Sunday, July 30, 2006

Addiction
July 22, 2006

The latest survey on the habits of street-level injection drug users in the Capital Region is a grim little reminder of all the things we don’t yet get about addiction.
Since the last assessment in 2003, the only bright spot in the most recent survey is a two per cent decrease in the HIV rate. Virtually all other indicators - rates of hepatitis-C, amount of needle-sharing, condom use - have gone in the wrong direction.
As is our wont, we’ve talked and talked for years about addiction and drug use. If words were all it took, we’d be living in a drug-free paradise by now.
But we’re not. The Vancouver Island Health Authority’s newly released report on needle users in the downtown is most definitely proof of that.
Almost three-quarters of the 250 needle users surveyed by VIHA at two downtown social agencies last year tested positive for hepatitis-C, an increase of more than five per cent from the 2003 survey. Forty-two per cent reported sharing needles, also a five per cent increase.
Meanwhile, the number of needle users who had sex in the previous month without using a condom jumped 10 per cent between 2003 and 2005, to 65 per cent. The news gets even worse for the sex partners of those surveyed: almost a quarter of users with HIV or hepatitis-C hadn’t known they were infected prior to being tested as part of the VIHA study.
All of this is unfolding in a region that gives the appearance of working hard to combat the ravages of addiction. We’ve provided free access to clean needles and condoms for many years, and launched countless high-profile campaigns aimed at reducing risk behaviours.
More recently, we’ve sent the mayor to Europe to check out safe-injection sites, and debated in council meetings whether to install drop boxes around the city for users to dump their dirty needles. If ever there was a time and a place to attempt to be a “safe” and responsible needle user, here and now in the Capital Region is pretty much as good as it gets anywhere in Canada.
And such efforts are laudable. Consider how the stats might look by now had we continued to do nothing at all. As bad as things are among street-level needle users, they’d be significantly worse at this point if not for needle exchanges and other harm-reduction strategies. Ninety-two per cent of those surveyed in the VIHA report (www.viha.ca/about_viha/news/publications/) use local needle exchanges, and most said they’d frequent a safe injection site as well if the region had one.
But the problems of addiction won’t be dealt with as simply as making it easier and safer to use drugs. Addiction is what happens when hurting people with susceptible genetics discover something that takes the pain away. Drug use at that level is a complex behaviour far removed from the act that it appears to be on the surface.
On the streets, where the only “good times” are the brief moments before and after injecting, sharing needles can be the way people express friendship and trust. It can also be the way they express self-loathing, something of which they’re all very familiar with.
For one young needle user I know, it’s all about getting the drugs into her body as quickly as possible, before she has to think about it. If that means sharing a needle, or shooting herself up in the neck or straight through her filthy pant leg despite having been cautioned against both acts dozens of times, so be it.
There are ways to help her, and others as well. But they don’t exist in the Capital Region. Small wonder, then, that problems are worsening.
Clean needles and safe places to use drugs are just one piece of the puzzle. If we’re ever to get a handle on addiction, we need to rethink our entire strategy.
Family support. A place to live. A sense of belonging. Sober and happy pregnancies. Drug treatment. Mental-health care. Hope for the future. It all matters.
The VIHA report, done in conjunction with the Public Health Agency of Canada, barely scratches the surface around the full impact of substance abuse.
With surveys conducted only at Streetlink and the downtown needle exchange, any of the region’s 1,500 to 2,000 injection drug users who don’t use street services were automatically excluded. Women were also underrepresented, again because of the survey sites (most of Streetlink’s clients are male).
So as troubling as the VIHA survey is, it’s still just a partial picture. There’s a firestorm coming, and somebody’s going to have to do something about that.
patersonatpeers@hotmail.com

