TYLER J. MARR
MULTIMEDIA JOURNALIST

North Battleford is not isolated to headwinds faced through an HIV and syphilis outbreak and a rise in the number of needles found around the city.

Municipalities across the nation, and specifically Western Canada, grapple with similar, difficult to address social issues.

Since the calendar flipped to 2019, city lawmakers have faced repeated reports from the fire department outlining the surge in needle pickups.

In 2014, the department collected just 54 needles, but over 8,300 have been collected this year. In one call alone in May, over 3,500 were found at the recycling centre. The needles, Deputy Fire Chief Lindsay Holm said, were likely put in blue bins and didn’t rule out that some came in from out of town.

In 2015, 595 pickups were logged. That number rocketed to 5,300 the year after but fell sharply in 2017 with just 667. However, pickups rose again in 2018 to 5,300.

There are currently four needle disposal boxes around North Battleford; 11th Avenue and 102 Street beside Giant Tiger, in the parking lot of Frontier Mall behind Dollarama; outside the Battlefords’ Indian Métis Friendship Centre and the Lighthouse.

While the department picks up loose needles found on the street and in buildings, another agency looks after collecting them from the boxes.

“Who better to do that than us,” Brice said. “We have the personal protective equipment to enable us to do that. But it is frustrating when 20 per cent of our call volume is taken up by needle pick-ups.”

The spike in collections has spurred harm reduction strategists to work on initiatives to help mitigate the climb. Discussed are recommendations to add more disposal boxes where a growing number of needles are improperly disposed.

Downtown, according to the fire chief, is where a majority of sharps are found. Large numbers are also recovered in rental properties when tenants depart. The properties in question are throughout North Battleford but Brice said a large portion sit in the south end of the city, around Railway Avenue. and toward 13th Avenue and 101 Street.

On June 14, the Saskatchewan Health Authority (SHA) declared an HIV outbreak in the city and a syphilis outbreak for the Battlefords and Lloydminster area due to a rising number of cases in recent months

The SHA said the HIV outbreak is primarily among those who inject drugs and share needles.

In North Battleford, between 2013 and 2018, an average of four new HIV cases were reported annually. From January to the end of May 2019, 15 new cases were noted.

In the former Prairie North Health Region that included the Battlefords, Lloydminster and surrounding areas, fewer than seven cases of syphilis were recorded annually. But from January to the end of May 2019, 42 cases have occurred.

A number of initiatives take place locally in an effort to combat the situation. A spokesperson for the Saskatchewan Health Authority (SHA) said teams meet bi-weekly to coordinate the clinical response to those affected by HIV, hepatitis C, syphilis and other STIs.

Testing rates for these diseases are tracked monthly and physicians are asked to offer testing at every opportunity. Testing days ocurred in North Battleford and Lloydminster and more are planned. A laboratory tracking code has been established to improve data collection and tracking for all tests relating to the outbreak.

Staff from other communities and programs have been redeployed to support the local team. Both Battleford River Treaty Six Health Centre and the SHA have increased human resources by adding more nurses, social workers and clerical support.

To combat transmission, mobile vans go throughout the community to provide education, testing and distribute harm reduction supplies and provide needle return services.

As HIV is heavily transmitted via drug use, a vending machine has been purchased and will be operational in the Battlefords by the end of July. It will allow clients to get harm reduction supplies at any time of day. One is planned for Lloydminster at a later date.

A backpack program has been implemented, according to the SHA, that will see a peer go and pick up harm reduction supplies. They will then head out into the community and distribute the supplies and pick up used needles in an effort to meet clients in their own settings.

Several agencies in the Battlefords offer harm reduction supplies, be it needles, alcohol wipes, condoms, spoons, pipes, and other supplies as needed.

At any of the exchange sites – Primary Health Center, Battlefords Sexual Health Center and Battlefords Family Health Center – clients can pick up for their own or others’ use. There is no criteria or limit to how many supplies can be handed out, except for pipes.

In Red Deer, crews cleaned up more than 4,000 needles in public spaces between January and September 2018, according to the city’s website. It is estimated pickup costs exceeded $85,000.

Turning Point is a harm reduction agency focused on preventing HIV, STIs, and hepatitis C in central Alberta. It offers a wide range of services to Red Deer and surrounding communities like Rocky Mountain House.

The organization operates a syringe distribution program and regularly hands out safe disposal supplies and encourages users to fill them and bring them back to be properly incinerated or recycled.

