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87 APRIL 2006
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On hiking mountains in beautiful BC and fear of change in Child and Youth Care

Niall McElwee

Greetings from the University of Victoria in beautiful British Columbia, Canada where I am in residency with Dr. Doug Magnuson for the last week of March. We have been having a grand old time of it these past few days mixing writing, editing, sightseeing and mountain walking and, of course, visiting Child and Youth Care programs.

Substance misuse and harm reduction
The serious side of the trip over here has been around my learning more about harm reduction strategies and substance misuse that will assist me in the delivery of my Youth and Substance Misuse classes back in Ireland. So, on Monday gone by, Doug and I spent a full day in the downtown east side of Vancouver City visiting several programs for adults and youth. It’s hard to believe, if you haven’t been over here, the level of human misery and hopelessness that resides on these streets.

There are so many stories of lost opportunities, lost loves, lost work, lost lives. Our hosts from the Vancouver Health Authority informed us that there were an estimated 5,000 adults with serious alcohol and substance misuse issues all crowded into a defined geographical area on the east side. Just to take one practice example, the safe injection site opens for business at 10.00 am but there were queues of people from 8.00 am and 800 people a day go through that program!

My Iranian cab driver, Tarik, (who spent the journey singing the merits of Canadian citizenship) was so efficient that we arrived forty minutes early, and we felt it would be the prudent thing to go and have coffee and a bagel in a Starbucks uptown and wait until the staff came on duty, as I was fearful that my laptop case and weekend bag might be an invitation for robbery. Ironically, both Doug and I commented that we felt no fear or hostility walking around the area (for hours as it turned out) even though on every corner there were people obviously strung out. Men and women openly smoked bongs, were taking hits of crystal meth and were injecting themselves. This is serious.

I’ve seen quite a few programs in a number of countries and suppose a question I have is what message we might give people with such serious addictions when so many of them are located in just one area. The downtown east side really looks like a ghetto. People are crowded into the streets in groups, they stand, sit and lie in the laneways, they queue up for a range of services outside designated sites, they walk aimlessly around trying to get to the end of each new day.

But there does appear to be a clear sense of belonging among them. There is a sense of community. People at least have services that they can go to for assistance and these are staffed by professionals that really do care about dignity. However, one might argue that these people are too easy to avoid by the mainstream, e.g. people like us, and I don’t think this is a good thing.

A paralysing fear of change
Towards the end of my week in British Columbia, Doug was kind enough to take me on a hike up on Mount Finlayson in Goldstream Park. About three quarters way up the mountain hike my all-too annoying fear of heights kicked in. I tried my best to brave it out and pretend I was ok with the dizzying aspect, but it’s hard to do that when suffering from vertigo, nausea and an inability to move. Unfortunately, my fear overcame me and we had to stop. As I was resting (not quite hyperventilating, Doug, in case you are reading this story) against a craggy rock I reflected on why people downtown east side don’t change – and, of course, the answer is simple. Sometimes the thought of what might be around the corner is just too paralysing. In my case, Doug assured me that the view was even better if we just hiked a little more to the right, but I didn’t care. Being a good relational male he asked me which approach might be the most appropriate one to assist me in my choice – should he take a “Child and Youth Care” one or a “team sport” one? Should he gently cajole or shout and bawl? It didn’t matter because I was staying where I was – and this was despite the fact that several guys passed us both going up and down the mountain hike completely unperturbed by the heights. To stay where we are (in my case neither fully up nor fully down the mountain) seems the safer option because it is known.

The task for human services is to really concentrate on facilitating change in addition to dispensing services for those of us too paralysed to consider another path.

Gratitude
I want to thank Bill Ebbitt, HSE Ireland, Owen Ross, Athlone IT Ireland and Dr. Doug Magnuson, University of Victoria, Canada for making this trip possible for me. I want to also say a big thank you to Sarah, Linda, Pam, Jennifer and Cameron from the Vancouver Coastal Health Authority who took time out of their very busy schedules to show us around and discuss their projects and research with us. They are doing tremendous work.

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