Saturday, July 15, 2006

The Stephen Hawking solution
July 14, 2006

Deep thinker Stephen Hawking has gone looking for answers to how we will save our troubled world, and more than 22,000 people have weighed in so far. Their answers are at times sweet and at other times alarming, as you might expect from a random sampling of on-line opinion.
“In a world that is in chaos politically, socially and environmentally,” asked Hawking last week on the Yahoo Answers Web site, “how can the human race sustain another 100 years?” (Yes, notes the site, this is the “real” Stephen Hawking, recruited by Yahoo to post the question after touching on the same topic recently in Hong Kong.)
Hawking is something of a star recruit on a Web site that is striving to be seen as harvesting the collective wisdom of the world through its questions. He’s an astrophysicist and a mathematician with a decidedly philosophical bent, and maintains a global schedule of speech-making despite being almost fully paralyzed. Who wouldn’t be honoured to have a guy like that single you out for posting the best answer?
From my brief foray into the answers, I’d say that the viewpoints divvy up fairly equally between cheery optimism and end-of-the-world pessimism, with quite a number of doomed-but-hopefuls rounding out the mix.
“The only solace is that every generation has thought the same things,” noted one posting in response to Hawking’s question.
Hawking’s own answer, as delivered June 13 in that Hong Kong speech, falls solidly into the pessimistic camp. He believes the survival of the human race depends on its ability to relocate elsewhere in the universe. If humans can manage to avoid killing themselves off entirely over the next century, said Hawking, their big challenge will be to find new homes on space settlements independent of Earth.
His solution resonates among some of the answerers, who agree that the only hope for the future will be to abandon Earth and start over. “We might have to find a way to expand to another solar planet,” offers one.
Others put forward thoughts that at their best are sincere and caring, and at their worst are warm and fuzzy to the point of being completely unhelpful in terms of actually doing anything. “The Human spirit will overcome,” posted one such writer. “It’s within us, dude - we’re fighters and survivors.”
I place myself in the doomed-but-hopeful category - not nearly so gloomy as to think that we’ll be writing off the planet within a century, but still damn worried. With the lives of my children and grandchildren to consider, however, I have to hope for the best.
To me, the key to saving our world is to act. Take the neglected neighbour kid to a movie once in a while. Join one of a couple hundred service clubs that are dying for lack of new members and raise money for something terrific. Learn about the impact from some distant war, and do whatever is within your reach to do.
And keep doing it. “In truth, one step at a time is not too difficult,” noted the late pop philosopher Og Mandino.
As a “solution,” I admit my strategy for saving the world smacks of mom and apple pie. But is that wrong? Sure, we owe a great deal to the big men with big plans who got us to this point in our history, but it’s going to take a more delicate hand at the wheel to guide us through the current turbulence. A lot more mom and apple pie strikes me as exactly what’s needed.
In the Yahoo poll, count me in with the cryptically named URez2Read, a 32-year-old from parts unknown who sums up the good and bad of the human condition.
“Our future is what we make of it,” posts URez. “The question is: Will we make the effort to guarantee the survival of our species, or will we be at the top of the endangered species list?

Wednesday, July 05, 2006

Women and the glass ceiling
June 30, 2006

If the goal is to do what men do, then women still have a long way to go. We are creeping toward gender equality - at least the kind measured by big jobs and big money - at a glacial pace, and even losing ground on some fronts.
Perhaps it’s not too surprising given the findings of an international survey on the subject this month. The study by Catalyst - a U.S. non-profit that keeps an eye on women’s progress in the corporate world - found that around the world, people believe that women are better at “taking care” and men at “taking charge.”
Even countries approaching gender equity - socially minded places like Sweden and Finland - held that belief, Catalyst found. The findings provide at least one reason why women don’t make it to the top jobs: The world continues to think that men do those jobs better.
We all know women who have done exceptionally well in business and politics, of course, and men who are community-minded and nurturing. But I’ve come to think there’s some truth to women being a certain way and men being another. It could be argued that female workers are concentrated in the taking-care professions because they’re good at it. And what’s so bad about being good at “taking care”?
Probably nothing if all things were equal. But they’re not.
Being the type who takes care can, for instance, translate in the real world into looking after people for free: Your hard-charging partner; your children; somebody else’s children; eventually your aging parents - in most cases, nobody’s going to pay you for any of that. The ability to take care is a treasured societal value, but there’s no treasure attached.
If this were a world where money didn’t matter, maybe it wouldn’t be so bad to be the gender perceived as being better at “taking care.” If your fella is better at loping across the veldt in search of tomorrow’s supper and you’re better at maintaining the homefires and community connections, what’s to worry? If both roles are equally valued and rewarded, no problem.
Unfortunately, they aren’t. One path at least has the potential to lead to wealth and status. The other will barely keep you in pocket change.
Jobs that involve “taking care” don’t pay nearly as well as take-charge jobs, and are at the most risk of being cut in a downturn of government funding. Take-care types are rarely sought to run governments or chair major initiatives. That cuts them out of public policy and other decision-making.
On the home front, take-care work - raising your children, caring for a brother with a mental handicap, looking after your elderly mom in her final years - doesn’t pay a dime. In many cases, there’s even a financial penalty for doing the work, should the caregiver end up having to subsidize the cost of services for a family member in addition to providing free care.
The sticking points, then, are money and power. If being the gender that takes care paid just as well as if we’d taken charge, and garnered equal respect, maybe it wouldn’t be so bad to just give into it. Maybe we could leave men to be men and women to be women - different but equal, and equally rewarded and valued for the work they do.
But knowing that the real world is nothing like that, you can understand why women’s organizations like Catalyst keep talking about the need to push more of us through the glass ceiling. Being classified as the gender that’s better at taking care than taking charge shuts women out of both the money and the decision-making.
What’s the value of a good mother? What is it worth to a society to have their old people cared for at home by family members? There’s an amount there somewhere, a dollar value for the work that’s being done. Past studies have tried to calculate bits and pieces of the complex cost issue, but no one has yet come close to establishing the worth of unpaid labour in our communities, most of it done by women.
Money talks. Perhaps this business of who takes care and who takes charge in our world needs to come down to costing out the actual worth of of the service, which would at least give us a starting point for discussions around tax breaks, wage programs and innovative strategies for the kind of work women do.
Sure, everybody talks a good game about being thankful for those who are good at taking care. What would take-charge types do without them?
But gratitude doesn’t pay the bills. If the world thinks women are good at caring, then we need to set a price to that work that puts it on par with the take-charge work of men. As long as everything’s equal, there’s nothing wrong with being different.
Aboriginal realities
June 26, 2006

