Canada’s Bruce House on Pandemic-Mandated Service Changes for Its Clients Living With HIV

Bruce House in Ottawa, Ontario, Canada, has been serving individuals living with HIV and AIDS for 33 years. This video excerpt, in which we speak with Patrick Morley, office and communications coordinator, is part of our second entry in a series on individuals and international organizations working to bring local and global awareness to the ongoing HIV/AIDS epidemic, which is marking its 40th anniversary this year.

For our first video with Bruce House, click here.

Transcript

What top challenges have affected your ability to reach clients during the pandemic, and how did you overcome them?

First of all, I'll be honest, I think “overcome” is a bit optimistic. We've done our best, and we've done well. You know, we've had so many words tossed around about the pandemic, like unprecedented, challenging, rapidly evolving. I remember last year at one point, I said, “Can we stop with the euphemisms? This is horrible, and we're all confused and afraid.

For us, one of the first casualties, and we knew this would be devastating for clients, was having to cut all of our group events. And that's not just about the social support, and it's not just about the mental health support. That was also contact. You could see, “Oh, Bob seems to be struggling today, but Amy is doing really well.” That was a space that was very informal; that was a very important way to reach clients and was also a good way of exposing clients to our services. “Did you know we have this program?” or “Oh, you want to quit smoking, did you know we can refer you”?

We’ve shifted mental health and the volunteer buddy program to phone, texts, emails, and video, and we've also increased check-in phone calls. So some of our clients get a call from staff once a week, sometimes more, and we've had to adapt to that. And one of the things the program team is telling me is there's no such thing as a quick phone call anymore. The “Hey Janet, you have an appointment tomorrow,” to just [be] a reminder, becomes a 20-minute conversation because our clients are starved for that social contact, which to me just underlines the fact that there is a net loss. They are feeling that we are not reaching them as much as we used to, and I'm sure that happens for their other service providers.

Food insecurity has increased tremendously during the pandemic. As I've explained to some people, we're all seeing prices go up at the grocery store. Just last weekend, I did my groceries and I looked at a tray of chicken and I'm like, “I am not paying $25 for chicken.” It was a tray of 6 chicken breasts or half chicken breasts, $25. And our clients are coming in and saying, “Well, I can only afford the store brand. I can't pay 20% more for the brand name, but they're out of the store brand.”

Very quickly last March, we realized we could not have all of our clients coming to the office to access our food pantry, especially since we projected—and we were right—that we would be doubling food supports. So that meant a complete change of plans. We had to drive to people's homes, we had to deliver food. That means volunteers; we didn't have enough staff to do that. It means safety protocols to keep everyone safe, and it also meant sometimes a bit of a loss of that in-person contact, that informal check-in and saying, “Here's a bag of groceries. How are you?”

We've also had to reconfigure the office space; that's had an impact. [We needed to make] more room for food supplies, PPE [personal protective equipment]. We had to put in a new freezer, protocols, and that formality has distanced us from clients. We've always been appointment based, but we know that's not entirely realistic with our client population. Now it's like, “Well, you know, we can't have 2 client households in the office at once; you really have to call.” You know for people facing many barriers to accessing services, this can be one more.

I'm also really seeing the very basic inequities our clients face. [For example], “Here's an email.” Some of our clients can't afford internet access. Some of our clients can't afford to pay their cell phone bill every month, so it's hard to reach them.

For some clients, literacy is an issue, so [it’s asking], “How do we reach a client? Is it gonna have to be by phone? Can they understand public health messaging?” Even more so for newcomers who have English as a second language. Just because somebody can understand basic written directions doesn't mean they can decipher changing public health messages or messages from us. It's great that I can say, “Hey, our current hours of operation are on the website and on Facebook.” That assumes computer access and computer literacy.

So to wrap up, I’d say it has been a struggle as an agency to still reach clients during COVID, and our biggest challenge is creating ways to meaningfully communicate when the situation creates so many barriers to communication.