Wednesday, March 25, 2009

On Dental Health, yes dental...

His ashes don't lie
Within a couple of weeks of complaining about aching teeth, Ali Mohammed was dead

By MARK BONOKOSKI

From Toronto Sun: 22nd March 2009

One of Toronto's working poor -- homeless in his final moments -- died the other day at St. Michael's hospital, unnoticed by a greater world around him.

It was word of mouth that told of Ali Mohammed's passing, about how he could not be stirred from his cot at the Gateway hostel on Lower Jarvis St., and how staff members there did their best to keep him alive until the ambulance arrived for the short run to the emergency ward at St. Mike's.

Once there, doctors purportedly pumped him full of antibiotics to stem the poison emanating from obviously infected teeth and gums, even though he had gone three times to a walk-in dental clinic, and had at least one tooth extracted.

He hadn't been able to eat for days on end, so severe was his pain once the infection set in. As one friend said: "They got his heart going a couple of times at St. Mike's, but they could not keep him alive."

No obit appeared in any newspaper.

The coroner's office, which ruled that Ali Mohammed's death was from a heart attack, saw to his cremation.

He was 56.

As best that can be determined, Ali Mohammed's provincially funded cremation was the first time he has ever cost the taxpayer a dime, since there are no records that he ever took a dollar in welfare -- under any name.

For the 20 years he had been in this country -- arriving here as Addison James Soodeen, but living as Ali Mohammed, a nickname given to him by friends -- he had worked piecemeal as a handyman and contractor to learn the basics: Laying floors, putting up dry wall, painting interiors and exteriors, and even doing a little plumbing.

He lived, most of his life here, with friends -- ending up at Gateway when he tired of feeling beholding.

"He did good work. He was trustworthy. He was loyal," said Sam Sundar-Singh, an employee at the Scott Mission who only knew him a matter of months, and who employed Ali Mohammed to work on a house renovation.

"He was genuine -- gentle and kind is the way I have always described him," he said.

"Anyone who knew him would agree."

The Gateway, where Ali Mohammed lived for a little over a month, held a memorial service in its chapel a week ago Thursday and then ensured that his ashes will soon make their way home to a sister living in Trinidad.

Some 20 people attended that memorial. There was prayer, there were songs, and there was testimony from people who had met Ali Mohammed along the way.

"The Lord is my shepherd, I shall not want ..."

The executive director at the community health centre where Ali Mohammed was treated at its dental clinic was out of the province when the clinic was visited, but a director indicated that privacy laws negated the discussion of specific cases.

"No one is going to talk to you about specifics at the dental clinic," she said, stating that it would be best to call a dental office, or a community doctor, if one wanted to talk hypotheticals.

So we called Dr. Gary Bloch, who works out of St. Mike's and is a director for the Inner City Health Association, a group that helps fund doctors to deal with the homeless in 30 sites across the city -- from hostels, to drop-in centres, to makeshift walk-in clinics.

According to Bloch, some 60% of the homeless who come through his association's doors do not have a valid health insurance number -- meaning antibiotics would not be covered in any clinic other than a community health centre.

"And then antibiotics are not always considered necessary," he said, indicating, however, that unhealthy teeth and gums are the door openers to other health problems.

According to a study by a major U.S. dental school -- a probe of 18 years of medical histories involving almost 12,000 people -- people with infected teeth and diseased gums are twice as likely to die from a heart attack and three times as likely to die from a stroke.

"For low-income people, and for people like the homeless, the only dental coverage is for extractions," said Bloch. "And that's a huge problem because there is no coverage whatsoever for prevention -- like teeth cleaning.

"As a result, I've seen some pretty horrific looking mouths among the homeless."

According to Dion Oxford, director of the Gateway, Ali Mohammed returned three times to the dental clinic complaining about the pain and, each time, was given nothing more than Tylenol tablets, over-the-counter painkillers that require no prescription.

But not antibiotics?

"To get those, Ali found himself having to go to St. Mike's, and getting them there," said Oxford. "But he didn't get them at the dental clinic."

The exact time frame between Ali Mohammed's last trip to the dental clinic, his visit to St. Mike's to finally get some antibiotics, and the time he was found unresponsive in his bed at the Gateway is somewhat uncertain.

But, within a matter of a couple of weeks of his first complaint about his aching teeth, he was dead.

This is undeniable.

His ashes, in a cardboard box, do not lie.

MARK.BONOKOSKI@SUNMEDIA.CA OR 416-947-2445

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