Liben, CEO

“If we're responding to a crisis, we're late. People need to get to us before there is a crisis”

Liben’s story

My name is Liben Gebremikael. I am the CEO of TAIBU Community Health Centre in northeast Toronto.

“Taibu” is a Kiswahili word and it means “be in good health.” The founder of this organization really wanted to give a name that is rooted in an African descent. And so that’s why they called it TAIBU Community Health Centre.

It was established in the early 2000s, to be able to address the challenges and the disparities that Black communities face, whether it is in health or in social outcomes.

Health is not just defined as physical health. It also incorporates all the other social determinants of health.

How does TAIBU serve Black communities?

From the very beginning, the way that we really wanted to plan and develop the centre, including the design of the centre and what it should reflect, we really wanted to have that community feel.

As people come into the organization, they can see themselves represented into the design of the space, the staff that they engage with, the colours that are part of the organization. That creates a comfort and a trusting environment for people to even begin to seek services.

The second important component was that the services that were developed would be culturally and linguistically appropriate, so that people can access the services the way they want to access those services. We have consulted the communities to say, “What services do you want to see in the space?”

The program is not just delivered by us. It’s delivered with the community for the community.

What were the challenges for your health centre in 2020?

For the primary care groups, we made sure that, for those who are very vulnerable and required to be seen, that we continue to see them in person. But we had to stop all our community programs because of the limitation of people to be in one space. So that was a huge challenge.

To give you an example, we have a very strong, community-based seniors program here. We have what is called the Ubuntu Village project. Ubuntu is a Zulu concept from South Africa, and it means I am because we are, and if I’m not well, not everybody in the community will be well.

So that’s what we’ve been creating in the communities with this Ubuntu Village project. One of the barriers that we wanted to address with the seniors was social isolation. So we did a lot of outreach to get seniors out to come for activities, whether it was, you know, line salsa dancing or cooking or things like that.

And suddenly, we were telling them, “No more connection. You need to go back and lock yourself down.” So that has been a very significant challenge for us. But we also saw that there was some strength with some of the things that we have been doing. There is this story I always tell, that always touches my heart.

When COVID hit, we also were aware of some seniors who were living by themselves. As a staff team, we said, okay, maybe we need to share their contact numbers among ourselves and do wellness check with a few of them on a weekly basis to see if they’re okay. Do they need anything? Have they got contact with their families either here or abroad?

And so we started doing the phone calls. And one day I received a phone call from one of the seniors. So we exchanged a few, you know, how are you doing? And I said, “Well, tell me, how can I help you? You know, I know you called and so there must be something I need, we need to support you with.”

And she says, “No, no, no. The seniors’ group have said that we would take a few of our staff, the staff’s number, and we would call you for a wellness check because, you know, you’re working, you have families, so we want to know how well you’re doing.”

And I was like, “I don’t believe.”

She says, “No, no, no, you know, we have, the Ubuntu Elder Council have taken the staff’s extension and we’re calling all of you to see how you’re doing.”

That was very heartwarming and touching because there was this very strong relationship that the care is mutual. So that was great.

How were you coping during the pandemic?

It was a very challenging period of time for the last two, two-and-a-half years of COVID. I think I’ve worked seven days a week. And from a leadership perspective, there are a lot of meetings — you know, on your feet, kind of planning in real time, kind of things to do, because things have to be changed so quickly.

And as a community organization that is working with Black communities, we knew already that the pandemic was going to disproportionately impact Black, Indigenous, and racialized communities. So there was this added challenge.

For example, when the pandemic started, we were hearing already from the United States that the Black and Hispanic communities and Native communities were the ones who were impacted. We didn’t have anything here in Canada and in Toronto to demonstrate that was also happening. We knew that was happening.

So there was a lot of advocacy that we needed to do. There were other Black health leaders in the city. We got together and advocated for the race-based data collection. And then in June [2020], we had the murder of George Floyd.

Many of our staff were impacted by that, and so it was quite challenging. But I also think that it was also rewarding — as much as it was difficult and stressful — rewarding because there was also a lot of work that was done.

What type of COVID-19 advocacy did your organization do?

We had actually three messages: get the facts, get tested, and get support.

A lot of people did not have the right facts. So we were providing that information.

A lot of people did not know where to get tested, but were also very cautious about being tested. Because if they tested positive, they knew that they couldn’t go to work and if they didn’t go to work, they knew they were not able to survive.

And so we said we will also support you by providing them financial assistance, housing assistance, and stuff like that.

It was very, very busy, but it also was rewarding because we were able to reach those people who needed the support. And then when the vaccine rollout came up, we offered our space to be a vaccine clinic.

We partnered with the Black Physicians’ Association so that the vaccinators were also from the community. People would come and they could speak to somebody they could trust.