Well, well. Aboriginal children are dying at higher rates than their non-aboriginal peers. I don’t suppose anyone could be surprised at that.
What will we do about it? If past behavior is any indicator, not much. We’ve been telling each other stories of aboriginal disaster on any number of fronts for decades now, but doing very little. The result: Things just keep getting worse for Canada’s aboriginals.
Being aboriginal in Canada is now very much like being black in the United States. Just belonging to either of those racial backgrounds is now a risk factor all on its own for things like youth suicide, drug addiction and diabetes, not to mention a predictor of future income and level of education.
Our country’s aboriginals are three times more likely to be the victims of violent crime. Aboriginal youth are at higher risk of suicide, addiction and obesity. Diabetes is near-epidemic. HIV infections are rising sharply.
The dropout rate for aboriginals is an unbelievable 70 per cent. Almost half of the 10,000 children in the B.C. government’s care at any given point are aboriginal. That distinction adds a whole new set of risk factors to their troubled lives, as being a government ward is very nearly as bad as being an aboriginal in terms of the pall it casts over how well your life will turn out.
My recollection is of much hand-wringing in the past 20 years as to what could be done about such terrible revelations. But it’s clear that little of it had an effect. Case in point: School attendance for aboriginals actually fell between 1981 and 2001 in B.C., even while debates were raging on all fronts in that period around the importance of improving high-school graduation rates. The province’s rates were among the worst in Canada.
Fortunately, all is not lost. I attended the Victoria Native Friendship Center’s grand opening this week in the former Hampton Elementary, and felt the power of good ideas at work in the many busy rooms of the friendship centre.
A destitute and ruined aboriginal population need not be a Canadian certainty. People know what needs to be done, and it’s as fundamental as mom-and-tot groups and a place for kids heading into trouble to hang out. No magic involved - just thoughtful and sustained effort, led by people who know how to make good things happen.
If we’d gotten started all those years ago when we first identified a disaster in the making, we’d be a long way down that road by now. But talking about aboriginals almost always slides into a furious debate around whether they even deserve help and empowerment. Sure, some mistakes were made around aboriginals, the argument goes: cultural genocide; child kidnappings; forcing aboriginals to use a different door at B.C. beer parlours, to name a few from the last 50 years. Get over it.
But the terrible history of Canada’s aboriginals is exactly why everything is so wrong for them today. It was a war of sorts, and the damage has accumulated through the generations. And as the stats reveal, the situation worsens for every year we do nothing.
Where will we start? At the beginning, of course. The world will be saved through happy, healthy families connected to vibrant communities.
Making that happen on the ground means paying attention to everything from child mortality rates and levels of community involvement to the impact of opening another mall on the far side of town. Everything matters. Equally importantly, we need to act on the information. The importance of studies notwithstanding, it’s action that moves things forward in this world.
Seeing Victoria’s native friendship centre in its sprawling new digs - kids bouncing on the playground equipment outside, moms pushing strollers along the wide hallways - was heartening evidence of just such action. Families are being reborn at the centre. And that will be the way that Canada will ultimately combat the discouraging statistics around aboriginal health and well-being - one friendship centre at a time.
The lessons from a country that was unable to rouse itself to action around such issues are as close as our southern border. U.S. inaction around social policy has fueled widespread urban decay, and the dramatic growth of a poorly educated and hostile underclass operating outside the strictures of mainstream culture. In Canadian communities like Saskatoon and Winnipeg, the number of aboriginal gang members is on the rise, setting the stage for a similar disconnect.
Terry Smith, B.C.’s chief coroner, commented in Vancouver this week on his report, a review of 640 child deaths since 2003. He said his report’s findings will “save lives.”
And if the report sparks action to prevent aboriginal kids from dying young and in violent circumstance, it just might. But for as long as it sits on the shelf, it’s just more words.
Impact of television
June 24, 2006


