In the wake of a tragic loss, the executive director of a homeless shelter in Nanaimo has shared a poignant open letter.
Reflecting on the passing of a 23-year-old colleague, Paul Manly of Nanaimo Unitarian Shelter emphasized the preventable nature of the tragedy, urging for necessary changes and awareness.
Sophia, a dedicated member of the shelter’s professional team since 2022, passed away months after she began experiencing health complications. These issues forced her to reduce her workload, eventually necessitating a medical leave of absence.
“Occasionally we would get reports but then suddenly we were notified that she had died,” wrote Manly.
Without a family doctor, Sophia endured the chaotic queues at the sole walk-in clinic, hoping for a chance to see a physician. Months of declining health had plagued her.
Eventually, she secured an appointment at the the Youth Wellness Centre and was diagnosed with an eating disorder, joining a waiting list for specialized treatment.
Despite her objections and denial of intentional food avoidance, she persisted in attending appointments for a work medical note. Months passed before a blood panel was ordered, its results overlooked and meant for the Eating Disorder clinic. Trusting the professionals, Sophia maintained faith in their care.
After months of misdiagnoses and declining health, it was revealed that Sophia was not on the Eating Disorder clinic patient list.
On November 24th, she was diagnosed with immunodeficiency and an infection. Nanaimo Regional Hospital, recognizing the severity, transferred her to St. Paul’s Hospital in Vancouver for advanced treatment. However, sepsis had already set in, and she passed away three days later.
Below is the full open letter written by Paul Manly:
Remembering Sophia: An open letter about the preventable loss of a Community Champion.
It is not unusual for staff at the Nanaimo Unitarian Shelter to experience the loss of people they know who were guests at the shelter or clients of the shower program.
I get regular reports from staff about unhoused members of the community who died for one reason or another. What is shocking is when one of their colleagues dies and that death was completely preventable.
In 2023, Sophia, one of the shelter’s dedicated team of professionals, died. Sophia’s death was a shock for me and for the staff at the shelter. She was young, 23 years old. She had graduated from the VIU Community Mental Health Worker program and started working at the shelter in September of 2022.
Bright, compassionate and dedicated to her work at the shelter, Sophia was well liked by staff and guests. She worked hard and did her best to ensure that shelter guests were comfortable and felt at home.
In her last self-evaluation she outlined her ambitions and how she wanted to do more to assist people in our community who were marginalized and struggling. Sophia was one of our rising stars, with a bright future ahead of her, set to make an impact doing good things to assist others.
Last summer Sophia started having health complications and wasn’t able to work at full capacity. Staff members were expressing concern for her. I met with her and she acknowledged she was having trouble so we agreed that she should take a medical leave of absence.
We worked with her as she struggled to find a doctor who could provide a diagnosis and the letter we needed to ensure that she could keep her benefits active. Occasionally we would get reports but then suddenly we were notified that she had died.
In late January, I received a letter from her mother outlining what had happened. I read it in shock, sadness and anger. For months Sophia’s health had been deteriorating. She did not have a family doctor and struggled to get into the only walk-in clinic in town where people line up at 6am in the hope of seeing a doctor when it opens at 8am.
Sophia was finally able to get an appointment at the Youth Wellness Centre at the Nanaimo Leisure Centre. They diagnosed her as having an eating disorder. They told her that she would be put on the waiting list for the eating disorder clinic.
Sophia was adamant with her mother and the professionals that she didn’t think it was an eating disorder and she wasn’t intentionally not eating. She continued to visit the clinic in an effort to get a doctor’s note for work.
It took months before they requisitioned a blood panel but they didn’t request it back and it was supposed to be forwarded to the Eating Disorder clinic. Sophia trusted the professionals and assumed they knew what they were doing.
On Thanksgiving weekend Sophia’s mother took her to the emergency department at NRGH. The doctor that saw her was dismissive and gave her a prescription for a cream for what he diagnosed as hemorrhoids.
It turned out that it was much more than that. Sophia’s health continued to deteriorate, her hair was falling out and she was losing weight.
Her mom took her to the hospital again on November 16th, she was anemic and needed a blood transfusion. This was when it was revealed that Sophia was not on the Eating Disorder clinic patient list.
On November 24th the diagnosis came in, she had immunodeficiency and had an infection. Nanaimo Regional Hospital realized this was beyond their capacity and had her transported to St. Paul’s hospital in Vancouver for further care. But sepsis had taken hold and she died three days later.
The immunodeficiency was treatable if diagnosed properly but it made her susceptible to infections. Working at a homeless shelter exposes workers to a range of active infections and pathogens that members of the homeless population are struggling with.
It is very likely that Sophia contracted an infection at work.
At the shelter we get regular calls from the hospital for patients who are being discharged who do not have homes. We try to keep two beds open for emergency purposes like this but we have to set a hard line with the hospital because our staff are not trained for patient care and the shelter is not an appropriate environment for people with serious health challenges.
We have had people show up at our door with serious infections that we have sent to the hospital and then refused to have come back to the shelter. Homeless shelters should not be a dumping ground for homeless patients but we are.
Our healthcare system is in a deep crisis. Our hospital consistently runs over capacity, staff are overworked, there are not enough doctors and patients are suffering the consequences. In this case we lost a compassionate worker, and a mother lost her child.
What is even more brutal is that Sophia’s mother lost her only other child in 2020 due to deficiencies in our healthcare system. This is beyond unacceptable and demands action from the federal and provincial governments.
This is what tax cuts for the wealthy and austerity and program cuts in the 1990’s and 2000’s have resulted in today, people living on our streets due to a housing affordability crisis and the preventable deaths of people trying to help the homeless because our healthcare system is failing.
With condolences to Sophia’s family and friends.
Paul Manly
Executive Director
