Category "Local Health"

2Aug

Health Scams: a growing problem in the age of misinformation

by admin

“Everybody wants to be healthy. Everybody has been taken in by some sort of health scam at one point in their life — a product to improve their skin, or lose weight. It’s a normal human desire to try and improve our lives.” — UBC professor Bernie Garrett

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Bernie Garrett, author of The New Alchemists, in Pender Harbour.
Bernie Garrett, author of The New Alchemists, in Pender Harbour. PNG

In the opening of his book, The New Alchemists, author and UBC professor Bernie Garrett compares the rise of deceptive heath care practices and misinformation to the cons perpetrated by Renaissance alchemists, who swindled desperate people with promises of immortality and claims they could turn metal into gold.

“Everybody wants to be healthy,” said Garrett. “Everybody has been taken in by some sort of health scam at one point in their life — a product to improve their skin, or lose weight. It’s a normal human desire to try and improve our lives.”

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But when lives are at stake — or when a global pandemic hits — the outcomes of believing in pseudo-science, deception, scams and misinformation, can be more serious.

“It’s not just a question about losing money, some of these things can be detrimental and prevent people from getting effective treatment,” said Garrett, who cites several well-known cases that have had tragic outcomes, such as the death of a toddler in Alberta whose parents used natural remedies, rather than seek medical treatment for their seriously ill child.

Garret started writing the book in 2018 after noticing an increase in deceptive health care practices fuelled by the internet. Then came the COVID-19 pandemic, with its plethora of misinformation and fraudulent tests, cures, immune-boosting agents, anti-vaccination rhetoric, and fake cures, from bleach to sunlight.

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Watching the explosion of misinformation play out in real time as he wrote the book was fascinating, said Garrett, who compared it to bailing out a leaky boat: for every theory that was debunked, a new one would replace it.

“For my colleagues working in the ICUs and acute care units across the country, the effects of this pandemic are horrific, and any misinformation that prolongs it has serious consequences,” said Garrett, who has 35 years of experience in nursing and health care research.

Bogus health care claims come in many guises, whether it’s a “magical health machine” or magical technology, unproven supplements, super-juices, fake products, fake clinics, or even fake doctors like teen Malachi A. Love-Robinson, who was caught fraudulently practicing in Florida.

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“The most egregious are the fake cancer clinics in the way in which they prey on very vulnerable people,” said Garrett.

Mistrust of conventional medicine has led to distrust of some public health options, said Garret, in part, because of scandals associated with big pharma.

“We’ve had scandals with Abilify, OxyContin, Respiridal and others, where these pharmaceutical companies have behaved very poorly in terms of marketing, and that’s encouraged some people to move away from traditional medicine. ”

Deceptive healthcare providers have capitalized on that growing lack of public trust in science and medicine, and social media has fuelled the fire. Studies show that even “absurd” rumours and easily understood falsehoods spread faster on social media networks than solid science, said Garrett who cites Kaiser Family Foundation research that shows 2/3 of unvaccinated adults believed at least one vaccine lie.

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The psychology of advertising plays a role said Garrett.

“These folks are very good at pushing our buttons with buzzwords that appeal to us or invoke fear.”

Deceptive health care claimants tend to appeal to emotion rather than logic, and rely on techniques that connect positive social imagery and phrases such as “Moms like this,” or use images of nature, or “ancient traditions.”

They tend to rely on testimonials, and claims of groundbreaking or secret research science hasn’t caught up with yet, or the conspiracy theorists favourite: “doctors don’t want you to know this,” said Garrett.

“It’s a complex problem,” said Garrett. “With people in our own lives it’s important to debunk these idea when they come forward by pointing out why things are illogical or irrational and correcting misconceptions.”

Garret said the “wild west” of health care advertising needs to be better regulated, and our health care systems need to be made more user-friendly so fewer people will seek alternatives.

“Some of the key problems we have in health deception in Canada and more broadly are based on this lack of regulation.”

dryan@postmedia.com

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25Jul

Feds approve Vancouver psychedelics company’s trial use of ecstasy to treat PTSD

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Numinus, which specializes in psychedelic research, will study MDMA-assisted therapy on 20 people

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A Vancouver psychedelics company has been granted approval from Health Canada to study MDMA-assisted therapy for post-traumatic stress disorder.

