A TB outbreak should suffice as a wake-up call to start housing vulnerable people and end the serious overcrowding in the city's shelters. But five months after it started, a coroner's inquest into the causes of a February 2001 outbreak in Toronto's homeless shelters has been plagued by disorganization, scheduling interruptions, three different Crown counsels, security checks and, most recently, one entire half of the courtroom being blocked off after a disgruntled spectator sighed loudly and muttered under her breath.
The word "housing" is scarcely heard at this inquest, despite a February 2004 Toronto public health report making "a strong link between TB, poverty and homelessness." And early evidence provided by Crown witness Dr. Andrew Simor, an infectious diseases expert, showed that TB is about poverty and overcrowding, along with similar testimony by Dr. Tomislav Svoboda and Seaton House staffer Art Manuel.
Yet requests to put before the jury an expert panel's report into the outbreak after hearings in the community last year has been rejected by the coroner, as has a tour of the shelter system itself.
Housing and poverty experts have also not been allowed to take the stand. When Tuberculosis Action Group witness Margaret Sumadh, a long-time Out of the Cold volunteer, began to broach hunger and income issues, she was stopped and the jury was asked to leave the courtroom.
As a nurse, I know very well that a coroner's jury can develop reasonable recommendations that will save lives. In my view, the jury at this inquest hasn't been allowed to hear enough evidence to make meaningful recommendations.
The terms of reference, to look at the circumstances leading to the death of one of the three men who died in the 2001 outbreak, are too narrowly defined to give the jury a bird's-eye view.
I remember other valuable inquests. It was a jury recommendation that led to safer spacing on the bars of infant cribs. Every public health nurse and new parent in the country probably appreciates that one.
In the 1987 inquest into the freezing death of Drina Joubert, a jury recommendation led to 3,000 more units of affordable housing. I know many people who still live in those housing units.
In the 1996 inquest into the freezing deaths of three homeless men, the jury recommended establishing a "wet hostel." Because it was created, men now live there who otherwise would be left to die outside, drinking less desirable substances.
If 1,000 rent supplements were provided by the province over the next six months, many homeless people with serious health problems could be removed from shelters and housed.
This would accomplish the ultimate goal of an inquest - to prevent similar deaths.
"We must be able to talk about housing at this inquest if the jury is going to make useful recommendations," says Jackie Esmonde, a lawyer with the Tuberculosis Action Group. "Housing is the most effective strategy to protect the health of homeless people."
It should be noted that since the inquest began in December, two new and active TB cases were identified in a men's shelter. To date, neither the Crown attorney nor the city lawyer plans to call a current Toronto public health manager to the witness stand to account for the status of current programs. Strange.
Cathy Crowe is a street nurse and housing advocate with the Toronto Disaster Relief Committee.