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Posts Tagged "needed"

15Oct

Vancouver ramps up for more accessible city, but much more needed

by admin


Micaela Evans at Ash street and SW Marine Dr. in Vancouver.


Arlen Redekop / PNG

The City of Vancouver is planning to install up to 600 more curb ramps over the next few years to help make the municipality more accessible.

The initiative comes after the city’s engineering department identified about 5,000 locations “where curb ramps are missing” from Vancouver’s infrastructure, according to a recent request for proposal. The city plans to award a one-year contract to install 150-200 curb ramps, and may extend that contract at its discretion, according to the proposal.

But wheelchair users such as Gabrielle Peters, a disabled writer who used to sit on the City of Vancouver’s Active Transportation Policy Council, believe much more can and should be done to open the city for all to use.

In a 2017 motion passed by council, Peters identified that 8,000 of the city’s 27,000 intersections had no curb ramps whatsoever. Peters also calculated that the city budget allowed for 40 curb ramps to be built per year, meaning that it would take 200 years for Vancouver to be fully outfitted with ramps.

Asked what she thought about the city’s plan to put in another 150 ramps per year for four years, Peters said it was “raising a shockingly low number to an embarrassingly low number.” She said she believed the city had prioritized other things over ensuring access for many of its residents and users.

“What do you think that says to a disabled person living in Vancouver?” Peters asked. “Thank you eternally for almost treating me like I matter to you as a leader running my city, the city I live in.”

Micaela Evans, a wheelchair user who lives in Port Moody, said she doesn’t frequent many parts of Vancouver, but said older areas of most towns tended to be worse on wheels than newer areas. Still, she said she felt accessibility remained an afterthought rather than an integral part of design.

Eric Mital, a senior head of engineering with the city’s Streets Design Branch, said all new sidewalks in the city are now built with curb ramps. The 600 that have been prioritized were requested by members of the public, he said.

Peters has been a wheelchair user for over a decade now, so she has experienced the space by foot and by wheel. She said that when she started to use her chair, the Vancouver she knew suddenly transformed.

“I felt like I’d moved to a different city,” she said.

Peters described the place as a constant source of barriers, and most of them human-made. Asked if there were specific locations she could point to that were particularly accessible, she said “everywhere.”

Peters gave as an example the seawall ,”a spot where I tend to say that would be one of the more accessible, and it’s (still) not.” Accessing it around Denman Street near Beach Avenue involves crossing at least two intersections and a bike path, each of which includes its own set of challenges. Peters said she at times has needed to wait several lights to cross due to drivers who have blocked curb ramps with their vehicles. Once in the park, a relatively steep ramp that is not evenly surfaced descends to the path. And once there, wheelchair users will notice it is sloped, making for a tricky travel route.

Even sites that have curb ramps are not as accessible as some may think, Peters said. Some of the curb ramps at Burrard St. and West Georgia St., for example, unsafely exit wheelchair users directly toward the centre of the intersection, rather than into crosswalks, Peters said. There is a similar setup across the street from City Hall at 12th Ave. and Cambie St., she said.

Asked if she could compare Vancouver’s accessibility to other cities, Peters’ motion noted that for several years Calgary and Edmonton had budgeted for 250-350 curb ramp installations per year in intersections that had none.

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28Aug

Support needed for overdose survivors living with brain damage, B.C. doctors say

by admin

It’s been three years since Valerie Wilson’s son suffered a brain injury following a drug overdose.

The Port Moody mother calls her son “fearless”. He was an ironworker by trade who taught himself how to ride a two-wheel bike as a toddler.

But the overdose affected his sense of balance, speech, and temperament, Wilson said, leaving him unable to pursue his former career and some of his favourite pastimes.

“He used to love high places. Now he has a fear of heights because he tends to fall over,” she said. “He lashes out at people but without the intent to be harmful — he’ll get incredibly angry about things that make no sense to be angry about.”

In the past year, B.C. has successfully brought overdose deaths down to the lowest level in years.

But medical experts and advocates say more needs to be done for survivors, who are sometimes left with brain damage that can worsen underlying addiction and substance use disorders.