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Numinus, a company that advances treatments for mental health care based on psychedelic-assisted therapies, said the feasibility of using the drug commonly known as ecstasy is being studied in collaboration with MAPS Public Benefit Corporation (a subsidiary of the Multidisciplinary Association for Psychedelic Studies).

“We are thrilled that Health Canada has issued its ‘no objection letter’ allowing this important study to proceed and, in doing so, potentially advance Canada toward a legal, regulated system for MDMA-assisted therapy,” said Payton Nyquvest, CEO of Numinus.

“At Numinus, we are focused on expanding patient access to psychedelic-assisted therapies such as MDMA for PTSD, and we are gratified that our study will provide safety and outcome data to regulators to support integration of this treatment into mainstream mental health care.”

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The company’s aim is healing depression, anxiety, trauma, pain and substance abuse, rather than managing their symptoms, he said.

Numinus will now seek about 20 volunteers to study the safety and effectiveness of MDMA-assisted therapy. Ecstasy is a controlled substance and is illegal to use except for approved medical and scientific studies using medical-grade MDMA.

Participants in preliminary studies had PTSD diagnoses from a range of causes, including combat-related events, accidents, abuse, sexual harm and developmental trauma.

Those preliminary trials showed 88 per cent of participants who got three controlled and supervised MDMA-assisted therapy sessions experienced a clinically significant reduction in symptoms, with 67 per cent no longer qualifying for PTSD diagnosis, compared to 32 per cent of participants taking placebos, according to Dr. Devon Christie, medical and therapeutic services director at Numinus.

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“Health Canada should be recognized for its ongoing leadership through its support of this study,” Christie said. “At our Vancouver clinic, we have spent months establishing the physical, technical, clinical and human resource infrastructure needed to move the study forward and ultimately foster greater access to MDMA-assisted therapy.“

Those participating in the study will meet with therapists for a preparatory session and then a day-long drug session. Unlike preliminary trials, the participants will not be required to stay overnight.

gordmcintyre@postmedia.com

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23Jul

This Week in History, 1901: Plans for a ‘new’ St. Paul’s Hospital are unveiled

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When the original St. Paul’s Hospital opened on Nov. 20, 1894, it was in a relatively modest wooden structure that had room for only 25 beds.

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Construction crews have begun to build a new St. Paul’s Hospital on the False Creek Flats. The $2.174 billion project is supposed to open in 2026 or 2027.

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St. Paul’s will moving into a massive site that is nearly three times its current footprint at 1081 Burrard Street. But it isn’t the first time the hospital has undergone a major expansion.

When the original St. Paul’s opened on Nov. 20, 1894, it was in a relatively modest wooden structure that had room for only 25 beds.

A photo in the Vancouver Archives shows a handsome Victorian structure with bay windows at the northeast corner and a four-storey centre section topped by an open-air cupola and cross. It looks more like a school than a hospital.

St. Paul’s Hospital on Burrard Street, circa 1898. Vancouver Archives AM54-S4-: Bu N426
St. Paul’s Hospital on Burrard Street, circa 1898. Vancouver Archives AM54-S4-: Bu N426 PNG

But the city boomed during the Klondike Gold Rush, and demand grew. On July 27, 1901, the Daily Province unveiled a “sketch plan” for a “new” St. Paul’s “almost exactly doubling the present capacity” to 100 patients.

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“A new operating room with the most modern appliances, with sterilizing rooms and sterilizers, will be at the corner of Pendrell and Burrard,” said the description of the illustration. “The whole building (is) an exact copy of the St. Vincent’s hospital in Portland, one of the finest on the continent.”

That would make sense, because the founder of St. Paul’s, Mother Mary Frederick, had come up from Portland, Ore., to build the hospital. Both St. Vincent’s in Portland and St. Paul’s were built by the Sisters of the Charity of the Providence, a Catholic order of nuns founded in Quebec.

Illustration of “The new St. Paul’s Hospital” from the July 27, 1901 Vancouver Daily Province.
Illustration of “The new St. Paul’s Hospital” from the July 27, 1901 Vancouver Daily Province. PNG

St. Paul’s was named after Bishop Paul Durieu, the first Bishop of New Westminster. According to a 1969 Aileen Campbell story in the Province, the original four-storey building was 78 feet long and 48 feet wide and constructed where the south wing is today.

