Court ruling finally brings sex workers out of the shadow

You’ll be reading this today, or maybe even weeks from now. By then it will be old news that the Ontario Superior Court tossed out the bulk of Canada’s prostitution laws.

But it’s Tuesday, Sept. 28 right now, 11:01 a.m. I’m sitting down to write this mere minutes after the first amazing email landed in my inbox with the news. I’ve been crying happy tears ever since. I’m still in the buzz of the moment, so please don’t mind me if I get all emotional.

Years of battle lie ahead, of course. Brothels, living off the avails and communicating for the purposes of prostitution were all rendered legal in Ontario with the decision, which ultimately has implications coast to coast. The first thing the Crown’s going to do after everybody gets past the shock is file an appeal. Then it’s off to the ultimate arbiter, the Supreme Court of Canada.

Still, there’s no going back from what has already changed. The moment Ontario Superior Court Judge Susan Himel handed down her decision Tuesday, sex workers finally became people. They became flesh-and-blood women and men, out there working for a living like the rest of us.

"By increasing the risk of harm to street prostitutes, the communicating law is simply too high a price to pay for the alleviation of social nuisance," Himel wrote in her 131-page ruling. The danger sex workers face “greatly outweighs any harm which may be faced by the public.”

Court decisions seem like pretty sterile documents by the time the public gets a look at them. But there’s real pain, and incredible bravery, in the process that brought about this most recent judgment.

The sex workers who appeared before the court were subjected to intense and prying questions by prosecutors. I still remember the day a friend of mine came back from giving her testimony, the broken way she looked. It had been a hard and humiliating experience.

These women put their lives on public display as few would be willing to do. Without them, there would have been no case. I hope they are celebrating like crazy this week.

University of Toronto law professor Alan Young and the legal team who took on this challenge worked for free. They went to extraordinary effort to build a story that spoke to the law while also bringing the voices of Canada’s sex workers and advocates to the fore. There would have been no case without them, either.

When all of this got underway, I couldn’t have guessed how the court might finally rule. At that level, the law is not often something that the common person can understand.

But then I learned a few months back that the legal test was essentially whether Canada’s prostitution laws caused more harm than good. And that’s when I knew there was a good chance that the sex workers were going to win.

Our laws are well-documented for hurting and killing sex workers while doing nothing to curb the industry. If harm versus public good was the test, there was no question in my mind.

Even when the laws aren’t enforced - which is mostly the case in Canada for the laws around keeping a bawdyhouse or living off the avails - they cause harm by shutting sex workers out of the mainstream and deepening stigma.

It took me a long time to form my views on sex work, through many twists and turns in career and personal experience. I now feel unequivocally that adult, consensual sex work must be legalized.

But it took me years to get here, and I respect that not everybody will greet Judge Himel’s ruling as a gift from the heavens. Some may even see it as the end of the world.

But what is the argument for anyone being subjected to injury, death, immense shame and stigma just because another segment of the population believes the way they make their living is immoral?

Perhaps you can’t imagine doing the work and wouldn’t want it for your own daughter. But is that really reason enough for laws that ramp up the danger and difficulty for other people’s daughters and sons?

People struggle with the idea that sex work could ever be part of their community. But the truth is that it already is. Thank you, Judge Himel, for seeing the people in the shadows.

Wow, we are living in kooky times when a U.S. newspaper does a straight-up story about how homeless students have a tougher time than other students when schools in their neighbourhood close down. Pretty unsettling story not so much because of what it's actually about, but because it treats the concept of homeless students like it's a normal thing.

Check out the fascinating buzz going on at the CCSVI Facebook page, where the piece I wrote today about multiple sclerosis got posted. This is clearly one hot topic among people with MS.

What's the real reason for resisting help for people with MS?

Paulo Zamboni must have been hanging out with the marketers too long when he coined that cursed phrase “liberation therapy” for a garden-variety angioplasty.

