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St. Michael's 125th


Moving the dial on poverty and health

Dr. Stephen Hwang approaches Seaton House, Canada’s largest shelter for men, where he conducts a half-day a week clinic. (Photo by Michelle Gibson)

Drs. Judith Peranson and Danyaal Raza stand in front of the Sumac Creek Medical Centre. (Photo by Katie Cooper)
In 1996, Dr. Stephen Hwang joined St. Michael’s Hospital as its first researcher on inner city health, driven by a commitment to care for the least among us: I knew that I wanted to make a difference in the lives of people who might not otherwise have access to care if I weren’t there to provide it.”

Now, 21 years later, he is the director of the Centre for Urban Health Solutions and the inaugural Chair of Homelessness, Housing and Health, among more than 25 researchers who are focused on the health consequences of social inequity, the only Canadian hospital-based research organization to do so.  “It’s the largest and most accomplished group of its type in Canada,” said Dr. Hwang.

The driving force for that growth, according to Dr. Hwang, has been “the hospital’s unwavering dedication to its mission of serving the poor and disadvantaged.” From the hospital’s first days, when it was founded by the Sisters of St. Joseph after the diphtheria epidemic of 1890-91, the focus was on caring for the sick poor of Toronto’s inner city, and on treating everyone with respect, compassion and dignity – a commitment enshrined in the hospital’s mission and values.

For Sister Georgette Gregory, who first worked at St. Michael’s when she was 16 years old, in 1956, the hospital has always kept to the motto of “What you do to the least of my brethren you do unto me.” At the time, there were special floors for the poor and disadvantaged. “I saw the sisters who ran these floors do many small things for patients who shared a problem,” said Sister Georgette. “They always found a way to help them.”

Sister Therese Cleary remembers many acts of kindness from the well-known supervisor of obstetrics, Sister Vincenza (who was born Vincentia Mullen), in the 1950s. “The Sister had a great love for the poor mothers who could not afford the care given to them on delivery of the baby,” said Sister Therese. “Dr. O’Leary and other staff doctors delivered them pro bono.” They never asked their religion, ethnic origin or if they had money to pay – if they didn’t, they simply were not forced to do so.

"In emerg, which was always busy at night, I can remember many a poor street person coming in for treatment for cuts and bruises or fractures. The nurses knew letting them go out was very hard on them. The nurses would often make a sandwich or soup for them as they were hungry. They often slept on til morning. Many needed showers to remove the grime that had accumulated on their frail bodies as well as the lice build-up. We had wonderful orderlies who, without a complaint, showered and de-loused them and gave them clean clothes. This became a normal routine."
- Sister Therese Cleary

Currently, the hospital’s focus toward vulnerable populations is through both clinical care and research – with an emphasis on pragmatic and policy-level solutions. “We have clinicians who are outstanding at providing health care for people who are marginalized or disadvantaged,” said Dr. Hwang, “but we also have a dream team of world-class researchers studying these issues and developing solutions.”

This dual focus allows them to provide clinical care but also take a step back from the day-to-day to look at long-term, solution-based changes. “Our daily experience in the clinic helps inform and guide us in terms of problems at both the individual and system level,” says Dr. Hwang, who spends a half-day each week seeing patients at one of Canada’s largest shelters for men, Seaton House.

Looking toward the next 125 years, C-UHS hopes to make a measurable impact on urban health and in the lives of those who are disadvantaged, not just in Toronto but across the country.