TheTyee.caYou may have seen them in your neighbourhood. Lawn signs reading "We're watching you" and "How many surgeries were cancelled today?" are creeping across B.C. Signs that reflect anger over cuts to health services are just one tactic adopted by groups formed across the province in the past two years. Groups in the Interior, on Vancouver Island, and in the Lower Mainland are taking creative approaches to their advocacy because, they say, negotiating with the government and its agencies alone is a waste of time. The Delta Health Coalition is one group whose members are tired of talking. Coalition steering committee member Al Webb says the community is still suffering from cuts the Fraser Health Authority made to the Delta Hospital two years ago. The coalition has lost patience with the boardroom, says Webb. "We are of the opinion that if we can create a big enough disturbance and embarrass this government in as many ways as we can, and embarrass the Fraser Health Authority, then we can have some sort of a reprieve. "After a failed campaign to recall their MLA Val Roddick, who they say spearheaded the cuts to B.C. hospitals, the coalition appealed to the Corporation of Delta to take the Fraser Health Authority to court. The municipality filed a claim in B.C. Supreme Court last February, saying the health authority is violating the Health Authority Act, the Health and Social Services Delivery Improvement Act, and the Hospital Act. The health services available in Delta are not up to snuff, says George Harvie, chief administrative officer of the Corporation of Delta. "The mayor and council and the community are quite frustrated over the reduced services." Harvie says the cuts to Delta's hospital, including the removal of all 65 acute care beds, are costing the corporation, which must pay to transport patients to other hospitals. He couldn't say how much Delta is spending, because they're still tallying the costs. Lawsuit as last resort At the urging of the health coalition, Delta city council set up a phone hotline in April for patients to call with their hospital horror stories. Those stories will be used as ammunition in the court case, says Webb. "What they're doing to Delta, and what they're doing to Deltapatients, is next to criminal," he says. The lawsuit is a last resort. Community groups have met repeatedly with the health authority but without success. "[We can't] go cap in hand and say 'Please sir, may I?' That, with these guys, just doesn't work. You've got to smack them with a two-by-four a couple of times before you get their attention," says Webb. He is hopeful the lawsuit will succeed. "I'm sure that council [would] not going to undertake a lengthy and costly legal fight if they didn't have some expectation that they might be able to win it." Delta isn't the only B.C. community to try taking a health authority to court. The Nelson Save Our Services group launched a suit in July 2002, saying the reorganization of health services in the West Kootenay violates the Canada Health Act and the Charter of Rights and Freedoms, which state all Canadians should have equal access to adequate health care. Robin Cherbo, president of the Nelson SOS, says the society is collecting incident reports as evidence lives are at risk. But he says it's sometimes tough to get people to talk about medical problems - an intensely personal experience. The SOS also has more than 50 volunteers who take turns sitting in the emergency room and observing patient care. Many patients lives are at risk, they say, because they are often transported to Kootenay Boundary Hospital in Trail, an hour's drive away, over winding mountain roads.Tara Wilson, a spokesperson for the Ministry of Health, says regionalizing health services in key centres such as Trail benefits patients, because it provides British Columbians with more specialists closer to home. Specialists are hard to recruit, and Kootenay residents used to travel much further to Kelowna or Vancouver for treatment, she says. Adding more services in Trail has reduced the number of trips across the province. Tale of two spleens However, two recent high-profile cases have bolstered the SOS's case. Thirty-year-old Demitria Burgoon nearly died last fall after her spleen burst in a mountain bikingaccident. Nelson doctors saved her life, says her mother Marilyn, by breaking the rules and operating on her in town instead of sending her to Trail. In March, Edward Morritt died after being transported to Trail. He ruptured his spleen when he took a tumble in his Nelson garden. The SOS and Morritt's family claimed Morritt would have lived if services hadn't been cut from the Nelson hospital. But the legal fees have become too much for the SOS. Their lawyers have also told them they only have a 50 per cent chance of succeeding if they go to court, and without the money to fund it the lawsuit has been put on hold. Stephen Harris, communications officer for the Interior Health Authority, Kootenay-Boundary, says the lawsuit hampered discussion of the issues because the IHA won't negotiate with any group threatening legal action. "Their tactics have done nothing but alienate them," says Harris. "Those groups that chose to launch lawsuits are on the outside [of discussions]. And it's too bad. It could have been very different." Both the Delta and the Nelson groups admit the lawsuits are a last resort. But they plan to keep collecting information from patients who come forward with harrowing hospital experiences. 