“A doctor can be just as effective as a politician or a lawyer in bringing about social change”
In 1993, 6-year-old Nelab Alingary arrived in Canada, together with her parents and a younger sister, political refugees from Afghanistan. Growing up in “an immigrant-dense Toronto neigbourhood,” surrounded by Pakistani, Indian, and Afghani families, she saw the challenges many recent arrivals face in building a life in a new country. It was no surprise she double-majored during her first year at the University of Toronto in Ontario in both a premed science program and political science.
“Unfortunately, I didn’t think I could give 100% to both majors simultaneously,” says Dr Alingary. “I had to make a choice and I chose medicine.” But dropping poli-sci didn’t mean abandoning a deep commitment to social justice. “People are at their most vulnerable when they are sick,” says Dr Alingary. “A doctor can be just as effective as a politician or a lawyer in bringing about social change.”
She is now completing her residency at the Markham Stouffville Hospital just north of Toronto. The facility employs a multidisciplinary approach to family medicine, providing residents with the support of a dietitian, a pharmacist, social workers, and nurses to create a more holistic patient care environment. It also gives its residents the luxury of a little more time with their patients—time Dr Alingary uses to explore some of the poverty-related, mental health, and cultural factors exacerbating her patients’ medical problems.
“You get to peel back the layers of their lives”
She recalls one of her first patients, a middle-aged woman, morbidly obese, and suffering from heart disease and diabetes. “As sick as she was, she was still struggling to make ends meet as a part-time cashier for minimum wage,” says Dr Alingary. “Even though she had trouble standing, she was forced to spend long hours on her feet every day.”
In addition to medical advice, nutritional guidance, and an exercise program, Dr Alingary helped her patient successfully apply for the Ontario Disability Support Program. “Socioeconomic status is a major determinant of health and addressing this for my patient helped her focus on getting healthy,” says Dr Alingary. “Today, she’s lost 30 pounds and no longer has to see our local cardiologist.”
“As residents, we only have 2 years at the most with our patients. That means we are eager to see change quickly,” says Dr Alingary. However, she knows family medicine is a lifelong marathon, not a sprint. That’s why “family doctors are in the best position to recognize and accommodate the social determinants of health in their patients,” she says.
Footnotes
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Dr Alingary is a family physician completing her residency at the Markham Stouffville Hospital in Markham, Ont.
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Photos: Laura Bombier, Toronto, Ont
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