Shelters and Public Health: A Winter Institute

Location

Delta Hotels by Marriott Winnipeg
350 St Mary Ave, Winnipeg, MB R3C 3J2

The purpose of this gathering is to explore how shelters and public health can work together to improve the health of people who use shelters.

Objectives

  1. To explore the possibilities of partnerships between shelters and public health.
  2. To learn about building successful, respectful partnerships
  3. To understand some of the public health and healthcare needs of shelter clients.
  4. To spark discussions towards essential elements for shelter and public health collaborations that can improve the health of shelter clients.

Production of this event has been made possible through a financial contribution from the Public Health Agency of Canada. The views expressed herein do not necessarily represent the views of the Agency.


Day 1. Setting the Context

February 7, 2023

12:00 – 12:45 PM
Lunch and Meet and Greet

Opening Prayer
Audrey Richard and Leslie Spillett

12:45 – 1:30 PM
Welcome and Remarks
National Collaborating Centre for Infectious Diseases (NCCID)

1:30 – 4:30 PM
Plenary Room

  1. Why Shelters as Public Health Sites
    Jamil Mahmoud, Main Street Project,
    Adina Lakser, NCCID
  2. Primary Health Care: Shelters, Public Health & Primary Care
    Claire Betker, National Collaborating Centre for the Determinants of Health (NCCDH)
  3. Building Relationships: Shelters and Public Health
    Marcie Wood, Willow Place
    Tanya Wald, Sunrise House
  4. Table Conversations

6:00 – 8:30 PM
Dinner & Fireside Chat
Tessa Blaikie Whitecloud, Siloam Mission
Maureen Dobbins, National Collaborating Centre for Methods and Tools (NCCMT)
Moderated by Yoav Keynan, NCCID


Day 1. Resources

Yoav Keynan provides background to the project and NCCID’s role in connecting shelters and public health.

Adina Lakser summarizes NCCID’s engagement process with shelter leadership and highlights some of the findings.

Jamil Mahmoud describes Main Street Project and where and how they offer health care to people who experience houselessness.


Day 2. Learning Together

February 8, 2023

8:00 – 9:00 AM
Breakfast

9:00 – 9:30 AM
Welcome to the Territory & Highlights from Day 1
Margaret Haworth-Brockman and Adina Lakser (NCCID)

9:30 – 10:45 AM
Plenary Room

Cultural Safety: Thinking of Clients, Shelters, and Public Health
Laverne Gervais, Ka Ni Kanichihk
Jesse Thunderchild, Street Culture Project

10:45 – 11:45 AM
Concurrent Sessions

  1. Infectious Diseases Prevention in Shelters
    Donna Stanley, Northwestern Health Unit
    Room: Charleswood A
  2. With Child, Without Stigma: Building Trust with Pregnant Women who Experience
    Homelessness

    Lesley Spry-Shandro, Pregnancy Pathways
    Room: Plenary
  3. What’s in the Air: Indoor Air Quality in Shelters
    Sarah Henderson, National Collaborating Centre for Environmental Health (NCCEH)
    Room: Charleswood B

12:00 – 1:00 PM
Lunch

1:00 – 3:00 PM
Plenary Room

  1. Helping Clients Navigate Health Systems
    Nnamdi Ndubuk, Northern Inter-Tribal Health Authority (NITHA)
  2. Harm Reduction Strategies: What’s Working?
    Tia Maataa, National Collaborating Centre for Determinants of Health (NCCDH)
    Marliss Taylor, Boyle Street Community Services
    Jamil Mahmoud, Main Street Project
  3. Table Conversations

3:00 – 3:15 PM
Afternoon Break

3:15 – 4:15 PM
Concurrent Sessions

  1. Respiratory Infections and Shelters
    Ryan Cooper, Alberta Health Services
    Room: Charleswood A
  2. Health Services It’s Not Just About Us: Why Pets are Shelter Clients Too
    Judy Hodge, Katrime Integrated Health
    Room: Plenary
  3. Infectious Endocarditis among People Experiencing Homelessness
    Yoav Keynan, NCCID

4:30 PM
Free Evening


Day 2. Resources

Laverne Gervais defines and describes cultural safety and highlights how the Mino-Pimatsiwin Sexual Health Healing Lodge provides care from this model.

Donna Stanley identifies risk factors and chains of transmission which contribute to spread of infectious diseases in shelters.

Lesley Spry-Shandro describes the Pregnancy Pathways program and the steps to building trust with women who experience houselessness.

Tia Maatta defines “substance use health” and explains how an equity and justice lens underscores a harm reduction approach.

