Naomi Howson had been disappointed with health-care options in Timmins for several years. The bilingual Montreal native, raised francophone in Timmins from a young age, couldn’t find a suitable French-speaking family physician. “When I looked for doctors, I was wanting a French-speaking one, preferably,” she says. “There really wasn’t much, if any, because the ones I found were about to retire and not taking any patients.”
When she heard last year that Centre de santé communautaire de Timmins, a francophone community-health centre, was to open this January, she was elated. “For myself, personally, it was an answer to a prayer to be able to access these services,” says Howson, who’s now one of its 444 clients.
Howson’s response is one that’s familiar to the centre’s executive director, Julie Béchard, who says there is a regional shortage of French-language health services. “One of the biggest reactions we’ve seen has been relief from our clients,” she says, speaking in French. “They say, ‘Finally, I can access a doctor or practitioner in French.’”
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The centre, a non-profit organization, is funded through the province’s North East Local Health Integrated Network and provides both primary-health-care and health-promotion programs to fill local gaps in health-service offerings — especially for people with complex medical files. It is the first of its kind in Timmins, where more than one third of the population cites French as a mother tongue, according to the 2016 census, and the sixth in the northeastern Ontario region. “Our region needs to attract more professionals, and professional francophones in health care, to serve the clientele,” says Béchard.
Research suggests that accessing services in one’s preferred language is a key step to improving health-care outcomes. “If you can't speak the person's language, you can't communicate one way or another — then it's guesswork,” says Patrick Timony, a PhD candidate and research associate at Laurentian University’s Centre for Rural and Northern Health Research (CRaNHR). “And that is very important when we're talking about patient safety and about patient experience,” adds Timony, who has studied francophone access to health care for more than a decade.
If a patient and doctor aren’t fluent in the same language, miscommunications can easily occur, Timony says: for example, mal au coeur, which in French commonly refers to heartburn, could be interpreted to mean a heart problem. And when a patient can’t properly describe their condition — or a doctor can’t fully explain a diagnosis, prescription, or health instructions — vital information can get lost in translation. Timony recalls an encounter with an older francophone patient who said, “When I'm sick, I'm not sick in English. I experience this in French, and how do I experience something in French and then translate that to English properly? I can't do it.”
Prior to the centre’s soft opening this past November and grand opening on January 27, the nearest francophone community health centres were in Gogama, Kapuskasing, and Kirkland Lake (each more than 100 kilometres away). Béchard says that she’s already seen clients come to the centre from as far away as Iroquois Falls, roughly 70 kilometres east of Timmins.
Of the province’s 504,130 mother-tongue French-speakers, 112,990 live in the northeast, accounting for 20 per cent of the region’s population — francophones account for 3.7 per cent of Ontario’s population. Yet in northern rural communities that are French dominant, there are 0.9 French-speaking doctors per 1,000 French speakers, versus 5.9 French-speaking doctors per 1,000 French speakers in urban and non-French-speaking communities in the south, according to a 2012 study from CRaNHR that Timony contributed to. “Sudbury, the areas around here, that's where you have the largest proportion and the largest percentage of francophones per population,” says Timony. “And that's also where we find the smallest number of French-speaking physicians.”
Timony points to a 2017 CRNHR study that indicates that French patients who have to access English services have negative associations with visiting the doctor’s office and that those who get services in French show higher satisfaction. Negative associations, he notes, could deter someone from seeking medical help, resulting in worse health outcomes.
Concrete health statistics on the franco-Ontarian population are hard to come by, though, Timony says, because most studies don’t factor in language. But, according to a 2006 article from the Canadian Journal of Public Health, “Ontario Francophones are less likely to say they enjoy excellent health. They are more likely to say that their activities are limited due to chronic health problems.” A survey cited in the report suggests that Francophones experience higher stress levels, take more medication, and are more likely to report lacking access to necessary health care.
It’s Timony’s hope that the new health centre will benefit many in the area. But, he as told TVO.org via email, “I also believe that more initiatives such as this will need to occur through the north in order to have a measurable/noticeable impact on the health of our francophone population.”
Béchard is now working on expanding services at the Timmins community-health centre. It can currently accommodate 1,679 clients; once it’s fully staffed — it plans to hire another doctor and nurse — the number will rise to 2,800. Other francophone community-health centres in the region offer satellite locations, and Béchard hopes eventually to do the same.
And there are plans to recruit a psychologist, dietician, a systems navigator (who can help clients through the health-care system), and community workers who could run health-promotion programs in such subjects as yoga and knitting. “Eventually, we hope to have a space for francophones can do things like art therapy or potentially follow a yoga course,” Béchard says. “It’s a gathering place for the francophone community.”
Correction: An earlier version of this article incorrectly referred to the centre as a family practice. TVO.org regrets the error.
This is one in a series of stories about issues affecting northeastern Ontario. It's brought to you with the assistance of Laurentian University.
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