Tuesday, September 13, 2011

Harm Reduction?

This past weekend, I facilitated a workshop in Sault Ste. Marie on improving the health of the community targeting infectious diseases.

As many of you know, I work with a program of the Ontario Lung Association, called the Youth Advocacy Training Institute (YATI) as a workshop facilitator. The curriculum for this workshop was new to me, in particular the focus on infectious diseases (in this case, Hepatitis B, Hepatitis C and HIV).  And so I spent the greater part of the week prior learning all I could on the topic. While doing my background reading, I got to learning about all sorts of approaches to drug policies which I had never really thought about at much length before.  

A while back, I did a blog post on the use of methadone as a treatment for heroin addicts. This is just one example of harm reduction in general. In the 1980s, when HIV/AIDS was growing as a public health threat, it was apparent that stopping the use of illegal drugs would not happen fast enough to stop the spread of the disease. As people who feared getting arrested for their drug use were not getting tested, harm reduction became a more widely used approach to preventing the spread of HIV/AIDS. In short this includes providing education about the dangers of sharing needles, distributing clean needles and cleaning kits and giving out condoms.

Harm reduction programs operate under the assumption that some people who engage in high-risk behaviours are unwilling or unable to abstain from it. So the support becomes about making drug-use safer. On the grander scale, it seems that harm reduction is based on incremental behaviour change, and the hope is to go from safer drug use to abstinence eventually. Prior to this, a zero tolerance approach was more common when it came to narcotics. Criminalizing drugs, and creating a war on drugs was thought of as an effective deterrent. Both are interesting approaches to dealing with drug use, because at the root of it, they use different assumptions on human nature.

When I was younger, everything used to feel so disconnected and compartmentalized. Politics, law, society... I knew they all came together but I never thought about how all of these policies are based on what we assume about human nature. Questions about whether people are able to change, whether fear of punishment will keep people from doing "bad" things, what "bad" is and motivations for us doing what we do are all part of considering how to approach illegal drug policies.

I personally feel conflicted about my thoughts on harm reduction. I do see how it can seem like a gateway to making drugs acceptable in society. On the other hand, we know drugs are not going anywhere. As the safe-house in Vancouver has demonstrated, harm reduction efforts can be effective. At this location, drug users inject themselves, but with clean needles under nurse supervision. The rate of fatalities based on drug use decreased, not to mention the spread of infectious diseases from dirty needles. But is this really helping people? Are people quitting eventually and with support, or does this just keep users sustained on drugs but alive? 

Coming from a tobacco control background, I see how policies to ban various ways of promoting positively impacted the reduction of smoking in North America. The underground nature of illegal substances, and widespread availability and prevalence provide an interesting consideration. Does punishment work as an effective deterrent? I mean, the prison system is based on this concept, along with of course, rehabilitation. But aren't there always going to be people who are drawn to high-risk behaviours? 

This conversation does not even bring into play the fact that there are plenty of legal drugs that cause harm to people and policies have yet to create effectively how to manage those forms of addictions. From what I've learned though, harm reduction work is vital to addressing the existing drug use problems. I think it is important to provide clean needles, condoms and knowledge. In London, I saw harm reduction pamphlets teaching users (in comic book form) about shooting up, and why certain spots are more dangerous and the different between arteries and veins. It seemed contradictory, but I understood why this was important having met people who were already so dependent that sending them to prison for their drug consumption would do nothing for them.

Harm reduction is just the start. There's so much more to consider and once safety concerns can be addressed, risks reduced even a little, steps can be taken to help the user become less dependent. I still have a lot more to learn on the topic, these are thought based on what I've learned recently. I'm curious to know more from people who've been around it or know more about it, and the assumptions they feel these policies are based on.

Tuesday, August 30, 2011

Lessons from Abroad

It's been 13 days since I've been back, and in this time, the most common request I've had from family and friends has been to summarize my most memorable moments. It's a difficult task at best, because the entire experience has been such a learning process. It's hard to pinpoint the defining moments of growth, fun or change but I am going to try to share the more overarching lessons I've learned from spending almost 3 months living in Europe.

1. On Humility and Dignity 
This is a lesson I learned from working at Thames Reach. Being on the streets and talking to people who were homeless taught me about humility and dignity. One of my most memorable experiences occurred during a friend-raising event I helped coordinate with the fundraiser on staff. We held an open evening where we invited a small group of long-term donors to come visit our offices, see what our outreach team does and chat with a previous service user (rough sleeper) turned employee of Thames Reach as well as our chief executive.

Quite often, the service user's story would be thought of as a "success story." But I do not like to think of it like that, because as much as it is about someone's success, it is at the heart of it, someone's story. A story about having the courage to change their life and to classify it into a box does not do it justice. He shared how low he felt, how little faith he had in himself, even when he found himself off the streets and into housing. He talked about the lack of motivation, lack of social skills and the fear of not knowing how to move forward or find the strength to actually do something. And so much of it resonated with me because while I do not share his experiences, at times, I have experienced some of those feelings. Listening to his story was quite humbling. I learned about dignity, of learning to value yourself and your ability to not change, but grow and that is a lesson I can say changed how I view the world. 

