Failed by
the system
Posted by Paul Manly
Executive Director
It is not unusual for staff at the Nanaimo Unitarian Shelter to experience the loss of people they know who were guests at the shelter or clients of the shower program. I get regular reports from staff about unhoused members of the community who died for one reason or another. What is shocking is when one of their colleagues dies and that death was completely preventable.
In 2023, Sophia, one of the shelter's dedicated team of professionals, died. Sophia’s death was a shock for me and for the staff at the shelter. She was young, 23 years old. She had graduated from the VIU Community Mental Health Worker program and started working at the shelter in September, 2022.
Bright, compassionate and dedicated to her work at the shelter, Sophia was well liked by staff and guests. She worked hard and did her best to ensure that shelter guests were comfortable and felt at home. In her last self-evaluation she outlined her ambitions and how she wanted to do more to assist people in our community who were marginalized and struggling. Sophia was one of our rising stars, with a bright future ahead of her, set to make an impact doing good things to assist others.
Last summer Sophia started having health complications and wasn’t able to work at full capacity. Staff members were expressing concern for her. I met with her and she acknowledged she was having trouble so we agreed that she should take a medical leave of absence. We worked with her as she struggled to find a doctor who could provide a diagnosis and the letter we needed to ensure that she could keep her benefits active. Occasionally we would get reports but then suddenly we were notified that she had died.
In late January, I received a letter from her mother outlining what had happened. I read it in shock, sadness and anger. For months Sophia’s health had been deteriorating. She did not have a family doctor and struggled to get into the only walk-in clinic in town where people line up at 6 a.m. in the hope of seeing a doctor when it opens at 8 a.m.
Sophia was finally able to get an appointment at a Youth Wellness clinic. They diagnosed her as having an eating disorder. They told her that she would be put on the waiting list for the eating disorder clinic. Sophia was adamant with her mother and the professionals that she didn’t think it was an eating disorder and she wasn’t intentionally not eating. She continued to visit the clinic in an effort to get a doctor's note for work. It took months before they requisitioned a blood panel but they didn’t request it back and it was supposed to be forwarded to the Eating Disorder clinic. Sophia trusted the professionals and assumed they knew what they were doing.
On Thanksgiving weekend Sophia’s mother took her to the emergency department at NRGH. The doctor who saw her was dismissive and gave her a prescription for a cream for what he diagnosed as hemorrhoids. It turned out that it was much more than that. Sophia’s health continued to deteriorate, her hair was falling out and she was losing weight.
Her mom took her to the hospital again on November 16, she was anemic and needed a blood transfusion. This was when it was revealed that Sophia was not on the Eating Disorder clinic patient list. On November 24 the diagnosis came in, she had a compromised immune system and had an internal infection. Nanaimo Regional Hospital realized this was beyond their capacity and had her transported to St. Paul’s hospital in Vancouver for further care. But sepsis had taken hold and she died three days later.
The immunodeficiency was treatable if diagnosed properly but it made her susceptible to infections. Working at a homeless shelter exposes workers to a range of active infections and pathogens that members of the homeless population are struggling with. It is very possible that Sophia contracted an infection at work.
At the shelter we get regular calls from the hospital for patients who are being discharged who do not have homes. We try to keep two beds open for emergency purposes like this but we have to set a hard line with the hospital because our staff are not trained for patient care and the shelter is not an appropriate environment for people with serious health challenges. We have had people show up at our door with serious infections that we have sent to the hospital and then refused to have come back to the shelter. Homeless shelters should not be a dumping ground for homeless patients but we are.
Our healthcare system is in a deep crisis. Our hospital consistently runs over capacity, staff are overworked, there are not enough doctors and patients are suffering the consequences. In this case we lost a compassionate worker, and a mother lost her child. What is even more brutal is that Sophia’s mother lost her only other child in 2020 due to deficiencies in our healthcare system. This is beyond unacceptable and demands action from the federal and provincial governments. This is what tax cuts for the wealthy and austerity and program cuts in the 1990s and 2000s have resulted in today, people living on our streets due to a housing affordability crisis and the preventable deaths of people trying to help the homeless because our healthcare system is failing.
Condolences to Sophia's family and friends.
Addendum
Here is some information to help provide context to this tragedy.
