in the kitchen and he always went right to the shower. So I would just wait until he finished his shower and then I would put the coffee on and we would have breakfast around 7:00. So he went into the shower and I heard him. He said, Anne, can you come in here quickly? And I went in and he was on his knees on the floor. And I said, What's wrong? He said, I don't know. I said, Are you weak? He said, yes. He said it happened. It's happening suddenly. So I hollered to my son who lives with us. I said, phone 911 one right away. And he did. And he came in and he was standing in the doorway with me. And I'm holding him because he's he's very weak. And so I'm trying to answer the questions to 911 when I tell them to come. And so we we disconnect that. And my son goes downstairs. So I'm waiting and waiting and waiting. And Kelly saying, where are they and what's taking them so long? He said, go to the window. I said, we'll hear them. I can't leave you. I can't leave you. So we're both struggling. And then I call again. I say, where are they? They said, we can't tell you that. So this goes on. And after 28 minutes after a while, he started to say, and I'm dying. I know I'm dying. And I like to do is hold him and then he got so cold and after my third call, I phoned my neighbour downstairs who is an RN retired, and she came up and she helped me turn him over to the floor. And as soon as I did, his eyes were fixed and she said he's unresponsive and run down, get Walter because he's just had a CPR. That's our son. He came up, he just took the CPR course in. The first person he had to do it on was his dad. So I'm waiting downstairs, still waiting, and there's nobody coming. And finally, the fire department came and finally the ambulance arrived and a thirty four point fourteen seconds for them to get to our apartment. And it took them 40 minutes total for them to arrive inside of our door. And they came in with me and my husband was on the floor, so totally unresponsive without any oxygen for 12 minutes. Then I told them to stop. I said it's all too late and we suffer through that all by ourselves, and you're trying to comfort somebody, and even if he would have lived or he would have died, we don't know. But if they had arrived at the normal time should have been nine minutes or less for the distance we were from the hospital. He would have died in comfort and [unintelligible] the same it takes. It's so hard to close your eyes in the night because that's all you hear and that's all you see.

MG: I'm so sorry.

ANNE MCPHEE: Thank you.

MG: Did they ever did you ever get any information as to why it took them so long? I mean, it's incomprehensible for a lot of people listening, given, again, how close the hospital was, but also what you were going through at the time. Did they ever say?

ANNE MCPHEE: What I know, I have the police there. I have the ambulance attendants. I have the firemen in there all saying the same thing. It's the system. There was no ambulance available in the city. The closest ambulance available for your husband was coming from my home bay, which is eighty four point four kilometres away. The two that ended up coming there came from Cole Harbour and they had picked up a ship from another crew who had been assaulted through the night.

MG: Why is it important for you to speak out about this?

ANNE MCPHEE: Because I want this to stop and I want it to stop now. Our health care is just a total mess right through. It's a systemic problem, like from the top to the bottom, from one end to Nova Scotia to the other. We have 18 counties in Nova Scotia and at times there are 11 counties in Cobequid. If anybody knows what Covequid is, it means there are two or less ambulances for one county. They're so burnt out, it's terrible. There's about 200 of them that are often stress leave everyone. Everyone is suffering because of it.

MG: Simone, what does it mean for you to have someone like Anne, I know in it you found strength. You've become friends through everything that you've been through.

SIMONE HARKER: I remember reading her first story. I didn't realise how long ago it was, but it resonated with me. And when I seen her article this time saying it's been almost a year and nothing has changed. And at that point I had lost my husband. And when I read her article this time, I thought she said something about empowering more voices. And I thought, she's talking to me. That was when I felt I needed to do something. I wrote, I sat down at the computer and I wrote a letter. So I sent it to the publisher, to the paper. But through that and then I reached out to each other and it's been so helpful for me. And I don't know where this is coming from, from me, because I do not like to be in the public eye, but I think I have anger and I have energy and I need to try to make my anger go into a positive place. And I know it's not going to help my husband, but I'm hoping down the road somebody else may have a life saved because of the voices or the noise that we're making.

ANNE MCPHEE: We've talked it over that by sharing our story, it might make other people feel that they can come forward and tell their story. And the reason we are speaking out is because we just want to help people. We want to help the doctors. We want to help the nurses, and we want to help the paramedics and everybody that's suffering because of the mess of this system.

