Community Health and Social Services Network

Navigator helps anglophone patients find their way in Quebec City

Ruby Pratka, Local Journalism Initiative reporter

editor@qctonline.com

There was a time when walking through the doors of a Quebec City hospital was the last thing Steve Guimond ever wanted to do again. He and his family were living in Montreal and had to make regular trips to the provincial capital so his children could receive care for a long-term medical condition. The family found the three-hour road trips, bureaucracy and navigating the health system in two languages exhausting.

“We had no choice but to come here [to Quebec City] and our experiences were not great. My wife and I actually told ourselves that after the situation with our kids was over, we would never come back here again,” said Guimond, a bilingual anglophone originally from Saguenay who has lived most of his life in greater Montreal.

A decade later, perhaps ironically, helping English- speaking patients get in and out of Quebec City hospitals is Guimond’s full-time job. He works as a patient navigator for the Community Health and Social Services Network (CHSSN), a Quebec City-based provincewide nonprofit promoting access to health care in English. When patients from isolated English-speaking communities in the Gaspé, the North Shore or the Lower North Shore need to come to Quebec City for medical appointments, Guimond is the person they call.

“The way the health system is set up in the province is that anyone living east of Quebec City – and that’s a very large region, the Lower St. Lawrence, the North Shore, the Lower North Shore, the Gaspé and the Magdalen Islands – [is] usually sent here for specialized health services, because the services they have access to in their own regions are pretty minimal. Anytime you need an MRI, you have to come here.”

For someone from the Lower North Shore – the stretch of isolated, primarily English- speaking villages between Kegaska, where Route 138 ends, and Blanc-Sablon – this means several days of travel, often by ferry or snowmobile and then by plane. Once a patient arrives at his or her destination, the culture shock of going from an anglophone village of a few hundred people to a mostly French-speaking city of close to one million can be intense, especially for patients who never learned French or who aren’t comfortable in the language. “You have the stress of the medical aspect, the stress of the travel – the Lower North Shore has a very unreliable air carrier – the stress of arriving in a big city where you potentially don’t know anyone, the stress of not knowing much about the hospital or where you’re staying … and the stress of actually going to the hospital, which is much larger [than health facilities patients are used to]. There’s also the language barrier.”

Jody Lessard is executive director of the North Shore Community Association, which helps connect the estimated 2,500 anglophones of the upper North Shore – between Forestville, across the river from Rimouski, and Natashquan, until recently the end of Route 138 – with services in their preferred language. “If you’re an English speaker from a small town of 20 or 200 people, there’s a lot of fear [when you arrive in Quebec City]. By just having someone like Steve there to pick you up when you arrive, that fear is gone,” she said. “He provides a sense of security. This is a great project and it’s highly needed … and he’s the only one doing it.”

Both Lessard and Guimond said they believed the project, currently run by the nonprofit CHSSN, could benefit from increased government support. “We’re basically stepping in to deal with the problems or the issues that are created by the health system. It’s like the health system should be the one making sure that these measures should be in place, but they’re not,” Guimond said. People from remote communities and people living with chronic conditions often pay the price, he observed.

As a patient navigator, Gui- mond often drives patients to and from appointments at hospitals in Quebec City and Lévis, helps them get admitted, helps patients find long-term places to stay and acts as a translator and patient advocate. No two days are ever the same. “It takes a lot of flexibility, foresight and ingenuity, I guess, but people are great – they understand I’m the only person doing this, so there are times I can’t be there exactly on time.”

Guimond said he has noticed that health-care professionals are increasingly willing and able to ensure patients who need service in English get it, despite a recent raft of confusing and contradictory government guidelines on the use of languages other than French in health care. “There’s a real disconnect between what the government is trying to instill [in terms of the prevalence of French] and what is actually happening on the ground,” he said. “The patient comes first, and no one is going to be refused service because they can’t speak French. I’ve seen people go out of their way to make sure patients are comfortable and make sure there’s someone around who can communicate with them.” Even so, he pointed out that not all written documentation handed out to patients is available in both languages, due in his estimation to inter-agency communication challenges within the health system.

He advised anyone preparing for a medical appointment, even if they live in the city and don’t need directions or help getting to the health facility – to make sure they have their health insurance card on them at all times – “that’s like your passport.” He also told patients not to hesitate to ask for English service if they need or prefer it. “That’s your right.” For more information on the health navigator program, visit travel4health.ca/going-to/quebec/patient-navigator.