A Toronto street nurse runs for office

By John Rieti

After years of providing care but seeing little change, Cathy Crowe ran in the Feb. 4 Toronto-Centre provincial by-election.

--

It’s another extreme cold alert outside, the temperature plunging below minus 15 degrees even before the icy wind is factored in. Street nurse Cathy Crowe has seen homeless people, friends, die in weather like this. Tonight though, one week before polls close, she stands at the podium of her Cabbagetown campaign headquarters and tells the packed room “I want to be a Member of Provincial Parliament.”

--

Crowe has called herself a street nurse ever since a homeless man yelled it out to her as she worked near the intersection of Dundas and Sherbourne streets, an epicenter of homelessness in the city. She knows the intersection well. She’s bandaged people up there, tried to ease their pain, and sometimes handed out bus passes so they can find a bed on the warm air of a subway grate.
Eventually it was too much.

“I was looking all around me, and after 22 years of being a street nurse not enough has changed,” said Crowe.
“There’s more hunger, more poverty.”
And so the street nurse decided to run for the New Democratic Party in the Feb. 4 by-election for the Toronto Centre riding.

The riding is spectacularly diverse, housing both rich enclaves like Rosedale and maligned housing projects like Regent Park, as well as the gay neighbourhood at Church and Wellesley and the huge new-immigrant population of the St. Jamestown apartment block. The area has voted Liberal for over a decade now, and it did the same this time.
Poverty, the environment, neighbourhood safety, these are all issues politicians are elected to figure out. For Crowe, they’re also the social determinants of health.

“A lot of people’s eyes glaze over when you bring up social determinants. I think a lot of what I can bring is translating,” said Crowe.
Simply put, if you’re homeless, your life is at risk. If you’re poor, you’ll likely face more illness. And even if you’re well off, social determinants will factor in to your health.
For Crowe, politics is intimately tied to health. She can trace when things were bad for her homeless patients, and when policy passed at Queen’s Park made things worse.

In 1995 the Conservative government under Mike Harris cut 17,000 units of public housing, creating a group of people Crowe would call “homeless by policy.”
In the winter of 1996 four homeless men died on Toronto streets within three months, attracting national media attention and quickly turning Crowe into an advocate and media go-to on homeless health issues.

Crowe's job became as much politics as nursing. “If politics is about the distribution of limited resources … nothing is freely given … you have to fight for it,” she wrote in her book, Dying for a Home.
 Physicians like Dr. Stephen Hwang at St. Michael’s Hospital produced studies that proved homeless patients died earlier than the housed public. Hwang found over 50 per cent of homeless people suffered from a mental health illness, often from a traumatic injury, before they wound up on the street.
When Dalton McGuinty’s Liberal government took power, it promised 20,000 units of social housing. So far, the government has delivered on only half, Crowe said, “crumbs” of improvement that hasn’t done anything to take on the “deep poverty” many face.

Two Fridays back Glen Murray, who would go on to win the Toronto Centre election, and McGuinty toured one of the city’s newest social housing buildings — Regent Park’s gleaming grey glass and concrete mixed-income apartment tower. Crowe went, too.
McGuinty announced his government was making progress on its social housing goals. Murray told reporters he saw the cup as half-full.
To me, it was a bit like ‘How dare you?’” Crowe said.

The past few years have been “more advocacy than bandaging” for Crowe, and she admits she needs to brush up on her nursing skills and the literature of her practice. But she still has a strong connection with healthcare providers.
Sarah Reaburn, a fourth-year nursing student at Ryerson University, and Crowe first met at the launch of Dying for a Home.
“I think it’s exciting … it’s very hopeful,” Reaburn said of Crowe’s move into politics.
“It isn’t politics that’s driven her to speak out about the social determinants of health. She’s realized that health is a result of politics, and what happens in politics has a direct affect on the streets.”
Reaburn hoped Crowe would have used a Queen’s Park office to address the controversy over special diet forms.

Healthcare providers from physicians to registered nurses can issue the forms that increase payments to people receiving social assistance. Those with diabetes, obesity or other diseases qualify for the extra money to help them afford better nutrition.
After groups like the Ontario Coalition Against Poverty helped thousands qualify for extra money, the special diet form’s budget line swelled far beyond its usual size. The province announced plans to pass policy requiring social workers to check the claims aren’t fraudulent.
Reaburn is furious the government would question frontline healthcare workers. Worse, she said this policy might deter many from getting the help they need

Some nurses wonder what Crowe could have accomplished if she had made it to office.
“You never really know how their policies will be once they’re in a public office,” said Albert Ho, a graduate of Ryerson’s nursing school who now works at a Toronto hospital.
Ho, who spent a frigid afternoon canvassing for Crowe, said she has “visibility, credibility, and clout.”
Ho singles out the “one per cent solution,” a policy Crowe has been advocating for several years that calls for every level of government — municipal, provincial, and federal — to put one per cent of their budget toward social housing.

For Ho, the policy has promise. “What government can’t allocate one per cent? If she gets elected and pushes this policy then she’ll be good.”
Crowe writes in Dying for a Home that she avoids burnouts by celebrating small victories. Certainly, winning close to a third of the Toronto Centre vote (with 282 of 292 polls reporting Crowe had 33 per cent of the vote, to Murray’s winning 47) was a good showing.
Perhaps a bigger win for Crowe was the chance to watch homeless people she had treated in the past spreading word of her candidacy.

At the Parliament Street headquarters Bonnie Briggs wears a pair of orange shoelaces as she works in Crowe’s campaign office. She grumbles when rosy-cheeked canvassers leave the door open too long and the wind gets a lick in.
She and her husband were homeless when she met Crowe. Briggs has since moved into a small Parkdale apartment, and she’s an outspoken supporter of efforts to eliminate homelessness. She’s short with her words when we speak, but she tells me homelessness took a tremendous toll on her health. “It affects everything,” she said.

Nursing student Reaburn said social determinants are prioritized in class, but nurses are mostly taught how to deal with them. In other words, treatment changes. The causes remain.
Crowe’s next move remains to be seen, but perhaps she can look back to the first street nurse she met, Dilin Baker.
Baker, another nurse, founded Street Health, a Dundas Street organization that provides healthcare services to homeless people. The nurse, Crowe recalls in her book, was “the only nurse I know who thought nothing of taking the Minister of Health out to lunch to tell her quite bluntly what was going on, and what the Minister should do about it.”

Toronto Centre, and indeed many more parts of the city and country, need blunt assessments from people like Crowe, say nurses like Reaburn and Ho.
Crowe, too, knows that. She would eventually adopt a simple equation to her work as a street nurse, and as a health advocate. “Witness + honesty + speaking out = right thing to do,” she wrote in Dying for a Home.

--

Our interview ends as Crowe rushes off to talk with some supporters lingering around after the rally. She leaves with one last thought.
“People are in crisis,” Crowe said. “Make no mistake.”
It’s near suppertime, already dark, but people sit on park benches in nearby Allan Gardens. One man asks for change at the corner of Gerrard and Jarvis streets. Tonight the City of Toronto will open emergency shelters for them — church basements and other empty places.

It will be hours before most retreat to a shelter, if they do.

John Rieti is a Toronto Star radio room reporter and studies in the Master of Journalism program at Ryerson University. jrieti@thestar.ca.