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EXAMPLES FROM
VANCOUVER'S DOWNTOWN EASTSIDE |
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The population we will focus on involves those individuals who reside on the Downtown Eastside of Vancouver, British Columbia. This group of individuals is seen as a marginalized, high risk, hard to reach population, that is, a group of individuals who are currently oppressed by society due to their issues such as drug use, involvement in the sex trade, poverty and homelessness. These individuals are seen by society as having less to offer, a drain on resources. We will pay particular attention to the treatment of women within this subgroup of society and the challenges they face over and above those of their male counterparts. The case study we will base our discussion around has been modified from an article written by Alicia Priest. This article was published in the October 10th edition of the Georgia Straight entitled, �Street Saints: Women-only health services in the Downtown Eastside are in tragically short supply.� According to this article, 35% of all women and 26% of men on the DTES are infected with HIV. The DTES has a drug-overdose rate five times higher than that of any other Canadian city and the highest HIV infection rate in the western world. Aboriginal women, 70% of DTES sex-trade workers, are targeted as the fastest growing group of HIV infected people and are three times more likely to die of AIDS than other women there. This is due to women�s usual �second on the needle� status. Of the 180 programs including food lines, shelters and detoxification programs on the DTES, only five are dedicated as women only resources. One of the challenges this case study addresses is addiction to crack cocaine. Addiction is a compulsive, uncontrollable dependence on a substance or practice in an attempt to cope with a psychic pain engendered by conflict and anxiety (Mosby, 1998). This definition is of textbook quality, however, to understand what the personal meaning of addiction is we asked one of our friends who is a user on the downtown eastside. She explained that using is simply a means of relieving the pain for a moment. She is an admitted heroine addict, and said that her background and current life situation are just too painful to deal with. Her only escape came during times when she was using. Imagine you are a street nurse working out of the Vancouver Center for Disease Control just down from 12th and Cambie. You are off on a Popsicle run to provide some cool relief to the working girls (prostitutes) during a heat wave. You bring, along with your cooler, a bag full or prevention items such as clean needles, sterile water, antiseptic ointment, condoms, and your trusted partner for added safety and a second set of arms to pack supplies. You are equipped with the latest knowledge on outbreaks of tuberculosis, syphilis, and gonorrhea in the area, and are prepared to hand out information on health promotion in a caring respectful manner to whomever you meet that day. You know most of the working girls by name, and they seem to accept you as you reach out to them. You measure success not through a change in HIV infection rate numbers, but rather on an individual basis, much like your approach to Popsicle patrol. The daily victories of supplying clean needles, having one person ask for condoms, one girl enter a detox, seeing an old worker who is clean and getting her life on track- anything that is a step toward health is cause for celebration. These numbers do not reflect societal changes but rather, they represent changes to individuals and families. In the alley between Carnegie and the Regent Hotel you meet Samantha. She is a young aboriginal woman, slouched in a school desk parked beside a dumpster. A man stands by her, silent but watchful. You spend the next fifteen minutes with her; you give her condoms, clean syringes, and ask if she is aware of the latest outbreak of syphilis. She shies away and tells you that she doesn�t want to talk about it now. Trucks rumble by, and a street cleaner. The water sprays away every type of garbage imaginable onto Hastings. Your partner sifts through the cooler and finds her requested flavor of Popsicle. You stand there and watch as she finishes cooking her drugs. She draws up the mixture in a syringe, and hands over the syringe to her friend. He injects the contents into her neck vein as she tilts her head back. You ask if she obtained the results from her HIV test last week, she shakes her head no and you call the office on your cellular. Because she can�t remember which alias she gave at the clinic, her results are lost, you lean in and encourage her to get retested. Her eyes dart back and forth between her male companion, you and your partner. You hand over some Band-Aids and antiseptic ointment on her request and urge her again to get retested as you slowly walk away. She slouches in her seat. |