Executive Director Stacey Carmichael said Red Deer has 10 disposal boxes in the city and others literally duct taped to trees near high camping areas.

“We have those conversations every time someone comes in — ‘Do you want a disposal container,'” she said.

A night outreach team, she said, tours the downtown, parks and trail systems after dark to ensure people have access to information and supplies they need to be safe. The agency also attempts to connect clients with mainstream health care services.

“We believe whole heartedly in the work that we do. We recognize it is often looked at as controversial but it is not,” she said. “We know the work that we do actually prevents the spread of infections and saves lives.”

In October 2018, an overdose prevention site (OPS) opened in Red Deer to severe pushback, despite the city boasting the highest overdose death rates in the province. The provincial health minister at the time had to enforce a ministerial order to forcefully open the site.

While Carmichael said the pushback to the supervised consumption site is overwhelming, in mere months, the city’s overdose death rate fell to the lowest in Alberta.

“We are probably the most hated agency in the whole of Red Deer and that is OK,” she said. “Because we understand it is benefiting the entire community. We will take a little big of egg on the face because we believe in this too much.”

She said the site not only prevents deaths and infections, especially of HIV, but on-staff nurses help address mental health concerns and other medical conditions like frostbite in the winter. The staff connect users to the right services and make ample number of referrals to housing, shelter and detox agencies.

“For some, we are just keeping them alive,” she said. “It is controversial but it is doing what it is made to do.”

ARCHES Lethbridge has operated as a harm reduction agency in some form since the 1980s. The non-profit works to reduce the harm associated with HIV and Hepatitis C in southwestern Alberta.

Director of Programs Megan Williamson said the organization started to distribute needles to users in 2001 but scaled down the operation in recent months to meet the community halfway after concerns were raised. Over the past year, they have decreased the number of needles going out by 70 per cent and increased intake by 83 per cent, which has resulted in less needles on the street than there were years prior.

The agency operates a supervised consumption site and encourages people to use inside the facility to mitigate the spread of needle debris in the city.

“But there is a subset who are not [using here] and we can’t force them,” Williamson said. “We strongly encourage them to use here, but if they are going to use anywhere else, we want them to do it as safely as possible. In order to do that, they need to be using sterile supplies.”

Because of this, they now use greater discretion when handing out supplies based on a client’s return rate and other factors.

In a four-block radius of the site, ARCHES operates a community outreach addictions program (COAP) team. Their goal is to balance the needs of business owners with the needs of those who use drugs or experience homelessness.

“They will connect with people and support them and help move them along and address loitering,” she said, adding they will walk people to their cars and help in other ways.

Security is present in the building around the clock and police are contacted on occasion. Other outreach teams work to ensure people have access to the services they need.

Before opening the supervised consumption site, ARCHES launched a needle debris hotline. They operate a peer needle pickup program where they pay those who use drugs or experience homelessness to pick up needles. They are paid based on how many they bring back.

“It gives them an opportunity for some meaningful employment, to learn to get into the workforce and give back to the community and it is one of the ways we have increased the needle pickup,” she said.

There are 21 bright yellow disposal boxes installed around Lethbridge where needle debris is a recurring problem. Eighteen are in public places and three are located on private property.

ARCHES recently launched an Indigenous Recovery Coaching Team, which is the first of its kind in Canada. It is adopted from an American recovery model and has been Indigenized to meet the needs of the region. The peer-to-peer community based and culturally informed program supports those undergoing opioid replacement therapy.

The program combines one-on-one community-based case management practices with culturally-focused healing and behaviour relapse prevention.

All the staff identify as Indigenous and connections are made with Indigenous Elders and building ties to culture.

“Harm reduction is meant to be an entry point into the spectrum of care,” she said. “We are able to connect with people who are interested and move them along the spectrum.”

While in its infancy, Williamson is eager for what may evolve from the program.

NDP leader Ryan Meili said while addressing prevention and treatment is critical, targeting poverty, which is the root cause of the matter, is key. Supervised consumption, he said, could be part of the mixture of solutions, too, as a vast majority of HIV transmissions in the province come via interveinous drug use.

“When you add poverty to addictions you get HIV, you get syphilis. We need to be looking at things like sex education and harm reduction,” he said, adding a provincial poverty reduction strategy needs to be developed.

“When we talk about social housing and crime rates, all of that is coming from a common root cause, which is an insufficient investment in people.”