MG: I'm sorry for what both of you have been through. And I can't imagine how difficult it is, as I say, to speak about this. But it's really important. Your stories are incredibly powerful and I wish you the very best. Take care of yourselves and thank you for being here. Simone Harker and Anne McPhee, I want to talk more about this with Chris Parsons. He's coordinator with the Nova Scotia Health Coalition. It's a nonpartisan group that advocates for public health care in the province and he's been listening in. What's going through your mind as you hear these stories, Chris?

CHRIS PARSONS: I mean, at a really basic level, they're hard and heartbreaking. But it also, I think to a certain degree, is an indictment of our society and our priorities that we allow this to happen.

MG: What do you mean?

CHRIS PARSONS: These are avoidable. We have our organisation has existed since 1996 and spent decades being accused of Chicken Little thing, of being told that we are fear mongering and doctors and nurses and paramedics within the system of doing the same thing for decades. And I've been told and dismissed that that we were unrealistic to think that we could improve the health care system with the health care system was in a bad spot. And now it's obvious to people that it is in the Spotnitz in Nova Scotia, but it's across the country. And I think at the end of the day, it comes down to a moral choice of whether or not we think that people, when they're in their time of need, deserve to be taken care of. And I think that in a just society, the answer to that is yes.

MG: You say this is across the country. I mean, if you take a look at this, we're here in Nova Scotia talking about the situation in this community in this. Province, but how big is the crisis in the health care system, do you think, more broadly?

CHRIS PARSONS: I mean, the crisis in Nova Scotia is I don't think it's necessarily worse than other provinces. It certainly is different. And we face our own challenges. I think that it is acute and it's getting worse. But one of the things that I think is really important to keep in mind is that this is not simply a crisis in health care, it's that health care is the backstop and the last social programme we have left in a lot of cases.

MG: It's interesting, we spoke with Dr. Robert Strang, chief medical officer of health, and he talked about the social determinants of health. You can look at primary care, for example, but he was pulling the lens back to take a look at larger things. And you're nodding, as I say that.

CHRIS PARSONS: Absolutely people end up in the emergency room because there's nowhere else in the health care system for them to go. And they often end up going to the health care system because there's nowhere else left in our social safety net for them to go. So, you know, we look back, we were founded in 1996, the massive budget cuts that we saw during the mid 1990s at the federal level that gutted not just health care, but gutted social programmes across the board that stopped building public housing. They cut social assistance rates that led to the beginnings of an addiction crisis in this country. All of these things that cause people to get sick, all the things we used to have to try to prevent them were cut to the bone. So what we really need to see is certainly an investment in health care, but also an investment in preventative care and an investment in the social programmes that prevent people from getting sick in the first place, that mitigate against poverty, against homelessness, against colonialism and systemic racism. They're are the things that lead people to get sick and injured in the first place and that overwhelm the health care system that is bursting at the seams. And we haven't done that.

MG: If you look at primary care at the front line, the front door of that, in terms of a family physician, what are the things we talked about, the lack of family physicians and the long, long wait list? I spoke with a woman yesterday who was about to be added to that waitlist in December because her physician physician is retiring. She can't figure out who's going to take her on. What is it that could be done at that front door to ensure that people have somewhere to go? That's not the emergency room, that they have a family doctor.

CHRIS PARSONS: So I would say two things. The first thing is that we need to think beyond just family doctors. I'm so part of this. We need to think about primary care practitioners. And that looks like family doctors as a key part of that. That also looks like primary care nurses and nurse practitioners. But it also looks like a team approach that allows doctors to work alongside other professionals and allow everyone to use the expertise they have. So bring in occupational therapists, dieticians, social workers, because often these problems are not necessarily health related, but are often the result of social conditions. Allow this team of experts to work together to use the expertise that they have in conjunction with each other and to form relationships with patients. So I think part of it is expanding upon the question of family doctors, even for people who have family doctors to have access to these other professionals. And I think the other thing is, is to recognise that when we take family doctors and put them in communities where they're alone and isolated or nurse practitioners where they're alone and isolated and don't have this sort of support, we're guaranteeing that they will leave those communities because they will be burnt out or to make sure that people who are in those positions are in training, in schools or doing internships are had the opportunity to practise before they become professionals or study before they become professionals in rural communities, in the communities they might practise in. We know that they're much more likely to stay.

MG: Simone talked about anger. So a lot of anger in this province during a recent provincial election when many people believe that a government flipped in large part because of issues around health care. We're in a federal election right now. Justin Trudeau, the leader of the Liberal Party, was in Halifax this week talking about health care. What do you want to hear when it comes to - there's a lot of issues that you raised, but what do you want to hear from the people who want to lead this country about how they're going to tackle this in a meaningful way?

