By Amy Au, Registered Social Worker
While millions of Canadians stay home to keep safe and help flatten the curve of pandemic, many victims of domestic violence found their home to be more dangerous than ever.  Many experience a greater threat as they are confined to their homes with their abusers.  In an interview with CBC News1, Maryam Monsef, Canada's Minister for Women and Gender Equality, says that the COVID-19 crisis has empowered perpetrators of domestic violence as consultations reveal that abuse rates are rising in parts of the country (CBC news, April 27, 2020).  According to a survey about COVID 19 impacts done by Statistics Canada in March and April 20202. One in 10 women say that they are “very or extremely concerned” about the possibility of violence in their home.
 
S. is living with her partner and children.  She is scare whenever her partner is around.  He criticizes everything she does, the way she cooks, the way she cleans, the ways she walks…  He blames her for everything that goes wrong.  He tells everyone that she is a bad mom.  He criticizes all her family and friends, saying that they are no good to her.  There were a few times when he was drunk, he hit her hard.  S.gets a breakwhen he is out to work or when she takes her children to the community centre.  The “Stay at Home” order brings a heavy storm to her life.  There is no place for S.  to hang out. He was laid off.  Now he stays home all the time.  He brings home more liquor….
​

Domestic violence is a pattern of behaviors used by one partner to maintain power and control over another partner in an intimate relationship.  Behaviors can include the use of physical and sexual violence, threats and intimidation, emotional abuse and economic deprivation.
 
According to Canada Department of Justice3, there are many forms of violence, including physical, sexual, emotional, financial abuse and neglect.

1. Physical abuse is the intentional use of force against a person without that person's consent. It can cause physical pain or injury that may last a long time. 
2. All sexual contact with anyone without consent is a crime. This includes sexual touching or forcing sexual activity on a spouse, a common law partner or a dating partner. Even when married, a spouse cannot be forced to have sexual contact. 
3. Emotional abuse happens when a person uses words or actions to control, frightens or isolates someone or takes away their self-respect.    
4. Financial abuse happens when someone uses money or property to control or exploit someone else. 
5. Neglect happens when a family member, who has a duty to care for you, fails to provide you with your basic needs.

 
It is not always easy to tell at the beginning of a relationship.  Some of the signs of an abusive relationship include a partner who might:

• tells you that you can never do anything right
• controls every penny spent in the household
• discourages you from seeing friends or family members
• threaten to hurt you or your children
• threaten to have you deported from Canada
• threaten to take your children away from you
• force you to do things you do not want to do sexually

 
Suddenly, you find it hard to make decision.  You start to doubt your own ability.  You find yourself penniless.  You do not want to meet people.  You are isolated.  You feel depressed and trapped.   You feel helpless and hopeless!  

It is very common for people who experienced domestic violence to have mixed emotions, including fear, confusion, anger, or even being numb and not feeling much of anything7. You may feel guilty or shameful.  You may try to minimize the abuse or hide it by covering bruises and making excuses for the abuser. 
 
There are long term mental health effects on people who experienced domestic violence4, including post-traumatic stress disorder, depression and anxiety.  If you are easily startled, feel tense or on edge, have difficulty sleeping, or have angry outbursts; if you have trouble remembering things or have negative thoughts about yourself or others; if you are feeling depressed; if you are anxious about everything which interferes your daily life, you can get help from a mental health professional.
 
Please remember that you are not alone. 
 
If you are in immediate DANGER or fear for your safety, please CALL 911.  Police are still responding to domestic violence calls.  Police stations are still open for walk-ins for domestic violence victims.
 
Many services are available to you, including counseling, shelters, financial help, legal assistance, etc.  If you don’t know where to start, you can call the Assaulted Women’s Helpline (416-863-0511) which offers a 24-hour crisis line for emotional support, information and referrals, etc.; or you can call the Canadian Centre for Men and Families, at 647-479-9611.
 
You can also find many helpful resources online.  Remember that your computer can be monitored by your abuser and is impossible to clear your tracks completely5.  However, you can erase two things on your computer browser to reduce the chances that someone can find out what you have been reading online:

1. Cache: this is where the computer stores copies of files you recently looked at with your browser.
2. History List: this is a single file containing the addresses of the places you recently visited.

