Windsor

No health card, no car, no doctor? No problem for this travelling rural clinic

A travelling clinic equipped with mental health staff, a nurse practitioner and a community paramedic says no health care card, appointment, or form of payment is needed.

MobileCare is serving rural communities that traditionally face barriers to health care

On-site staff members stand outside the MobileCare Clinic in North Buxton.
Onsite staff members stand outside the MobileCare Clinic in North Buxton. Pictured from left to right are Jessie Zabula, nurse practitioner student; Nicole Basiaco, nurse practitioner; Nick Zimmer, community paramedic; Edna Cornwall Shadd, CMHA mental health care coordinator. (Josiah Sinanan/CBC News)

Pulled into the driveway of a local museum off of a rural road in southwestern Ontario, a 38-foot-long van with decals of cedar trees, a medicine wheel and an 2SLGBTQ flag is parked — ready and waiting for people seeking medical or mental health care.

It's a travelling clinic, equipped with mental health staff, a nurse practitioner and in some cases a community paramedic, with the goal of abolishing traditional barriers to health care. 

No health care card, appointment or payment is needed. 

One of it's regular stops, the MobileCare Clinic is parked outside of the Buxton National Historic Site & Museum.
One of its regular stops, the MobileCare Clinic is parked outside of the Buxton National Historic Site & Museum. (Josiah Sinanan/CBC News)

The service, aptly named the MobileCare Clinic, recently expanded its schedule to stop throughout rural areas in Chatham-Kent, Ont., based on a needs assessment from local hospitals and 911 calls. It's run primarily through the Canadian Mental Health Association (CMHA) and other community partners. 

A travelling clinic run by the CMHA is providing medical and mental health supports for a range of communities across southwestern Ontario. CBC's Josiah Sinanan stops by to speak to some of the staff during a stop in North Buxton, a community in Chatham-Kent.

"Our hope is that we are able to address some of the social determinants of health," says Andria Appeldorn, the director of fund development and communications with CMHA Lambton-Kent. She has seen the project manifest from its origin during the pandemic.

"We really consider obstacles to care. It could be transportation, it could be reticence to walk into a doctor's office ... thinking about international workers who come into our communities, we're here to serve them as well."

On a recent Monday afternoon, the van is at one of its regular stops in North Buxton, a small rural community that was established by escaped African-American enslaved people in the mid-1800s.

According to Edna Cornwall Shadd, the staff mental health care coordinator onsite that day, the population is older and might face specific challenges to getting medical or mental health attention. 

"As a Black woman, it was very important for me to ensure that the communities I identify with were having this type of support available to them, especially in North Buxton," she said.

MobileCare workers stand outside the Buxton National Historic Site sign in North Buxton, Ont.
MobileCare workers stand outside the Buxton National Historic Site sign in North Buxton, Ont. Pictured second from the left is Edna Cornwall Shadd, a mental health care coordinator who says she particularly values the service provided to communities like North Buxton. (Josiah Sinanan/CBC News)

Cornwall Shadd says it's a primary objective of MobileCare to solidify relationships over time, especially when a new community is added to the van's schedule. One recent addition as part of the expansion is Wheatley, Ont.

"It's exciting trying to build that relationship [because] there may be some barriers that we ourselves might not even be aware of," she said. "Engagement with the community is really important."

For the first time, the MobileCare clinic will also be in North Buxton's community parade, a longstanding heritage celebration called homecoming that draws hundreds into the community. It's something Cornwall Shadd is excited about.

"North Buxton in particular is rich in Black history and it's actually quite amazing the number of people even within Chatham-Kent who aren't aware of that," Cornwall Shadd said.

"So any way we can help promote the community and that history while also ensuring the population is getting good quality health care is very important."  

A posted schedule is listed inside of the MobileCare van, showing each scheduled stop in the area of Chatham-Kent, Ont.
A posted schedule is listed inside of the MobileCare van, showing each scheduled stop in the area of Chatham-Kent. The van makes stops regularly in Chatham, Walpole Island First Nation, Wallaceburg, Thamesville, Blenheim, Delaware Nation, Dresden and North Buxton. (Josiah Sinanan/CBC News)

James Bromley, the CMHA's manager of integrated client services, oversees the service, which includes a second bus that services the area of Sarnia-Lambton. He says sometimes it takes a couple of visits for people to understand the breadth of what is available to them through the clinic. 

James Bromley, manager of integrated client services for CMHA in Chatham-Kent, stands inside MobileCare clinic.
James Bromley, manager of integrated client services for CMHA in Chatham-Kent, stands inside MobileCare clinic. (Josiah Sinanan/CBC News)

"It's a difficult time. There's long wait lists, primary care might not be available in some centres, so [we're] trying to address that, even taking some relief away from our local emergency rooms," he said.

Inside the van, three areas are sectioned off. A client is greeted by staff, triaged through an intake form and then seen by professionals. Bromley says some visits are 15 minutes, while others can be up to an hour, addressing everything from wound care to addictions. Three people can be seen at one time on-board.

MobileCare Clinic operates three days a week, typically from 9:30am until 3:00pm on a rotating schedule. Clients are triaged and seen for free.
The MobileCare Clinic operates three days a week, typically from 9:30 a.m. until 3 p.m. on a rotating schedule. Clients are triaged and seen for free, without appointment. (Josiah Sinanan/CBC News)

"We can offer referrals, whether for therapy, housing supports, Indigenous supports and even our community paramedic team can arrange home visits [if follow ups are required]."

Not every community has the same needs, however. Appeldorn says that the dynamic and needs can change drastically from stop to stop.

James Bromely (left) and Andria Appeldorn (right) are both staff with the Canadian Mental Health Association (CMHA).
James Bromely (left) and Andria Appeldorn (right) are both staff with the Canadian Mental Health Association (CMHA), which operates two MobileCare Clinics in southwestern Ontario, one in Chatham-Kent and another in Sarnia-Lambton. (Josiah Sinanan/CBC News)

"Some communities have a lot of seasonal agricultural workers who don't have time to see a family doctor, others have elderly residents who haven't seen a doctor in years. We can really catch things before they become too advanced to be cared for."

Other stops on the van's schedule include Walpole Island First Nation, where an Indigenous services team member is added. In urban centres like Chatham, the team includes housing and homelessness support. 

MobileCare operates year-round. The van's schedule is available on their website. Services are free with no appointment required. 

ABOUT THE AUTHOR

Josiah Sinanan

Reporter/Editor

Josiah Sinanan is originally from Calgary and is now a reporter with CBC Windsor. His work can be found on southwestern Ontario's Afternoon Drive radio program and previously Canada Tonight and The Key of A. You can contact him at josiah.sinanan@cbc.ca.