All eyes may be on the race to deliver a vaccine for COVID-19. But mobile clinic DocTocToc wants to make sure children in Montreal North don鈥檛 miss out on existing vaccines and check-ups that save lives each year.
From August 20 to 22, DocTocToc rolled into Place de l鈥橦armonie in Montreal North and, under colourful tents, assessed over 120 children under 5 years old. 鈥淢uch more than we were expecting,鈥� Executive Director Dr. Rislaine Benkelfat said with a laugh.
Benkelfat, a pediatrician at the 苹果淫院 Health Centre, runs the mobile clinic on top of her practice and teaching at the Montreal Children鈥檚 Hospital. At the inaugural pop-up clinics, she had only expected to see 20 kids a day. Many families that visited DocTocToc were worried their children would not receive vaccinations they needed before the school year started. Others wanted to meet with a primary-care doctor.
鈥淥ne of the collateral damages of COVID-19 in pediatrics was the delay in vaccinations,鈥� said Benkelfat. 鈥淧art of it was that human resources were allocated elsewhere.
鈥淎nother reality was that families were very scared to come to healthcare settings,鈥� she said. 鈥淲e saw drastic decreases in children coming into the hospitals and clinics.鈥�
The COVID-19 pandemic didn鈥檛 create health disparities, but it exacerbated them. Montreal North was one of the hardest hit neighbourhoods on the island in the first wave. The neighbourhood is also home to more low-income and immigrant families. Accessing health services, already a challenge, became more difficult for these families as hospitals and doctors turned to telemedicine and reduced in-person visits.
鈥淪o we asked: how can we bring the care to them and break down these barriers?鈥� Benkelfat said.
For three days, pediatricians, a social worker, nurses, and volunteers donned their masks and orange smiley-faced shirts, ready to serve clients in bright blue and pink tents. Benkelfat is grateful to one medical student in particular, Anne Xuan-Lan Nguyen, who has been a 听for听DocTocToc, among other projects.
Health equity considers the financial, cultural, language and personal barriers that prevent some families from getting the care they need. Benkelfat thought of the families with four or five children that came to the pop-up clinic. 鈥淗ow do you get an appointment for four or five kids? Most doctors or clinics can鈥檛 or won鈥檛. But for the parent struggling to keep up with work, they can鈥檛 miss four days of work.鈥�
Partner organizations Parole d鈥檈xcluEs and the CIUSSS du Nord-de-l'脦le-de-Montr茅al spread the word of the DocTocToc. The Lucie and Andr茅 Chagnon Foundation awarded it $25,000 from its emergency COVID-19 project fund, which was created to respond to the needs of vulnerable populations. That money was used to buy the tents and equipment for the three-day clinic.
In non-COVID-19 times, the foundation gives money to organizations for capacity-building, data collecting, or regional networks 鈥� but not programs that provide direct service. The emergency fund was created to fill the gap in services created by the pandemic.
鈥淚t鈥檚 clear we all feel the consequences of the pandemic, but there are definitely certain populations that feel it more than others,鈥� said Patricia Rossi, acting Vice-President of Partnership and Learning at the foundation.
鈥淒uring a pandemic, when people were scared to go out, this project was going into the area where people were.鈥� The foundation was impressed with not only DocTocToc鈥檚 immunization for children, but the opportunity to check up on the overall well-being of these children to detect other health problems.
The need for mobile clinics is there, Benkelfat said. DocTocToc is just a start.
鈥淔or now, it鈥檚 one project in Montreal for vulnerable families,鈥� she said. 鈥淏ut this could definitely be seen in rural environments, different populations, younger and older ones.鈥�
In the US, mobile clinics are more common, according to Benkelfat鈥檚 research. In Montreal, one ongoing mobile clinic is M茅decins du Monde, which serves people with unstable or no housing. DocTocToc has plans to expand and deliver regular services for vulnerable children in Montreal.
The project has grown slowly but steadily since having been听created by Benkelfat and Jean-Philippe Couture, a financial analyst. Both were studying at HEC Montr茅al鈥檚 MBA program in 2017 when the idea was born. First called Ma MobiClinique, the idea took home prizes from various innovation competitions, including as a last-minute participant in the Coop茅rathon sponsored by Desjardins.
Along the way, Benkelfat said, it has earned the support of Geoffrey Dougherty, MDCM鈥�79, MSc鈥�86, former director of General Pediatrics at the Montreal Children鈥檚 Hospital, Michael Shevell, BSc鈥�80, MDCM鈥�84, Chair of the Department of Pediatrics at 苹果淫院 and David Eidelman, MDCM鈥�79, Vice-Principal (Health Affairs) and Dean of the Faculty of Medicine and Health Sciences. Quebec Junior Health and Social Services Minister, Lionel Carmant, PGME鈥�92, stopped by the pop-up clinic in August.
In addition to serving vulnerable communities, mobile clinics can be used to build a med school curriculum for advocacy. Benkelfat sees Doctoctoc as an alternative setting for training med students, residents and other health care professions.
鈥淯niversities are meant to be innovation-driven,鈥� she said. 鈥淲e have, at the department of pediatrics, a very strong commitment to social pediatrics. But our program right now doesn鈥檛 have enough capacity to allow many residents and students to do extra training. Very often, we鈥檙e not able to accommodate them.鈥� DocTocToc can provide that link between students and communities.
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