Television’s power can be harnessed for great good, as the New Yorker magazine notes in an article about a socially minded style of Mexican soap opera that has been working its magic for three decades. More than 100 countries now air versions of Miguel Sabido’s soaps, which manage to be entertaining while also acting as agents for social change.
The story lines are as intricate and dramatic as any soap, reflecting the drama in the lives of their real-world viewers: HIV, an abusive spouse, too many kids, a secret abortion, discrimination. The social messages are subtle, woven inobtrusively into a broader story. Still, the messages come across loud and clear, as evidenced by the things that happen after a particular show airs. Viewers not only like what they see in Sabido-style telenovelas, but take action based on watching them.
From the very earliest days in the mid-1970s, Sabido’s soaps have underscored the awesome reach and potential of television as an agent for change.
One of the early episodes in 1974 featured a story line about visiting the Mexico City headquarters of the government literacy program. The day after the show aired, an unprecedented stampede of 12,000 people showed up at those same headquarters to see for themselves. Almost a million people signed up for literacy classes as a result of the show.
A story line about the search for birth-control alternatives by a stressed-out mother of three led to a 23 per cent increase in sales of over-the-counter contraceptives in Mexico. In India, a village enthralled by the story line of a young girl’s fight to be educated went on to petition government for a day-care centre in their own community, so that young girls could attend school rather than be left at home to babysit younger siblings.
Without the power of television, how would such sea changes be accomplished?
The average Canadian devotes a month and a half to television in any given year. Our youngsters watch at least 13 hours of TV a week - almost a month’s worth over the course of a year. A typical senior spends almost five hours a day watching TV, the equivalent of two and a half months annually. More than a third of Canadian households have at least three televisions.
And when TV is good, it’s very good, as the Sabido experience makes clear. But what about when it’s bad? .
What about when it crashes and bashes around with barely a thought to whether it’s having any impact at all? What about round-the-clock exposure to sex, drugs, violence and inexcusable behaviour, often on hundreds of channels? Where will it end - and will we be happy with where it takes us?
The power of Sabido’s telenovelas to affect change underlines our failure in Canada and the U.S. to harness television for anything resembling public good. But it also serves as a grim reminder that television left to follow its own random course could be having an equally dramatic impact on viewers, and not necessarily for the good.
“All television is educational,” former U.S. Federal Communications commissioner Nicholas Johnson once said. “The question is, what does it teach?”
Consider, for instance, the U.S. finding that 15- to 26-year-olds drink more for every alcohol ad they see on TV or at the movies in a month. By the time a kid hits 14 in the U.S., they’ve seen the equivalent of eight hours of alcohol consumption play out on the screen. And if you’re feeling smug because you’re Canadian, keep in mind that almost 65 per cent of the TV we watch originates in the U.S.
New Zealand found a direct link between hours of TV watched as a child or teenager, and lower levels of formal education. Children who watched more than two hours a day were less likely to get a university degree as adults; adolescents who watched that much TV were more likely to drop out. A 2004 study published in Pediatrics, the magazine of the American Academy of Pediatricians, found that every hour of TV that preschoolers watched daily increased their chances of being diagnosed with attention deficit by 10 per cent.
And even when the content doesn’t harm us, just sitting still for all those hours of TV is a danger.
The British medical journal The Lancet reported in 2004 that higher rates of obesity and smoking had been found among those watching more than two hours of TV a day (Canadians on average watch three). Longer hours in front of the television ended up being at the root of almost a fifth of all problems among the 1,000 people studied related to overweight, high cholesterol, cigarette smoking and poor fitness levels.
Sabido’s dramas remind us that it doesn’t have to be that way. But until North American television fare gets the rethink that it so badly needs, that’s how it is.