Pubdate: Wed, 28 Nov 2012
Source: National Post (Canada)
Copyright: 2012 Canwest Publishing Inc.
Contact: http://drugsense.org/url/wEtbT4yU
Website: http://www.nationalpost.com/
Details: http://www.mapinc.org/media/286
Author: Meghan MacIver
Page: A16

MORE HARM THAN GOOD?

Working at a women's agency in Vancouver's Downtown Eastside, Meghan
MacIver learned how to clean up after drug addicts - but not how to
change their lives

This might sound crazy, but I was pretty excited when I first got my
job as a woman's housing support worker in Vancouver's Downtown Eastside.

The neighbourhood has been pegged "Canada's poorest postal code"
because of its high density of heroin addicts and homeless people. I
got a job with ATIRA Women's Resource Society, the largest feminist
housing agency in the area, which managed housing projects that other
organizations wouldn't touch, and used the profits to fund the women's
housing they operated. They made a point to hire women from all
backgrounds who could bring expertise from life experience, placing
value on experiential knowledge, rather than formal certifications.
Even though I was getting my master's degree, I wanted to have a
career in that kind of environment.

I believed I had gotten a progressive job that I could grow in, learn
from, contribute to and, most importantly, use to actually make a
difference in someone's life. Nothing could have been further from the
truth.

Within the first few weeks on the job, I discovered that any
difference I made was probably going to be made through cleaning. I
thought I'd be counseling the women, but it was like being a glorified
janitor. But I'd never worked in a job like this though, so at first,
I thought, who knows? Maybe cleaning up the women's rooms would help
them with their self-esteem and give them a clean place to sleep.

Even though I didn't interact with the clients as much as I'd thought,
I eventually got to know a few of them quite well. When I met Rita, we
hit it off immediately. Despite being one of the most hardcore addicts
in the neighbourhood, Rita remained quick-witted and charming. I was
happy to have her to talk to on my shifts because I figured I would
learn something from her about addiction, or at least about how she'd
ended up down there. She made me feel reassured that there was more to
the job than just cleaning, and that I would learn more as I went along.

I soon discovered that the other main part the job was to break up
fights and suppress acts of violence between residents. ATIRA made a
big deal of talking about how we were keeping the women safe from
outsiders, but a lot of the time, I was keeping the peace between the
tenants, and keeping myself and the other staff members safe from them
as well.

Once, a client cornered another staff member in the kitchen with a
knife. I heard my colleague cry for help and I ran over and distracted
the resident so the other staff member and I could run back to our
office.

I slammed the door to our office as tight as I could, while the
resident started to throw all of her weight into it to get at us with
her knife. We yelled at her to calm down, which she eventually did. We
kept the door locked until she forgot what she was doing and we heard
her sit down on the stool outside our door. When we finally opened the
door, she had passed out, and we just left her there for the remainder
of our shift because we were too tired to deal with it.

Nobody liked to talk about how we were actually in danger on the job,
but the truth is we were totally helpless in the face the ferocity of
some of the women. We wouldn't call the police because we were
instructed to handle emergencies ourselves - the police were
considered untrustworthy because of their historically oppressive
attitude toward our clients. It was a fair enough point, but the
unfortunate result was that staff members sometimes ended up acting
like wardens of a jail - but without the ability to properly protect
ourselves, or the residents. Even if we had called the police, there
wouldn't have been much they could do. They wouldn't have put the
residents in jail, and we wouldn't have kicked them out - we were
their home. We were the only place left for these women.

What most of the women in the house really needed were full-time
doctors, nurses and psychiatrists. The area mental institution was
dismantled in the late 1970s, but all that's been allowed to replace
it is a transient and flexible work force. Instead of a hospital or
healthcare facility for the neighbourhood, you get us - part-time
musicians, artists, single moms, former addicts and a lot of
social-work students who work here for slightly better money than what
Starbucks has to offer.

Of course, harm-reduction work is fairly new, but there just didn't
seem to be much knowledge about addiction or mental health to support
us on our mission. For example, there was no training except a tour of
the building and a handout on crisis management and privacy policies.
So we were kind, made referrals and always listened, but that was it.
When I spoke to friends who worked at other agencies, it seemed to be
the same story.

