By Angela Hill

Going west to seek HIV services

Nov 16, 2011 | 11:14 AM

VANCOUVER — Robert Deschambeault left the province six months ago to try to find someplace to get help for his HIV and Hepatitis C.

He is 45 years old and originally from Prince Albert.

“In Saskatchewan you have to fight to get stuff. There’s no places to help you out and here, I’m on my medication already,” Deschambeault said, from his current residence, a three-month treatment program located on Vancouver’s downtown east side.

Most treatment programs in Saskatchewan are 30 days, he said “but here in B.C. you can stay in treatment up to two years … it’s awesome.”

After using drugs and alcohol for more than 25 years, Deschambeault said he needed more than 30 days to deal with everything.

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When he arrived in Vancouver, he said didn’t have medical coverage, but he found his way to the Vancouver Native Health Society’s Positive Outlook Program (POP).

Deschambeault isn’t the first person to make the trip to Vancouver with nothing except the clothes on his back. People from across Canada come to get help, said Doreen Littlejohn, nurse co-ordinator for the Vancouver Native Health Society.

She runs the Positive Outlook Program, which through partnerships offers medical and dental services, nutrition and outreach to all people living with HIV.

“We have people that come to us and say there are no services on their home reserves. They have great difficulty accessing services in the bigger centres,” she said.

Deschambeault said he was able to access the methadone maintenance program the day he arrived and started HIV medication soon after. He said in Saskatchewan he was in hospital, because there was nowhere else for him.

“I’m already on my medications and I’m getting my health back. It’s just awesome. I’m just happy,” he said.

Linking to care

The process that Deschambeault went through has been simplified and streamlined over more than a decade.

When POP started in the late ‘90s, the need for services for people who had HIV was huge, Littlejohn said.

“There were people dying in our doorsteps, we were nursing people on couches.”

Lou Demerais, executive director for the Vancouver Native Health Society, said he realized they needed the program back then because people were dying without access having services.

“Back then the life expectancy was measured in months … and so we had a pretty rough time, where we lost a lot of people quickly. Now those people were quite often shunned by their home communities and were no longer welcome there because of the stigma.”

It started slowly, the program offered coffee and soup so at least the clients would have something to eat when they came in, Littlejohn said.

“Then we asked the clients if they’d help us cook the soup because again we couldn’t do it (alone),” she said.

They couldn’t run the seven-day-a-week program on their own, so their partnered with AIDS services organizations and outreach nurses from other health organizations, Littlejohn said.

The team was built of people with a common purpose, with people who would see the underlying causes of behaviours and not just judge, she said.

“It’s so important to listen to what your client needs.”

Now, with that mantra in place, they are like the Little Engine That Could — specialists like optometry, dental care, infectious disease and mental health come to them, Littlejohn said.

“We just kind of built this incredible one-stop shop, with no extra money, but through relationships.”

On a Friday morning in September, the place is packed and buzzing with activity. Each morning everyone gathers to talk about the clients, who has been taking medications, who hasn’t, who are they concerned about, have there been any issues?

Then they throw open the doors to welcome the more than 200 people that will access their services daily and get ready to head out to find the ones who can’t make it in.

It’s busy, but the staff all believe in what they are doing, Littlejohn said.

“We cry when people die, we have a lot of loss and a lot of grief, but I think what keeps us going as a staff is we’re focused on working as a team, sharing the stories together,” she said.

There is also satisfaction in what they are doing— helping people die with dignity.

“HIV does steal your dignity … your whole body image of who you are as a person is destroyed,” she said.

One of her clients is so sick that he can’t walk, he has no strength so he’s scared to be outside. His fingers are contracted, so he can’t do the thing he loves — playing the guitar, she said. He can’t take the medications because they make him sick, but he’s sick because he’s not taking his medication.

“If he continues down this path, the only (thing) we can do is comfort and make sure he’s got pain control,” Littlejohn said.

They will do that and if it wasn’t for the outreach workers that daily check on him, and others like him, he would have no support at all, Littlejohn said.

It sound unique, but the program can be done elsewhere and it doesn’t have to be expensive, she said.

“I faced a lot of opposition in the early years,” Littlejohn said, but they overcame it, securing funding and participating in research to prove their worth.

“Certainly we have a lot of expertise on the west coast that we can certainly share with other provinces,” she said, adding that partnerships can make addressing HIV and AIDS easier.

See more in the series: The face of HIV in Saskatchewan

ahill@panow.com

This story is the sixth in a series about the face of HIV in Saskatchewan. Research for this project was made possible by a journalism grant from the Canadian Institutes of Health Research.