Marliss Taylor describes how programming at Boyle Street Community Services operate from a harm reduction lens and some barriers faced in providing harm reduction services.

Jamil Mahmoud describe how programming at Main Street Project operate from a harm reduction lens and some barriers faced in providing harm reduction services.

Ryan Cooper uses a case study of a tuberculosis outbreak in Northern Alberta to highlight the steps and collaboration necessary to respond to and prevent outbreaks.

Judy Hodge explores the role pets can play in the lives of people who experience houselessness and opportunities for building trust through pet care.

 Yoav Keynan explains how infectious carditis impacts people who experience houselessness and factors to consider in treatment and prevention.


Day 3. Where to From Here?

February 9, 2023

8:00 – 9:00 AM
Breakfast

9:30 – 11:30 AM
Plenary Room

What Have We Learned: Summary of the Preceding Days
Group Discussion

Moving Forward: What are the Strategies? What Would it Take?
Group Activity and Discussion

11:30 AM – 12:00 PM
Closing
Closing Prayers and Remarks
Evaluation


Speaker Bios

In order of agenda, as provided

Audrey Richard, from Camperville, Manitoba, and a member of Sandy Bay First Nation, will wrap up her role as a student advisor and counsellor with the Mahkwa omushki kiim: Pathway to Indigenous Nursing Education (PINE) program (previously Aboriginal Nursing Cohort Initiative) in the College of Nursing, Rady Faculty of Health Sciences. Her work over the years also extended to the Aboriginal Focus Programs, Access Program and many community organizations.


Elder Leslie Spillett is a Cree/Metis community kohkum and organizer who has been involved in many grassroots social justice movements over several decades. She has contributed to the Indigenous sovereignty and equity within Manitoba’s Indigenous NGOs and co-founded Mother of Red Nations Women’s Council and Ka Ni Kanichihk in 2000. Both organizations were early leaders to support families of MMIWG2S and to advocate for systemic changes within Canada’s colonial institutions including health, education, justice and child welfare. Currently Leslie works with Ongomiizwin Indigenous Institute of Health and Healing, Rady Faculty of Health Sciences and supports Indigenous students, faculty and staff within the five faculties of health and Mino Pimatisiwin Sexual Health Healing Lodge. She serves on the board/council of the Manitoba Harm Reduction Network, National Consortium for Indigenous Medical Education, Missing and Murdered Indigenous Women, Girls 2SLGBTQQIA+ Manitoba Advisory Committee, and Iskwewak Awetowak Nipocawin: Indigenous Women Leading Knowledge.


Adina Lakser is the Shelters Project Coordinator at the National Collaborating Centre for Infectious Diseases (NCCID) in Winnipeg. She joined NCCID in the summer of 2022, bringing over two decades of experience managing projects in the community and with the University of Manitoba to address health inequities, exploring topics such as women and HIV, sexual and reproductive health, harm reduction and cultural safety. As well, Adina has worked with individuals and communities to provide mental and spiritual health care.


Jamil Mahmood is the Executive Director at Main Street Project and he’s held in the role for over two years. He has a wealth of knowledge and a diverse background of experiences supporting vulnerable members of our community. In the past, Jamil’s worked with the Winnipeg Regional Health Authority, providing mobile outreach services, including harm reduction supplies, education, and support services to Winnipeg’s most marginalized people. Jamil was also previously the Executive Director of the Spence Neighbourhood Association, another important community organization he led for ten-plus years. He graduated from the University of Winnipeg with a bachelor’s degree in International Development Studies after spending two years working abroad in Pakistan and Ecuador. His education includes courses in restorative justice, intercultural competencies, and victim-offender mediation. Through all his work and experiences, Jamil has seen firsthand the importance of better outcomes when meeting people where they are at, as well as the importance of collaborating with different partners and funders to meet the needs of the community served by Main Street Project. Jamil is a passionate and tireless advocate for people experiencing mental health issues, substance abuse, and homelessness in Winnipeg, and he is uniquely qualified to lead MSP.


Claire Betker is a registered nurse and, since March 2019, has been the NCCDH’s scientific director. Prior to coming to the NCCDH, Claire was the Executive Director of the Population and Public Health Branch with Manitoba Health, Seniors and Active Living. Her career has included roles in rural and urban public health, home health, primary health care, a regional health authority and the Public Health Agency of Canada, as well as previously serving as a senior knowledge translation specialist with the NCCDH. Claire is a past president of the Canadian Nurses Association and of the Community Health Nurses of Canada. Her PhD work focused on the capacity for public health leadership to advance health equity, a knowledge base that informs her contributions to the NCCDH, the public health field and community. Claire brings a wealth of expertise, rich networks, and a passion to translate knowledge and evidence, especially to position public health to advance health equity.