Our only guideline for working day to day was to be nonjudgmental and
respectful of the women's right to do what they wanted. They said
being hands off would empower the women by honouring their own
knowledge. It was a convenient philosophy, however, because we really
didn't have any authority to intervene anyway. Sometimes, there were
very messy consequences. Like when Rita got a hold of some extra cash,
and blew it all on a big load of drugs.

The thing was, it was our organization that gave her the opportunity.
They went back in the books and realized they owed Rita some money.
All the staff were reluctant to let her know about it, but in the end,
the manager decided it was none of our business what she did with her
own cash. It was her right to have this money, my manager said, and we
couldn't dispense it to her like a child. So she was given it all in
one big go, and she proceeded to spend it all in one big go, buying a
huge amount of drugs in one day. She got very sick.

We all spent weeks of shifts taking care of Rita, carrying her into
her room, helping her to go to the bathroom, making sure she didn't
light herself on fire with her cigarette butts. Finally, someone spoke
up at a staff meeting about the situation. A senior manager had come
in and we told her we were concerned.

"She's a big girl," the manager said, laughing. Then she reminded us
we had a lot of other things we had to deal with and that it wasn't
our place to judge her choices.

She insinuated if we couldn't handle it, we should think about finding
new jobs. So we handled it, but I was beginning to realize that
handling it was different from making any difference in these women's
lives. Cleaning rooms, stopping people from jumping out of windows and
kicking drug dealers out of the place could all seem like it was
helping, but it wasn't, because it wasn't really addressing the
problem at all. We could kick the johns out at curfew, we could call
the cops if someone set a fire, but in the end, we were totally
powerless to do anything that could have lasting positive impact.

When I spoke to other workers about it, we all agreed that we could be
doing more harm than good with our approach, but there weren't many
other options.

It was very strange to find myself swimming neckdeep in addiction and
mental health issues and discover that no one was paying attention.
Perhaps, somewhere, in the silos of academia, someone was reading
books and theorizing about approaches to curing addiction. But while I
was in the trenches, I never encountered one person, one practice or
one strategy from research to help us.

Of course, you always heard about the next big project for the
Downtown Eastside, announced by the directors of the community
non-profits, the edgy new art galleries in the neighbourhood or even
some academics, all trying to outdo each other for funding and
attention. But those projects were so removed and distant from the
reality of my day-today work - it seemed no one involved in them
talked to anyone who actually worked or lived in the
neighbourhood.

Once, I suggested to one of these project co-ordinators that she
actually spend time in our building to better understand what it was
like. She was from an outside agency, and hadn't spent any time in the
neighbourhood, let alone the housing. Her eyes widened as if I'd said
something downright frightening.

"I really see myself as an ideas person, you know," she replied
defensively. "I'm not so into the practical side of work, like you."
She said this carefully, trying not to sound above me, but failing
miserably.

At the end of the day ATIRA is still doing what very few are willing
to do: work with poor, drug addicted women who are hard to house and
extremely vulnerable. So these new projects kept getting funded, while
no one from the government, other NGOs or the university were willing
to check if they were actually working, or what alternative approaches
there might be.

One day, when Rita nearly stopped breathing, we called the paramedics
for her. While we were waiting for them to arrive, I reached out to
touch her hand for the first time ever. I had never touched a client
before, but she just seemed so small, and frightened.

"Everything is going to be OK," I whispered to her as we waited for
the ambulance to arrive.

I tucked my hand into hers, but as I touched her, she flinched
sharply, and then her hand went limp. A deep sadness engulfed me in a
surprising way. She was just so cold and unfeeling. I thought I meant
something to her, but she was too far gone for that now. Maybe she
always had been.

I don't know if I ever made a difference in Rita's life, but I knew
that without any training or support, it was unlikely I ever would in
anyone else's.

There were a lot of reasons to quit the job, but when Rita finally
passed away, it was like something switched off in me and I no longer
felt there was a point in continuing. Of all the challenges I faced
down there, the thing I couldn't handle anymore was the dishonesty of
carrying on working, when I knew what I was doing wasn't working at
all.
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MAP posted-by: Matt