There are 20,000 people without a family doctor in Nanaimo and only 1 walk in clinic to serve them. Health Minster Adrian Dix acknowledges that more than 880,000 people in BC are without a family doctor. This makes it extremely difficult for people to get the care they need and deserve. If you are sick and feeling weak you shouldn’t have to wait for hours outside in the cold first thing in the morning to see a doctor.
The Nanaimo Regional General Hospital NRGH was built in 1963 when the city had a population of 15,000 people. There have been additions since then but the Nanaimo region has grown rapidly and has the highest percentage of seniors over the age of 75 per capita than anywhere else in Canada. This is the age when people need the most health care services. This region is a retirement destination and the NRGH will continue to serve a growing and aging population.
NRGH consistently runs at over 120 per cent capacity, there’s room for 344 beds but often 425-450 beds are full with people sleeping in the hallways. The NRGH emergency room is the busiest ER on Vancouver Island. The hospital staff are overworked and under incredible strain, which creates risks for staff and patients. There is an urgent need for a major expansion of NRGH including a new patient tower and cancer ward. This need has been known for decades.
The April 2023 Nanaimo Point in Time count identified 515 people as homeless. The data collected from BC Housing and a number of BC government ministries estimates that the number is closer to 800-1,000 homeless people. There are 69 year-round emergency shelter beds in Nanaimo with an additional 35 added in the winter time for a total of 104 beds. Of the 515 people identified in the homeless count 78 per cent of them had no access to shelter. In comparison only 15 per cent of the homeless people in Victoria and 30 per cent of the homeless people in Vancouver have no access to shelter. 78 per cent in Nanaimo!
The impacts on the health outcomes of people who have no shelter are horrific. The unhoused population struggles with preventable illnesses, infections and parasitic outbreaks (lice, scabies). This creates an incredible strain on our health care system, just visit the NRGH ER to see for yourself. It also creates a risk for shelter workers, such as Sophia who had an undiagnosed weakened immune system.
The Canadian health care system is in crisis. It’s really a sickness care system that is failing. We would be far better off if the system focussed on keeping people healthy rather than just reacting when people are sick. Following Maslow’s hierarchy of needs is a good start by making sure people have food, water, shelter (warmth and a place to rest), clothing, security and safety followed by psychological needs that can be met through social prescribing and community connection. After these needs are met people can reach their full potential and we will all be far better off.
Sophia’s mother Melonie asked me to help amplify Sophia’s story so that Sophia’s death would result in change. We can do better, we must do better - we owe it to each other.
Unitarian Shelter celebrates 15 Years
with $150,000 fund raising campaign
The Nanaimo Unitarian Shelter is having its 15th birthday with an Open House at the Unitarian Hall, 595 Townsite Rd., Saturday, Dec. 2nd, 1:15 to 3:15 pm.
There’ll be a cake with 15 candles, one for each year the shelter has been in operation, music by singer/songwriter Tony Turner, testimonials from shelter staff and former shelter guests, and the launch of a major fundraising campaign.
The campaign goal is to raise $150,000 to help pay for the renovations required to comply with the provincial building code as well as other operational costs – an ambitious target, but one that is necessary for the shelter to continue.
The Unitarian Fellowship was the first church in Nanaimo to operate an emergency weather shelter when it opened in December, 2008. Since then, the shelter has been a temporary home for hundreds of people living in poverty who have found themselves without housing.
Among them have been seniors renovicted from their homes or forced to live in their cars, people with disabilities, students, low wage workers, those suffering from mental illness, and people struggling with addictions.
“What all these people had in common was a struggle to find suitable affordable housing in Nanaimo, becoming homeless and finding respite from the streets at the Nanaimo Unitarian Shelter,” says Shelter Executive Director Paul Manly.
One of them is a 63-year-old man the shelter team found housing for recently. He relies on a scooter for mobility and was homeless for a year before he arrived at the shelter. Here’s what he had to say about his experience:
“Don’t give up if you’re out on the streets. Go to the Unitarian Shelter. They really do care and they really do what they say. They got this old man a home and I want to especially thank the shelter team for being so understanding, and helping me when nobody else seemed to care.”