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The addition was opened on Oct. 1, 1904.

“The new wing has a frontage of 45 feet on Pendrell, with wide verandas facing the sun all around and on each floor,” the Province reported.

“This veranda feature was particularly commented upon (at the opening), as the modern idea of giving the patient plenty of sunlight and fresh air is now universally adopted.

“The building is a four-storey one. On the ground floor there are nine private rooms, a large dining room and a general ward. This ward will very likely be used as a sailor’s ward, the hospital being the marine hospital of the port.”

The examination room was on the first floor. The second floor had 11 private rooms and three general wards, while the top floor was “given over to entirely to the use of the sisters,” and included “a beautifully arranged chapel, community room and dormitory.”

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The operating room for the hospital remained in the original 1894 building, but was updated. A separate two-storey building was constructed in the back of the main structure for contagious diseases.

A photo of the 1904 St. Paul’s shows it was also made of wood, and was attached to the original 1894 building on the south side. But it also proved to be too small for Vancouver, which virtually quadrupled in size from about 27,000 in 1901 to over 100,000 in 1911.

St. Paul’s Hospital, 24 Apr. 1923. Vancouver Archives AM54-S4-: Bu N251
St. Paul’s Hospital, 24 Apr. 1923. Vancouver Archives AM54-S4-: Bu N251 PNG

So in 1912-13, the current St. Paul’s was constructed. It was originally just the centre portion, but was expanded with a north wing in 1931 and a south wing in 1940, which added another 500 beds between them. Modern 10 storey additions were added in 1983 and 1991.

How much of any of the current St. Paul’s will be retained in the redevelopment of the Burrard site is unknown. It is listed as a Heritage A, the top ranking, on Vancouver’s Heritage register. But it is not designated, so it could be demolished. The structure is made of reinforced concrete with a brick and terra cotta facade, and needs costly seismic upgrading for earthquakes.

Developer Concord-Pacific reportedly paid close to $1 billion for the St. Paul’s site. At the time of the sale, Concord VP Peter Webb said “I imagine that through the process of working with the city and the heritage group within the city, we’ll ensure that the heritage element is accommodated, for sure.”

jmackie@postmedia.com

New South Wing Addition to St Paul’s Hospital, circa 1939-45. Leonard Frank/Vancouver Archives AM1376-: 2015-044.01
New South Wing Addition to St Paul’s Hospital, circa 1939-45. Leonard Frank/Vancouver Archives AM1376-: 2015-044.01 Photo by Leonard Frank /PNG
The Sisters of Providence established St. Vincent Hospital, the first permanent hospital in Oregon, in 1875, at NW 12th and Marshall in Portland. The second St. Vincent Hospital, shown here in 1909, was dedicated in 1895. It was sited on hilly land on NW Westover Rd. between Glisan and Irving Streets. This building was demolished in the late 1970s. Postcard from the Portland Archives; description from the website Vintage Portland.
The Sisters of Providence established St. Vincent Hospital, the first permanent hospital in Oregon, in 1875, at NW 12th and Marshall in Portland. The second St. Vincent Hospital, shown here in 1909, was dedicated in 1895. It was sited on hilly land on NW Westover Rd. between Glisan and Irving Streets. This building was demolished in the late 1970s. Postcard from the Portland Archives; description from the website Vintage Portland. PNG
Population growth in western cities, 1901-1 to 1911. From Norbert MacDonald’s A Critical Growth Cycle For Vancouver, 1901-1914 in B.C. Studies, Spring 1973.
Population growth in western cities, 1901-1 to 1911. From Norbert MacDonald’s A Critical Growth Cycle For Vancouver, 1901-1914 in B.C. Studies, Spring 1973.

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23Jul

COVID-19: Pride events to bring ‘sense of joy’ for LGBTQ+ community hit hard by pandemic

by admin

Advocates hope this month’s Pride events will bring renewed hope, even if the annual parade will be virtual again, after the mental health of many LGBTQ+ members suffered during the pandemic.

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The pandemic forced Karn Sahota, a young gay man from Abbotsford, to take his social work classes online, to lose his job with a seniors’ recreational organization, and to cancel some regular social outings, such as Tuesday night movies with a friend.

