Pubdate: Thu, 13 Apr 2017
Source: Castlegar News (CN BC)
Copyright: 2017 Castlegar News
Author: Chelsea Novak


In the midst of the fentanyl crisis, a local organization that
provides overdose training and harm reduction is bracing for the loss
of a major chunk of its funding.

ANKORS (AIDS Network Kootenay Outreach and Support Society) was
founded in 1992 at the height of the HIV/AIDS crisis and provides
services around HIV and Hepatitis C, harm reduction and prevention
education. Originally established in Castlegar, the organization now
has offices in Cranbrook and Nelson, and between the two may soon lose
five employees and a significant part of its funding.

ANKORS has two major funding sources: Interior Health and the Public
Health Agency of Canada (PHAC). Interior Health funds ANKORS' support
worker, outreach worker and its community care team, while PHAC funds
ANKORS' Hepatitis C education and support program, its HIV prevention
and support program and its Rise Up Community Engagement program,
"which addresses barriers to health care and services for people who
are living with HIV and/or Hep C and who are at significant risk and
who use drugs."

PHAC has been funding ANKORS for over 20 years, but in September 2016,
when PHAC announced the successful applicants to its new HIV and
Hepatitis C Community Action Fund (CAF), ANKORS was not among the
successful applicants.

"We've been funded for over 20 years by the Public Health Agency of
Canada and in this last call out for funding, there were over 40
organizations in Canada that had previously been funded that were
turned down, including ANKORS," explained Cheryl Dowden, executive
director of ANKORS.

A total of 124 organizations were successful in applying to CAF, but
42 organizations that were previously provided funding were
unsuccessful, while 41 new organizations received funding. Not one of
the three applicants from the Interior Health Region received funding.

ANKORS and other unsuccessful applicants have been provided with one
year of transition funding, which will end March 31, 2018, which PHAC
says "is being provided to help organizations seek other sources of
funding, transfer their services to other local providers, or close
out their currently funded projects."

But if ANKORS is unable to either find a new source of funding or
convince PHAC to reinstate funding, it will lose funding for its HIV
and Hepatitis C programming.

"We're really looking to our community for support for those programs
and looking for alternative funding, because we're basically run off
our feet offering those programs and it's taken us many years to
develop the Hepatitis C program - it's hugely significant - and also
the prevention and education program," says Dowden.

"We know that there's a community need for this. We get requests for
workshops and training in Kaslo and Lardeau and New Denver and Nakusp
and all over the region. A loss of that funding is going to have a
significant impact and we really feel that we gained a lot of ground
in terms of addressing HIV and Hepatitis C, but it's not a time to
take our foot off the gas pedal, so to speak."

Dowden hopes that community members will assist ANKORS by pressuring
the federal government to restore ANKORS' funding.

"We've had great support from our MPs in this area and we asked for
letters of support to be sent to our MPs, to the federal Minister of
Health, and to the president of the Public Health Agency of Canada,"
she says. "Some of those letters were hand-delivered to the president
of the Public Health Agency of Canada and she read them, and I think
some of those efforts really resulted in the transition funding, but
we need to stay that course."

The funding loss comes at a time when ANKORS' staff say they are
busier than ever, due to the fentanyl crisis sweeping the country.

Jamie MacBeth is one of the three ANKORS employees working out of
Nelson who will lose her position unless funding can be found. Since
the fentanyl crisis began, MacBeth has been offering community
Naloxone training and has seen a growing demand for the service.

"Since last March I've been doing a lot of Naloxone training - like a
lot, I've probably trained 500 people in the last year," she says.

Attending one of her training sessions, it becomes clear that
MacBeth's experience with Naloxone kits goes beyond injecting water
into an orange for training. She has helped people during overdoses,
she has injected Naloxone into their thighs and delivered rescue
breathing while waiting for the paramedics.

She says that Naloxone training is something she does off the side of
her desk. Her actual position is education and prevention regional
coordinator, and she is only paid for three and a half days a week.

