Feature Story Saturday, June 22, 2013
Taking it to the Street
Healthier Community bus represents a fundamental shift in how preventative health care is delivered in Chilliwack
Submitted by Jay Niver for the Chilliwack Healthier Community Stewardship Council/Handout photos
The Pacific Community Resources "Healthy Options" mobile bus offers a health contact point for drug addicts, prostitutes and street people. Below, Tom McMahon, Sam Mohan (C) and Kim Lloyd meet in the new mobile clinic.
he phrase "Bigger and Better" sounds like a marketing cliché, but in the case of the new Fraser Healthy Options Mobile Clinic, it’s a fact.
What was informally known as “the needle-exchange van” is now a 22-foot, custom-renovated Ford bus that essentially operates as a mini-clinic for homeless or street-entrenched persons, including sex-trade workers and those with drug addictions.
Pacific Community Resources (PCRS) operates the Chilliwack-based program with funding and a firm mandate from the Fraser Health Authority (FHA).
The original idea focused on collecting used needles from intravenous drug users, to stem the spread of HIV and Hepatitis C – diseases contracted largely from sharing used contaminated needles.
While Abbotsford debates and agonizes over establishing a needle-exchange program, Chilliwack has had one for 20 years – with broad community support and a stellar record of keeping needles off the streets.
“Our local businesses and government have been very supportive,” said Kim Lloyd, program coordinator. “We work directly with the BIA (Business Improvement Association), and if any of their cleanup crews find a syringe, they return it to us.”
In some years, the Chilliwack program has a needle-return rate higher than 100 percent, meaning it collects more needles than it distributes.
“This is a tremendous step toward improving what was already a very successful program,” said Stewart McLean, co-chair of the Chilliwack Healthier Community Stewardship Council (HCSC). “To put this kind of resource on the street, where it can reach so many of our marginalized residents is exactly the kind of initiative we want in Chilliwack.”
The HCSC, co-chaired by the City of Chilliwack and School District 33, is comprised of 24 local organizations, individuals, government entities, and agencies including PCRS.
The Council’s mission is to promote affordable housing, mental health, public safety and healthy lifestyles to help build a healthier Chilliwack community.
Above, the old van and new bus will used for the PCRS mobile clinic show the program’s substantial jump in “size” from a Dodge Caravan to a 22-foot Ford mini-bus. Below, FHA public health nurse Karen Coates helps PCRS staff move materials into the new Fraser Healthy Options mobile clinic.
For the first dozen years, the HIV-Hep C prevention program ran from downtown storefronts near Five Corners, Princess Avenue then in Southgate Mall, said supervisor Sam Mohan. The program went mobile in 2005 and has been operating out of a Dodge van since 2007.
“It was intended on being only a temporary solution, for only a year or two at the most,” said Mohan, “however it turned out to be more than seven years”
On June 13, both the old and new vehicles were side by side in the Empress Lane parking lot at Young and Princess Streets, where the clinic has operated noon to 4 p.m., five days a week for the past six years.
Mohan, Lloyd, and FHA nurse Karen Coates were busy moving supplies and equipment from the crammed van to the long, wide-body bus.
“Our clients used to stand outside no matter what the weather,” Mohan said. “Now they can come inside, sit down with us, and receive services that we now have space for to include outreach health and education, testing and immunizations, and simple but important basic supplies like toiletries and some clothing.”
FHA outreach worker Tom McMahon knows many of the clients personally. He recalled “some church ladies” who seemed apprehensive about the program and stopped to ask what was going on when they first saw the old van.
“They returned the next day with some baked goods for the clients,” said McMahon. “It’s not unusual for people to inquire about us, then come back with blankets or clothing or food.”
The Healthy Options bus was donated to PCRS by Surrey’s Mobile Youth Outreach (MoYO) program. The vehicle, which began its life as a 16-passenger bus, got a new “skin” as part of its PCRS makeover – an original depiction of Chilliwack scenery. Video gaming consoles were removed, but one flat-screen TV remains to be used for educational videos by Lloyd and public-health nurse Coates, who is at the mobile clinic from 1 to 4 on Thursdays.
“It’s important that we’re able to build relationships,” said Lloyd. “To provide support for clients’ mental-health and addictions needs, follow-up and referrals, we have got to build trust.”
The Fraser Healthy Options Clinic operates four hours a day Monday through Friday at the Empress Lane parking lot near the corner of Young and Princess streets. Below, the Healthy Options’ former vehicle (right) was crammed with supplies that now fit comfortably into the newly converted bus (left).
The program maintains a healthy, working relationship with the RCMP, she added; one built on respect and support for clients, so trust is developed between them and law enforcement.
The Fraser Healthy Options Mobile Clinic is operated as part of the new Chilliwack Health Contact Centre, where it will be parked when not in use. All services available at the vehicle will be offered at the Centre, so not limited to hours when the bus is in service.
The Healthy Options vehicle shares a tangible relationship with the Contact Centre, which grew from the shell of the former Days Inn at Young and Hocking streets. To transform the motel, its furnishings were removed – and some wound up in the bus.
Explained Mohan, “The two dressers we have (in the mobile clinic) are from the Days Inn, and the benches and tables we’re sitting at were built from wood recycled from Days Inn furniture.” It’s part of an agency-wide “green” commitment to recycle whenever possible, she said.
Lloyd said the mobile HIV/Hep C program has more than 400 users. She and Mohan can recite precisely what clients come for services, without knowing a single full name: To ensure confidentiality, users are identified only by their birthdates, but their data is compiled by age, sex, residence, health, addiction, etc.
The program’s impact goes far beyond those who come to the vehicle, and last year there were about 2,500 visits. Lloyd said that each visitor typically returns and/or picks up supplies for two or three others, since “most users don’t use by themselves. They’re making a trip for their household.”
Some clients drive from Agassiz, Hope or Boston Bar to serve 10 or more friends who don’t make the trip. It counts as one visit from one person, said Lloyd, but the outcome is far more significant.
“Over the years, our users have come to take responsibility for ownership of the program,” according to Lloyd. “They’re proactive. They will actually challenge other users if they find syringes lying around. I think that shows they trust us and believe in what we’re doing.”
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