Maybe if the Italian doctor hadn’t made it all sound quite so fancy and amazing, we’d just be doing what we always do for people with blocked veins, giving them angioplasties to open things up.  Instead, we’re acting like it’s some unheard-of procedure and putting up a real fight to stop people with MS from trying it.

You probably know the story by now. Zamboni tried angioplasty on people with MS to test his theory that the devastating illness might be caused by blocked veins that affected blood flow in the brain. Patients responded in near-miraculous ways, and the “liberation therapy” was quickly news all over the world.

But even as people with MS grew hopeful at the news, a massive resistance was building among governments, doctors, MS support groups and virtually anyone else with a professional tie to the issue.

On the one hand, it’s understandable.

Zamboni didn’t do the double-blind, control-group kinds of studies that are required in countries like Canada.  His theory goes against everything we think we know about MS, challenging the common wisdom that it’s an incurable auto-immune disorder best managed through lifelong drug therapy.

On the other, what’s this wave of resistance really about? More than 35,000 angioplasties are performed in Canada every year, 99 per cent of them without incident. Other than touting it as a potential cure for MS, Zamboni isn’t advocating an unusual or dangerous procedure.

 So why are the MS professionals so resistant to even considering that people with MS might have blocked veins? Why are we forcing ill Canadians to travel to other countries on their own dime just to get a scan to confirm whether their veins might indeed be blocked? Why are we making it so hard for desperate people to hold onto hope of reclaiming at least a little mobility?

“Right now, it’s my only hope,” says Sharon Kristiansen, a Victoria woman who has lived with MS for 31 years. “Maybe it would mean that one day I could walk again. But if not that, then at least maybe I could get more feeling back in my fingertips. The slightest things make a difference.”

I’m not a conspiracy theorist, but the power of the pharmaceutical companies can’t be underestimated when trying to understand the resistance.

On average, people with MS use $20,000 to $40,000 worth of prescription drugs every year to control their symptoms. (Kristiansen’s annual drug costs are $25,000.) Onset is typically between ages 20 and 40. MS isn’t noted for shortening your lifespan, so many people live 40 to 60 years with the disease.

Close to three million people around the world have MS, including 55,000 Canadians. Based on my rudimentary math calculations, that means that just the current crop of Canadians with MS will use between $44 billion and $134 billion worth of prescription drugs over their combined lifetimes.

Assuming people in other countries are also paying at least $20,000 a year for drug therapy and living with MS for the same length of time, we’re talking a mind-blowing $2.4 trillion worldwide  just to treat the people who have the disease right now.

That’s a lot of sales at risk. I know that’s an ugly thing to say, but can we honestly feel confident that we’re exploring potential cures for MS when that much money is at stake?

Drug companies are very good at public relations, to the point that everyone from researchers to doctors to advocacy groups and “grassroots” health organizations ends up compromised. Case in point: The Multiple Sclerosis Society of Canada.

Kudos to the society for issuing its first-ever proposal call last fall for further research into Zamboni’s theory. That can’t have been an easy decision given that drug companies donate half a million dollars or more every year to the society.

Six drugs are approved for use in Canada for the treatment of MS. The manufacturers of five of them were listed as major donors in the MS Society’s 2008 and 2009 annual reports.

Just four donors in the country gave at the top level last year, with gifts of $100,000 or more. Two were drug companies.

Is any of that proof of something afoot? No. Zamboni’s theory challenges the status quo in all kinds of ways, and for all I know the resistance is simply about sound medical practise.

But for the first time ever, there’s a glimmer of real hope on the horizon for people with MS. I just find it odd that we’re putting so much effort into raining on their parade.

  

Why some of our biggest problems just drag on (and on)

My late father took to calling me “Little Miss Know-It-All” once I became a columnist. My mother still teases me about it.

It’s a funny thing, being an opinion writer. You have to be out there with something to say - otherwise, what’s the point? It seems I’m always weighing in on one thing or another, and never mind that I might not have known the first thing about the subject prior to that. 

