A Knapsack Full Of Dreams

Excerpt from A Knapsack Full Of Dreams, Chapter 9 -

Street Health’s roots went deep in the community around Sherbourne and Dundas. Homeless people themselves had come together to say they needed health care. They called themselves “the balcony crew,” as they had concocted their dream of better health care for homeless people on someone’s balcony. They were adamant they were not receiving good, if any, health care in the existing system. They identified that they were not only under-serviced, but when they accessed care, they frequently experienced discrimination. They knew they deserved better and fought for it. They approached Dilin, a nurse who was volunteering in the community. Fortunately, she was a fearless, skilled, and feisty innovator who thought out of the box when it came to health care.

The organization’s entire philosophy sprang from the principles of primary health care traditionally employed in developing countries, in sharp contrast to the medically dominant model of health care routinely provided in Canada. So, the care Street Health provided was essential, practical, relevant, accessible, street level, and looked upstream. The nursing role was expansive and pioneering for Canada. We operated regular nursing clinics and did outreach or hung out in various loca- tions where homeless people spent their time and responded to their needs.This included what is traditionally seen as hands-on nursing care (wound dressings, foot care), but it also focused on health promotion in a useful way: developing identification clinics so people could get their birth certificate or health card, obtaining funding for AIDS prevention, doing action research on homeless issues to influence public policy.

Advocacy and grassroots organizing, for example, to fight for better shelter conditions and affordable housing, were part of the job description. Speaking out at public forums, to the media, and at City Hall was expected, indeed, demanded by Dilin, who became the organization’s executive director. It was a huge learning curve, and I remember feeling a mixture of excitement and terror.

On the whole, the nurses were loved and respected by our homeless patients. I remember the sunny day that I was with my nurse co-workers walking at the corner of Sherbourne and Dundas when a homeless man across the street yelled out in a jovial manner,“Hey, Street Nurse!”That’s how the term was first coined.The title was in sharp contrast to the many titles that could describe a nurse in the community and which so often confuse the public. Street Nurse was clear, and it was definitely a compliment, as people who were homeless often referred with affection to their “street family” of friends. The term was also most definitely a political term, suggesting that homelessness had gotten so bad in this rich country that a nursing specialty has arisen called Street Nursing. I still use the term today for that reason and capitalize it whenever I can get away with it.

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