2. On Learning to Enjoy Your Own Company 
I had set aside two weeks following my internship to explore London on my own. While it was something I had really wanted to do, I feared it. I was afraid of feeling alone, especially in such a big city. I wanted to love it but I never expected to feel so liberated. I saw the Tower of London and Buckingham Palace alone, and it was pretty great. I was able to see things the way I wanted to, spend time on what I wanted to do without considering anyone else. I ate three course lunches alone, something I worried I would feel embarrassed to do but it was quite nice. This is not to say I do not love spending time with others, but I do recommend spending time alone and not just indoors. For me, it built confidence to know that I can enjoy my own company.

3. On Letting Go 
I am a person of lists and plans, and I hang onto security very tightly. However, my trip taught me to let go and not be so rigid. I sometimes left the house without a plan and it was great! Of course, it's not something we always have the luxury of doing when we're at home and have things to do and places to go to. However, the experience of not knowing where I was going or how to get there taught me relax, adapt and enjoy. Once you're not gripping onto something, everything feels a lot easier.

4. On Travelling
Lessons in travelling? Less is more. Don't panic. Trust yourself. Explore. Eat. Always carry cash. Talk to people. Adapt. Buy tickets online for whatever you can and google when the best times to go are to avoid waiting. Google everything. Try things you've never tried. Try to speak the language. Ask for directions. In London, always carry an umbrella. Buy good shoes. Take lots of pictures. Have fun!

5. On European Work/Life Balance
In London, the culture was not as uptight as I was expecting. If anything, working there was much more relaxed. As important as it is to work hard, having a life (so to speak) was equally important. I appreciated this at my organization, where I felt my life was so much more than just work. And that is not to say work is not important at all, but there is such an emphasis and value placed on your own time and this I truly loved. I found that it made me more productive at work because I felt content. I hope that as I start my career here, that is something I am able to maintain because one thing cannot define anyone (i.e. your job), nor should it.

6. On Independence 
Lesson #2 was about learning to enjoy your own company, but this is about being responsible for yourself and learning to trust yourself. This is perhaps my biggest take-away, knowing that I am able to take care of myself, find my way around and rely on myself. Mind you, coming home and finding my support system here again was wonderful. Because as much as you can take care of yourself, sometimes it's nice having someone else do it!

Monday, July 25, 2011

Paris, Je T'Aime.

I spent the past weekend in Paris, and I did not know if it would live up to the expectations that have taken years to build. But in the 72 hours I spent there, it was everything I thought it would be and more. I fell in love with Paris.

I will be honest here, when we first arrived in Paris via coach and pulled up past the Eiffel Tower, it was sort of anticlimactic. It was a giant gray metal structure, and admist the rain, did not seem like anything special. But at night, with the lights, it was something else.

My favourite moment was perhaps Friday night when my friends and I went to the Eiffel Tower at midnight. We saw it lit up first from the top of the stairs from Palais de Chaillot and it took my breath away.

As we walked closer, and saw it from all angles and watched the light show, I knew it was one of those moments in my life I would always remember.

I think my fascination with French culture started sometime during Grade 12 World History and learning about absolutist monarchies. I did a paper on Louis XIV and learned about the ch√Ęteau de Versailles, the grandeur of which, for someone who loves all things shiny and gaudy, further piqued my interest in French history.

In person, it was quite honestly one of the most amazing things I've ever seen. However, we were herded through the castle like sheep, pushed and prodded without any time to stop, observe and appreciate. The crowds were mean and pushy, parents with little kids attempting to run through the ropes and people stopping for pictures in the middle of the display were really bothersome.

We paid the extra fee to go into the gardens as savouring the castle experience was really not possible. This was even more spectacular than the castle if you ask me. I cannot even fathom how someone dreamt up the layout and the design. It was beyond incredible, and much less crowded. The water, the flowers, the view - it was something else.

Perhaps what I am most interested in is the French Revolution. From the Enlightenment to the French Revolution, starting with hope in the spirit of liberty, equality and brotherhood, and ending in terror leading up to the Napoleonic wars - the whole process of transformation, for me, is just about the most intriguing historical event ever. And that's just the beginning. From my many courses in French history, I have learned about art, fashion, food and wine. I have learned about festivals, architecture, music and interior design.

I did not get to go to Bastille, or to any of the museums really. But I did get to eat, and wow, was that an experience! Duck, bagettes, cheeses and wines, chocolates, crepes and pastries - I don't even know what I liked more!

One of my favourite experiences, however came on the last day while I was walking along the water with my friend Taylor, and over the many gorgeous bridges. One has locks all over the railings, and it was just amazing to see how many people had put locks on it with the names of their loved ones. On the river siene, we were in time to enjoy the Paris Plages. I loved it, it was set up with sandy beaches, deckchairs, palm trees and ubiquitous ice cream sellers. It allows city-dwellers and those who cannot afford a beach vacation an opportunity to enjoy a day escape to the sand.

