Passionate people from around the world gathered for one purpose: to facilitate the engagement of egalitarian, community-governed healthcare. This international conference, entitled "Acting Today, Shaping Tomorrow", was sponsored by the Association of Ontario Health Centres (AOHC) on June 9 and 10 in Toronto, Canada.
At a glance, these diverse health centres may appear to have little in common with one another. They operate within different political climates, often serving very specific local demographics. Service delivery can vary from place to place in order to accommodate local language and cultural requirements. But the synergy was tangible. Like the open source community, these intrepid pioneers in health care represent an open, meritocratic approach to problem solving. The binding mission is to make the Community Health Centre (CHC) model of care accessible to all.
Dr. David Reynolds, Senior Health Advisor to Vermont's Senator Bernie Sanders, summed it up when he quoted the senator:
"If you've seen one health centre, you've seen one."
(Dr. Reynolds accepted an international health leadership award on behalf of Senator Sanders. The award was for Senator Sanders's efforts to increase access to health care for all residents of the United States.)
CHCs in the United States had their roots in the civil rights movement of the 1960s, when Dr. Jack Geiger was inspired by successes in South Africa. Conference attendees had the privilege of hearing first hand Dr. Geiger's insight and experience with what can happen when the community becomes educated and empowered.
In Canada they began in Saskatchewan in 1944, with the late Tommy Douglas, then Premier of the province. Tommy Douglas is considered in Canada to be the father of Medicare. He brought single-payer healthcare to his province in the face of great opposition from doctors. It was during a doctor's strike that CHCs were born, thus empowering people to shape their total wellbeing from within their communities.
Another former Saskatchewan Premier, The Honourable Roy J. Romanow, who also chairs the Canadian Index of Wellbeing (CIW) Advisory Board, was the keynote speaker at the conference. In his talk, "Accelerating the Third Revolution in Health Care," Romanow called for a national strategy to promote a network of CHCs across Canada. He explained that socialized medicine as we know it in Canada is only the first stage of Medicare:
"The next or second stage of Medicare, of which CHCs are now at the leading edge, would involve breaking down the other barriers to good health. Douglas described this simply as 'keeping people well' rather than 'just patching them up when they get sick.' And the vision extended to improving the health of entire populations and communities."
Romanow applauded the United States for its 1,250 CHCs operating at over 7,500 locations. In Canada there are only 300. He went on to say that CHCs are the most effective, efficient, and affordable way to deliver primary healthcare. In order to address enormous disparities in health outcomes, it is important to tackle economic, environmental, and social determinants of health, and Canada is a leading country in developing the tools to measure this wellbeing.
"A key objective here is to stimulate discussion so we can break out of the straightjacket imposed by silos," he said. "Because, until we start connecting the dots, we’re just going to be spinning our wheels."
Romanow provided an example of community involvement in the CIW, the Resilience Collaborative , led by Gary Machan, Health Promoter with the BCHC, on behalf of the Barrie Community Health Centre, adding, "It is local real-life stories that breathe life into the statistics and show the human side of the picture."
Delegates at the conference were then called upon to create a vision of healthcare "where people are empowered and governments held accountable."
The conference featured an impressive list of experts, such as Dr. Ben Chan of Health Quality Ontario and Dr. George Rust of the Morehouse School of Medicine (USA). Workshops spanned a range of topics from governance to statistics to the hands-on work that Shoulder to Shoulder is doing as it empowers poor Hondurans to improve their health and that of their community.
While it could be said that the visionaries at the conference were preaching to the converted, this audience represented a vast range of governing systems and approaches to healthcare delivery.
In the end, there truly are many paths to the same goal.
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