I wish I really did know it all, because wouldn’t that just be the coolest thing? But what journalists are good at is identifying problems. That doesn’t mean we know how to solve them.

Still, you learn a lot after years of writing about problems.  The upside of journalism is getting to see big thinkers working together with the information, insight and team skills needed to solve a problem. The downside is realizing how often we get stuck, and how the ruts in the road just keep on getting deeper in the places where we’ve spun our wheels a hundred times before.

Every positive change - gay rights, fewer motor-vehicle deaths, lower dropout rates, higher birth weights, environmental protection, equality for women, on and on - came about because people who knew their stuff simply got to it and figured things out. We’re impressive problem-solvers when we want to be.

Yet other problems linger on. Why? In my opinion, it usually comes down to a lack of honesty within the process and conflicting interests. We talk about our commitment to the issue at hand, but not about the hidden agendas and politically influenced decision-making that derails any problem-solving process.

We do not badly in the first stage of problem-solving, where we’re gathering information. Think of all those fabulous reports that have come out of the many royal commissions, task forces and inquiries we’ve created to help us with stubborn, complex issues.

But so many of those recommendations never make it off the shelf. We appear genuine in our search for answers, but rarely are.

I was part of a corporate process years ago in which complex problems got addressed by bringing anyone with a piece of the issue into the same room to figure things out as a group. It’s amazing how quickly a problem can be resolved when everybody puts aside their own self-interest and works for the greater good.

But there’s the sticking point. If anybody is there for the wrong reason, or less than honest about adopting the solutions that emerge from the process, it all goes wrong pretty quickly. You need to be willing to compromise your own interests to solve a problem, and honest in talking about the challenges. Change can’t happen otherwise.

An example: We can’t possibly solve the problem of people with mental illness falling into homelessness until those with the power and the funding base to change that are honest about the level of service needed and the fact that we’re not even close to having enough.

We can’t wish everybody off our streets while at the same time slowing the building of subsidized housing across Canada to a trickle and gentrifying every neighbourhood to suit the middle-class.

We can’t address the crisis in our health, social and justice systems caused by drug addiction without acknowledging that we’ve stripped down services so aggressively in the last decade that treatment these days is readily available only if you’ve got  money to buy private care at $10,000-plus a month.

We can’t address the needs of the 35,000 British Columbians who live with mental handicaps while cutting and capping vital supports that were never generous in the first place. We can’t feel good about expanding disability services to include people with Fetal Alcohol Spectrum Disorder while at the same time cutting overall funding so that everybody will receive less help.

We can’t help people with brain injuries by scrapping a community program that used to help them make the transition from hospital to home, as we did two years ago. That not only exacerbated problems for that group, it complicated potential solutions around homelessness: Brain injury is a fact of life for more than half of the people living on our streets, and the reason why many are homeless in the first place.

We’ll solve our tough problems when we’re honest about them, and cognizant of the political spin and self-interest that undermines the process. 

I’d like to say the day is soon coming. But Little Miss Know-It-All isn’t at all sure about that.

There's a great new report out from the Vancouver Board of Trade and the Justice Institute that really puts some solid figures to the argument that an ounce of prevention is worth a pound of cure when it comes to social services to children and families.
We all know that - even government knows it. But the reality is that time and again we ignore the wisdom and scrap preventive services, leaving some future taxpayer to foot the bill for all the crisis costs that will come due once the child who didn't get the support they need grows up into the adult awash in poor health outcomes, criminal involvement and low productivity.
Read the report here. 

I can relate to that poor bus driver who got lost on the way to Bamfield with a busload of students. I've done that drive, and found myself wondering many times along the way which was the most likely outcome: That I would take a wrong turn and get lost forever on the winding gravel roads between Victoria and Bamfield, or be killed by one of the giganto super-size logging trucks whooshing past me.
Fortunately, I happened to pick up a mom-and-son hitchhiking duo a couple weeks ago on a drive back to Victoria from Courtenay, and they hailed from Bamfield. The son gave me very sound advice for staying on the straight and narrow while driving to Bamfield: Follow the power lines.
Either that or drive in sensible fashion to Port Alberni and take the Lady Rose steamboat in. Lovely way to see Bamfield.