 
Scarborough Centre for Healthy Communities is also here for you, right in your community.  Our experienced counselors in the Sexual Assault and Domestic Violence Care Centre, Inter-professional Primary Care Team and Community Health Centre are able to provide support and counseling, offer options and help you navigate through the services.  Call us at 416-642-9445.  Our friendly staff will direct you to the right program for help.  We keep your information confidential.
 
 
References

1. CBC News, April 27, 2020, https://www.cbc.ca/news/politics/domestic-violence-rates-rising-due-to-covid19-1.5545851
2. Statistics Canada, Concerns expressed by Canadians about COVID-19 impacts, March and April 2020, https://www150.statcan.gc.ca/n1/daily-quotidien/200408/t001c-eng.htm
3. Canada Department of Justice, Family Violence, https://www.justice.gc.ca/eng/cj-jp/fv-vf/about-apropos.html
4. US Department of Health and Human Services, Effects of violence against women, https://www.womenshealth.gov/relationships-and-safety/effects-violence-against-women
5. Assaulted Women’s Helpline, Web Security- Erasing Your Tracks, http://www.awhl.org/social-media-web-security

 
 

By Ruchika Wadhwa, Diabetes Dietitian

During these unprecedented times of the pandemic, it makes sense to stock up on budget-friendly, non-perishable food items so that you don’t need to go shopping if you are unwell and minimize the risk of exposure to infection.

Firstly, take an inventory of what’s in your cabinets, fridge and freezer. This will help you plan your shopping list. It is easier on the supply chain and your available finances to gradually build up on your household stores instead of making large-scale purchases all at once. To do this, you can add a few extra items to the grocery cart every time you shop. 

Some tips and advice to follow when doing groceries:
1. Shop the perimeter, the healthiest options are all around the perimeter.
2. Got a few minutes? Browse the produce section more than you normally would, spend time looking at produce and buy the unbruised ones. Look for washed and bagged salads, baby carrots, cabbage in your grocery store.
3. Buy fresh produce in varying degrees of ripeness to allow for some ripening towards the end of the week.
4. Don’t shop when you’re hungry and always carry a list when you shop. You’ll be more likely to stick to your budget and nutritious food choices.
5. If you’re cooking that day, try buying manager’s special items or “unattractive” produce. They may be reduced for quick sale but still make a great addition to soups and stews.
6. Use store flyers to help you find specials.

If resources to buy food are a challenge, there are community supports available.  Please phone them and check your eligibility.
Scarborough Food Access
SCHC Food Bank
4100 Lawrence Avenue East, Scarborough, M1E 2R9, 416-847-4147
 Christ Church 155 Markham Road, 416-261-4169 office@christchurchscarborough.com
Scarborough Food Security Initiative: Response To COVID-19
647-846-0300, scarbcares@gmail.com, Scarboroughfoodsecurityinitiative.com
Community Hamper Support (East, Central and West GTA)
416-969-8510, covid19hamperrequest@nativechild.org
Canadian Muslim Response Network
Sadaf Jafri, 416-867-7535, covid19relief.ca
Good Neighbour Project GTA
647-873-2230
5N2 Kitchens-Food for All
2050 Ellesmere Rd Unit 7b, Scarborough, M1H 3A9 416-551-0910 5n2kitchens.com
GTA Food Access
UHN Friendly Neighbour hotline - For seniors living in TCHC:
http://uhnopenlab.ca/project/hotline/
Online Help and Community Supports: Facebook Groups
The following is a list of Facebook groups where you can post to connect with others in the community to receive help.There are a lot of people offering to bring food to folks who can’t leave their house or who are having financial difficulty food and supplies at this time.
• CareMongering-TO: TO Community Response to COVID19
 • PALZ Trading Zone
• PALZ Helping Zone
• Homes for Queers
• Queer Exchange Toronto

Chalmers Bot 24/7 https://chalmers.app/
A web/phone app that uses your current location to find the closest free meal/drop-in/clothing resource/etc

Good nutrition and hydration are vital even more so now during the times of the pandemic. A well-balanced diet helps to strengthen immunity and lower risk of chronic illnesses and infectious diseases. So one should eat a variety of fresh and unprocessed foods and drink enough water daily.

