About once every month, I buy a patient or a patient and their family a meal. This is always embarrassing for them. Parents especially struggle when I insist that they must also pick something for themselves. I understand this. No one likes to admit that they’re struggling to feed their family. I did learn, however, that when I didn’t insist that parents eat themselves that food was often saved for other children at home. At the same time as I would feed people, I would call the food bank closest to their home to arrange for the family to pick up food on the way home. Another embarrassment for them, but I insist, telling the family that they can volunteer at the food bank once they are managing themselves.
As a doctor, I find it discouraging that there is so much food insecurity in a country like Canada. Food Secure Canada estimates that 4 million Canadians are food-insecure – 1.15 million of these Canadians are children. In northern and remote communities, the situation is even worse. It is estimated that 2/3 of indigenous children are food insecure. Given how unlikely it is that families are volunteering this information, I am confident that these numbers are low. I have met teenagers who are not even aware that they are not getting enough to eat. They are told that adolescents are “always hungry” and they believe that their own hunger is a normal state. I advise residents and medical students to find out in detail what their patients are eating so that they can truly assess whether their patients are getting enough to eat. Adolescents need a lot of nourishment, especially adolescent boys. We have known this since the time of Plato who said, “A boy is an appetite with a skin pulled over it”.
Food Secure Canada works to advance food security and food sovereignty through 3 goals: zero hunger; safe, healthy food; a sustainable food system. To help the youth that I see, I encourage schools to support breakfast and lunch programs. Snacks and meals are available in many of our Outpatient and Day programs. In my neighbourhood, the Parkdale Food Centre works with restaurants, schools and even the local theatre to grow food all year long and to help young people learn to cook. Community meals are a part of the social support network across Canada, often run by faith groups but also by food banks and restaurants and other agencies. Despite all these efforts, people still go hungry. The Ottawa Mission serves 1300 meals per day and food banks estimate that over 40,000 people in Ottawa are food insecure. Last year in Toronto, 136,000 children needed school lunches.
There are just over one hundred youth seen in our outpatient program at my hospital every week. These youth and their families are already managing at least one family member’s chronic health condition. Given how many of these are from marginalized groups, it’s likely that as many as 40% are not getting enough to eat, leading to even more health problems. We have not been able to figure out who most of them are. I don’t know if food banks and social agencies could manage to help everyone if we did.
The lesson from my experience is that every doctor in Canada, no matter where we practice, no matter how prosperous our community, needs to ask their patients if they are getting enough to eat. Once we have asked, we then need to accept that many, many people will not be truthful about this. They are too ashamed.
Our patients are hungry, and we must be hungry also…for justice.
(Note: This is a picture of one of the Parkdale Food Centre’s growing towers.)