Tessa Blaikie Whitecloud is currently the CEO at Siloam Mission since November 2021. Siloam has over a dozen different programs that help them live out their Mission to offer Christ’s compassionate love to all who are in need of support, healing, and recovery. This year they are working on becoming a housing focused shelter with behavior based entry. Their programming ranges from the basic needs: a safe warm place to eat, sleep, shower, do laundry, access clothes, to transitional and long term supportive housing at two properties or in community supported by caseworkers. In the last year Siloam has developed relationships with Knowledge Keepers and Elders to build out the availability of culturally competent care for Indigenous community members accessing services. They have also strengthened there Christian Spiritual Care offerings, expanded health services and employment opportunities for people experiencing homelessness.

Prior to Siloam Tessa was in leadership at 1JustCity where she spearheaded opening Winnipeg’s first NO barrier overnight winter warming space. Tessa started full-time at 1JustCity in 2015, the same year she married her husband Hanwakan Blaikie Whitecloud. Together they spent time facilitating workshops on reconciliation and restitution, mentoring youth and volunteering. The couple spends a lot of time cycling, practicing yoga, and evolving through learning.

Growing up active in all facets of her home congregation Transcona Memorial United Church; Tessa looks back with special affection on her time in Canadian Girls in Training, delivering Christmas Hampers with her dad, Bill Blaikie, and many games of hide and go seek in the church buildings. Winnipeg’s North End for many years as a summer camp leader, Tessa developed her passion for social justice. Initially going to school to Psychology, Tessa’s professors eventually gave her a kick toward Sociology as she was too often asking the question “What about the societal factors that lead to this person’s experience?”

During her MA in Political Economy Tessa continued to look at the ways that Canadians must not be ‘allies’ but owners of the injustices Indigenous people are facing as a result of colonialism. Tessa lectured on this regularly on top of teaching in the Sociology department at University of Winnipeg from 2015- 2019.


Yoav Keynan is an Assistant Professor at Departments of Internal Medicine, Medical Microbiology and Community Health Sciences, University of Manitoba and visiting lecturer at University of Nairobi, Medical Microbiology. He is also the Scientific Director of the NCCID. An infectious diseases consultant for the Manitoba HIV Program, Dr. Keynan’s clinical background is Internal Medicine and Infectious Diseases. His research focus includes: immunogenetic determinants of HIV disease progression; immunogenetic factors associated with influenza disease severity and cross protection; evaluation of immune responses to infection and vaccination; novel methods of detecting antibody and cell mediated immune responses.


Margaret Haworth-Brockman is Program Senior Manager at NCCID since 2013. She has over 25 years of experience leading cross-provincial comprehensive research, policy and communications programs, including training and program evaluations. She is highly knowledgeable and competent in policy and process, including board governance, non-profit management and government accountability structures. Also an experienced researcher, Margaret is an international expert in gender-based analysis and gender and health statistics, with over 50 publications.


Laverne Gervais (Anishnabe/Dakota/French Canadian) is a member of Peguis First Nations with roots that spread out wide and far in Treaty One Territory. She is a Sexuality and Sexual Health Educator working at Ka Ni Kanichihk as the Project Manager and Auntie at the Mino Pimatisiwin Sexual Wellness Lodge. She has had the honour of working alongside Sisters of Fire and in HIV health and research for over 8 years.”


Donna Stanley, Manager, Infectious Disease at Northwestern Health Unit in Ontario since 2008. I have experience in community and institutional outbreaks, including an outbreak involving mainly those experiencing homelessness, control of infectious diseases, vaccine preventable disease programming, and infection prevention and control. Our organization covers the area of Ontario that is west of Thunder Bay, with staff in 10 offices throughout the region. Previous positions include: infectious disease resource liaison for staff in First Nations in Northern Ontario from an office in Sioux Lookout; Hospital infection prevention and control practitioner at a hospital in Owen Sound, Ontario; hospital staff nurse in Winnipeg and Thunder Bay; and as a nurse in the Canadian Forces spending time in Halifax, Ottawa and Winnipeg. I attended University of Manitoba for Bachelor of Science and Bachelor of Nursing Degrees and am certified in infection control through CBIC. I currently live in Dryden, Ontario with my husband 2 dogs and intermittently, my 2 young adult children.