CHRIS PARSONS: So I think the first thing is certainly that the federal government needs to return to its role in funding health care. Every dollar that goes in is playing catch up. So we need more of that. We also need the them to take a role in leadership in terms of setting standards for the provinces to make sure that people not just from province to province, but community to community, have equal access to care as is guaranteed to them under the Canada Health Act. If we do not properly fund the system, if we don't come up with a national human resources plan to staff the system, if we don't have standards that ensure that everyone across country is getting equal access to care, we will essentially be abandoning public health care. And in that sense, we will also be abandoning the promise. And I, quite frankly, do not want to live in a society where we say that whether or not you live or die is based on whether or not you can find a doctor and pay for it out of pocket.

MG: We're going to come back to you a little bit later on. In the meantime, Chris, thank you. As Chris said, just an issue of doctors. For the past several years, Nova Scotia has been trying to expand the role of nurse practitioners, nurses who provide direct care to patients and diagnose and treat those patients independently. And we are glad to have a nurse practitioner with us tonight.Tanas Sylliboy is a Mi'kmaw nurse practitioner at Millbrook Health Centre on Millbrook First Nation. Grateful to have you as part of our discussion as well. Thank you very much.

TANAS SYLLIBOY: Thank you for having me.

MG: Describe your role. I read something where you talked about. Wanting to be a familiar face in the emergency department for your community, how would you describe what your role is for your community?

TANAS SYLLIBOY: Yeah, so there is a huge gap between first nation people and health care. And it's been evident day one since I started working in an emergency department that there's a long road that we need to make meaningful change. What inspired me to go into the emergency room was stories from my communities hearing the ongoing racism that we continue to face in this day and age, experiences of people not knowing what residential schools were and having the biggest trauma happen to indigenous people. And when it comes to nurses and physicians saying that we are trauma informed but not know, one of Canada's biggest problem problems like this health care system has always failed us and will continue to fail us. And I always advocate for trying to dismantle what it is right now. And we need to dismantle white supremacy. We need to dismantle systemic racism by working with the communities. We don't need people to be our voices. We need people to look at uplifting their voices. So as an MP working in Mi'kmaw communities like, I'm happy to be able to provide translation services because a lot of things get lost in translation. And Nova Scotia, we don't have translation services for Mi'kmaw patients. We do in some capacity, but not all our emergency departments. So it's really important to because there's a whole bunch of things that we're going to miss if we're not understanding what's being said from physicians or employees. So having like myself in these roles is vital for improving indigenous people's lives.

MG: I think of what it's like to run into a familiar face and you get a smile on your face and you feel at ease. How do members of your community react when they see you, when ou are recognised and seen in in a moment of crisis?

TANAS SYLLIBOY: I feel safe here. that it's so common for you to hear that you feel like an animal when you present to these places. And you look out west and you look at the death of Joyce Echaquan and you look at the death of Brian Sinclair, these are things that are continuing to happen. And you have politicians and politicians promising that change needs to happen. And yet here we are again. This continues to happen and this is why we need meaningful change. This is why we need to continue to engage with indigenous communities, black communities, because we're suffering.

MG: There's a lot of talk about moving back and not just focussing on individual parts of the system, but looking at this as a system. Is your sense that that that is underway right now?

TANAS SYLLIBOY: I certainly hope there is going to be movement like they made this big shuffle for the board of directors. They fired them and people--

MG: In the health department in Nova Scotia?

TANAS SYLLIBOY: Yes. And there's an indigenous representative, a black representative. And it's makes you nervous that we hope our voices are still at the table because we, like I said, we know what's going on. We know the solutions. Just have to work with us.

MG: You want to be in the driver's seat, in many ways, yes. Not in the passenger seat.

TANAS SYLLIBOY: Yes.

MG: Thanks for the work that you're doing. Well, and thank you. Tanas Sylliboy is a Mi'kmaw nurse practitioner at Millbrook Health Centre on the Millbrook First Nation. Chris Parsons. That systemic change that the US is talking about when a system is being pulled in all these different directions, how do you how do you start to address that, do you think?

CHRIS PARSONS: I mean, it's not simple and it's not easy, right. And I think that we do need to accept that. I think that part of it, though, has to come from having really honest conversations in our communities. So I think that most people in most particularly rural communities, don't believe that they need to have access to every single service directly in their community. What they want is a say in which services are important to them. But I also think part of it is accepting that it's hard, right? Like politicians often say, fixing health care is harder than people think. No one's saying it's going to be easy. But for goodness sakes, you're running to lead a country. You're going to have to do something difficult. We're asking you to do something difficult and that's fix health care. Because the reality is with the average nurse goes through on 12 hour emergency room shift is it's far more difficult than what the average politician has ever had to live through.

