Injured protesters who are detained at a temporary jail during the G20 summit will be treated in a 10-foot-by-30-foot trailer with no plumbing and water provided by a hose, according to an e-mail circulating among Toronto physicians.
A representative of EMS Special Operations put out an electronic call for doctors to work on a "Treat and Release Intervention Team" during the two-day summit, offering $120 an hour to treat injured demonstrators held at a detention facility in a former film studio on Eastern Avenue. The e-mail, which has been condemned by the protest community and the Canadian Civil Liberties Association, says doctors will provide onsite medical attention to detainees so they do not have to be taken to hospital.
"The role of the physician in this team is intended to deal with short, acute interventions which should result in a patient being discharged back to police custody," says the e-mail from Michael Feldman. "These patients would otherwise need transport to hospital."
Dr. Feldman's e-mail also suggests that injured protesters will be young and healthy, and some "will probably claim factitious injury as part of their tactics."
That idea angered Sarah Reaburn, a nurse with the Toronto Community Mobilization Network, who said she does not believe it is possible to fake the effects of tear gas. "I think it's really problematic that they would instruct health-care providers pre-emptively that these people are probably faking their condition. That goes against every kind of ethical guideline. You must always believe the patient's report of pain and injury."
Nathalie Des Rosier, of the Canadian Civil Liberties Association, also took issue with the e-mail. "Certainly this would not be a statement that I think is ethical," she said. "That's another way in which people can be mishandled: not only the police officers, but the doctors."
Reached by phone, Dr. Feldman said he was not authorized to speak about G20 preparations and referred questions to Craig DuHamel, a spokesperson for Sunnybrook Health Sciences Centre, where Dr. Feldman works. Mr. DuHamel said the e-mail was intended for the author's medical colleagues and not the public eye.
"I think what he's referring to in the e-mail is something that they've been told has happened at other events," Mr. DuHamel said. The medical clinic at the detention centre is designed to help ease the burden on city hospitals, he added. "With any big event they try to triage people to keep them away from hospitals."
But Ms. Reaburn, who will act as a volunteer medic at the G20 protests, worries about injuries being treated at a detention facility rather than a hospital. "What do they plan to treat in a trailer with barely running water? What kind of quality of care is that?" she asked.
Dr. Feldman's e-mail offers the first glimpse of what conditions may be like inside the temporary jail. The Integrated Security Unit has not confirmed that the facility will house arrested protesters. But Dr. Feldman said that prisoners will be kept in cells individually "or in groups of up to 10."
"The standard for cohorting prisoners is a ratio of three prisoners to one officer at any time, and therefore the police would not allow a large number of beds or seats in any potential clinic.," the email reads. "We are essentially working in a partitioned zone (a trailer) inside a prison. As such, we will have to make sure that all supplies and sharps are securely locked."
The Treat and Release team is expected to start work on June 18, and will treat "for G20-related problems" such as "sprains, strains, minor lacerations, abrasions, riot control agent exposures, bites and stings (not anaphylactic), contusions, minor illnesses (URI, UTI), minor allergic reactions, and chest pain that is obviously chest wall/non-cardiac."
Janine Hopkins of the Toronto Central Local Health Integration Network said that an online system is being set up so that hospitals, EMS providers and other response teams can share information about injuries.
"Of course, if there are any significant injuries, those individuals will be directly transported by EMS to hospital," she said. "There's a whole plan in place to make sure that people with injuries get to the first available place of care quickly."