There is so much I have left to see and do in Paris. I wish I could summer there, the way I am doing in London because I do not think even a week would be enough to truly understand and appreciate all that the city has to offer. I really just sampled Paris, and I am so glad I was able to, in particular, enjoy it with some of the other interns who truly made this experience even richer.

This is definitely not a goodbye, in fact, it is just the start. I hope to be back there as I soon as I can afford it. Till we meet again... au revoir Paris, je'taime.

Wednesday, July 20, 2011

Night Shift

I arrived at work yesterday around 7:30 PM for my first late night shift. It was a shift with London Street Rescue (LSR), which is not the outreach team I normally work with. If you look at the map below, the pink dot is the borough I work in with the Tower Hamlet Street and Outreach Response Team (THSORT). Thames Reach has some specific SORT teams in boroughs like mine as well as LSR which covers 20 boroughs. Any borough in white below does not receive services from Thames Reach. (The green dot is just to show where I live for anyone who is curious - I am a 5 minute walk from King's Cross and St. Pancras station.)

My shift was specifically a No Second Night Out (NSNO) shift. This is a pilot project in London, a scheme to end rough sleeping by 2012. The main objective is to have no individual arriving on the streets sleep there for a second night. According to their own blurb, other projects exist to support those already rough sleeping. NSNO aims to prevent someone new to rough sleeping from spiralling downwards into a long term life on the streets where they are very vulnerable to crime, drugs and alcohol, and at high risk of serious illness, and potential early death.

Currently the focus is on Camden, City of London, Tower Hamlets, Westminster, Hammersmith & Fulham, Kensington & Chelsea, Lambeth, Brent and Southwark. If the pilot goes well, it will be extended to the rest of the London boroughs. Of course, it's all a little convenient to have this date set just in time for the summer Olympics. However, at the same time, whatever gets a project funding and contributes to helping people not become entrenched in a cycle of rough sleeping is valuable in my books, political motivations or not.

A major problem in London is that many new rough sleepers are not from Britain, but rather from Central Eastern European (CEE) countries. Since 2004, 10 CEE have joined the European Union, this makes it a lot easier to cross borders and start lives over in the UK. However, the problem is many do not find legal work and sometimes have drinking problems all which lead to rough sleeping. It is a difficult problem to address, because if you just moved here but will not be working, it is not fair to expect welfare services to provide for you. At the same time, you have to wonder about people who would rather sleep on the streets in the rain in London than go back home, and your heart sort of bleeds for what you're sending them back to. Quite often though, many do not speak English fluently, and communication between outreach teams and the clients are challenging. Sometimes I do wonder if they would not be more comfortable in their home country, where at least language would not be a barrier

NSNO works with mostly CEE clients, as that is the population that is generally becoming homeless. If the clients have worked legally in the UK and paid taxes, they can qualify for benefits and NSNO will help set up appointments and things with resources like job centres to help them. There is a separate team called Reconnections that works mainly with CEE clients to help find their way back home. They can connect clients to services in their home cities, find family members and facilitate the process of going back. It is a really tough situation, especially when there is a language barrier and people are rough sleeping to know what is the most appropriate course of action. Quite often though, the reluctance to be "reconnected" (or I supposed "sent back" depending on how you want to look at it) is quite high. Sometimes there is embarrassment at the thought of going back, and other times they still feel there are more opportunities here, or they have nothing to go back for.

Last night we met a Polish woman in Hammersmith. She was lying on a doorway when we went to the sleeping site. We only go to sites that were referred to us on these NSNO shifts, and so we knew that this was a location she had been seen at. When we found her, she was drunk and sleeping. She did not speak any English, and trying to communicate with her was was very challenging. For NSNO, when we find a referral, we take them back to a place ominously called The Hub. Here they receive an assessment interview in their native language to see if they can be connected with resources here or want to be reconnected back home.

Trying to explain to her that we wanted to take her to a safe place because rough sleeping is dangerous is most definitely one of the most taxing experiences I have had here so far. I felt horrible for her because she had no idea who we were or what we were trying to say. She was drunk and confused, and we were trying to convince her to get into a van with us. I mean, thinking of it from her perspective, that in itself (getting into a van with strangers) must have felt more dangerous than sleeping in the doorway.

She was upset, and she loudly sobbed. I wanted to pat her on the arm, but I do not think physical contact is allowed. After using many hand gestures and repeating simple words like "safe place," "sleep" and "help you" we convinced her to come into the van. As she was sobering up, she was getting more annoyed at not knowing where she was going, and calming her down was not an easy task. We could not really offer the support she wanted, so we called a coworker who speaks Polish to communicate with her and explain where we were taking her. After the phone call, she cried for a bit longer, but then it was as if she forgot the conversation and she started asking where we were taking her all over again.

The difficult part was not just the communication barrier, but also that she was very intoxicated. At times, I felt bad and at other times I would get frustrated and to be honest, at moments I would feel quite annoyed. I felt horrible, but when she shouted "please give me cigarette," it bothered me that that was a phrase she knew but words like safe place were not in her vocabulary. However, my emotions were all over the place with the whole situation, fluctuating between concern and annoyance. I did however want to know that she would be okay. From the phone conversation with our coworker, we knew that she had been here for years and years, had paid legal work and previously a flat and should be eligible for benefits. This did ease my concerns, as I know reconnection is quite often the only option for CEE rough sleepers who do not speak English or have work prospects here.