MG: Stay with us. When we come back, we are going to speak about another part of the health equation and the health system, and that is the issue of mental health and what it's like to try to access therapy or psychiatry when doctors are scarce and waitlists are very, very long. It is a crucial part of the system and one that we will discuss coming up in just a few moments. My name is Matt Galloway. You're listening to a special edition of The Current from Musquodoboit Harbour.

A special broadcast from Musquodoboit Harbour, N.S., about access to health care and mental health resources, including in smaller, more rural communities- Part 3

Guests: Chris Parsons, Dr. Jackie Kinley, Dr. Lisa Bonang, Crystal Tobin, Margaret Tobin, Kristen Cudmore

MG: Hi, my name is Matt Galloway. This is a special edition of The Current. The community of Musquodoboit Harbour in Nova Scotia has welcomed us today and I've had the chance to visit over these past couple of days. It is an absolutely beautiful part of the country. You can understand why people from across Canada are moving here, doesn't go over entirely well with some folks, but you can understand why people would come here. It just draws people in. This is a part of the country that has a lot of beauty, but it has a big problem as well. And we've been hearing all about it over the course of our programme. It's a problem with health care. As you listen, no matter where you are in this country, some of these problems might be familiar to you. Across Canada, we know that health care is stretched and strained. It's something that we hold dear as part of the national fabric. Chris talked about it in some ways being the promise or a promise of Canada. And that promise. Is finding itself under threat and being asked some pretty tough questions, so we're here talking to people on the front lines, patients and those doing their best to care for them. Crystal Tobin Legere is part of this community. She is helping to offer mental health support to people here. In yesterday, we went to Martinique Beach and she told me a bit about herself and how she got involved in mental health advocacy.

SOUNDCLIP

CRYSTAL TOBIN: It started when I was young. As a teenager, my father was diagnosed with a mental illness, bipolar disorder, and he tended to self medicate with alcohol. And back then, you know, rural Cape Breton, there weren't many services or supports available. And so it kind of started there, like what can I do to help my father? So I kind of had a baptism by fire with this. And then for my own life, I was a young mom. I had my son when I was 15, again, had to advocate for a lot of services and supports and fight just to be able to continue to go to school. I was the first person in my family to graduate from high school and the very first person to go to university. And then, you know, I lived with my own mental health challenges with anxiety and depression. And then later in life, as a result of of losing my dad, tragically, I experienced and was diagnosed with complex post-traumatic stress disorder. So it was just layers and layers, kind of like our health care system. So I learnt to navigate systems and to keep knocking on doors and to keep asking questions and to not take no for an answer.

MG: You brought us down here to this beach. Why are we here?

CRYSTAL TOBIN: I come here because with all of this work, it can be really draining. You can't pour from an empty cup. So how I refill my cup is coming here. Oceanside, listening to the surf, having that tactile feeling of the sand on your feet and grounding. And so this is my place where I come to recharge. And I thought it'd be really nice to share that with you both.

MG: It's beautiful. And there's a seal that's right out there.

CRYSTAL TOBIN: Welcome to the Eastern Shore.

MG: I put my feet in the ocean and I felt better. Crystal Toby Legere is here with us at our gathering at the Old School Community Centre. This is a place you know really well.

CRYSTAL TOBIN: Yes, it's a real community hub. I know it well because I am involved as a mental health promoter, as a community literacy practitioner and communitarian at large.

MG: How much need have you found for the work that you do here?

CRYSTAL TOBIN: The need is especially evident in my work that I do with literacy. I have all of these brave folks who come through the door to ask for help, not only with reading and writing and getting a GED. It's also these folks who are coming to the door who don't understand what this health care system is. What is a nurse practitioner? What is a locum? What is a collaborative care practise? So a part of the work that I do. And to Dr. Strang's point and thank you for saying this, Dr. Strang. The social determinants of health, those are the building blocks and units of our health care system. You know, whether you have a job or employment, whether you know how to read a document or fill out an application form. These are all simple things, it would seem. But these are the connection pieces to health and some of the other work I do here, right in the old school, is teaching mental health first aid. It saves lives and empowers people and it provides help.

MG: When we speak about a crisis in the system of health care, do you think that mental health is given the consideration that it is deserved and that it is due in that larger systemic conversation?