​It is important to receive information from credible, trustworthy sources during this time. Dietitians are a regulated health profession committed to providing evidence-based advice and information that is tailored to your personal needs and challenges. Call SCHC at 416-642-9445 to book an appointment with a dietitian.

By Diana  Kinslikh-Mohamed MSc OT Reg. (Ont)
Occupational Therapist, Interprofessional Primary Care Team

The most common reason for referral to Physical and Occupational therapy at SCHC’s IPPC team is chronic pain.

Every day we work with people who have been suffering from chronic pain conditions anywhere from 6 months to 30 years and more. The experience of pain has many factors including social circumstances, emotional wellbeing, and physical ability. The good news is that there are things you can do to treat your own pain.

The first and most important step is to understand what exactly chronic pain is. There are currently two main ways of understanding chronic pain and they both involve understanding a little bit about how your brain and nervous system work.

1. The body is able to heal many injuries either on its own or with some therapy/medical intervention.  Often times muscles, bones, and tendons will heal within months.  However, some people will continue to experience pain even though their injury had healed a long time ago.  Why does this happen?  The brain gets used to the fact that you have an injury and becomes fearful that you will injure that area again.  It therefore continues to send pain signals in an effort to warn you and protect you.  In addition, the brain may have also associated certain activities, times of day, and maybe even specific situations with pain and therefore continues to send those pain signals even though none of them are actually harmful to your body.
2. The second way of understanding chronic pain is as a “Diagnosis” developed by the late Dr. John Sarno who named this diagnosis Tension Myoneural syndrome or TMS. He wrote four books on this topic describing all the conditions that fall under this diagnosis from back pain to fibromyalgia, and even irritable bowel syndrome. Dr. Sarno stated that our brains sometimes protect us from fully experiencing certain uncomfortable emotions such as anger or fear.  However, these emotions don’t just disappear, they linger in our unconscious mind until they are somehow triggered and end up expressing themselves as physical pain.  The emotions show up as physical pain because the brain appears to prefer this as a kinder experience for us than emotional agony.  The brain creates these pain signals by restricting blood flow to various parts of your body, often times to areas of old injuries.  This can affect absolutely any kind of tissue including muscles and nerves and can show up as anything from a muscle ache to shooting electric kinds of pains.
   

​Fully understanding the concepts above and how they relate to the individual experiencing pain is important to treatment.  For this reason, we will be releasing weekly content to make you more familiar with chronic pain and steps you can take to overcome its effects on your life.
Your first step is to test your knowledge about chronic pain.  Please complete the quiz below by answering true or false for each question.  Stay Tuned!  We will be posting answers to these questions and further resources next week.

By Ayzha MacLean, SCHC Harm Reduction Worker
​2020 has definitely been an interesting year.  With COVID-19, most of us are experiencing life as we never knew it.  Sadly, many people have lost their jobs or businesses, domestic violence and child abuse rates have increased and our health care system is overwhelmed.  As a result, people are not receiving the care they need. 
 
Social isolation, anxiety and fear are battling with optimal wellness; people are dying at home or hospital alone, while others lives have been turned upside down.  
 
Scary, huh?  This experiencing life as we never knew it thing. 
 
As a response to this life changing event, we see people adjusting their behaviours, businesses accommodating contactless sales and even our government providing financial support.  These are all examples of harm reduction; methods in which negative consequences are minimized and which support a healthier community by promoting optimal health and social inclusion. 
 
I mean, I think we can all agree that we just want life to get back on track.
 
You know that phrase, “if you build it, they will come”?  Well whoever said that wasn’t considering complex needs and a global pandemic! 
 
The Harm Reduction Workers (HRW) at SCHC have been pushing through COVID-19 with our new “Mobile Harm Reduction Bus”; achieving meaningful connections while providing individuals with harm reduction supplies, water, snacks and connections to resources. 

​

When it comes to substances, some of our day to day work includes preparing harm reduction kits, needle distribution, providing access to clean supplies and naloxone as well as developing or facilitating programming.
 
