Harm Reduction

I apologize to anyone who may still be curious about this blog. It’s been near an entire year since I’ve posted, for a number of reasons. First have been some challenges with my health. Nothing terribly serious, but I do have Crohn’s Disease and had a flare-up almost three years ago. It’s currently under control and 95% stable with Remicade (infliximab) treatment, but there are times when I’ve eaten something that disagrees with me vehemently and it takes me a few days to get back to normal. Accompanying the Crohn’s is a form of inflammatory arthritis that we Crohn’s patients are susceptible to, and the closer I get to treatment date the more it starts to bother me. Living in a temperate rainforest climate does make it uncomfortable at times but for the most part Tylenol and a natural anti-inflammatory called Infla-Heal Plus from New Roots Herbal keep it largely under control. Then – yes, there’s more – I’m still getting used to living with tinnitus, which started about 18 months ago, possibly linked to flying with a sinus infection which also spread to an ear infection. These days it doesn’t bother me quite as much as I am able to tune it out most of the time, but after a long day at work in front of a computer monitor under fluorescent lights, there are days when it overwhelms me. And then I have to continue the thesis writing process in spite of it.

The second main reason I haven’t posted in so long is mostly due to more mundane reasons: working. I took on a teaching assistant position this spring and also had my regular job which has nothing to do at all with my thesis or my education, but it’s been busy in our industry and lately have been putting more hours in at the office.

Yet I can say that there has been progress. I am working on re-framing my current draft, and in doing so with my supervisors we have been able to uncover the main elements of my project I wish to discuss and start re-organizing the draft into a more coherent format.

One of the biggest realizations I’ve had during the whole research and writing process of my damn thesis – yes, that’s how I refer to it now - is that the concept of harm reduction is applicable not only to the issues of addiction in Vancouver’s Downtown Eastside (DTES) and other “inner city” areas of Greater Vancouver (e.g. Surrey, where I live). Harm reduction is a principle that can be easily extended to the challenges of women involved in sex work in our communities, and this is one of the main elements that is coming to light in my research. (Because my own work experience and the bulk of the research available examines women working in the sex trade, I am not ignoring the young men who have chosen sex work as their option, it simply has not been part of my work and research.)

Harm reduction is working in terms of Vancouver’s policies regarding addiction. The InSite safe injection site’s reports have shown that Vancouver’s injection drug users are being helped; users have been treated for overdose by the on-site medical staff, people ready to stop have been referred to treatment and rehab programs, which then gets them in to housing and job training services.

Using this model, then, we could well expect similar successes for women who are still involved in sex work but who may not be ready to exit. Providing them with a safe environment and conditions in which to work, programs and services that do not require them to stop working immediately (e.g. counselling, job readiness, primary health care, self-defence & safety training), and outreach services in areas during the hours when most women are likely to be working (i.e. the MAP van by PACE and WISH, the Maka Project), are ways in which service providers can connect with these women and start to build trust and relationships.

In my last post I talked about working with women “where they are”, and I realized that I meant that literally as well as figuratively. Since that post, I was contacted by Andy Fiore of Fiore Films for a documentary he is working on about survival sex work in Vancouver’s Downtown Eastside. One of the questions he asked me was whether I was in favour of a “red light” district for Vancouver. At first I wasn’t sure how to answer that; I want the women working in the sex trade to be safe, to be protected from violence, and safe from harassment whether by people on the street or from the police.

But the reality is that it doesn’t matter; young women I’ve worked with have confirmed that sex work still goes on, whether at street level or in indoor venues in Vancouver such as strip clubs, “gentlemen’s clubs”, and the “entertainment district” downtown. One need only turn to the classified section just past the Sports section of the Vancouver Province newspaper to see all the “business personals” advertisements including exotic massage, bodysage, and “outcalls”.

The argument over whether Vancouver should allow sex work to occur is moot; it’s already here and has been for a long time. Moving it to a restricted geographical area is no solution if there is no means of ensuring the safety of the women who are still choosing to work in the sex trade.

Harm reduction can work for those who wish to get out of sex work but aren’t sure how to do it. Service providers can connect with women and help them to identify what they need in order to get out, without pressuring them that they have to get out. Trust me, these women know there’s a better way. Whether it’s supporting women to have safer working practices and environments, or to assist them to find a new way to support themselves and their families, we need leadership and policies that show people that at-risk and disenfranchised women in our communities are valued and protected.

How I got started

I first got involved in researching prostitution during my first practicum for my Bachelor’s degree, deciding that instead of working at a community police station filing paperwork I wanted to do something more hands-on, more than just clerical work. My practicum supervisor suggested the Provincial Prostitution Unit – now disbanded – doing research for the inter-departmental unit. I worked under Sophie Mas, who still works in non-profit with marginalized youth in Vancouver, and my main project during my term was to confirm a list of organizations that offered services for at-risk, exploited, and street youth across Canada.

As part of my education with the Unit, I learned a lot about the realities of life for street youth in Vancouver, the adult and youth sex trade, and where the prostitution strolls were. I even met experiential youth – young people who had exited street life and were working with other non-profit groups – and learned their stories. I knew that I was going to learn a lot in this placement, but I wasn’t sure about just how much I didn’t know.

I learned about the sex tourism industry, and about websites where men posted information about the “kiddie strolls” with underage and young-looking women, even information about the youth working the streets and descriptions of their experiences. The government had to give me special clearance through their firewalls to be able to search out websites with the words “prostitution”, and “sex” in order to conduct any research and to email organizations across North America.

I met community groups that worked to raise awareness about the existence plight of street youth in and around Greater Vancouver. I met parents who lost their children to the lure of living on the streets, youth who had run away from home to escape abuse, dysfunction, or to engage in their drug habits.

But I still believed that there was a way to “rescue” these young people, who were often not much younger than me, who came from homes and communities like mine, who had similar backgrounds. Of course you want to rescue them, to take them off the streets and make them better, why wouldn’t you? It’s what we’re taught to do, right? I believed that given the choice between living on the streets with the threat of violence, the elements, and no security, most people would go into a shelter and work towards transitioning back to “straight” or “square” life.

What I didn’t understand was that for many young people, and adults who had left home at a young age, even a poor choice made on your own may be preferable to having no choices of your own. Living under one’s own rules, even without the security and comfort of a home, may be more desirable than having to defer to someone else’s authority. This is something I am still understanding, and have only just come to accept about those who live their lives differently than we may think they should.

But that’s what my research is leading me to; a better way to work with people where they are and allow them to make their own choices, and hopefully make better, healthier choices.

Back alley, Downtown Eastside Vancouver

Back alley, Downtown Eastside Vancouver

Originally uploaded by strollerdos

This is what we’re used to seeing when we think of Vancouver’s Downtown Eastside. This is the place we want to rescue people from, thinking that no one would choose to live here.

But sometimes we’re wrong, and sometimes people have made this choice. It’s not a great choice, but then, when this is the place that someone thinks is best, it’s likely that they had other similar choices, or – worse yet – no other choices at all.

This is one of those realizations I’ve been having recently as I’m researching articles and books for my literature review for my MA thesis.

There will be more posts starting with how I got into prostitution research, my perceptions and beliefs about it, and my experiences working in a non-profit assisting female youth exiting the sex trade.

But it’s the research I’ve been reading lately from good academics, experiential people, and other service providers with lengthy histories that is showing me my perspective was wrong; that to help people move forward you have to work with them where they are.

Thanks for reading, and hopefully you’ll have some realizations of your own.