CRYSTAL TOBIN: Wow, tough question. However, Margaret Wheatley, I'm not sure if people are familiar who she is in this room, but she is a communitarian like myself. And she said whenever there is a problem with the system, community has the answer. And here we are. Look at all of these wonderful people here in the room. You guys, CBC, Woo, really happy to have you here. So that mental health piece, the thing that I'm afraid of, though, is that in these platforms that I read is that government is saying that they are going to give mental health care the same attention as physical health. And if that is the situation, we are in big trouble. So what can we do? We can dial it back, you know, instead of giving us seed funding to run a little programme for six months and clapped her hands and fill out an evaluation form and we're done. What happens from there? You know, we need investment in community here in Mosquodoboit Harbour, in our indigenous communities and our African Nova Scotia communities. It's really quite a simple fix. We need to do systemise the system and bring it back to community.

MG: Thanks for the work that you're doing and the community, I think. Thanks you for that as well. It's Crystal Tobin larger. It's not just here in Musquodoboit Harbour where people are trying to fill the gaps in mental health care. Margaret Mauger is here from Schubin Arkadi, which is about 40 minutes north of here. She's a registered counselling therapist, opened a private practise at the beginning of last year and right away saw the demand for therapy was intense. She began to treat some clients free of charge. How did you come to this decision to treat clients for free?

MARGARET MAUGER: Oh, somebody already said. How do you say no? I was receiving calls from individuals who had experienced trauma, mainly sexualised violence, trauma, and they weren't able to access support. And I was in a position where my husband works full time and I started volunteering one day a week to see clients for free. And within about three months that went up to four days a week. And I volunteered most of last year.

MG: How many clients would you estimate that you're treating for free?

MARGARET MAUGER: 35 to 40.

MG: 35 to 40 at a time?

MARGARET MAUGER: At a time. Last year, the After Trauma Empowerment Network, which is the non-profit organisation that I co-founded, we saw one 117 individuals.

MG: When you think of what would have happened to those individuals had you not been there, what goes through your mind?

MARGARET MAUGER: It would be in the system somewhere.

MG: And what does that mean, in the system somewhere, means on those wait lists?

MARGARET MAUGER: On the wait list, the wait lists, I believe, for psychiatry is a year to a year and a half and for mental health services. It could be anywhere from three to eight months. And we're talking about people's lives here when it comes to psychological health. Suicide is is real in this province, in this country. And that is often the end result if someone does not access mental health or psychological care.

MG: Part of what we have been hearing over the course of these conversations is, I mean, a very acute portrayal of the problem, but also trying to scratch at some of the solutions. What needs to be done to ensure that someone like yourself isn't volunteering your time, that people are able to get the care that they need when they need it the most.

MARGARET MAUGER: All areas, health is holistic. It's not just physical health, it's mental health, all different areas of us. And we need teams of people, even the stories that have been shared in here. And I mean, what a wealth of information and knowledge and experience in this room. And it's it's like, let's go, people. Come on. Like, let's march somewhere and do something. I don't know. And I don't know the solutions for this. I just know there are people suffering needlessly. It has to change. It's unacceptable the way it is.

MG: Thank you for the work that you're doing.

MARGARET MAUGER: Thank you for coming to our beautiful province and and having this very important, necessary conversation.

MG: I'm grateful, as I say, to have the opportunity to be here for people like you.

MARGARET MAUGER: And please come back, any time.

MG: I would love to. Thank you very much. Margaret Mauger, Dr. Jackie Kinley has done a lot of thinking about how the system treats people with mental health problems. She worked for years as a family physician, became a psychiatrist and associate professor in psychiatry at Dalhousie University, director of the Mental Health Day Treatment Programme at the Queen Elizabeth Health Science Centre in Halifax. Thank you for being here.

Dr. JACIE KINLEY: Thank you.

MG: How big is the gap? Or how big are the gaps when it comes to mental health care in Nova Scotia right now?

Dr. JACIE KINLEY: We have very large gaps and people fall through the cracks because of those. There's gaps in terms of access. And then once people get in, there's waitlists inside wait lists and, you know, and then they see somebody and they have to wait several months to see somebody. And a follow up, there's a lot of gaps and inefficiencies within our system.

MG: How was that exacerbated by what this province has been through over the last few years, covid, but also the shooting here?

