In the late 1800s and the early 1900s, Winnipeg threw open its doors to the world. The businessmen of our city needed workers—and lots of them! Winnipeg was quick to recognize the economic need for immigrants, but painfully slow to recognize their social needs.
As immigrants arrived in Winnipeg by the thousands, the majority concentrated in the North End. Cheap housing was plentiful, but physical isolation, coupled with prejudice, led many newcomers to develop business, professional, social and religious institutions of their own.
Despite the growth of a vibrant and active community, one thing remained a problem: accessible and affordable health care. Those who couldn’t afford to pay for services could still visit a hospital with outpatient facilities for the poor, but these hospitals kept records that included the ethnicity of each patient. They tabulated these numbers and regularly printed them in the paper.
It was this environment that prompted the Jewish community to establish the Mount Carmel Clinic. The Clinic, established by Jews to “look after our own,” began in a house on Pritchard Avenue. In 1929, it moved into a new facility funded by the Jewish community, located at 120 Selkirk Avenue.
In 1948, the clinic had just two staff members: Anne Ross, who was hired as a nurse, and a bookkeeper-secretary. By this time in history, the economic conditions of the Jews had improved, like that of many other Canadians. That meant little need for the services of the clinic. Only three or four patients came in each day and it soon became obvious that the clinic’s very survival depended upon a change in orientation.
Mount Carmel Clinic began as an ethnically-based clinic, providing service to anyone who wished to use the facilities. Under the leadership of Anne Ross, the emphasis of the clinic changed. It became a strongly community-oriented service, catering to the needs of the community in which it was situated.
The change in perspective is best explained by Anne Ross herself in her book Clinic with a Heart:
“…health workers [in 1948] emphasized curing only the physical affliction, without regard for the contributing factors of the illness. From my perspective, such a philosophy was terribly narrow-minded and almost nonsensical. I believed in a system of health care that was not acknowledged at the time. I believed in the idea of treating the individual – or family – as holistic entities. Every person responds physically and emotionally to their immediate environment and to their network of friends and family members. I felt it was highly advisable to investigate these factors as a function of an individual’s general health.”
The 1940s and 1950s
Over the next 20 years, Mount Carmel Clinic truly came into its own. What was once only a passive service—dispensing care to those who came through the doors—became an active agent for change in the community.
The clinic established a regular roster of volunteer doctors, which gave public health nurses the option to refer patients to Mount Carmel Clinic instead of a hospital setting, where many clients felt so uncomfortable.
Home visits were increased, helping to ensure proper follow-up on treatment and to provide information about preventing illness and maintaining good health. Home immunization programs now meant families didn’t have to travel with one or more young children in tow, increasing the likelihood that children would receive preventative care at the right stage.
During this same period, Mount Carmel Clinic took a lead role in providing family planning information, mostly to young and low-income women. While it is hard to imagine now, taking the step to provide this type of counseling took great courage—at that time, it was a direct violation of federal law.
Immigrants continued to arrive from around the world, now joined by a wave of Aboriginal and Métis. Many came from reserves, hoping that Winnipeg would provide greater opportunities. Unfortunately for many, any advantages to city life were paired with so many cultural changes that adjustment was often difficult. This meant many of the newly arrived were forced to live in poor housing conditions, without proper nutrition or the necessary warm clothing.
These conditions were especially hard on the children. The clinic saw more and more cases of upper respiratory and ear infections. Families were confronted with so many hardships that even when they were able to get medical care for their children, it wasn’t always possible for the families to provide the necessary follow-up care. In the face of this overwhelming need, Mount Carmel Clinic created a day hospital. Children came to the clinic each day for treatment, but then returned home at night. This meant they received the care they needed while allowing the family unit to stay intact. An additional benefit of daily visits was the connections that many families made with the staff. They learned about life in the Winnipeg and how to cope with the issues that city life brought with it.
When Medicare arrived in the late 1960s, many thought the clinic had finally outlived its usefulness. This proved not to be the case. Patients came in growing numbers for a variety of reasons, but underlying its continuing relevance to the community was one thing: an appreciation for the dignity and respect given to each client.
At this time, a variety of programs were available, including counseling, a milk fund for “at risk’” pregnant women, free dental care, pharmacy and a day nursery.
By the early 1970s, the clinic’s space was no longer adequate. Serving 120 patients per day in a space of only 2,500 square feet, it was clear that the original facility could no longer house all the programs and services Mount Carmel Clinic had to offer. Social workers and the nutritional counselor occupied a rented house nearby and the Day Nursery was accommodated in a trailer.
Through persistent effort, the clinic finally raised enough funds to build a new facility at the clinic’s current location, 886 Main Street. It took no less than ten years of negotiation spanning two provincial governments!
During this same period, Mount Carmel Clinic played an advocacy role in issues perceived as health related. This included both improved housing and the ongoing struggle to control the price of milk.
In the early 1970s, Mount Carmel Clinic presented briefs to the government to make the case for property tax adjustments for the elderly that would enable them to continue to live in their own homes. The clinic also requested that more Senior Citizens’ Homes be built to enable elderly residents to stay in the area.
The clinic also advocated for increased public housing, as well as the upgrading of existing houses in Point Douglas and the North End areas through purchase and renovation programs. In 1974, it was gratifying to see the establishment of the Neighbourhood Improvement Program, with funding from three levels of government.
The 1980s to Now
The community-centred approach pioneered by Anne Ross in the 1950s has continued to thrive. As the needs of the people of the North End and Point Douglas have changed, the clinic has responded to meet those needs. This has meant new programs such as the Cross-Cultural Counseling Program, the Diabetes and Hepatitis C Clinics, Teen Clinic, the RB Russell Student Health Clinic and the Parenting-Student Support Program.
The legacy of Anne Ross lives on not just in the spirit of the clinic, but also in a building that bears her name. The Anne Ross Day Nursery, dedicated in her honour, now has its own building adjacent to the clinic with space for 48 children.
It becomes more clear with every year that passes: Mount Carmel Clinic’s focus on promotion of good health and prevention of illness leads to positive results not only for the personal well-being of our patients, but for the economic well-being of the health care system and the clinic itself.
The clinic has received public acclaim not only in Manitoba, but across Canada and into the United States. Many see it as a model for care that is responsive to community needs and that addresses root causes of poor health.