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But he fared better in the past 16 months than many other South Asians he knows in the LGBTQ+ (lesbian, gay, bisexual, trans, queer) community, mainly because he could regularly escape his family home to a retail job that was not disrupted by COVID-19 restrictions.

“I was working at Walmart as a cashier and customer service. So that was the one lifeline that kept me going because that never shut down,” said Sahota, who is also an outreach worker with Sher Vancouver, which provides support to South Asian members of the LGBTQ+ community.

Sahota has been in touch with other young people who suffered, and continue to suffer, during the pandemic. Some, for example, have not disclosed their sexual identities to their families and therefore struggled when COVID restrictions around jobs, education and social gatherings forced them to spend so much time at home.

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“They’re kind of feeling a bit more suffocated because they’re not able to really, truly be themselves around their parents,” said Sahota, 26, who often hears from young people in response to a Metro Vancouver “survival guide” for newcomers he created for Sher.

Karn Sahota in Abbotsford.
Karn Sahota in Abbotsford. Photo by Francis Georgian /PNG

Before the pandemic, Statistics Canada figures and research showed LGBTQ+ populations faced significantly higher rates of mental health and suicide ideation challenges than heterosexuals, which was largely thought to be caused by social stresses such as stigma, prejudice and discrimination.

And those mental health woes have only worsened during the pandemic, as restrictions led to the cancellation of many services and social connections, according to four Metro Vancouver organizations that work with the local LGBTQ+ community.

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Sahota and others, however, hope that both the easing of COVID rules and the series of Pride events organized for this month will boost spirits among gay, lesbian, bisexual and trans people, even if the beloved Pride parade will be virtual again this year.

“My friends and I, for the past few years, we always go out to take part in the festivities. Even if there’s no parade, we just like to go around Davie Street, I guess the ‘gaybourhood’ as they call it. It’s kind of getting the vibe and getting immersed in a different world than way out in the valley here,” said Sahota, who recently completed a social work degree from Douglas College and a business certificate from Kwantlen Polytechnic University.

“I’m very excited. And I think a lot of people really need it after so long of being cooped up in their homes in situations where they might not be accepted, where they might feel not welcome. But hopefully these festivities, even if they’re on a much smaller scale, will help people have more of a sense of joy coming into the end of this year.”

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Vancouver Pride Society is holding more than 60 events — many online, like the parade, and a few in-person, such as three Pride lounges — this month. The celebrations culminate with VanPrideFest July 30 to Aug. 1 in Jonathan Rogers Park in Mount Pleasant, featuring live entertainment with 10 different themes, including drag, yoga, music and family picnics.

Andrea Arnot, Vancouver Pride Society executive director.
Andrea Arnot, Vancouver Pride Society executive director.

There was pre-registration for VanPrideFest to keep numbers in line with COVID protocols, and the free tickets were snapped up very quickly, said Andrea Arnot, Pride’s executive director.

“People are really eager and hungry to be in spaces with other queer folks after so many months of isolation and being in the pandemic. So I think it’s important for us to hold the events,” she said.

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“We know that some people in our community are not fully out. And so they really need those queer spaces to be able to be themselves and feel comfortable, because sometimes they go home and they’re not.”

The 2021 lineup, she said, is a hybrid of 2020 when COVID forced everything except the art walk to be virtual, and of 2019 when all events were public, including the Pride Parade that drew an estimated 650,000 people. When restrictions were loosened July 1 to allow up to 5,000 at outdoor gatherings, supporters had hoped the parade could be salvaged but Arnot said it would have been impossible to keep attendance below that ceiling and the turnaround time was too short.

“It’s really challenging. We have heard from community how much they miss the parade, and would like to see it happen,” she said, adding the parade is important because it dominates downtown Vancouver for a day to remind everyone of the region’s large LGBTQ+ population.

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“There’s still work that needs to be done to eliminate discrimination. So even though our events are small, we’ve got them spread out through the city. And I think that visibility is really important for the general public to see that we’re still here.”

‘Pretty critical moments’

Of course, those who advocate for the LGBTQ+ community are not just fighting discrimination these days, but also the well-being of people who have lost so many crucial services during the pandemic.

The doors were locked at QMUNITY — a non-profit in Vancouver’s West End that provides social services to homosexual, trans and two-spirit people — when the pandemic struck in March 2020. It didn’t reopen until earlier this month — which meant counselling, outreach and events were online. Fewer people accessed the virtual resources, but those who did were very vulnerable and needed extra support, said co-executive director Joel Harnest.