"The position is defined as offering … preventative workshops on HIV
and STIs and Hepatitis C and harm reduction, but in our rural area, to
actually address those issues with adults and youth, it's a much
bigger… It's not just teaching the HIV prevention equation. [It's]
talking about culture, talking about use, talking about consent,
talking about party scenes."

MacBeth also runs the Party Safe program, which teaches people about
harm reduction and responding to overdoses. But what MacBeth teaches
as part of the program has changed since the beginning of the fentanyl

"In the past, we would have done tips for safer partying in a harm
reduction way, but the fentanyl crisis has changed a lot of that,
because what we would have offered as harm reduction tips for safer
partying doesn't really matter anymore," she explains.

For example, in the past MacBeth would have talked to people about
test-driving substances - trying a small amount to see what happens -
but fentanyl doesn't have a uniform concentration, so test-driving
doesn't work.

"So now I kind of have pulled the Naloxone training into the Party
Safe structure," says MacBeth.

ANKORS has also been playing a role in battling the crisis at the
provincial level.

Alex Sherstobitoff is the Rise Up Community Engagement Project
coordinator and another ANKORS' employee whose position will be
eliminated when the PHAC funding runs out.

He says ANKORS is one of the few rural B.C. organizations providing
input to provincial bodies overseeing harm reduction, such as the B.C.
Center on Substance Use, the B.C. Centre for Disease Control, and
gives some input to the Canadian Research Initiative in Substance
Misuse. ANKORS has also had input on opioid management guidelines and
has given input to various committees on the opioid crisis.

"Without this input, particularly the West Kootenay-Boundary is going
to lose out because we're already lacking in resources. Urban folks
they have a lot of resources there, but if we lose that piece, we're
going to feel it," he said.

Asked what the effect of the PHAC funding loss will be on ANKORS'
ability to play a role in the fentanyl crisis, Sherstobitoff said, "I
think that our resources will be so limited that we may be only doing
mobile needle distribution and then as far as working in partnerships
and collaborations with the various agencies throughout our
communities is going to be limited, because we just don't have the
resources. Our mobile services are already barely just hanging in there."

Loss of the PHAC funding will also mean the loss of Hepatitis C
services, and that's far from all Chloe Sage is responsible for.

Sage is the Hepatitis C coordinator for ANKORS and runs the festival
harm reduction and drug checking programs. Her job is also on the
chopping block.

Sage not only works with people living with Hep C, but does education
and prevention work.

"In the prevention and education it's really broad because we work
with people who use drugs a lot, because a lot of folks get Hep C from
using intravenous drugs," Sage explains.

The fentanyl crisis has also led to a demand for needles, which comes
with an increased risk of transmitting HIV or Hep C.

"One of the things that we've been noticing in this opioid crisis is
that our needles are flying off the shelves, because new needle users
are happening, because fentanyl is so addictive that people are moving
to needles quite quickly, because you can get addicted to it so
quickly." Sage explains. "A lot of the times when you're addicted to
something, you're always chasing that first high, so if snorting is
not getting you that any more you may move to needles to get the rush
that you need."

Sage predicts a spike in Hep C cases if her position is

"When there is a new population of needle users, you need to find them
and connect with them, and if we don't have community organizations
that can put that time in, who's going to do that?" Sage asks.

She also administers a drug-checking program in partnership with
Interior Health and is on several national drug-checking committees.
That includes testing substances at the Shambala Music Festival. She
also administers fentanyl urine tests throughout the West Kootenay in
partnership with Interior Health. If her position is eliminated those
programs will also end.

Sage emphasizes that while there has been funding provided to health
care authorities to help with the fentanyl crisis, it's community
organizations that have made connections with those most affected.

"I think it's a tragedy to ignore the role of community organizations
in this crisis, because it's community organizations that have the
relationship and the relationship with people is the most important
thing, because if we don't have relationship, we cannot help people."
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MAP posted-by: Matt