The rest of the night was spent looking for referrals we could not find. I do not think I will ever get used to the incapacitating smell of urine and alcohol, that is quite often in some sites where some rough sleepers sleep. Doing the night shift really affected me more than the day shift, because at night, rough sleepers seem more vulnerable, when you're catching someone at the end of their day. I'm not sure how I feel about NSNO just yet but I am hoping to get to do one more shift before I leave. I think it is great that the plan is help rough sleepers before they become entrenched in this lifestyle, but I do wonder about the places clients are leaving from and what their life must have been like before that returning seems unfavourable. It's difficult to find someone and not see them through to the end, but there are different workers involved at every stage and this is probably what keeps things orderly and systematic.

I cannot believe I have only 2 and a half weeks left here, and then it's back home and to the Mississauga Food Bank. I've really grown to appreciate the programming side in a new way. It's very humanizing. I wonder how it will be being on the fundraising side once again when I return home.    

Friday, July 1, 2011

A is for Alcohol

I've had the most difficult time deciding how to start this entry. The topic is a loaded one, and one where my experiences are varied in a way where I know a little, but not enough. I spent my morning at a drinker's hostel in Tower Hamlets, where I'm working as an outreach worker with homeless people and it was definitely an eye-opener.

It's odd to think that for the average university student, drinking is about having a good night and waking up with some regrets and a bad headache. Binge drinking is a recurring activity, and often associated with fun. Movies like American Pie perpetuate a world of partying and boozing that is all light-hearted and easy. While, there are always consequences, they never really seem that bad and even out of control drinking seems within control.

What I saw today would be the total opposite of that. The drinker's hostel is one that accepts clients that really wouldn't be accepted elsewhere because their alcohol support needs are so high. When I walked in, the air reeked of pee and cheap beer. It was incapacitating and I found myself sniffing my sweater for comfort. The client we were meeting had woken up 20 minutes prior to our arrival. He had stitches that needed to be removed (injuries from falling down while intoxicated) and we were taking him to the hospital so that it got done. He's a very impatient man, and without someone there, likely he wouldn't have gone. Before leaving, we suggested he have a glass of water, but his instinct was to pour a glass of super strength lager (someone else's) and drink that first. His hand shook as he poured.

He's frail and had difficulty walking to the hospital about two blocks away. Watching him, I realized how debilitating alcohol can be, and it scared me thinking about how easily this sort of addiction could happen to somebody. Unlike drugs, which are illegal and have a different sort of stigma about delinquency, alcohol is not only readily available, but also acceptable. Although of course, people expect a certain sense of balance, and I guess the difference between a frat party and a drinker's hostel is the difference between alcohol consumption and alcohol dependency. Our client had the shakes, he could not stand straight, or take regular steps. We had to take the elevator up one floor, and have him lean against a wall instead of wait in line. He had barely had a drink when we'd seen him, but the effects of alcohol are long-lasting.

It's difficult to reconcile these two contrasting views of alcohol consumption, whereas one is seen as de-stresser and the other can pull apart someone's life. Our client has siblings, had a wife and child, a job, a home and really, a life full of people who loved him and cared about him. After his mom passed away, his addiction to alcohol took over, and now his days are spent in this hostel, drinking. It breaks my heart to know that this is someone's reality, and I cannot imagine what it would take to break the cycle. How does something that is so accessible, and accepted in society, especially in London (where you can buy alcohol at a 24 hour off-license anytime of day) become avoidable?

It's strange to think that alcohol, something you can sip with dinner, or use for "liquid courage" before a nerve-wrecking moment can be so lethal. In the past two weeks, I have met so many clients who are on benefits, and really do not do anything but drink all day. Working becomes impossible, as does maintaining relationships when your addiction takes over. And rehab is sometimes not effective, because the temptation is far too easy to give into after getting out. In many situations, I have wondered if the drinking led to the homelessness or if being homeless enabled the addiction. It doesn't really matter, just that there needs to be effective ways to address alcohol dependency so that some of these people can get their lives together. I don't know how someone who has spent more of their life drinking than they have working finds the motivation and support to break the cycle and go through the motions of building a life.

In London, there is an added issue (that may exist at home too, but I just don't know about it) of super strength lagers. Alcohol in London can be bought at any hour of the night from just anywhere that is open (gas stations, convenient stores, grocery stores, etc.) Alcoholics are buying 9% proof lager and 7.5% proof cider at rock-bottom prices and then spending all day binge drinking it in large volumes. It is cheap (some less than £1 for twice as much alcohol in one unit than recommended as acceptable daily intake), really harmful, and readily available. Research suggests that increasing the taxation on it would deter consumers of super strength lagers, but passing this policy has been a nightmare.