Dr. JACIE KINLEY: Yeah, well, I think part of, you know, was sort of perfectly positioned, you know, within covid. I think when, you know, we sort of went through covered a lot of people were scared and frightened and had experienced a lot of losses. And, you know, the Portapique shooting really sort of became kind of a lightning rod. It sort of polarised things and sort of it actually, I think, propelled us into into into a grief process. So I think in some ways, sort of just like this, you know, sometimes you can gather around things that are really difficult and community pulls together and it's very helpful. But I also think that there were a lot of fractures in the system even before covid. And when you you know, when something's fractured and you put pressure on it, the cracks get bigger. So the system was already struggling. And I think this is really just accelerated the decline of something that was quite fossilised in the beginning.

MG: How do you take that momentum, the energy in a room like this, but also whether it's the anger that someone was talking about, whether it's just the real sense that something needs to be done. How do you take that and turn it into something?

Dr. JACIE KINLEY: Well, I think, you know, anger gets a bad rap. You know, anger's mobilising. It's passion, ambition, advocacy. And so I do think it's about having these conversations, bringing people together, finding that common ground and that common bond. It's about grounding us in what matters and in our values. So when you hear things about that moral disruption, moral injury, that moral injury is you know, it's not just physical, it's not just a psychological problem. But we're living in a way that doesn't align with our values and our moral compass. And so I think we have to you know, I often call covered the great pause because I think it's been very helpful. It's slowed us down and it's allowed us the time and the space to start to actually think about things, to think about what matters. And so as these things are surfacing, I think people may be in a better position to have more honest conversations. I think emotion is really helpful and emotion is surfacing. It's energy, it's motivation. So I think we just have to capture it. We have to harness it.

MG: So what's the way through this then?

Dr. JACIE KINLEY: Compassion is free. And, you know, we don't have a health system. We have an illness system. We treat people when they're ill. We don't support them in their health. We don't teach them how to be healthy, just like physical fitness. Your brain is like a muscle. How do we exercise people's brains? How do we build their mental fitness, the resilience? How do we teach them how to deal with emotions? Right. How to ground themselves. Some people don't know to go to the beach. Right. But within the system itself, one of the things that I my God, my heart goes out to treating people one on one. You know, I used to do individual work. And so what I have learnt is the power of the group. People help other people and you don't necessarily have to see a psychiatrist or a mental health person. But we need to be able to come together in ways to facilitate healing spaces and healing processes. Our system doesn't do that. Our system says it use evidence based care, and it does. But is the care actually effective? The programme that I work in is one of the very few programmes that we actually measure outcomes and not just getting rid of symptoms. That's an absence of illness. Are people actually getting healthy? Are they getting back to work or are they meaningfully engaged? Are there relationships better? The system doesn't measure effectiveness. I mean, it just blows my mind. You know, you can go in and you can see them 10, 20, 30 times, but there's no evidence that it's actually made a difference. That's a significant problem in our health system.

MG: Dr. Lisa Bonang. Once again, nodding through much of what you are hearing. I mean, again, you would see a lot of this, I would think, in the emergency department, if people can't access care, it's not just primary care, but if people can't access the care they need for their mental health, does that present itself in the emergency department, too?

DR. LISA BONANG: Of course. You know you know, the emergency room, as John, Dr. John Moore said, is the canary in the coal mine. It is where things add up when everything else is not going right. So I'm not in my head because one of the things I've been preaching for the longest time is that the definitions, the accountability is not been based on are we actually positively impacting our patients lives? It's about right now my my accountability in terms of how I'm getting paid is how many people am I seeing, not how well am I doing at taking care of what their needs are.

MG: Dr. Kinley.

Dr. JACIE KINLEY: Doctor Kinley. Well, I just wanted to add to that because, you know, it's interesting. When I first went into medicine, you know, when I was in family practise, one of the reasons I went into psychiatry is because I was so frustrated, because I I kept throwing pills at people and I was just like, gosh, I keep, you know, you know, give a man a fish, give him a fish, give when I was like Nova Scotia, I can say fishing, you know, and I was like, you know, finally we have to teach people. Right. So I thought, well, if I go in psychiatry, I'll be able to spend more time with people. I'll be able to work with them. And in psychiatry, the practise was very much around throwing pills at people. And it was very frustrating because I thought, you're just symptom checklists and you weren't- you were losing sight of the person. And so. And then what happened when I started to work deeper, then that's when I got interested in the social determinants of health, because people end up with mental health problems when they're under stress and the stress outstrips their capacity to cope. And the capacity depends on the resources they have. And some are external, you know, things like finances, housing, all these things that people need to maintain their dignity but psychological resources to enhance the resilience. Yes. How do we support people? How do we give them the skills they need to advocate for themselves, to find their voice, to overcome shame and guilt and and to recognise that they're human?

