While the situation was already problematic before the COVID-19 pandemic, it has become critical due to the combination of several factors, such as the health system crisis, the COVID-19 outbreaks in homelessness shelters, the lack of human resources in all work environments, the housing crisis, but also the chronic underfunding of community organizations.
I have seen so many people pass away too soon, alone, anonymous. As a society, have we done everything in our power to prevent this tragedy?
We may claim that emergency shelter spaces are currently sufficient, but the reality is that we are unable to keep everyone out of danger when necessary.
This is what the Médecins du Monde team observes, working in the streets and community organizations to provide primary care, both physical and psychological, to people experiencing homelessness, for whom access to health care is an obstacle-ridden journey.
The lack of resources in community organizations working in homelessness traps people in survival mode, as they cannot find answers to their ailments. They then focus on their basic needs: staying warm and feeding themselves. Everything else takes a back seat, further compromising their physical and mental health in the medium and long term.
A system overwhelmed
Everything seems to have evolved in the wrong direction. Overcrowded shelters and the last-minute setup of temporary warming centers are signs of an overwhelmed system. While they are a solution to address the crisis, no one should be satisfied with them. This emergency response creates enormous pressure on people experiencing homelessness, as well as on the organizations that welcome them and their staff.
It is high time the expressions of powerlessness from outreach workers, who are exhausted yet still hold up essential services, were heard. As a humanitarian health organization working in partnership with community organizations—particularly by offering psychological support to frontline workers—Médecins du Monde is particularly concerned about the current situation in Quebec. Yet, solutions exist.
Our partners publicly attest: the current context results from actions taken in urgency to address a predictable situation, whereas measures aimed at strengthening the organizational capacity of the community sector would likely have been more effective.
Community-based intervention should not be treated as an emergency response, but as an essential public policy strategy in supporting and combating homelessness.
Because it is a major player in the fight against homelessness and supports the public health and social services network, the community sector should enjoy greater recognition from public authorities. In fact, the expertise of community organizations in Quebec should be further valued, and to do so, it would be necessary to consider long-term funding for their mission, rather than allocating funds to specific and one-off projects. This way, these organizations would be much better equipped to contribute to better planning of health and social services in times of crisis.
While homelessness is an extremely complex issue, let us rise to the challenge with multiple and adapted solutions, but also by opting for a preventive rather than reactive approach. And above all, let us take into account, from the outset, the expertise of the community sector, and even more so, the experiential knowledge of people affected by these crisis situations.
Let us stop repeating the same mistakes: pandemic or not, winter comes back every year!
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Penelope Boudreault, Director of National Operations and Nurse, Médecins du Monde