As it stands, approximately 50% of rough sleepers have an alcohol problem, and half of them have an addiction to super strength lagers. Frontline workers at Thames Reach (where I am interning) have plenty of evidence of rapid deterioration in health caused by super strength lagers, and an escalated dependency. When I was at the drinker's hostel today, I noticed a 2L bottle of White Ace that cost only £3.49. Ever since learning about super strength lagers, I am so easily able to spot it and it is amazing how many homeless people I have seen with half empty cans of "Special Brew" beside them.

A campaign Thames Reach has worked on has been to advocate for policy to increase taxes for brewers to make it economically nonviable to produce them for mass consumption; hard-hitting health warnings like those on cigarette packets indicating that consumption of a single can will lead to exceeding the Government's daily recommended safe alcohol limit and risking damaging their health; and creating a 6% strength ceiling on alcohol content for canned and bottled super strength lagers and ciders. Of course, this has not been easy or successful necessarily. It's amazing that something that seems so simple to benefit society can become so political when it involves corporations and money.

Over the last few weeks, I have seen so much of how different peoples' lives have been affected by different factors. Alcohol is one that has been interesting because I have of course, known alcohol in a completely different sense. To see how it impacts individuals who become dependent, who drink all day and cannot work or get out of poverty because of it... it's a new dimension to how some become homeless and why they sometimes stay that way. I'm very interested in continuing to learn about alcohol and drug support needs, and the sorts of policy around it. I feel that learning about the policies that exist and how they are failing society is what would bring about change.

Thursday, June 30, 2011

The London Experience

I have scavenged the city trying to find the kitschy things I associate with the UK. When I first arrived, red telephone booths and double-decker buses made me really feel like I was here, like everything I had only seen in pictures were really true.

I love all the old buildings. London is such a mishmash of the old and the new, and has such a rich history mixed with a sense of modernity.

While the English weather is not my favourite thing about being here, I do love how these storms remind me of Harry Potter! This picture was taken right before it poured at King's College Chapel in Cambridge.

I loved Cambridge. Beautiful, cosy, and the type of place I dream of living in.

The city was filled with gorgeous churches and courtyards. 

Last Sunday, it was quite positively the warmest day we've had so far (all of 25 degrees Celsius). I love how the streets filled with thousands of people, at the parks, in shops and restaurants. This picture was taken as I was walking past a part of Hyde Park. It was crawling with people enjoying (and complaining about) the weather.

Pretty much every area seems to have its own market. It's quite lovely, the sense of locality and community. This was taken at Borough Market, mostly a market of fresh food and local wines.

This picture embodies two things I love about England. First, the guard reminds me of all things royal. Second, it was taken at Harrods, retail wonderland and shopping haven!

Although I haven't had the opportunity to mingle with many Londoners, I have really enjoyed getting to know and share this experience with the other interns. This was taken at Electricity Showroom in Shoreditch (home of the hipsters).

This picture was taken at the Ministry of Sound, when Fedde le Grand DJed. I've enjoyed experiencing new things in London. It has been amazing to explore, and try new things.

Friday, June 24, 2011

A Lesson on Methadone

On Monday, I shadowed an outreach worker who was meeting with a client just released from prison the previous week. There was a mix-up with his release, and he was sent out without his paperwork. This was a major problem as the client was a drug addict who used to do heroin. During his incaceration, he was sustained through a prescription for methadone (script). When we met with him, he had been without his script for 3 days, and he was anxious and unable to focus for very long. He was having a difficult time coping without his script. 

Prior to starting work at Thames Reach, I had never heard of methadone or Subutex. Once I started looking into methadone, I realized how prevalent it is - not just in the UK but throughout Canada as well.

Methadone is a synthetic opiate manufactured for medical use that has similar effects to heroin so it curbs withdrawal, reducing some of the more serious side effects and offers more more hygienic course of treating addiction. It is a sedative that depresses the nervous system, slowing down body functioning and reducing physical and psychological pain. It causes relaxation and detachment. Methadone does not deliver the same high and allows people to stabilize their lifestyle without experiencing withdrawal symptoms. That is not to say there aren't problems with heroin withdrawal symptoms, but it is much less severe. This form of opiate substitution therapy generally leads to a reduction in dosages until the user is off the drug completely.

I am not sure what I think of this type of treatment. I am in no way an expert in this field, and this is not so much an opinion as it is thinking out loud. I am not sure I understand using drugs to replace drugs as an effective practice, just because one is considered "less harmful" than another. From what I have learned, users sometimes stay on this form of treatment long-term, spanning decades. While I cannot begin to understand how difficult detox is, and how stopping heroin use can be debilitating, I do not see how a sustained script can be helpful in living a clean life.

As I began to learn more about this topic, articles were published about a report by The Centre for Policy Studies, a think-tank suggesting that Britain spends £730m a year on maintaining methadone addicts. Methadone prescriptions are part of harm reduction efforts, started in the late 1980s as a way to prevent the spread of HIV/Aids, and considered more of a concern than creating policy around drug misuse. However, since the release of this report, a bitter row surrounding the merits and consequences of heroin treatment has been brought to the forefront. I think there is a lot of different issues at stake, including how taxpayers feel at a time of recession, as well the impact on the drug industry if other forms of treatments take precedence, so I am sure this debate will continue.

It is interesting though that methadone is considered to be more of a normalizer than a narcotic, as users are able to function without impairment. However, from what I have seen from the client who was really anxious without his script, it does seem that there is a certain level of dependency on methadone for functioning. Is this that different than drug treatments for depression or anxiety? I'm not sure, if it helps someone function and maintain a healthier lifestyle, perhaps it is useful. On the other hand, would rehabilitation services that help users off drugs completely not be more beneficial? Surely, heroin created the problem and it was not necessarily a natural anxiousness that needs to be addressed but rather withdrawal. Of course, as with anything, a one-size-fits-all solution is not possible, but it is rather important to consider how beneficial drug policy is in helping addicts live a better life without costing others who have managed to steer clear.

Alcohol dependency is another aspect that I am learning a lot about, as it seems to be very closely linked to homelessness (though of course that is a generalization) and I will be posting about it soon. I am eager to understand the many aspects of policy that affect homelessness, even if not directly. Drug misuse, alcohol dependency and the welfare system all play such a pivotal role in this issue as street homelessness seems to be an amalgamation of factors and a very cyclical problem.

Wednesday, June 22, 2011

5:30 AM

This morning, I woke up at 4:00 AM. I had a sore throat, runny nose, congestion, slight fever and was running on exactly 2 hours of sleep. I was tired but I knew I did not want to miss my first 5:30 AM shift, and let me tell you, I am so glad I made it.

The taxi driver came early, so I arrived outside of the office at 5:15 AM. I walked around the empty neighbourhood that is normally so busy. I work in East London in a borough called Tower Hamlets, which is an area that has a history of being one of the poorest in Britain. However, it is also rife with culture. It is now an area of predominantly Bengali people and stores, though in the past it used to be mostly Jewish. I work minutes away from the famous Brick Lane, known for its curry houses. Walking around the area so early felt like a scene out of a movie, maybe like 28 Weeks Later as it was bare - just me and the birds. It was beautiful and a completely different London than what I've come to know in the last 10 days and really, just a good start to my day.

At about 6:00 AM I was briefed about how the day would work. We were going to go to "hot spots" where groups of homeless people rough sleep together as well as check out some of the spots where we were told people would be sleeping. We usually get referrals (via email or phone) with the names or descriptions of rough sleepers and the areas they were noted bedding down. Bedding down literally means where they were setting up to fall asleep. Once we verify that they have been rough sleeping, our team can work towards finding ways to help these individuals.

When we arrived at the first spot, it was empty. There were some pieces of cardboard, often used as padding to make rough sleeping more comfortable. There was no one rough sleeping though and I thought maybe it would be a slow day.

But as we started travelling through the borough in our van, and stopping at other spots, we found people sleeping on ledges, under bushes in the gardens, under awnings in less populated areas and on pavement by the gardens. We would generally go up to where they were sleeping and wake them up with a gentle good morning, and let them know we're from outreach. Not all are excited about the early morning wake-up call, some ignored us, some were in deep sleep and didn't hear us. We generally start a conversation, asking questions about their name, how long they've been rough sleeping and where they're from. Based on their answers we suggest they meet with us to further discuss options for how we can get them off the street. Some are known rough sleepers and we are really just checking in to see how they're doing.

It was unlike anything I have ever experienced before, finding people in these spots and talking with them. It was my first shift so I played more of an observer role and watched a coworker interact. I am so impressed with the team of people I work with, they are compassionate, helpful and knowledgeable in ways I would love to and hope to be. Watching these interactions was eye-opening, learning about people and how they ended up where they are. Most of rough sleepers we met were Eastern European, and the services offered to them first and foremost would be "reconnection" (a project I will delve into sometime in the coming weeks) if they hadn't worked here legally. From one to the next, all the interactions were different, and all of them pulled at my heart strings in new ways. I am still trying to wrap my head around the circumstances which puts people on the streets.

We met with clients who lost their jobs and couldn't make rent, clients who've worked here illegally, and ones who couldn't work because of injuries. We met clients who didn't want to talk to us, or give us their real names and clients who were smiling and ready to chat with us even though it was so early in the morning. Many had been drinking the night before. One gentleman wouldn't make eye contact, and another kissed our hands. It's a different world than anything I've known, but the experience makes you realize what we all have in common. With or without homes, we're people- in different situations, and junctures in our lives but it doesn't make us any less human.

The services offered really depend on their circumstances, and for some of the people we met, options are limited. Some are stuck without really any way of finding peace, and these situations are dealt with all on a one by one basis. I like that individual attention is given, and that care is taken to learn someone's name and circumstances. It makes everything so much more real, more than statistics. I still have so much to learn about this sector, and the efforts taken to deal with homelessness in London but I feel like I'm finally grasping the process of how outreach works and am getting ready for more responsibility on the job.

Tuesday, June 21, 2011

Why Fundraising?

A recurring question people ask when I tell them that I am doing a postgraduate program in fundraising is why?

When I first chose the Humber Fundraising and Volunteer Management (HFVM) program, I had very different reasons for why I thought it was right for me than I do now. It was only when I started the program that I really learned why fundraising is exactly what I'd like to do.

I did my undergraduate degree in Global Development Studies (DEVS) and History at Queen's University. No one ever knows what DEVS is. It's an interdisciplinary program focusing on theoretical concepts of development; it's about understanding the history of global inequality through courses in politics, economics and history. This program had a profound effect on how I think and look at the world. It taught me how to think critically but at times, it was very disheartening. To learn about how people have treated each other in our world history is both horrifying and heartbreaking, from slavery to genocides. To realize that my experiences of wearing shoes, owning a computer and drinking clean water is not accessible to most of the people on this planet is something that I still cannot wrap my head around, let alone getting into the rights and freedoms I am (or not) granted based on where I was born and live.

The program left me with a fear that nothing I did could change the world for the better. Ever since I was young, I have always been passionate about two things: people and helping. I thought learning about the world would make it easier to learn how I could combine those interests but it made it harder.

As much as I have always wanted to help people, I have also always leaned towards interests of a less noble nature. I've always loved fashion, trends, and been fascinated by a ritzier lifestyle. I always imagined myself working in a fast-paced office, dressing up to work. When I was younger, my dream was to be just like Jennifer Lopez in The Wedding Planner.

I stumbled upon the HFVM program while researching public relations programs. I read an article that suggested fundraising was sort of like public relations for non profits and it seemed like the perfect balance for me. It would allow me to work for a cause I really believed in, raise money to make a difference and yet manage some of those lifestyle options I wanted, like getting dressed up for work on some days (of course depending on where you work).

As I started the program, I had a hard time adjusting to the practical side of knowledge. My undergraduate program left me criticizing the methods I was learning, of whether they would really help to create an impactful change. But as I gained more knowledge in the field, I began to reconcile critical thinking with a certain hopefulness. Fundraising is a vehicle towards creating change. The more important part for me would be the cause I choose to work towards. And I gained a sense of belonging.

There are so many different options within the field, and a world has opened up to me that I had not known existed. I know many older fundraisers happened upon the field, but for me, it was a choice I made straight out of university and one I would not take back. Fundraising is the balance of creating change, building and managing relationships and working with people. It provides the opportunity to work in events and communications, which always interested me but leaves a sense of satisfaction knowing that the money I would help raise would go towards helping people and making a difference in something or someone. Of course, maybe this is from the point of view of someone who has just dipped her toes in the water. Talk to me in 5 years, maybe I'll be singing a different tune.

Monday, June 20, 2011

An Introduction to Homelessness in London

Homelessness is a sector of its own in London. With a population of over 7 million in 32 boroughs, it is the largest and most densely populated ciy in Europe. London is full of life and culture, it is a world of its own and as such, draws people in from all over the world. People seeking new opportunities, but may be who have not yet realized how competitive and expensive city life can be. There's no surprise then, homelessness is an issue.

Each borough in London has a strategy for how to tackle homelessness within its borders. There are services offered from hostels and supported housing assistance and employment workshops to advice and support services. I am working in Tower Hamlets with the outreach team at Thames Reach, who focus specifically on those that are rough sleeping. Rough sleeping is exactly what many think of when they think of homelessness, it describes those sleeping rough on the streets. Others may be sleeping in squats (spots like abandoned buildings and warehouses, which are extremely dangerous and provide little protection and do not qualify as an address, let alone a home).

In the last few days, I have learned so much about homelessness in London. It's fascinating how multifaceted this issue is, and the partnerships that exist to help someone out of rough sleeping. I have no knowledge of how homelessness is tackled in Toronto, but the strategies and process in London is nothing short of impressive and intricate.

Rough sleepers can be referred by anyone from the public or those working within the field to be met by the outreach team. In addition, the London Street Rescue team is out every night to meet with those that are homeless. Rough sleepers are helped out by the workers assigned to their borough, and must have a connection to the borough to receive services. If they are sleeping somewhere where they do not have a connection, they can be referred back to their hometown. Workers develop relationships with rough sleepers, who sometimes can be reluctant to accept help. It may seem ridiculous, but imagine how isolated someone must be to sleep on the streets night after night - I'm sure they sometimes feel let down and fearful of trusting others.

Rough sleeping in London is sometimes deeply connected to alcohol and drug misuse and mental health issues. I cannot say I am surprised, I assume a lot of it is a coping mechanism as well as an addiction. Destitution, of course can lead to deviant behaviours. The help clients are offered depends on their situation, their willingness to accept it and the availability of resources. Outreach workers work with individuals to get them the services they need, and if not, to keep track and develop a relationship. Clients are treated as individuals to be respected, and outreach workers know the names and stories of those they work with.

There is a database where all the information of individuals helped by homeless organizations is recorded. I find this amazing, it demonstrates the extensive work with the homeless done in London. Updates are recorded about their whereabouts. Non-national homelessness has a separate strategy, often dealing with "reconnection." (I will write a separate post about this, as I will be doing some work with this team as well!)

Day centres provide opportunities to wash up, shave, get something to eat, use a computer, etc. for those that are rough sleeping. Homelessness in London seems to be an issue that is taken seriously, and organizations like the one I am working for are developing strategies towards creating a lasting change. I have so much more to learn this summer and I can only imagine how much my views will change as I gain exposure to clients and their stories, and more about the governing systems in place to deal with homelessness.

Friday, June 17, 2011

Where Are You From?

I hate this question. I understand why people ask, but I hate it just the same. I know, for some people it is a pretty straight forward response but for someone like me, having grown up in a mixture of cultures and values, it is not easy. Add to that the fact that some people believe that where you are from determines who you are and what you stand for, it becomes a contentious issue.

A recurring conversation I've had:
Where are you from?
But where were you born?
In the Middle East, Kuwait actually.
Okay... but where are your parents from?

So, where am I from? What does "from" even mean? I have no idea, I'm from everywhere and nowhere. Identity is such a funny thing. I find myself in situations where I relate to what is convenient to me. For example, sometimes I am so proud of being Bengali - I'll post messages on Facebook celebrating different cultural milestones. I can speak Bangla, a language that my father fought for in the Bangladesh Liberation War. But there have been times where I have walked into a shop, and I can hear them speaking Bangla and I secretly hope they can't tell I'm one of them. I'm not sure what it means, to be Bengali and Canadian, of when I accept which part. I thought it was okay to be a mutt, but when someone probes further it makes me feel culturally homeless.

I would consider myself a global citizen. I think global citizenship is the new way of the world, with cross-cultural sharing and evolving immigration patterns. Global citizenship allows for a complex understanding of differences in cultures, languages and people in general. It allows for integration of cultures, religions, ideas and language in society. It breaks down the walls of stereotypes, racism and discrimination. For me, it's given me the opportunity to learn so much about people and question why people think what they do, like what they do, believe what they do. My multinationality (which should really be a word) has allowed me to really consider what I believe because I believe it and not because I was conditioned to think it.

But at other times, it's hard. To not identify wholly with any particular culture makes you feel sort of without a home. A sense of belonging that isn't there, never knowing which flag is yours because your situation is unique. And although I know many family friends share an understanding of this, our experiences are still so different, based on which parts of which cultures we've picked up or discarded. I think though, more than anything, being in London makes me feel Canadian.

To me being Canadian means I can still be Bengali, born in the Middle East and living in Canada. It gives me the option to keep the other parts of me and still identify with one nation. And so when someone probes me further than me saying I'm Canadian, it annoys me. To have to defend this as a nationality because I may not look like a "typical Canadian." At the same time, I recognize that I am not completely Canadian, because although my passport is from there, my history is not. Perhaps someone whose family has been in Canada for generations does not appreciate being painted by the same brush as me. It's hard to know what makes someone from somewhere.

I'm not sure I'm any further in understanding "where I'm from," but as difficult as it is to define, it's interesting to consider.

Monday, June 13, 2011

Random Acts of Kindness

I arrived in London with 88 pounds of luggage. I am (almost) 5 feet tall. Needless to say, I had not thought through the process of getting myself + 88 lbs in three wheelie suitcases + 2 shoulder bags with only 2 hands... from Gatwick to my residence by King's Cross.

And so here I was, in a city I had never been to, ready to embark on a "life-changing" summer, but feeling a little alone and a lot stupid. I used a trolley and enlisted help from a porter to help get me to the train station from the airport, still feeling a little down and a lot overwhelmed. Trying to get off the train was the worst because the doors close pretty effing quick and everyone around me seemed more annoyed than anything else.

As I contemplated what to do next, an older gentleman who had already walked passed me turned around and came back to offer me help. He asked where I was going and when I told him King's Cross, he said he was headed that way too and asked if I needed help carrying my bags. My mom had told me not to accept help from a stranger, however at this point, I was pretty much desperate. With a little apprehension, I said yes. As I walked towards the platform, with him wheeling my suitcase beside me, I began to question whether this was a good idea.

And then the guilt set in. I was in a brand new city, feeling lost already and a stranger was kind enough to offer me help and there I was, questioning his motives. While not all strangers have good intentions, we live in a society that is built on trust. You pay for your meal after you've eaten it, you pay for your cab after you arrive at your destination and so on. It is not enough to accept help. It is more important to appreciate the kindness and goodness of people, especially strangers. 

Recognizing that changed my whole outlook. I knew I would be okay. There would be people who would help me along the way. In a city where you know no one, you don't have to be alone. I thanked him, and decided that this is what I want my trip in London to really be, a sort of pay it forward. I want new experiences, but I also want it to be about random acts of kindness.

I feel that working outreach at Thames Reach this summer will offer me a glimpse into the struggles of the homeless and vulnerable in London, and afford me the opportunity to look at society from a new perspective, both intellectually and culturally. I start work on Wednesday and I am as anxious as ever. But more importantly, I'm ready for this experience.

In omnia paratus.
Latin: Prepared for all things.