MG: Dr. Jackie Kinley is a psychiatrist. She's in Halifax. We have a room for a small but mighty crowd of people who are here who have been listening to this. And we've heard many of your stories. But we want to hear more. Our producer, Mary Catherine McIntosh, is here with a microphone. So if you have a story that you'd like to tell to us, put your hand up and we'll get to you.

KRISTEN CUDMORE: Hi. I'm going to take my mask off just for a second.

MG: Tell us your name.

KRISTEN CUDMORE: Kristen Cudmore. I'm a master of social work student at Dalhousie University. And I'm here because I've been working in the social work realm, not as an official social worker for the last 17 years. The main thing that I wanted to say tonight was that there's a growing amount of research coming out of Dalhousie right now about how we need to decentralise the health care system so that it is more community based so that the community members can determine what they need. This is actually been researched and it is more fiscally responsible than what is happening right now.

MG: What does that mean to decentralise the system? Can you explain what that would look like?

KRISTEN CUDMORE: Like what Chris was speaking about, where we as a community know what the issues are in this community and we have more control over what we need. So if we need six doctors, if we need four ambulances, then we need to go, OK, these are the things we need. This is the funding we need. This is how we're going to make it work. This is how we can measure it, because we are the ones that that know what what needs to happen in this community. And a lot of people don't know what social workers are. And there's tons of us. And we're also burnt out. And, you know, I was sitting here listening to your stories and, you know, it's not just a silo. I'm not just a mental health and addictions person. Maybe I can help you with something else or maybe I can help you navigate the system, because not many people can speak up for themselves if they don't know what the system is.

MG: What worries you? Just finally, what worries you the most about the system that's that's in place right now in your community?

KRISTEN CUDMORE: What do you do, if you can't get to the doctor?

DEEDE WYRE: I'm Deede Wyre, my husband died seven years ago of Alzheimer's. He was home for two years at home and became more paranoid and eventually became violent. And so I had to take self care to take care of him. I did meditation. I met with other people. I did a lot of medication. So we need to look at our seniors. This is a population along the Eastern Shore that is a has a large seniors population. We need to take care on a community level of our people.

MG: Thank you for coming. We have time for just a couple more.

ANNE: Hi. I'm Anne I'm one of the nurses down here, T[unintelligible]. And there's been times that if there's not one person in the building at Night-Time, we have to ship all of our patients out. So staff are working double overtime. Sometimes they're working 24 hour shifts just so that we don't have to ship our patients out. It's very unfortunate our merged departments are closed and when they're running, we're slammed because people don't have family doctor. So people are coming for prescription refills, waiting for hours. That's a big thing on the Eastern Shore, keeping our nurses. We can't get enough casual nurses because people that are working there, they have positions. They're not giving them up. So to keep a casual nurse is impossible because they're not guaranteed shifts. And then mental health, we don't have the resources down here. People are fighting for resources. We've had three suicides in a month. We're we're in trouble like we're we're desperate down here.

MG: Can I just ask you, how are you holding up?

ANNE: Staff are stressed. They're tired. Everybody's working overtime, beyond. Like it's crazy. And then you get people angry. It's like we're doing the best we can.

MG: Thanks for doing what you're doing. I appreciate it..

ANNE: Thank you.

MG: We'll take one more question just in the back here.

ANITA ROSE: Hello, my name is Anita Rose and I run Easter for mental health here and we collaborate with the old school. And for well over 10 years, we knew that we couldn't rely solely on the public health care system. That's a very important piece. Of course it is. So we do grief workshops for people that are having a really hard time with that because that's a serious issue in itself. And what happens if if people feel like they're alone and they have nowhere to turn off and things will become worse? And so in my journey anyway, in my mental health journey and my health journey, I've learnt that making sure that I didn't feel alone was where it starts, I guess. And so sometimes that peer support, it's free, it's available, it's close by. It helps an awful lot to know that you're not alone and that you're going to be OK while you're waiting for professional care. It's been working so far for the last 10 plus years in community. Thank you.

MG: Thank you very much for the work that you're doing. One of the things you learn in having conversations like this is that when a system is buckling, the community really steps up and people really do some hard work just in the in the remaining minutes that we have. I wanted to ask Chris and Jackie and Lisa just a couple of questions about about where we're at right now. This is a lot to hear, Dr. Bunnag. This community really cares for each other and cares for itself and cares for a system that they see as breaking and bending. How do you manage that? The responsibility of this as somebody who is one of the people that they see when they are in that moment of crisis?