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Joel Harnest, Co-Executive Director of QMUNITY.
Joel Harnest, Co-Executive Director of QMUNITY. Photo by Francis Georgian /PNG

“In all of our programs, staff said they were working with fewer people, but those people were requiring so much more in-depth support in recognition of deteriorating mental health, that sense of isolation and loneliness, job and housing precarity. The people who were most at the margins were just doubly, triply impacted by COVID,” said Harnest, who also worried about increasing rates of depression.

“I think a lot of people were tested in ways that none of us have been tested (before).”

QMUNITY saw the challenges in a range of age groups over the past 16 months. Older clients, who often go back into the closet when they enter long-term care homes, were stuck inside during lockdowns and unable to attend the organization’s seniors’ programs. Young people, who perhaps have not revealed their sexual orientation to family, missed the outlets provided by QMUNITY’s youth programs or going to school.

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“Our youth workers were confronted with really challenging conversations pre-COVID, around anxiety and suicide ideation and precarious housing, etc. But there was also an element of: We’re hosting a space where a bunch of 16 to 20-year-old queer youth can come together and just be social and engage with one another. And so there was a lightness to it,” Harnest said.

“Whereas now we find that the lightness in our work is actually quite hard to come by, because I think the people who are showing up on our doorstep or showing up on our Zoom cameras, are ones who are at some pretty critical moments in their lives.”

There has been some good news over the past year, though, at Vancouver-based QMUNITY, which has a provincial mandate to provide LGBTQ+ resources. When its peer support groups went online, people from across B.C. were able to access them, so rather than just dealing with Metro Vancouver residents, there were participants from Kelowna, Smithers and Vancouver Island.

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When the pandemic is over, Harnest hopes to get more government funding so he can continue to offer online support to youth in other areas of the province where there are far fewer services.

He also hopes the Vancouver Pride Society festivities will boost spirits this summer, along with additional activities held by other LGBTQ+ organizations Those include QMUNITY’s “Aging With Pride” for older people on July 30, a variety of events run by Alternative Pride Vancouver from July 29 to Aug. 2, and a half dozen virtual talks through July and August by two-spirit Indigenous leaders, people of colour, drag queens, sex workers, elders and youth, organized by the Health Initiative for Men (HIM).

The 2019 Vancouver Pride Parade.
The 2019 Vancouver Pride Parade. Photo by NICK PROCAYLO /PNG

‘A cause for concern’

HIM, which offers services to gay and bisexual men as well as gender diverse people, receives funding from the B.C. Health Ministry to operate five health centres in Metro Vancouver. However only the two in Vancouver remained open during the pandemic.

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The locations in Surrey, New Westminster and Abbotsford were closed when Fraser Health needed the nurses who work in those centres to focus on COVID instead, but the hope is that they will open again this year, said Simon Rayek, HIM’s program manager of health promotion.

Some Fraser Valley residents have travelled to Vancouver so they could continue to receive the health services offered by HIM, which include testing for sexually transmitted infections, help with HIV exposures, and vaccinations for hepatitis A and B.

“We also believe that a lot of people just aren’t getting tested and are still having the kinds of sex or the kinds of interactions that we would suggest someone get tested more regularly for,” Rayek added.

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“We have come a long way in offering tailored services to meet queer people where they’re at, and to ensure that people who are vulnerable have access to the kinds of programs that keep them healthy. And the fact that those haven’t been able to operate for 16 months is definitely a cause for concern.”

But as services declined in Fraser Health during the pandemic, HIM was able to increase operations in Interior Health by running anonymous testing stations dubbed “Prick!” — where participants are tested for HIV and sexually transmitted infections in cities such as Kamloops, Vernon and Penticton.

Simon Rayek, program manager of health promotion at Health Initiative for Men.
Simon Rayek, program manager of health promotion at Health Initiative for Men. Photo by Francis Georgian /PNG

HIM also has mental health programs, and demand was already high pre-pandemic for these peer counsellors who helped clients with issues that include loneliness, anxiety, coming out, racism, self-esteem, body image, and substance use.

