Only 5 kilometers separate the Montreal General Hospital from the nearest hospital, but almost 300 kilometers separate the Le Royer hospital in Baie-Comeau from that in Chicoutimi. When an emergency closes in the region due to lack of personnel, thousands of citizens find themselves in a “medical desert”.
Johanne Tremblay lives in Forestville. When, last April, her 14-year-old daughter, suffering from a disease that causes muscle atrophy, injured her ankle at school, Mme Tremblay first went with her to the CLSC in her municipality. The radiology department was closed. “I was told that I could wait until the next day, but my daughter cried and cried,” says the mother, two months after the events. They moved to the next closest service point, in Les Escoumins, 50 kilometers away.
” [À notre arrivée sur place]we were told that there was no orthopedist and that we had to go to Chicoutimi. That’s another two hours’ drive,” explains Johanne Tremblay, in a telephone interview with The duty. Due to the nature of her daughter’s illness, she was eventually transferred to the CHU de Québec. In total, the Tremblay family had to travel more than 500 kilometers to treat a broken foot.
“It’s nothing new to have to travel to receive care in the region,” explains Myriam Tardif-Harvey, a doctor at the Escoumins hospital. Small hospitals have never had the resources to treat all emergencies. “But we’re not talking about 40 or 50 kilometres anymore. When [on ferme] emergencies at relatively central service points, such as Les Escoumins or Forestville, can mean traveling 150 kilometers for patients for basic services. »
Mother of two young children, DD Tardif-Harvey experiences this reality beyond the walls of the hospital where she works. To give birth to her second baby, she was forced to stay with relatives in Chicoutimi for a few days, as the Escoumins hospital does not offer obstetrics services. “It’s better than [d’accoucher] on the passenger seat of a car with the spouse in the area where there is no cellular network between Les Escoumins and Chicoutimi…”
With the closure of emergency rooms and certain operating theaters, many women cannot give birth in the hospital they had previously chosen. “There are patients who had to travel to La Malbaie or Chicoutimi to give birth. It’s long ambulance rides,” explains the doctor.
The origin of the situation
But where does the problem come from? How are medical deserts created in Quebec? Is this due to a lack of service centers, the extent of the sparsely populated territory or rather the shortage of labor?
Since May, the Legault government’s new legislation aimed at abolishing the use of private health agencies has been heavily felt in certain remote regions. The Minister of Health, Christian Dubé, affirmed that he would stay the course despite the movement of patients and emergency closures in regions where an independent workforce was crucial to their proper functioning.
According to Lily Lessard, co-holder of the Interdisciplinary Chair on Health and Social Services for Rural Populations, “what is dangerous in Quebec is wall to wall. “It’s the idea of having a policy that covers everything, when there are several different realities.” She believes that the centralization of services and the standardization of health measures in Quebec do not take into account the particularities of each region and encourage the appearance of medical deserts.
The researcher at the University of Quebec in Rimouski notes, however, that it is not necessarily the number of health service centres in a specific region that indicates the presence of a medical desert. [Dans le Grand Nord québécois], you always have a doctor at the end of the day, you have a camera, you have the necessary equipment. The population is also aware. I would not talk about medical deserts in this case. [Un désert médical apparaît] rather in situations where there are people, there are services, but they are not necessarily easily accessible.”
Not being prepared for possible service reductions, some territories find themselves “overdrawn”. Unlike “very, very remote” regions, in some territories, “the organization of services is not used to managing contexts of disruptions,” says Lily Lessard. [Ces déserts médicaux] cause really significant stress. Especially for people who have precarious conditions. It really puts populations at risk.”