It’s also important to us to support our harm reduction family by “meeting the person where they are at” – wherever that may be on their journey.  Sometimes this can mean providing housing stability or financial supports, connecting clients with external resources, providing condoms and hygiene kits and/or providing clothing and food packages in special cases.  We also work closely with Toronto Police Services and other organizations to locate missing clients to ensure safety.  Why?  Because we know our clients are worth it!
 
“If it wasn’t for SCHC harm reduction, I wouldn’t be housed or have furniture!  Even though I live in the west end now, I will be travelling back to Scarborough just for their support.” – SCHC Harm Reduction Client
​
In any case, being present in the moment with the individual is the most important thing we can do – to truly “be there”.  Knowing our harm reduction family for who they were, who they are and who they want to be.  Knowing what is important to them and how we can use their strengths to support them to be the best version of themselves that they can be.

“I’ve always seen myself as an alcoholic, but you’ve helped me to see I am a man with a problem that I can fix.” – SCHC Harm Reduction Client
 
As Harm Reduction Workers, people often ask us, “How do you do what you do?” For us, we truly believe that every life is valuable, including the lives of people who use substances or engage in any other high risk behaviour.  I often found it interesting that when somebody dies by suicide, people often respond by wishing they were there for the individual when they were alive.  Individuals living with substance use give us that very opportunity – to be there for them!

“Nobody cares if I’m alive or dead except you, you are truly my angels – I love you guys!” – SCHC Harm Reduction Client
 
The reality is that, without harm reduction, people would still use substances but in unsafe and unsupported ways.  This often leads to poorer health outcomes and possibly overdose and/or death.  As such, harm reduction encourages safety, reduces illness and injury and maintains or improves the health status of the people using the substances.

To truly understand the implications of life changing events (or trauma) is to appreciate another’s journey.  Respect for autonomy and dignity is a really important part of our role.  The right to choice.  This is where trusting and honest relationships come in – and those don’t happen overnight!  As a HRW, we don’t always agree with the decisions of our clients, but we do respect that these decisions are not ours to make.  Wherever the decisions take our clients on their journey – we will be there, with no hesitation nor judgment!

“I trust you because I know you care” – SCHC Harm Reduction Client
 
Whether you consider that piece of lava cake you just sliced, the layers of onion you just pulled back or a butterflies cocoon - there’s a lot more to it than what we see on the surface! 
 
Remember, a plant won’t grow without water!


​

One of the most striking aspects of hospice and palliative care that is unique in the medical world is the expected clinical outcome of death, not wellness nor recovery. Hospice and palliative clients and their families do not get well in the traditional sense of getting back to their former selves or their sense of normality, though this is often the deepest wish of many in facing their human mortality. Instead, persons in palliative care have varying spans of time to face their impending death that victims of accidents or more sudden tragedies do not have. The shock and questions arising from this time also vary: Why me, why now, why is this happening, how did this start, how long do I have, how will it be, who will be with me, is there anything afterwards? How do I live with this until then? Who will care for my family?
 
A key support that I offer in end of life spiritual care and counselling is assisting in the opportunity to make, seek, find, create or recreate meaning that is true for the individual person, regardless of their age, gender, health condition, socio-economic status, personal beliefs or religious or cultural practices. Recently the CBC offered an in-depth look at the work of the late psychologist Dr. Viktor Frankl, a survivor of the German genocide and one of the leading teachers in the past century in care for the mind, heart and soul of suffering persons. His life’s work was founded on the need for “meaning making” that he felt to be essential for human life to succeed in spite of any obstacle, and in surpassing sheer survival.
 
The Coronavirus pandemic has thrown most of the world into the chaos of suddenly facing the utterly unknown. Though this is also true for many in the world living with war, famine, disease, poverty or persecution, many of us who have been previously unaffected are now in similar positions to the person facing a sudden diagnosis of “life-limiting” illness: Why us, why now, why is this happening, where did it come from, what will solve it? Will we and our loved ones survive, and what of those who don’t? How do we live with this now, individually and together?

