Elder-led mobile health program brings healing to Downtown Eastside
Transformation. Unconditional love and acceptance. Healing and good health. These values-in-action are transforming lives through a trail-blazing community organization at work in Vancouver’s Downtown Eastside.
Two years ago, the Kílala Lelum Health Centre opened its doors as an Indigenous, Elder-led primary care centre serving residents of a tight-knit, but troubled neighbourhood at the heart of British Columbia’s overdose and homeless crisis. To honour the Host First Nations of the region now referred to as Vancouver, the name Kílala Lelum (Kee-LAH-LAH Lee-LUM) was chosen in consultation with the Musqueam people.
The name, which means “butterfly house,” makes clear the centre’s purpose.
“We were looking at how to bring our members in from the Downtown Eastside, trying to get them to go into a good place, a place of transformation. That’s what Kílala Lelum is for — the transformation for our members, that they go into a good way, a healthy way,” says Bruce Robinson, a founding member, board member and one of the Elders-in-residence.
The health centre exists to fill a much-needed gap in the medical system.
Approximately 2,223 citizens experience homelessness in the City of Vancouver on any given night, and Indigenous people represent 39 percent of that population. Systemic racism, discrimination, poverty, trauma, violence, and addiction add to the barriers to quality care experienced by many in the neighbourhood — a critical situation further magnified by the COVID-19 pandemic, which disproportionately affects Indigenous people.
“Simultaneously, these same people often have the greatest healthcare needs and typically only present to care when there is an extreme health crisis,” says Dr. David Tu, a Vancouver physician, and founder and board member of Kílala Lelum.
Kílala Lelum, by contrast, has crafted a model that partners Western medicine and Indigenous healing practices to deliver timely, culturally safe and trauma-informed care, and promote greater health, wellness, and social stability.
Dignity and respect are deeply rooted in the organization’s mission, and steeped in the invaluable guidance and wisdom of the Elders.
“Our role is to provide one-on-one support for the members who need it. They come in and visit me in the Elder’s room where it’s nice and quiet and we can hear each other and listen to each other without interruption,” says Ruth Alfred, another founding member and Elder-in-residence.
“Many of them who come to me are without family. They’ve been either locked out of a family relationship or have lost family members so I am basically their surrogate auntie, grandmother, whatever they want to call me. We have conversations about how they came to be where they are at and how much they want to be released from that addiction or whatever it is that is keeping them down. We have quite some conversations,” she says.
“I always offer them that spiritual part of it, too — a brushing with cedar or an eagle fan, or a smudge,” says Elder Bruce. “They are just offers, it is their choice. It’s with the understanding that they’re living the life they want to live, but they’re here because they want to change something for themselves.”
We are all on the same path
Helping Kílala Lelum succeed is the reason TELUS has expanded its innovative Health for Good program in Vancouver. Via a specially equipped clinic-on-wheels, the organization can now bring its culturally appropriate primary medical treatments, Elder-led cultural care, mental health services, and addiction support directly to the underserved citizens of the Downtown Eastside.
Backed by a five-year, $10-million commitment from TELUS, similar mobile clinics are across Canada. Each van is equipped with TELUS Health electronic medical records (EMR) technology and TELUS LTE Wi-Fi service, enabling practitioners to collect and store health data, examine results over time, and provide better continuity of care to patients who may have undocumented medical histories.
The clinics are specifically designed to operate in communities where frontline care is urgently needed and to act as a vital link between the community and local health authorities.
For Dr. Tu, the mobile clinic is a means to build on relationships Kílala Lelum has formed with members/patients, and, ultimately, bring specialized care to more people.
“It’s a bit of a discovery process. We are going to learn over the next months and years how this program is going to impact people’s lives,” he says of the new service. “I'm hoping that people can recognize that this mobile team is trying to bring the best services they can to situations where people are not otherwise able to engage in healthcare.”
“By bringing their humanity forward, that helps to create a relationship. That’s the foundational piece. Once a relationship is in place, then we can work to address people’s basic needs,” says Dr. Tu
“Now we have the mobile coordinator, an outreach worker and a nurse practitioner on board the mobile clinic. They can go through the community and clients can just come and see them to get their meds or whatever treatment they need,” says Elder Ruth. “We can make sure everyone is taken care of.”
“No one is different than the other. No one is above another person, that is how I feel about my relationship with the Kílala Lelum members. I’m not above them and they’re not above me. We are on the same path, looking for the same thing.”
Accelerating connectivity in all communities will help more communities access community-centric health solutions.
Learn how connectivity policies can benefit underserved communities across Canada: TELUS.com/Get5GRight.