We partnered with the City of Toronto in creating the Black Scientists’ Task Force for Vaccine Equity, and that was very important to do the education and the community engagement. Not so much to convince or coerce people. But for people to have the right information for them to make the right decision that they feel is right.

As a healthcare leader, how do you build trust in communities?

We start with conversations and relationship-building. Because we know trust is very, very important for Black and racialized and Francophone communities.

Traditionally, historically, there has been — and there still exists — significant mistrust with healthcare, education, criminal justice, because of how Black and racialized communities have been treated. Continue to be treated.

So when COVID came, a lot of people did not trust what information was being provided, you know? Because we know, Indigenous, Black people have been, you know, mistreated.

It’s the same thing with police, right? We always try to include police in the work that we do, because we have to start that relationship-building. But institutions are framed in such a way that they’re not easy to change and move.

But COVID has created an opportunity where we’ve seen systems change. So, for example, the death of Regis Korchinski-Paquet.

So, the City of Toronto took a year to consult with communities to try to find an alternative way off responding to community crisis. TAIBU who was part of that consultation. And then the recommendation was to create a community-led crisis response. The pilot has been established now for a year, we’re seeing the results.

But the mere fact that when somebody is in crisis, they don’t have to deal with somebody in uniform, that’s already very de-escalating. And they can engage with somebody that looks like them. It’s more of a supportive model. And so that has been established.

We have four pilots in the city. And many of the police officers said, “We’re glad that you’re here, because in many instances, we know we are not the right people to respond.”

They’re not trained, right? When you have a heart attack, it’s EMS that responds, because it’s a health situation. When you have a mental health crisis, why is it the police that respond? So many of the police are very happy that it is the right service that is going out for response.

Our motto here at TAIBU is, if we’re already responding to a crisis, we’re late. Right? We need to get the people or people need to get to us before there is a crisis.

How did you support your staff during the pandemic?

Being a Black-focused, Black-led, Black-serving organization, the challenges have been significant. One, because as a staff, we had to respond to this emergency. We had to respond to the traumatic experiences that black people faced after the murder of George Floyd.

And then as individuals, being Black has impacted many of the staff. And one of the things that we did was we opened up some space for staff to have — just a space to have a conversation. Then there was also the offer of additional support for staff who may have needed, either for them, for their families.

The other component was when the vaccine rollout came out, we did not enforce compulsory vaccination. We provided the right information for people to do that, and we said we will support you either way. If there are accommodations, we will make those accommodations, but our accommodations did not, were not just for people who had religious or medical conditions. And guess how much our percentage of vaccinated staff was? Ninety-seven per cent.

So we were able to achieve what we needed to achieve through discussions, conversations, and allowing people to make informed decisions for them and for their families.

What do you wish people knew about your leadership role?

I know there are times when this position could be lonely. Number one, there is expectation that you know everything, you have to solve everything, right? You know, leaders in this position, I’m sure I’m not the only one who’s feeling that way. But the best thing to deal with that is to have a good support network around you.

At this level, it’s also very important to have a very good, positive, trusting relationship with your board, so you can go there with vulnerability and say, “I’m struggling here.”

You know, if you go to your board only to kind of give positive image, it’s not good. You know, if you don’t have those difficult discussions with your board, and the board does not know really what is happening with you, but also with the work that you’re trying to do, and understand the complexities and the problems, that’s also not — you know, you have to have that kind of relationship with the board.

I was blessed to have a very supportive board.

What keeps you going?

I was blessed and privileged to have been here from the very beginning, 2008. We were five, then we were eight. Today we’re close to a hundred staff. When we started, we had, I think, $1.2 million budget. We’re at $14 million today.

So to really see this progress and, most beautifully, to work with all the communities out there and to see the results that we can do, that is what drives me on a daily basis.

We definitely can bring about change in our communities, and we’re seeing on an individual level. But change is also possible at the community level, at the systems level.

A special note of thanks from Healthcare Salute

Over the course of the COVID-19 pandemic, healthcare providers from across Canada have participated in our research on “COVID-19-Related Stress, Moral Injury and Minority Stress in Healthcare Workers and Public Safety Personnel in Canada.” Their struggles, heartbreak, courage, and resilience have inspired and moved us, and formed the bedrock of our research for this project. We are deeply grateful and committed to sharing their experiences.

We would also like to express our heartfelt thanks to our funders, the Public Health Agency of Canada, for giving us the opportunity and the autonomy to share our research with the larger Canadian audience without bias or restriction. This work would not have been possible without their generous and arms-length funding support. We also wish to thank our collaborators and supporters — McMaster University, St. Joseph’s Healthcare Hamilton, Homewood Health, and Homewood Research Institute.

After viewing, visit “Applying cultural competency in practice,” an education module for mental health providers and peer supporters.