Janelle Breese-Biagioni is a registered counsellor and the CEO of the Constable Gerald Breese Centre for Traumatic Life Losses, a charity she founded 30 years ago in memory of her late first husband, an RCMP officer who suffered a traumatic brain injury.

She said brain injuries, which can worsen the risk of substance use, depression or criminality, are an under-examined part of the overdose crisis that killed over 1,300 British Columbians last year.

“If we don’t include brain injury in this conversation, we will never have a 100-per-cent solution to the problem,” said Breese-Biagioni.

The province has said there were 446 fentanyl-related deaths between January and June of this year, compared to 1,334 for the entirety of 2018. This June saw the lowest monthly number of fentanyl-related deaths since September 2016, according to the B.C. Coroners Service.

But Dr. Delbert Dorscheid, a physician and researcher at St. Paul’s Hospital in Vancouver, said the number of people he sees with traumatic brain injuries has not been declining.

Fentanyl, the cause of the majority of illicit drug deaths in B.C., can interrupt blood and oxygen flow the brain.

He says provincial and federal governments do not track the prevalence of acquired brain injuries resulting from overdoses, the impacts of which range from mood swings to memory loss to paralysis.


Valerie Wilson with her son Dayton.

PNG

“They’re not feel-good stories, and they’re not stories the politicians want to promote,” he said. “It’s making the whole topic so black and white, life and death. But in between there’s a lot of grey. We are just not acknowledging the grey.”

Dr. Perry Kendall, the co-interim executive director at the B.C. Centre on Substance Use, speculates the number brain injuries caused by an overdose is “easily in the high hundreds.”

He says those impacted are often stigmatized for their substance use and may have had negative experiences in the health-care system, which he believes is partly why the issue hasn’t been addressed.

“Those who use drugs and are admitted to hospital often can’t wait to get out. They’re not having the best experience with health-care providers,” he said. “We kind of blame people for the symptoms of their illnesses.”

Breese-Biagioni said the impact of brain injuries can trap patients in a “vicious cycle” by worsening the symptoms of underlying mental health and substance use disorders.

She said current funding for counselling for affected persons only covers eight sessions, but she considers the minimum should be a full two years.

Debbie Dee, the executive director of the Powell River Brain Injury Society, has sponsored a motion at her town council to ask the Union of B.C. Municipalities to recommend adding brain injuries to the name and mandate of the provincial Ministry of Mental Health and Addictions.

She said it currently straddles so many ministries and mandates that action on it is almost impossible.

“Brain injury isn’t a mental health issue. It isn’t a substance use issue. It’s not an inclusion issue,” she said. “Where does it fit? It’s never fit anywhere.”

Dorscheid said improving relations with patients and securing research funding is key to understanding the problem and its extent.

“We would probably be able to reduce the burden of addictive disorders within our society if we found ways to treat people more compassionately and more completely,” he said.

Kendall believes the issue is part of a case for a non-toxic regulated drug supply, which he argues would greatly reduce the risk of overdoses in general.

But one problem Breese-Biagioni identified would not be solved by a safe supply — the situation of people already living with brain injuries, and their families.

Wilson is a member of Moms Stop the Harm, a national coalition of families impacted by the overdose crisis.

She supports implementing a safe drug supply, but says the grief she feels isn’t the same as other members of the group whose loved ones have passed away.

“They’re grieving the death of their children, and I still have mine,” she said. “I feel like a faker in some ways, right? It would be so much worse to lose him. But I still see him struggle. I do still have him, but I don’t.”

28May

Daphne Bramham: More needed to redress the tragic fact that Indigenous people are disproportionately victims of opioid crisis

by admin

Overdose deaths linked to illicit fentanyl-laced drugs rose 21 per cent last year among First Nations people in B.C. even as there was a glimmer of hope that the crisis may have peaked among the general population.

Since the crisis began four years ago, B.C. Indigenous people have been overrepresented in the deadly count. Last year, they accounted for 13 per cent of the deaths, while making up 3.4 per cent of the provincial population.