Thank you, UBC researcher Kate Shannon, who wrote this piece for the Canadian Medical Association Journal this month. Note the tremendous surge in arrests for outdoor sex workers in Canada due to short-sighted changes in the communications law in the 1980s, and with zero improvement in the lives of sex workers despite a lot of talk around that time of how the new laws were going to "help" women. We can't let them add another bad, poorly considered law to the mix by toughening up sentences for keeping a common bawdyhouse.

From the September edition of the Canadian Medical Association Journal:

(All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Can adian Medical Association.)

The hypocrisy of Canada’s prostitution legislation

Often described as the world’s oldest profession, the exchange of sex for money has always

existed and will continue to exist worldwide.

For many, the sex industry evokes a sense of moral unease, and divides feminists and society alike on whether it is an oppression and commodification of women, or a woman’s right and choice to sell her body. Canada’s federal legislation reflects this divide: The buying and selling of sex among consensual adults has always been legal, yet criminal code provisions on communicating, procuring, bawdy houses and living off the avails of prostitution make it virtually impossible to work legally in safer indoor settings.

Against this backdrop, the numbers of missing and murdered women continue to swell in Canadian cities and street-involved women engaged in sex work experience some of the worst health outcomes in our society, including drug-related harms, trauma, and HIV and other sexually transmitted infections.

Standardized mortality rates among female street-based sex workers are higher than any other population of women in North America, with homicide being the most common cause of death.

Sadly, there are multiple examples of convictions of serial murderers of sex workers over the last decade in North America and the United Kingdom, and ongoing concerns remain of potential

serial murderers in Edmonton, Winnipeg and along the “Highway of Tears” in Northern British Columbia. The recent convictions for the gruesome homicides of women on the streets of Vancouver and Seattle — the largest serial murders in Canadian and American history — should be a vivid and chilling reminder.

Importantly, growing peer-reviewed research published in some of the top medical journals now suggest that enforcement of criminal sanctions targeting sex work, including communicating

in public spaces, displaces sex workers to isolated alleys and industrial settings away from health and support services.

Enforced displacement and lack of access to safer indoor work environments independently increase sex workers’ risk of physical violence and rape, and reduces their ability to safely negotiate condom use with clients, thereby protecting themselves from sexually transmitted infections and unwanted pregnancies. Qualitative evidence further describes how criminal sanctions limiting sex workers’ ability to regulate safer industry practices (e.g., create unions,

safer indoor work spaces. etc.) compound health-related risks.

Globally, evidence-based public health research is being used in calls to remove criminal sanctions targeting sex work; one such call even came from the United Nations Secretary-General Ban Ki-moon. Yet in Canada this public health policy gap has been met with

scaled up enforcement-based efforts targeting sex workers and their clients.

According to the Canadian Centre for Justice Statistics, following the enactment of the 1985 ‘communicating code’legislation designed to remove the visible presence of sex work, annual prostitution arrests increased nearly 10-fold,

from 1, 255 arrests in 1985 to 10, 457 arrests in 1987. These rates have remained constant at about 10, 000 arrests per year, with 97 per cent occurring in Vancouver, Toronto and Montréal.

Despite three separate parliamentary sub-committees on prostitution since the

mid-1980s, sex workers and human rights experts are now being forced to

challenge the criminal sanctions through the courts, as a violation of the Charter of Rights and Freedom.

Now, as we wait for the Ontario Supreme Court decision on one challenge, the federal government has taken another backward step, this time by reclassifying the Criminal Code on

“keeping a bawdy house” (a place kept for the purpose prostitution) making it a

serious crime with a maximum sentence of five years imprisonment.6 This new

Criminal Code regulation, introduced without Parliamentary debate, is in blatant

disregard of the evidence and has the concerning risk of pushing sex workers

further underground and outside the public health umbrella.