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A 2018 survey of 793 Vancouver cis or trans men who have sex with men found they were two to three times more likely than straight men to struggle with mental health problems, for a range of reasons that included eating disorders, relationship problems, gender dysphoria and suicidal thoughts. The survey, by Community-Based Research Centre, found more than one third of respondents had felt depressed in the previous two weeks, and 60 per cent of them wanted professional help.

During the pandemic, Rayek said, gay, bisexual and trans men struggled with issues such as unemployment and isolation, which then led to even more mental health challenges. He said COVID restrictions were more palatable for people who live in a more traditional family setting. Many LGBTQ+ people, by comparison, were alienated from their “chosen family,” such as friends and community organizations.

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“Anecdotally, we maybe don’t couple the same way all the time as straight couples do; don’t have children, I’m sure, at the same rates that straight couples do; and a lot of us are estranged from our parents and our siblings,” said Rayek, who hopes policies during any future pandemics could better consider the realities of different lifestyles.

Like QMUNITY, though, HIM’s counselling was mainly available only in Metro Vancouver before COVID struck, but now it is expanding virtually through all five health authorities.

“One of the silver linings of the pandemic is that as much as it maybe exacerbated mental health problems, it also opened up a way of meeting people where they’re at through telehealth and online counselling,” Rayek said.

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In June, HIM also launched the More Than Sex resource guide for the public and health care providers, after trans, non-binary and two-spirit people said that type of information is desperately needed — especially in smaller and remote towns where there are still high rates of stigma and fewer unique medical services, Reyak said.

The guide defines the language around different types of sex and the lived experiences of trans, non-binary and two-spirited people, and it offers contact info for regional organizations that can provide additional health and well-being services to this community. HIM has just begun providing the guide to supportive health care providers, who will be asked to share it with like-minded colleagues, especially in towns outside urban centres.

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“Having a resource like this where we lay everything out in a really transparent way we think will be helpful. What it requires is us to get it into the hands of the people who will champion it, and the people who other doctors and other nurse practitioners and other counsellors will listen to,” Rayek said.

Pride about celebration and ending discrimination

Alex Sangha created Sher Vancouver 13 years ago to support queer South Asians who, perhaps, hadn’t told their families about their sexual orientation or who felt alienated because their traditional family didn’t understand or approve.

Sher’s Facebook, Instagram and Twitter have received an average of 40 to 60 requests for information a week since COVID struck, more than double the pre-pandemic numbers. He believes the increase is partly due to people being online more during the lockdowns and potentially because services like in-person counselling or drop-in centres were closed.

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“We get messages from families from local people coming out. We get messages from immigrants. We get messages from newcomers and students who are studying here,” said Sangha, a social worker. “We are actually really growing rapidly and the demand on our organization is really a lot.”

Alex Sangha, founder of Sher Vancouver.
Alex Sangha, founder of Sher Vancouver. Photo by Avi Dhillon

Despite a greater demand for help, though, many of these organizations struggled financially through the pandemic. Sher, for example, was unable to hold its major fundraiser this year, a Christmas gala, and as a result couldn’t continue its tradition of giving out grocery gift cards to low-income members during the 2020 holiday season.

Sher was also unable to hold its annual ceremony to hand out youth leadership awards, named after January Marie Lapuz, a trans woman who was murdered in Vancouver in 2012. During the pandemic, Sangha had to mail out the winners’ certificates, which he said was a shame because those youth missed out on being celebrated.

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“It’s good to recognize people in our community for leadership, in a vulnerable and marginalized segment of the population, and especially when they’re so young, and they have the courage to come out,” he said.

Sangha, who also founded Sher Films to produce documentaries on LGBTQ+ people and social justice issues, knows how difficult it is to speak with parents about sexual orientation. He recently released Emergence: Out of the Shadows, a documentary about how three South Asians came out to their conservative families.

As COVID case numbers decline and more social and professional services reopen, HIM’s Rayek encourages LGBTQ+ people to “take stock” of the last 16 months, and address any unmet physical or mental health needs.

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The challenge, though, remains finding non-judgmental health care, he said. Recently collected data, for example, indicate that many trans people are not comfortable going to hospital emergency rooms for help because they or someone they know has faced discrimination there.

“Every pride season, I encourage straight allies to celebrate with us, and at the same time recognize how much work needs to be done and how health-care access continues to be disproportionately unavailable to queer people with unique health needs,” Rayek said.