Put another way, First Nations people were 4.2 times more likely to suffer a fatal overdose and six times more likely to suffer a non-fatal overdose than other British Columbians.

No one is suffering more than First Nations women and girls, who already have the worst health outcomes in Canada because of violence, exploitation and poverty.

They are unique in this epidemic where 80 per cent of the victims in the general population are men. Women, by contrast, account for 39 per cent of First Nations’ overdose fatalities last year and 46 per cent of the non-fatal ones.

They are bearing the brunt of marginalization, says Dr. Evan Adams, chief medical health officer at the First Nations Health Authority. Another measure of that is expected to come next week in the report of the murdered and missing women’s inquiry.

Among the reasons that he suggests for the widening gap between First Nations’ and the general population’s statistics are the effects of colonization including residential schools, the lack of social supports, childhood experiences and limited access to safe spaces and services.

The litany of dreadful statistics compiled by the provincial coroner’s office was read out Monday against the backdrop of a quilt with the names of some of the hundreds who have died. Among those names was Max, the son of the health authority’s knowledge keeper, Syexwaliya. Max died 12 days before his 41st birthday in March 2018.

“My son was just too lost,” she said. “I couldn’t do anything for him. I had to love and accept him as he was.”

Still, Syexwaliya takes heart from the statistics.

“The statistics make me feel that Indigenous people aren’t invisible and what’s brought out in the statistics and in the reports means that work is being done,” she said.

Addiction is a disease of pain — physical, emotional, mental and spiritual. Addiction piles tragedy on tragedy.

“It’s a journey of pain, a journey of suffering and a journey of seeking health services that couldn’t be found,” said the chair of the health authority, Grand Chief Doug Kelly.

Too many Canadians, too many British Columbians and too many First Nations people have already died, but Kelly said that for Indigenous people, things are not getting better. They’re getting worse, especially for those living in cities and most especially for women.

Overdose hot spots include the usual ones: Vancouver’s Downtown Eastside, the Fraser Valley, Chilliwack, Nanaimo, Victoria and Prince George. But for First Nations people, there’s also Campbell River and Kamloops.

Those stark differences mean distinct and targeted solutions are required. As Canada’s first Indigenous health authority, the First Nations authority (with its unofficial motto of “no decisions about us, without us”) is well positioned to do that.

With a goal of addressing causes of addiction, it has its own four pillars approach: preventing people from dying, reducing the harm of those who are using, creating a range of accessible treatments and supporting people on their healing journey.

The authority also strongly supports the call from B.C.’s chief medical health officer to decriminalize possession of all drugs for personal use as has been done in Portugal. (The suggestion was quickly shot down by the B.C. government, which says that could only be accomplished with federal legislation.)

Among the reasons Kelly cites are yet more terrible statistics.

Of Canada’s female offenders in federal prisons, Public Safety Canada reported last summer that 43 per cent are Indigenous. In youth detention, Indigenous kids account for 46 per cent of all admissions — a jump of 25 per cent in a decade.

Addiction is often contributing factor in the crimes committed, as is fetal alcohol spectrum disorder (although the report said there is no evidence that FASD is more prevalent among First Nations than other populations).

Because so many First Nations women are incarcerated, it means their children often end up in government care or with relatives, which only exacerbates the cycle of childhood trauma, loss and addiction.

So far, the First Nations Health Authority has spent $2.4 million on harm-reduction programs. It’s trained more than 2,430 people in 180 communities how to use naloxone to reverse fentanyl overdoses, has 180 “harm-reduction champions” and peer coordinators in all five regions.

But the biggest barrier is the one that led to Max’s death — lack of accessible treatment.

Last week, FNHA and the B.C. government committed $20 million each to  build treatment centres in Vancouver and Surrey and promised to upgrade six existing ones. Kelly says that’s great. But it’s not enough. They’re still waiting for another $20 million from the federal government for construction.

Still, where will the operating money come from? That’s the next multi-million-dollar question. But it must be found.

Now that there is evidence that First Nations communities — and women in particularly — are suffering so disproportionately, ignoring them is unconscionable.

[email protected]

Twitter: @bramham_daphne


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