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Taking medical care to the street


Susan Burgess knows all too well about the overdose crisis and other complex health issues of Vancouver’s Downtown Eastside. She sees it firsthand each time she ventures out in search of her patients.

“I go to patients where they are. I go to the shelters, the social housing, the street, the park,” says Dr. Burgess, a physician in the Downtown Eastside for over 15 years.

“The people I see are so busy negotiating the street and searching for housing, drugs and food that they don’t have time to seek medical care the way you or I might. That’s their life.”

House calls when there’s no house

Dr. Burgess is equipped with rain gear and medical supplies including Naloxone, the drug used to reverse the effects of powerful opioids like heroin and fentanyl. She says that her goal in going out to see people is to get them healthy enough where they can seek care on their own, at the Downtown Community Health Clinic for example.

“To treat people you have to meet them where they are and you have to develop relationships with them. I learned this from the wonderful street nurses who are out there. If the person has lost their housing, then you go find them in their tent under the viaduct.”

Building trust

Most patients Dr. Burgess sees have suffered a tremendous amount. Survival for them really means: don’t trust people. It takes time to build trusting relationships she says, so it’s not the kind of work you can do for six months or a year and be effective. It takes years.

“As providers, we might only get one chance with a person. If they’re confused by how we talk or how we do our work they could walk away and never return.”

Another kind of crisis

The overdose crisis currently devastating the Downtown Eastside is not the first or only crisis Dr. Burgess has seen here. She came to Vancouver in 1993 at the height of the HIV/AIDS epidemic.

“Vancouver’s west end was the epicentre of HIV/AIDS in the 1980s and 90s, and about the time I landed here it was basically transferring to the Downtown Eastside in terms of infection rates.”

Since the 1990's, infections rates for HIV and Hepatitis C in the downtown Eastside have declined significantly. While preventing overdoses is a current priority, Dr. Burgess stresses that we must maintain efforts in all areas of health improvement for this vulnerable population.

A love of people

“One thing I’ve learned here is that as much as you think you know someone, you really don’t. You don’t know that they’re a wonderful artist or that they have some kids that they really care about. And you might only find that out after they die. A good day for me is when I get to sit with someone and they’re able to talk from their heart about what’s really going on for them. I love the people.”

Learn more

See Sue's profile in our VCH 15 years of care campaign

Find out what VCH is doing about overdose prevention and response

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