DR. LISA BONANG: I reach out, I reach out to my therapist, I reach out to my colleagues, I can say, um, and nursing staff, they're fabulous and we are a family. And so we have difficulties. We talk about it. We are a community of itself within the community, and we try to help one another as best we can.

MG: Jackie Kinley, Chris Parsons earlier talked about health care in this country as being kind of the promise that we make as Canadians to each other, that this is something that is in many ways woven into the fabric of who we are as a nation. We're very proud of our health care system. Given what you've heard tonight, do we still have a reason to be proud?

Dr. JACIE KINLEY: Oh, my God, absolutely. I mean, we have we have incredibly courageous and strong people just sitting here in the room, I think it's hard to do the right thing sometimes in this world because it's easy to criticise and blame. And some people don't want to stick their neck out. But I think it takes courage. Right. And compassion is free and it's a renewable resource and it heals people and we need to leverage it. We have a lot in the room. We have a lot and a lot of different areas. And we have a lot of intelligence in the room. And I think the wisdom of the group, I think going back to the wisdom of the group, we have the wisdom here. I think it's making sure that we have the political will to actually listen and follow through and take a long view. It's not a quick fix. It requires perseverance. Right. It requires stamina, requires mental fitness. We need to be able to work through this. And so I think that for me, we can't give up. We have to have hope. We have to persevere. We have to harness I say should as fuel, anger, pain, it's fuel use it. You know, we can grow something new. Right. And I love it when I hear stories that are meaningful. People want to be meaningfully engaged in the world. They want to have a purpose. And our lives have become very superficial and people are not happy with that. And that's great.

MG: Chris Parsons, last word to you, you have Canadians who are listening to this coast to coast to coast, this is a story and a conversation about one community, but it is a national story as well. What do you want Canadians to be thinking about coming out of this?

CHRIS PARSON: I think more than anything else, it's to think about health care. It's something that's too valuable to abandon the public health care system. The universal public health care system is again the last thing we have left in our safety net and that we can't sign it over to private interests. The number one problem we have in our health care system right now is a staffing crisis. And to have staff siphoned off to the private sphere in the name of profit would both be disastrous, but would be even more disastrous for the communities that most need health care. So what I think more than anything else I'd like people to think about is, is that we should expect better. I think that what we're suffering from has been reduced expectations and a belief that we can't do big things anymore, we can't build great projects. It was a pipe dream when universal health care was built province by province, fight by fight, election by election, protests by protests, in some cases strike by strike. That built a national system that has saved millions of lives in this country. That was hard. Improving it is also going to be hard, but I think that it's worth it, and I think that the dream of the idea that everyone get the care they need when they need it, regardless of who they are, how much money they have or where they live, is a dream worth holding on to and a dream worth fighting for.

MG: Chris Parsons, Dr. Jackie Kinley and Dr Lisa Bonang, and that is all the time we have for today, special edition of The Current from beautiful Musquodoboit Harbour in Nova Scotia. I want to thank everybody who is here today for sharing your stories. This is important. These are meaningful stories, as Jacqui was saying, and they're difficult as well. And they will lead to change. And I really appreciate you all being here to tell those stories. We want to thank the old school, this community centre for hosting us, thanks to the amazing crew who put something like this together. Alison Masemann, Lara O'Brien, Gabbie Hagoriles, William Yarr, Cathy Simon, our executive producer Raj Ahluwalia and a huge thank you to our Network Producer in Nova Scotia, Mary-Catherine McIntosh. This is a national conversation, as I say, and if you've been listening and you have a story of your own about health care in rural Canada or wherever you live and how you are seeing a system being strained, being stretched, being broken, get in touch. You can email us thecurrent@cbc.ca, find us on Facebook or tweet us @TheCurrentCBC. Thank you to this community of Muscatatuck Harbour for hosting us. My name is Matt Galloway. Thanks for listening.

The Current Transcript for September 16, 2021

STORIES FROM THIS EPISODE

Prologue

A special broadcast from Musquodoboit Harbour, N.S., about access to health care and mental health resources, including in smaller, more rural communities- Part 1

A special broadcast from Musquodoboit Harbour, N.S., about access to health care and mental health resources, including in smaller, more rural communities- Part 2

A special broadcast from Musquodoboit Harbour, N.S., about access to health care and mental health resources, including in smaller, more rural communities- Part 3

Thursday September 16, 2021 Full Transcript

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