'Save St. Mary's' gambled on polling The Save St. Mary's Hospital Coalition recently lost their battle to keep "a beloved community hospital" open, says coalition organizer Jaimie McEvoy, when the New Westminster building shut its doors on May 20. They didn't file a lawsuit, but the group didn't let the facility go quietly. After erecting more than 3,000 lawn signs, the group commissioned an independent poll to prove residents opposed the St. Mary's closure. "We attempted to appeal to the government on the basis of reason, and that didn't work. We attempted to appeal to the government on the basis of conscience.that didn't work. So we went to pragmatics. We thought, maybe we can appeal to them on their own sense of survival," says McEvoy. Polling was a risk, he says, because the result was uncertain, but the gamble paid off. Seventy-eight per cent of 806 people polled in New Westminster, Surrey, Coquitlam and Burnaby said they were opposed to the closure of St. Mary's. Their effort didn't save the hospital, but McEvoy says the public controversy put health care higher up on the political agenda. "I'd like to think we've made it more difficult for [the provincial government] to screw around with health care in our region." Sound of 200 cars honking The residents of Port Alberni aren't afraid of creating a spectacle either. After nine beds were cut from their hospital last September, a cavalcade of 200 cars took to the highway at 40 km/h, to protest that the drive to Nanaimo is too far to go for health services. Motorists caught up in the defiance honked their horns in support, says Bev Denning, chair of the Port Alberni SOS. "[We're] a nuisance value, and [the Liberal government] doesn't like bad publicity," says Denning. "The town did tremendous fundraising in order to furnish [the hospital]," she says. "We have a lot of pride in the hospital, so for the health authority to take nine beds was just intolerable." They, too, have opened up a phone hotline to collect stories from patients who have waited hours for emergency care, or been transported around the province because the local beds were full. Port Alberni considering lawsuit Like the Nelson SOS, they have submitted petitions to the legislature asking the government to restore services that were cut. But those avenues aren't working, says Denning. The health ministry's Wilson says politicians in Victoria won't intervene in regional decision-making in any event. She says the government allocates funds to regional health authorities and regional district health boards, and they make the decisions about how the money is spent. It wouldn't make sense for politicians in Victoria to make local decisions when they're not sufficiently familiar with the region's needs, she says. Denning says the Port Alberni group is open to new tactics, maybe even a lawsuit. "We would consider anything that might be effective," says Denning. Although all groups say they are non-partisan, both the Nelson and Port Alberni SOS have the support of Vancouver-Mount Pleasant NDP MLA Jenny Kwan. She joined a rally organized by the groups outside the legislature in November and presented petitions from both communities demanding the restoration of lost health services. Kwan says she supports the use of unconventional tactics. "People are doing all that they can to get the government's attention. As long as they're not hurting anyone. they're within their rights to exercise the democratic right, to make this government respond to them." B.C. Green Party leader Adriane Carr also backs the groups. "When you can't get your MLAs to respond to you with reasoned argument, then you just up the ante." Costly protests How long can these health action groups sustain their momentum? Save St. Mary's McEvoy says it can be tough to keep the public interested when the groups are run by volunteers, who sacrifice time away from their work and family and often underwrite expenses. "I think it's pretty difficult to do. But I hope more people do it," says McEvoy. Nelson SOS president Robin Cherbo is a retired government employee, and has the time, but it can sometimes be more demanding than a full-time job. "I keep joking that I need to go back to work for a rest," says Cherbo. Money is another huge hurdle. The Nelson SOS rang up $40,000 in legal costs, and some say they have little to show for it. The money was raised from the community, and critics argue it would have been better spent on equipment for the hospital than on a legal battle they have little chance of winning. Money has also been a problem in Delta, says Webb. Another group, the Save Delta Hospital Society, spent $100,000 negotiating with the Fraser Health Authority, with no results, he says. When people see money "squandered" like that, he says, they lose their appetite for the fight. Yet with groups emerging all over the province - including Kaslo, Castlegar and Revelstoke - some organizations are bound to persist. "In some cases it's very difficult for them to operate," says Webb. "In our case here, we have a very dedicated group of people who've been working on this for two years." With the right people and a source of cash, the Delta group may even get their services back. They'll find out when they have their day in court. Janet French last wrote for The Tyee about living with anaphylactic allergies. She is currently an intern at The Edmonton Journal.