For more information, please contact Paul Manly, Executive Director, Nanaimo Unitarian Shelter, 250 729-1254.
Paul Manly
Manly sets the record straight on
role with Unitarian Shelter program
(Minor editing to focus on the shelter program)
I am replying to these questions from my Nanaimo Unitarian Shelter email since these are questions that should be directed to the shelter (my email is published on the website). I would never use my council position to advocate for the shelter.
Is the Unitarian operation a registered non-profit?
The Nanaimo Unitarian Shelter is operated by the First Unitarian Fellowship of Nanaimo
The Charitable tax number is 830236949RR0001
The BC Society number S0049301
If people wish to make tax deductible donations they can do so through Canada Helps.
You still employed there? Are you receiving any remuneration from them?
Yes, I am still employed there as the Executive Director and yes I absolutely get paid for the work I do. It’s not an easy job, there are lots of challenges. If your reader thinks this should be an unpaid position please let them know that I would happily pass the reins on to anyone who has the skills and would like to do this as a volunteer. I have been doing this since March 2022 and I am reaching my best-before date with this position…
I get paid for up to 20 hours per week from the BC Housing budget which covers 95 per cent of the costs to run the shelter. I earn less than half of what I earn as a camera operator and about one third of what I charge as a producer director. Your reader might be curious why I would do this work for so much less than i could earn with the skills, experience and abilities I have in video and television production? Part of the answer can be found in this Facebook post about my cousin Patrick who suffered from schizophrenia. I see people like my cousin Patrick on the street of Nanaimo and I understand the pain that their family members feel.
I also see a lot of people come to the shelter that I am shocked to see homeless in our community such as the 75 year old woman who showed up at the door last week. We’ve had a number of seniors who have stayed at the shelter recently (as many as 6 staying there in April) including this 71 year-old retired miner or this 64 year old retired widow or this retired double amputee all of whom stayed at the shelter for several months before my team was able to find housing for them. We also have people with disabilities staying at the shelter who are younger including this young woman with a learning disability. I feel compelled to help people who are less fortunate. Being born with a disability, being injured in an accident, being a student, being a low wage worker, being a working class person who wants to enjoy retirement but hoped to do so as a renter… does not mean that these people deserve to be homeless. They all deserve dignity, respect and a place to call home.
Is the city giving them any funds at this time?
Yes, the city of Nanaimo has long standing contracts with the Nanaimo Unitarian Shelter that were in place before I started working there.
- The City of Nanaimo has been providing funds from Emergency Measures BC (EMBC) to the shelter when the weather hits extremes. These funds allow the shelter to stay open for guests during the day when the weather is too hot or too cold, during snowfalls etc.. Normally the shelter is only open to guests between the hours of 5pm and 7:30 am. EMBC sets the thresholds for when the shelter can stay open and these funds can be dispersed to cover the extra costs. The budget is set annually. The City has had annual agreements with the shelter since 2008. I do not receive any extra payment when EMBC funding is triggered.
- The Shelter has run a shower program in partnership with the City of Nanaimo at Caledonia Park since 2018. After the Salvation Army closed its shower program to everybody but their tenants during covid this is the only free shower program for homeless people in Nanaimo. The budget provided by the city has not increased in the last two years and we receive the other half of the operating funding from the federal Reaching Home program administered through the United Way. I do not receive any of my wages from this program.
I recuse myself from all decisions at the council table and from all discussion and negotiations with city staff that relate directly to the shelter or shelter operations. The shelter Operations Manager, Administrator and board members deal directly with city staff for these contracts and any other matters. My signature is on the contracts because I have the signing authority for the shelter but i am not involved in any discussions or negotiations for those contarcts.
Thank you for the questions, I invite you and your readers to explore further.
Why are so many seniors, people with disabilities and working poor becoming homeless in our community? That’s a really good question for journalists to explore.
Did you know that the Unitarians have been running this shelter for 15 years and that for the first number of years they ran it as volunteers? Why would a small congregation put so much time and effort into helping those who are less fortunate?
On Saturday, Dec. 15 the Unitarians will celebrate the 15th anniversary of the operation of the shelter. Please see the details below in a separate report.
Paul Manly
Executive Director
Nanaimo Unitarian Shelter
shelter@ufon.ca