In perhaps the saddest reflection of this public health policy gap, in 2008 sex workers in Edmonton began giving samples of their DNA to a community agency and RCMP network to ensure their bodies would be identified in case of future harm.

While rigorous evaluation of legal policy approaches to sex work remains critical, it is also time for government and policy makers to take into account the evidence of the failures of the criminalized approach to sex work on health and human rights in Canadian society.

Kate Shannon PhD

Assistant professor

Department of Medicine

University of British Columbia

Vancouver, BC

REFERENCES

1. Shannon K, Strathdee SA, Shoveller J, et al. Structural and environmental barriers to condom use negotiation with clients among female sex workers: Implications for HIV prevention strategies and policy. Am J Public Health 2009;99:659-65.

2. Shannon K, Kerr T, Strathdee SA, et al. Prevalence and structural correlates of gender-based violence in a prospective cohort of female sex workers. BMJ 2009;339: b2939.

3. Rekart ML. Sex-work harm reduction. Lancet 2005;366: 2123-34.

4. Goodyear M, Cusick L. Protection of sex workers. BMJ 2007;334:52-3.

5. Duchesne D. Street prostitution in Canada. Ottawa (ON): Statistics Canada; 2002. Cat. no. 85-002-XPE

6. Perreaux L. Tory legislation takes aim at brothels and bookies. The Globe and Mail [Toronto] 2010 Aug. 5. Sect A:6 DOI:10.1503/cmaj.100410

© 2010 Jupiterimages Corp.

Previously published at www.cmaj.ca

CMAJ • SEPTEMBER 7, 2010 • 182(12)

© 2010 Canadian Medical Association or its licensors

Canada has a habit of following the U.S. into good times and bad. But with that big country to the south of us deep in the grips of truly terrible economic times, let's hope we're not following too closely.
Here's an alarming read about the astounding amount of U.S. households going into foreclosure these days, and the equally astounding rise in homelessness happening in the big cities like Los Angeles, where homelessness grew  30 per cent between 2007 and 2009.
As the story notes, one in 400 homes went into foreclosure in July 2010. In Nevada and California, the foreclosure rates are five times higher - one in 80. Scary to contemplate where this is all going.

If you needed any more of an excuse to lie around in the sun (oh, wait - that's me), there's a new study linking a lack of Vitamin D to the development of schizophrenia. Seeing as a lack of that vitamin has also been linked to higher risk of multiple sclerosis and a few cancers, maybe it's time for us to quit slathering on the sunscreen QUITE so thickly and start letting a little of that Vitamin-D-maker-in-the-sky shine on our skin. Just a little.

Google has changed my life, but you do have to wonder if they're aiming to take over the world. Here they are talking about their new "instant search" feature, in which you don't even have to wait that draggy millisecond after you hit Enter to find the info you're searching for on-line. Pretty soon, you won't even have to type in your search criteria - Google will just know.

Scientific evidence isn't for everybody

An intriguing article out of the U.S. on how people have a tendency not to trust scientists. Apparently we don't trust scientists as a general rule, and tend to pay more attention to the bad news and less to the good. But really, why is it a surprise that we don't always trust science? Science has been known to get things wrong many times in the past. So it is when you're human, of course - scientists are no more able than any of us to avoid mistakes and see past their own prejudices and presumptions that could slant findings. Pharmaceutical companies' growing power as funders of scientific research should only make us even more suspicious.

Have years of dislocation taught us nothing about people living homeless?

What’s left to say on the subject of homelessness? We’ve studied the issue from every angle for almost 20 years now. We’ve lamented it, lived it and produced many, many reports on it, all urging immediate action.

And yet at the end of the day, we’re still standing here wringing our hands - this time over conditions on the Pandora boulevard, but ultimately about a recurring problem we’ve pushed around the city for a long time now.

Once it was the neighbourhood around Holiday Court. Then Speed Street. Then Fernwood, and Cormorant.  Now it’s Pandora. A couple years from now - who knows? If we still haven’t comprehended by then that the solution is to fix the problem and not just move it along, bet on a new hot spot somewhere in the city.

