Some came requesting rapid HIV tests. Others sought methadone for their opiate addiction. And a fair number, looking tired and weary, came with more mundane complaints of sore throats and headaches.
More than 300 people attending the International AIDS Conference during the past few days have sought medical care at the health clinic, a cheerful place tucked in a basement corner of the Metro Toronto Convention Centre.
At the side of the clinic, which usually functions as a bar, are all the usual things one might expect in a makeshift supply cabinet and a little more: antibiotics, anti-inflammatory drugs, medicines to treat sexually transmitted diseases, pregnancy tests and Plan B, an emergency contraceptive.
“The idea of providing health services is to make it convenient and cheap,” said Brian Cornelson, the conference's medical director. “What we want people to do is minimize the time that they would need to be away from the conference to get health care and not to be avoiding health care at the early stage of an illness because they are afraid of the cost and uncertainty.”
At the free clinic, doctors and nurses see those with addictions, patients suffering from headaches or fatigue, and they see the unusual — such as a man who had a malfunctioning screw on his leg brace.
Wamarou Traore, a 49-year-old virologist from Burkina Faso, a West African country, was fiddling with his custom leg brace, a device made necessary after he was struck by polio as a child.
“It's all this walking around,” Dr. Traore said in an interview, in explaining how the screw was about to break.
Dr. Cornelson, an amiable man with a towering stature, examined his patient's brace and recognized it had to be fixed straight away. And he managed to work a little bit of magic: He telephoned St. Michael's Hospital, where one of his contacts arranged for Dr. Traore to get the brace fixed free of charge at an orthopedic appliance provider on the east side of Toronto.
No sooner did that end when Mark Bardsley, a 46-year-old from Philadelphia, came in complaining of dizziness, a tingling from head to toe and difficulty concentrating. The night before, he said, he suffered from a headache but nothing as severe as the migraines he had in the past.
Mr. Bardsley, who is also a registered nurse, gave his history: he has high blood pressure, is HIV-positive and has suffered some recent prostate problems. More than a decade ago, he suffered a transient ischemic attack, known commonly as a mini-stroke, following a visit with a chiropractor.
After doing a neurological exam and checking and rechecking his blood pressure, Dr. Cornelson, who works at St. Michael's Hospital as an HIV primary care physician, was concerned that Mr. Bardsley may be having another mini-stroke.
But after a careful examination, he was satisfied Mr. Bardsley's condition was likely related to his elevated blood pressure and the aftereffects of a migraine. He instructed Mr. Bardsley to increase his blood pressure medication and, if his condition worsened, he should call 911 and go to hospital.
The assurance that HIV test results in Canada are kept confidential was part of the draw for five patients seeking to know their status. Rapid test results of the five — three from Africa, one from Iran and one from Canada — were all negative, Dr. Cornelson said.
As well, seven patients have received methadone for their opiate additions, either by prearranging care before coming to Canada for the conference, or in a few cases, requiring it after it was spilled or lost. While the services of health care staff are free, the methadone, which is given orally with an orange drink, is not. The patient must pay.
“Some have come once and some have come on more than one occasion,” said Thea Weisdorf, a family physician at St. Michael's who is on call to treat those who require methadone. “Some missed seeing their regular provider or may have gone a few days without methadone.”
Whatever brings patients to this health clinic, many of them will be greeted by a smiling Grace Bezaliel, who works at the front desk of the clinic as a clerical administrator. She took a week's vacation from St. Michael's so she could work for free in the clinic during the conference.
“I came here as a refugee from Zimbabwe in May of 2002 and I want to give something back,” Ms. Bezaliel explained. “I have lost friends to AIDS.”
