—=- SUNDAY FOCUS Let’s preten there is n Health region examines lack of local services Jan-Christian Sorensen News Reporter oorcnsen@nsnews.com THE North Shore Health Region (NSHR) is drawing up a new battle plan in the fight against HIV and AIDS within its boundaries. The renewed effort comes in the wake of a report that draws attention to the lack of support and medical services available for people living with HIV and AIDS on the North Shore. ‘the NSHR — home to over 190,000 people scattered throughout the City and District of North Vancouver, West Vancouver District, Lions Bay and Bowen Island — is the fifth largest health region in the province but ranks in the top three in terms of the number of people living with HIV and AIDS resid- ing within its jurisdiction. Among the key findings of the report: ME The NSHR has the third bighest prevalence (135 total con- firmed cases) and third highest rate of new HIV infections in the Lower Mainland; @ The NSHR claims the third highest prevalence (87 total cases) and the second highest rate of AIDS cases in the Lower Mainland; 2 The current direct treatment of a single HIV/AIDS infection (doctor, hospital and pharmacy costs) is estimated at between $152,000 and $225,000, based on a 200-month window from diagnosis to death. According to those figures, the NSHR will spend a minimum of $20.5 million on its current caseload of the 135 HIV-positive people that live here. HIV is detected by laboratory testing, while the onset of AIDS is heralded by clinical markers such as skin lesions (Kaposi's Sarcoma), lung infectians (puetenacytis carinit pucnmonia, or PCP), or the self-explanatory “wasting syndrome.” The time between infection and the presentation of early illness can stretch from five to 10 years or more with the median age of infection now pegged at 23. . _ According to a December 1998 report by UNAIDS — the joint United Nations program on HIV and AIDS — 13.9 miltion people have died from AIDS globally since the beginning of the epidemic, 3.2 million of them children under the age of 15. Compiled in the fall and winter of 1999, the local report was authored by consultants Jeanne Legare and Carl J. Bognar and commissioned by the NSHR as part of a provincial grant to assess the state of HIV and AIDS services available in health regions throughout the province. However, even gamering enough feedback to compile North Shore-specific data proved 2 roadbluck in itself With no AIDS support service groups or care facilities centred on the North Shore, where would researchers canvass local HIV-positive people? “We didn’t really have a good network to reach out into,” adinitted District Medical Health Officer Brian O’Connor. Instead, the report's authors posted notices at four prominent AIDS suppert organizations in Vancouver -- AIDS Vancouver, B.C. Persons with AIDS Society, Positive Women’s Network and YouthCo. Individuals were given a $20 honorarium for their par- ticipation in the study. According to the report, researchers opted not to advertise for survey participants through North Shore newspapers for fear of “an ant-gay/anti-HIV backlash from conservative factions active on the North Shore.” Fear. of disclosure may be the predominant factor driving North Shore residents living with HIV and AIDS to the down- town core for treatment, believes O’Connor. . “That’s part of the whole postulation . . . there might still be a - stigma attached and it might have an impact.upon your job or - _ other parts of your life. It is a very conservative community.” > -YAndrew Johnson, executive director of AEDS Vancouver, Canada’s oldest AIDS support organization, agrees. : . “Historically, in large urban centres people will come from _rural or suburban areas to receive their treatment so it’s done in secrecy. You go to the clinic and then you go back home and you live your life.” : . > “Small towns are very good at breaching confidentiality. It’s very scary to be HIV positive in a smaller community.” AIDS Vancouver currently counts 54 North Shore residents ~ among its membership. All of them utilize the organization’s gro- cery program, which helps provide for the delicate nutritional needs of HIV and AIDS patients undergoing highly active anti- _ retroviral therapy (HAART) treatment. . Tt also operates volunteer teams that can be dispatched to che ’ North Shore to provide care and companionship to people living with HIV and AIDS. “The North Shore community just never has brought itself together to create (those services) within the community,” said Johnson. “That does not suggest that there is not a need. The * community has either not responded or we've been able to meet needs by having people come to us or us going to them directly.” HIVand AIDS medications are available free of charge * through the BC Centre of Excellence’s Drug Treatment Program. People living with HIV or AIDS on the North Shore can have their laboratory work done locally and receive prescriptions, but the report states that no formal program is in place at Lions Gate to facilitate the distribution of medications to Centre of Excellence clients, “ee . Additionally, a number of Lions Gate Hospital nursing staff and physicians interviewed for the report said that they had had litte of no exposure to patients with the disease. Because of that, the report asks how North Shore physi- dans can keep current on the latest AIDS aeatments if they don’t treat patients on a regular basis. Even if the region were to boost its level of medical ser- vices, said O'Connor, people may still opt: to travel to St. Paul's Hospital in downtown Vancouver, which