Don’t get me wrong - good things are happening around homelessness. We’ve come a long way in understanding the complex problems and societal changes at the root of modern-day homelessness, a relatively recent phenomenon in every western country. We generally get that things happened to create homelessness in Canada, and things will have to happen to get us out from under it. 

And we’re doing some of those things. A partial list: Cool Aid’s brand-new shelter and services on Ellice Street, opening this fall. Pacifica’s Clover Place housing development. Woodwynn Farms. Longer hours for Our Place.  A terrific new health centre. The fledgling Streets to Homes program. Outreach teams focused on crisis intervention and stability.

But I can see with my own eyes anytime I drive along Pandora that despite the wins, we haven’t yet found a solution for a small and very specific group of people living on the streets. With problems too big to hide, they’re the visible face of homelessness, and lightning rods for virtually all of the community’s wrath and indignation around the issue.

The makeup of the group changes regularly, depending on whose addiction has worsened, whose meds are working, whose families are still clinging on, who’s headed for jail or just got out. Everybody’s got their own story to tell, but they all lead down.  

The group creates big problems wherever it settles. Petty crime rises, as does chaos, garbage, public health hazard, visible drug use and trafficking. Complaints to police increase. Media stories ensue, and businesses operating nearby feel the impact on their bottom line as customers shift away from the area.

I first met a version of the group at Holiday Court, a little motel on Hillside Avenue near Douglas that was the hot spot of the day back in 2001. As is the pattern, frustrated residents and businesses in the area tolerated the problems for longer than you might expect, but eventually cranked up the pressure until police moved people along.

Happy days for neighbours of Holiday Court, but not so good for the string of neighbourhoods that followed. These days, even a rundown motel with rain leaking through the plaster or a fleabag apartment in Fernwood looks like luxury compared to the full-on homelessness the group now lives with.

There was once about 30 people in this public and chaotic group, then 70 by the time they’d shifted to Cormorant Street. Now, it’s around 100. It’s obvious we’re losing ground on this particular front.

Why is that? Let me count the ways: Severe addiction with no ability to access treatment. Severe mental illness with no place to go. People so lonely that even a war zone feels friendly. People so poor and broken that they have to live near the free stuff.

Mental handicaps. Brain injuries. Poor social skills. A system of policing and justice that doesn’t work when people have nothing to lose. A splintered region that doesn’t yet get that homelessness is everybody’s problem.

Put it all together and it’s a recipe for bedlam, and immensely frustrating for all involved. I’ve long thought that someone should just put money on the table and hold a contest to come up with solutions for reducing the friction over this small group. What could we do differently - and immediately?

The transient group is really just the tip of the iceberg when it comes to homelessness, but their presence shapes the community dialogue.  It polarizes the debate. It leaves us thinking that nothing is working even when it is, because the rubble of these people’s lives is so obvious.

We can do better than just pushing the mess and chaos into another neighbourhood. We can fix this problem. We have to.

Public forum coming up with Victoria Police Chief Jamie Graham, Sept. 7, from 7-9 p.m.  at Canada West University, 950 Kings Rd. The topic: "Families, Mental Illness and Police Involvement." Sounds like required viewing if you've ever wondered how police deal with people in an acute phase of their mental illness when they get a complaint.

 If you follow the news, you'll know that a significant number of people in Canada and elsewhere end up killed by police in conflicts that occur due to somebody's mental illness. Often the person's family has even phoned in the initial complaint as a way of getting help for their loved one. Too often, it goes very badly - witness the tragic story unfolding in Pickering, Ont. right now. We all know police have a tough job to do, but there has to be a better way.

Sadly, I can't make this Sept. 7 forum, but I hope to send somebody in my stead to report back. Register at  250-384-4225 or admin.bcss@shaw.ca. The forum is being hosted by the local chapter of the B.C. Schizophrenia Society.