April 7, 2009
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Outreach workers in the Street Health Program demonstrate how to place needles in the biohazard bin inside the outreach van.
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A white van pulls up along the curb. The side door opens and within minutes, a man approaches the open door. He walks in and hands over used needles to the people inside. The man receives clean needles, but he also receives information through his conversation with outreach workers inside the van. This is the Street Health outreach van, operated by the Saskatoon Health Region as part of its needle exchange program and this is one of its regular stops. The van travels every week night to areas of the city frequented by clients so they can have access to condoms, immunization and blood work, in addition to clean needles, referrals and education.
“Because we connect with individuals known to use injection drugs, many of whom are positive for Hepatitis C and some with HIV, we can help ease them into the primary health system where they can receive ongoing care from doctors and nurses,” says Karen Grauer, Manager of Disease Control with Public Health.
Needle exchange programs are controversial in the eyes of the public. A recent review by Saskatchewan Ministry of Health raised questions in the public and in the media such as: “Would you deny health care to someone who chooses to put his life at risk?” and “Would you deny a life-saving intervention because it is misunderstood or unpopular?”
The needle exchange program review recommends a community-based, province-wide approach to biohazard waste collection and disposal, such as increasing the number of drop boxes, destruction devices and biohazard containers. In addition, the province is calling for a more aggressive, integrated approach to harm reduction among injection drug users such as enhanced and consistent tools for monitoring and tracking drug use. For a full copy of the ministerial review of needle exchange programs, please visit http://www.health.gov.sk.ca/.
Saskatchewan has seen a dramatic increase in new HIV cases due to injection drug use. This highlights a need for increased vigilance in ensuring clients with HIV have access to clean needles. Needles obtained through needle exchange services operate on a one-to-one exchange rate, meaning that used needles must be returned in exchange for new ones.
“Needle exchange is about keeping people safe and is only one of many interventions. It helps create trusting relationships and provides clients with access to care they might not otherwise receive, such as medical testing and addictions counselling,” says Dr. Johnmark Opondo, Deputy Medical Health Officer, Saskatoon Health Region.
The provincial government has developed a steering committee to work with Saskatchewan medical health officers to strengthen needle exchange programs.
Saskatoon Health Region supports the review’s findings and is looking forward to working with the steering committee, as well as continuing to work with its community partners at Needle Safe Saskatoon (NSS) and Building Relationships Around Injection Drug Use for Greater Engagement (BRIDGE) Saskatoon.
NSS has been instrumental in placing 12 needle drop boxes throughout the city, developing educational videos around needle safety, creating Needle Safety Kits for picking up discarded needles, and coordinating the annual spring clean-up of unsafely discarded needles. It also partners with BRIDGE Saskatoon, which is a partnership of about 40 organizations exploring the larger issue of injection drug use, with a specific focus on health promotion and primary intervention; harm reduction; treatment and recovery; and enforcement.
The Region will soon be releasing a report, “Bridging Community Voices with Harm Reduction Services,” which collected feedback from injection drug users about the needle exchange program and related services.
But it all comes down to people and their health. Back on the street, the man at the “Street Health” outreach van leaves with some clean needles and information - both vitally important to avoid the risks of contracting Hepatitis or HIV associated with injection drug use.
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