has tradi- tionally been the facility on the cutting edge of the latest treat- ments and therapies for HIV and AIDS patients. “Ics certainly the number one facility in 3.C.,” agreed Johnson. “There are certainly a number of places that are doing their very best to provide ser- vices but St. Paul's has over the years carried about 75% of the entite | infected population through its doors for the province.” But Johnson believes Lions Gate — and other Lower Maintand care facilities — have todo more to absorb the num- hers of people who will require treatment for HIV and AIDS as the population increases. “Different hospitals (in the Lower Mainland) have to receive people who are coping with some sort of issuc related to HIV because there’s just no room at St. Paul's.” He would fike to see the North Shore Health Region work to establish loca! satellite health stations to give residents increased access to quality health care. He'd also like to see a regular sched- ule established for specialists to visit patients on the North Shore. His comments echo the report’s recommendation that a Provincial Centre of Excellence be established on the North Shore and that the NSHR work on building an ever-increasing, frame- work of pharmacy, laboratory, specialist and support services to assist those living with HIV and AIDS. “We see more and more families becoming infected,” said Johnson. “And families need to stay together and be home and close to their communities. If it means that they can do that by being able to go receive care at Lions Gate, that should be the goal of the North Shore Health Region.” To that end, the report recommends that the region work toward building increased prevention and education by fostering relationships with agencies at the federal, provincial and municipal Jevels as well as school districts, HIV and AIDS support groups and First Nations groups. It also recommends the NSHR and neighbouring health regions collaborate to develop an_ inter- regional HIV/AIDS plan. O’Connor is currently making plans to draw together various parties — including AIDS Vancouver — in an effort to address some of the issues outlined in the report. “Why there are no services over here is hard to say for certain,” said O’Connor. “Obviously we need to bring people together to sit around the table and ask what it is. Do they just prefer to receive services elsewhere or do they have a more welcoming com- munity elsewhere?” North Vancouver resident Umeeda Switlow believes they do — downtown. Eleven years ago her husband Gary found out through a rou- tine blood test for a life insurance policy that he had HIV. He had contracted the virus through heterosexual sex. Three years after testing positive, he succumbed to AIDS. Switlow says her family kept Gary’s condition a secret because of where they lived. . “It was hard to live on the North Shore. We were always con- cerned that someone would find our what was wrong with him,” she said. “Gary did not want to disclose his disease.” At the time Gary discovered he had tested positive, Umeeda ran a preschool in Deep Cove. They sold it inmediately after his diagnosis. “We didn’t want people to feel that Gary would contaminate their children, even though he had no contact with them,” said Switlow, who has since tested HIV-negative, as has her 14-year-old daughter Nareena. Gary had to travel twice a day to St. Paul’s to receive regular treatments of Gancyclovir, a drug that hefps halt blindness in See Drug pages Sunday, August 20, 2000 - North Shore News ~ 3 NEWS photo Jelle lrerson ' AIDS Vancouver's executive director Andrew Johnson in front of St. Paul’s Haspital,; the primary care facility for many persons living with HIV and AIDS In B.C. He believes the North Shore should do more for its residents with HIV and AIDS. AIDS volunteers make a difference — News Reporter porensen@nsnews.com SHARON McKinnon is about to mark a bitter- sweet anniversary. McKinnon works as a volunteer care team leader with AIDS. Vancouver's Project Sustain, an outreach branch of the support. - organization. . a 2 Five years ago Wednesday one of her North Shore clients suc-" cumbed to AIDS. - eo, . She was one of the three care team members that tended to the. ; patient during the week. On the weekends his parents would trav- el from their home on Vancouver Island to pick up the slack... Every year since her son died, the mother has travelled to. + Vancouver to hold a celebration dinner with McKinnon and her .’. fellow members as a thank you for the services and companionship they provided. Sy It’s McKinnon’s version of another day at the office. .. A pharniacist by trade, McKinnon had moved into teaching but missed volunteering her time to help people, so she decided - to look into volunteering with AIDS Vancouver. er She had a personal motivation for getting involved in the care * team program over seven years ago. ; “Pye had a lot of gay friends and seven or eight years ago it was gay men getting AIDS and that’s a tough road to walk alone with- out AIDS thrown in,” said McKinnon. “TI also had an II-year-old’. daughter at the time and everything I read said thar this is going |” to impact on her life. We all do stupid stuff when we grow up but, I wanted her to know enough not to do something that was going | Sce Cave pageS Coming up in Sunday Focus NEXT week in Sunday Focus Martin Millerchip looks at some of Lower Lonsdale’s heritage sights. To suggest a feature story that: deserves to be “in Focus”... : write to. Martin Miilerchip, North Shore News, 1139 Lonsdale, =. Ave., North Vancouver, V7M 2H4, fax 985-2104 or e-mail”. . : cores