Public health consultant Mary Carothers, in the youth health café she helped open in the Northwest Territories this past November. (Photo by Shawn Bell.)
What would possess a girl from the sunnier part of the Great White North to conquer a small gold rush town (population 2,300) on the 60th parallel? My interest was piqued when I found out the answer might involve straight talk, free condoms and a rather dignified cup of tea.
Mary Carothers, a 26-year-old public health consultant, has always been interested in Canadian Aboriginal issues, so it was no big leap for her to move to Fort Smith, NWT, a mere 2,000 kilometres away from her Southern Ontario hometown, in January 2009. Before leaving for the Northwest Territories, she specialized in health studies and sexuality at the University of Waterloo, then completed a master’s degree in health and health promotion at the London School of Hygiene and Tropical Medicine in the U.K.
She works with the NWT territorial government, and oversaw the opening of a Youth Health Café in November.
What was your motivation in moving to and taking a position in Fort Smith?
I enjoy travelling, and seeing different cultures. The North was always a place I had an interest in, perhaps as a tourist. When I finished my studies, I could go, find work there and experience it as a local resident. I was right out of school and relatively young, and it seemed to be the right opportunity.
What is a Youth Health Café?
The Youth Health Café is a health facility run out of our local high school, based on a needs assessment conducted with young people from Fort Smith back in summer 2009. Although having sexual health services was very important, having access to general health information, like nutrition, healthy living, smoking, drugs and alcohol was a big concern, too.
They wanted a service in a location that was more acceptable to young people, like the high school because it’s a place where they are everyday. The way the high school is set up here, there is a third floor not largely accessed by the student body, away from the hub of students. We were given our own room, which is an appealing location—when they need to talk to someone, they can do it at the school.
Keep in mind, it is a small community and young people have aunties, uncles, friends, and parents working at the health centre (as opposed to the café) and sometimes they felt that they were being judged when they went there. If a young person is going to the health centre, then people automatically (assume) that for a young woman, it’s because she’s pregnant or for a young man, it’s because he has an STI.
Why the name Health Café?
The name of the Health Café also came from the young people. They wanted a name that wasn’t associated with “clinic” or “sexual health” and encompassed health issues. The Health Café offers health services, and it also offers healthy snacks and drinks. We want to provide a positive atmosphere for teens to access information.
If a student has visited the Café, discovers that follow-up is needed, can the Café offer pregnancy tests or STI testing?
Up until now, we were open as a resource and referral centre. Young people could pick up booklets, pamphlets, free condoms, get nutritional advice and even have their weight and height measured.
In the new year, we now offer health services. We have a public nurse and nurse practitioner, even though we don’t have a full-time physician.
What demographic are you trying to reach?
The grades run from Grade 7 to 12, so the junior high population is in with the high school. From our anonymous statistics of who accesses the services, generally it’s the 14 to 15-year-old age bracket and, surprisingly, it’s 50/50 gender-wise. Statistically, young men are not as likely to access health services. Research suggests that when you offer a health service in a casual and holistic manner, you are more likely to capture your young male population. There is no stigma attached, you don’t have to pee in a cup just to come in.
Do you design your programs specifically for the large Aboriginal population in Fort Smith?
The Health Café was developed using the input from young people and it was generally all-encompassing. Some of the services may have a twist including Aboriginal culture, like the medicine wheel and approaches to healing. Fort Smith does have a mixed population, so we are able to reach all the young people in the community.
What are the most common issues you face in the café?
I get requests for information on nutrition, good meal ideas and exercise. Young men want to know about protein supplements. That’s an area of health I didn’t think young people would take initiative to find out about.
Sports medicine is popular; when young people want to enter a territorial competition, they need to have a physical, so we offer that. We provide check-ups and prescriptions for the flu or strep throat or emergency contraception. We do referrals to mental health programs or more serious injuries
I get questions about drugs and alcohol. They might say “I heard my friend talking about smack. What is smack?” “How many drinks does it take to get drunk?” “How can I get my parents to stop smoking?
We do get questions about sexual well-being, STIs and pregnancy testing. Females have questions about the males and vice versa.
Q: What kind of feedback are you getting? Any detractors, or all praise?
A: The clinic is still new so we are just getting feedback. With the Christmas break and the kids out of school for two weeks, they may have forgotten that the cafe is here and ready to serve them. We do promotional activities to remind the students. For example, on December 1, World AIDS Day, we gave out information packages with free condoms to promote the café. Having a familiar face to associate with the service is also a good way to keep interest. If young people are comfortable with the provider, they are more likely to seek out the service again.
We have evaluation forms that they can complete every time that they come to the café. As they become more comfortable with the café, they’ll even come in and say “why don’t you do this?” They are taking the initiative and saying this is a service for us and we want to make it better. I’m really impressed by that.
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