​The Coronavirus pandemic has thrown most of the world into the chaos of suddenly facing the utterly unknown. Though this is also true for many in the world living with war, famine, disease, poverty or persecution, many of us who have been previously unaffected are now in similar positions to the person facing a sudden diagnosis of “life-limiting” illness: Why us, why now, why is this happening, where did it come from, what will solve it? Will we and our loved ones survive, and what of those who don’t? How do we live with this now, individually and together?
 
Many of us have now had more than one month of self-isolating and the prevention of our most basic human instincts to gather together for companionship, help, warmth and love. We don’t know when this will end so we can get back to our previous lives, a stable economy and our ability to plan for the future. Meanwhile front line and “essential workers” who never knew they were previously called that continue in daily putting their lives on the line for the rest of us. Guilt, resentment, panic, fear may abound in this separation of those who must stay home contrasted with those at the frontlines. It may feel like we are free-falling through space, or that all the formerly solid parts of our lives and of society are now in constant change, like the ever-moving parts of a mobile dancing over a baby’s crib.
 
In working with people and families facing terminal illness, I continue to face my own fears of death and loss. This has never been easy for me nor for colleagues in this field. But death is the ancient reality now before all of us, as we hear of doctors and nurses completing their wills and making their healthcare directives known to their family members. The “hard conversations” at which palliative teams excel in assisting people are now facing all of us, of any age. Yet when have we ever not been facing death as our human end? Some say the privilege of our developed world has made us “death phobic” in our daily distancing from the life and death struggles of so many regions globally, as well as that of the natural world, and most of human history.
 
We now have the chance to face the simple fact of our mortality, alone and together, whenever that will be for us or our loved ones. How can we do this? How are you doing this? How are you feeling about this new world into which we have been collectively thrown into? In the familiar greeting to her patients by the founder of the modern hospice movement, Dr. Cicely Saunders asked, “How are you within yourself today?”
 
While we all continue finding new ways to live and work through the pandemic and beyond it, perhaps we can learn to face our human fragility in this new time, alone and together. Let us remember that, as so many of the world’s religions teach, and as so much of Mindfulness, meditation, thoughtful prayer and trauma therapy teaches, the breath is our start and it will be our end. If all we can control at this time is the conscious managing of our in-breath and our out-breath a few times daily, we can have greater ability to face our realities, alone and together. I highly recommend doing this with plants in your home, even in your bedroom. Remember that the plant world exists in direct, symbiotic relationship to us – they feed us with their output of life-giving oxygen, while we feed them the carbon dioxide that is so poisonous to us, but life-sustaining for them.
 
And when we are able to breathe together again, let us remember what we are learning now and carry it forward, whatever the future holds for us, alone and together.

A few weeks ago I had a conversation with my brother about our professional roles. We had both recently started to work from our homes due to Covid-19 and wanted to ensure we stayed connected to people. He asked what was happening with the SCHC volunteers and I said that we’d needed to tell everyone to stay home to be safe. The impact of not having the amazing SCHC volunteers and their help was felt immediately in many programs.

I thought a lot about the volunteers in the following days. I knew they wanted to feel connected to the clients they serve. Many of them had long time relationships with clients and had developed friendships. Some reached out, asking what was happening with various programs and expressed great concern over how people were doing. Some asked if Meals on Wheels was still being delivered and offered to help. Others asked about the community that uses the Food Bank and offered assistance to keep it running. In other words, the SCHC volunteers told me they were feeling disconnected and very concerned.

For many of us, this is week 2 of self-isolation. To protect ourselves and the more vulnerable members of our community, we’re working from home, or taking time off work, staying indoors and only leaving the house for the most essential reasons.
 
The outbreak of COVID-19 has caused fear and anxiety across the world. Being isolated adds to an already stressful situation.

According to the CDC People who may respond more strongly to the stress of a crisis include:​​

• Older people and people with chronic diseases who are at higher risk for COVID-19
• Children and teens
• People who are helping with the response to COVID-19, like doctors and other health care providers, or first responders
• People who have mental health conditions including problems with substance use

 
People with depression and other mental health conditions, may find themselves struggling during this time. Quick reminder to reach out to your friends and family, you never know who is in need of that human connection.

We’ve put together a few tips for coping with the stress of the 2019-nCov outbreak: