NORTH BATTLEFORD — From a distance, it looks like a normal vending machine.
However, its metal rings hold needles, alcohol swabs, pipes for smoking crack or methamphetamine — everything “except for chocolate bars,” jokes peer mentor and adviser Malcolm McNeil.
The harm reduction supplies are offered here for free outside the Indian and Métis Friendship Centre in North Battleford, part of a public health campaign to ease concurrent crises of HIV and Hepatitis C driven largely by drug users sharing equipment.
“When people walk into a liquor store, they’re not considered an alcoholic. But if they walk into harm reduction, they’d be considered an addict,” McNeil said.
“So to take that stigma away, that’s what the vending machine does.”
McNeil works for the Saskatchewan Health Authority as part of a region-wide program to reduce rates of transmittable diseases and connect people who use drugs to vital services.
Like many cities and towns across Canada, North Battleford has been hit hard by the emergence of more potent opioids and cheap, addictive crystal meth.
The small city of roughly 14,000 people also faces high rates of Hep C, and the region was the epicentre of a further HIV outbreak this summer, when 19 new cases were identified.
The vending machines are one of the ways the city’s health care providers, community members and peers themselves have adapted. Despite a shoestring budget, many of the city’s initiatives have now set the standard for what public harm reduction care in Canada can look like
Danielle Radchenko, a sexual health coordinator with the SHA, got the idea for the vending machine from similar initiatives in Australia and other regions.
She noticed there was no access to clean needles in the city after 4:30 p.m. The vending machine emerged as a 24/7 solution. People “pay” for supplies with free tokens picked up at the Friendship Centre, the Lighthouse or other harm reduction sites around town.
Radchenko applied for $200,000 in funding from the Public Health Agency of Canada last year to make the machine a reality.
“I thought it would be a cool project to bring to rural Saskatchewan,” Radchenko said. “Did I think we would get it? Absolutely not. But I’m glad we did.”
Radchenko is often asked about the machine, but she says the “backbone” of the project is peers like McNeil and Samantha St. Germaine, who shape the direction of the team’s work.
St. Germaine, one of the many “backpackers” the SHA employs in North Battleford and a small handful of other areas, travels around the city distributing clean supplies and picking up dirty ones. She’ll often visit people’s homes, handing out needles from her backpack to people who normally wouldn’t visit a clinic.
St. Germaine says she’s just lucky. She’s “their very own private investigator,” McNeil said.
“She can get into the trap houses. People trust her a lot more. They’re more open. It’s surprising, the people who are asking us for help now.”
McNeil says that’s made a huge difference — instead of having to track the people most at risk, they’re more likely to actively approach him, Radchenko or St. Germaine to get tested, obtain clean supplies or ask for help connecting to other services.
“It’s changed how we offer harm reduction in the community,” Radchenko said. “Before, I think people would come for their supplies but they weren’t really connecting. I think it’s given people the feeling that we really care, and that we’re there for them.”
The machine is made possible by close collaboration between different groups in North Battleford, many of which are equally happy to push the envelope on typical public health models.
The Battle River Treaty 6 Health Centre, located in a former Eaton’s shopping centre in North Battleford’s downtown, is one of the partners on the vending machine project.
“In smaller communities like North Battleford, there aren’t a lot of programs like this,” said Kent Lindgren, HIV project coordinator with the centre. “It was something people told us they needed, so we figured out how to make it happen.”
The health centre began as the Battlefords Indian Health Centre in 1979, after local First Nations leaders complained about the closure of a nearby hospital. Forty years later, it’s still First Nations owned and operated, and offers access to Elders, cultural programs and culturally-sensitive counselling and supports for its clientele.
“We try to balance a Western approach with a traditional approach,” wellness director Jose Pruden said. “That, in itself, is healing.”
The “wraparound” model of care, shaped largely by the philosophy of the Indigenous leaders who run the centre, is present in everything it does.
The Opioid Addiction Recovery Service’s (OARS) program began at the centre years ago, in response to a flow of people using opioids who would travel as far as Saskatoon to obtain a methadone prescription.
Today, the program’s 100-odd clients all have assigned caseworkers helping them set more long-term goals, like finding housing, employment or quitting drugs.
“We’re working with the client, not for them,” said Emily Bandeen, an OARS case manager.
That doesn’t mean they won’t go the extra mile, often literally, to bring care where it needs to be.
Last summer, amid the HIV outbreak, the centre and Radchenko converted an immunization van into a general outreach van. Radchenko drove around town, finding clients and delivering supplies herself.
At first, the vending machine received some pushback from residents who believed it enabled drug use, but just a few months in, the community is now almost entirely onside — tragically, in part because the province’s addiction’s struggles are spreading, McNeil said.
“When people have a son or a daughter who’s into their addictions, I’ll tell you, it doesn’t take them long to change their minds.”
Other regions of the country are starting to pay attention to North Battleford. McNeil said organizations in Winnipeg and Saskatoon have both inquired about the vending machine program. Vending machines are also slated to be installed in Meadow Lake and Lloydminster in the new year.
North Battleford still has its needs. McNeil estimates eight in 10 people who express a desire to enter detox are turned away. Many others have to travel far to surrounding communities just to get in, he said.
McNeil, who was HIV-positive himself for 33 years, lost his brother to the sickness. He said part of the reason was that he never shared his diagnosis with family, worried about the stigma that would come with it.
“Danielle and I don’t want to tell one more person that they’re HIV positive,” McNeil said. “That’s really hard. It affects their whole family. If we can avoid one more person from getting HIV or Hep C, then I think that it’s serving its purpose.”
Photo by Liam Richard, The Saskatoon StarPhoenix.