Leslie Spry-Shandro has worked as the Assistant Team Lead and now the Wellness Coordinator for Pregnancy Pathways since December 2017. Her past work history has also included a women’s shelter, a youth drop-in centre, RCMP Victim’s Services as well as a book store and library stint when I needed a short break from this field. When she’s not working, she has spent her time raising 4 children, volunteering for their sports teams, and coaching Rugby.


Sarah Henderson is trained as an environmental engineer and environmental epidemiologist. She is the Scientific Director of Environmental Health Services at the BC Centre for Disease Control and the Scientific Director of the National Collaborating Centre for Environmental Health (NCCEH). Dr. Henderson oversees a broad program of applied research, surveillance, and knowledge translation to support evidence-based environmental health policy and practice in BC and across Canada. She co-chaired the BC Safer Operations Working Group (SOWG) during the first 18 months of the COVID-19 pandemic, and has significant expertise in indoor environmental quality as it relates to climate change and infectious disease.


Nnamdi Ndubuka is a public health physician working as a Medical Health Officer with the Northern Inter-Tribal Health Authority in northern Saskatchewan. He is an Associate Professor at the College of Medicine, University of Saskatchewan with a cross appointment at School of Public Health. As a researcher and public health expert, Dr. Ndubuka is particularly interested in the contribution of social determinants of health to infectious disease epidemiology including TB, HIV- and HCV-related risk behaviors and public health practices. Over the past decade, Dr. Ndubuka has worked collaboratively with policy makers, academia, Indigenous communities, and people with lived experience on several community-based studies concentrating on the social construct of communicable disease-related risks. Dr. Ndubuka is an advocate of social determinants of health, anti-Black racism, quality improvement, equity, diversity and inclusivity. He has a passion for leadership, good governance and research. He is the national president of the Canadian Association of Nigerian Physicians and Dentists (CANPAD). He pioneered the establishment of CANPAD Mentorship program aimed at fostering personal and professional development among members. He has published several peer-reviewed articles and presented at various conferences both locally and internationally.


Marliss Taylor is the Manager of the Streetworks Program and Director of Health Services at Boyle Street Community Services in Edmonton. She received her Diploma in Nursing in 1982 and Degree in Nursing in 1992. After working for 11 years in adult and pediatric Intensive Care Units in Regina, Edmonton and San Antonio Texas, she moved to the high Arctic. There she received her certificate in Advanced Practice Nursing and worked as a Nurse Practitioner in the community of Kugluktuk, and Nurse Manager in the community of Gjoa Haven, Nunavut. In 1995 she returned to Edmonton as the Program Manager of the Streetworks program and has worked in Harm Reduction for the past 27 years. She was the first to initiate the use of community-based naloxone in Canada in 2005. She created the HER Pregnancy program – an innovative model of care for women who are street involved and who face multiple barriers to having a healthy pregnancy. She has been involved in Health Promotion/Harm Reduction Initiatives in Siberia and Guyana, and a multitude of local, provincial and national research and advocacy projects. She was a member of the Alberta Health Services Board of Directors (the largest health organization in Canada) from 2015-2019, and was a member of the Minister’s Opioid Emergency Response Commission for the time of its existence from 2017-2019. She is the Chair of the Canadian Drug Policy Coalition.


Judy Hodge is a veterinary epidemiologist who works by day with the Canadian Animal Health Surveillance System (CAHSS) and operates Katrime Integrated Health, a public health consulting company. She completed her pre-veterinary studies at Brandon University and veterinary school at the Western College of Veterinary Medicine. After 2 years in rural mixed-animal practice, Judy completed a Master of Public Health degree with a focus in Global Health Leadership, at New York University (NYU). Judy is a Diplomat of the American College of Veterinary Preventive Medicine. Judy is especially interested in connecting her training in infectious diseases with human mental health, the social determinants of health, and social justice. She is a co-regional director for the Winnipeg-branch of Community Veterinary Outreach, a nongovernmental organization that provides pro-bono preventive veterinary medicine for the unhoused and marginally-housed while simultaneously providing access to human health services.


Artist – Spencer Hanna-Haworth is a classically trained visual artist and illustrator based in Wakefield, Quebec, Canada. With a background in graphic novel illustration, his painting background originated in painted vignette narratives that blend Rockwellian humour and innocence with a theatrical counter-culture sensibility. Last year he began a project “I’m Always Here”, working with people experiencing homelessness in Ottawa that began with outreach, grew into a visual journal, and ended with gallery portraits. The intention was to bridge the widening gap between the Civil Service and street classes in Ottawa, during twin health crises- viral and opioid. Spencer is currently working to create a body of work over the next two years exploring the purview of theatrical performance and stage design in painting.