“There are still policies and decision-making happening that negatively affect, in really material ways, the lives of queer, trans, non-binary, disparate gender-diverse people.”

lculbert@postmedia.com

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15Jul

B.C. to offer Canada’s first safe drug supply in response to overdose crisis

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The initiative will start by offering opioid replacements, including fentanyl patches. Stimulants will come later. Prescribed heroin is not included in the program, because of a lack of supply, the minister says.

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B.C. will be the first province in Canada to introduce a safe drug supply, in response to the deadly overdose crisis.

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But the rollout will begin slowly, at pre-existing clinics that already offer pharmaceutical replacement drugs as part of a trial program, and will at first offer just opioid replacement options, including fentanyl patches.

The initiative won’t offer stimulants or prescribed heroin in the first phase — which critics say is moving too slowly when an average of five British Columbians a day are being fatally poisoned by toxic street drugs right now.

Officials with the Ministry of Mental Health and Addictions, though, argue they are moving as fast as they can with Canada’s first safe supply program.

“I don’t want people to lose hope and feel that they’re not going to get access,” Minister Sheila Malcolmson told Postmedia today.

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“Absolutely, we feel the urgency of the public health emergency. There’s no one else in Canada that has taken this step. So British Columbia is continuing to break new ground building on that addition of prescribed safer supply over a year ago.”

At the beginning of the COVID-19 pandemic, which exacerbated the existing overdose crisis, the B.C. government created a temporary safe supply program, allowing doctors and nurses to prescribe medication alternatives to substances, including opioids, alcohol, stimulants and benzodiazepines.

Now, $22 million has been earmarked over the next three years for the five health authorities to make this safe supply a permanent option, starting with opioids. Fentanyl patches were offered in a limited trial project, and that will now be significantly expanded.

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“Nowhere else in Canada can anybody be prescribed a fentanyl patch for this purpose, so that really is a breakthrough, and based on input that we heard strongly through our consultations (with drug users),” Malcolmson said.

The government’s announcement said the first phase of the initiative would take 18 to 24 months, and be continued and expanded in health authority programs that already prescribe alternatives to illicit drugs. However, many of those clinics are urban and at capacity, so the question remains how the province will extend these services to rural and remote areas of the province.

Malcolmson said the five health authorities must report back to government in the next two weeks with their implementation plans, and more details will be known then; but she said “we think that it might take three to six months for actual things on the ground for the patient” to begin.

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Malcolmson also said she “recognizes there is a need” to include replacements for stimulants — the most common street drugs that fall into this category are cocaine and amphetamines — in the program, but she had no timeline for when that would happen.

“What medications are available are going to vary regionally based on the program and the service setting and the prescriber. And I guess that’s probably the bottom line: that other medications will be considered by each prescribing program and based on the needs of people in the program,” Malcolmson added.

She said drug users have also asked for prescription heroin, but said that is not being included at this time because the government has not been able to find a domestic supply. She had no timeline on its inclusion, but said the government would continue to look for a supply.

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Vince Tao, a community organizer with the Vancouver Area Network of Drug Users (VANDU), said: “This step is a decent one. But it is, as always, too little, too late.”

It’s an issue, Tao said, that “the power still rests in the hands of individual prescribers,” because that arrangement can be an “obstacle to access.”

VANDU members have reported that while some physicians, nurses and pharmacists are sympathetic to their needs, many health-care professionals are not comfortable prescribing these kinds of drugs, Tao said.

Tao said it seems unusual that the policy includes fentanyl patches, injectable hydromorphone and tablet hydromorphone, but not heroin, which has been prescribed in a limited capacity in B.C. for years.

Researchers from Providence Health Care and the University of B.C. led North America’s first clinical trial of prescribed heroin back in 2005.

More than 7,000 British Columbians have been poisoned by the toxic drug supply since the overdose public health crisis was declared in 2016.

Doctors and nurse practitioners will prescribe the safe supply, but the $22 million will fund other “wraparound services” to further help drug users, the government says.

lculbert@postmedia.com

More to come …

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14Jul

Daphne Bramham: When it comes to drug policy, politicians aren’t following the evidence

by admin

Opinion: Why are our politicians ignoring experts on booze and drugs?

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Every day since COVID-19 struck, we’ve been told that evidence matters, that we need to listen to the scientists and researchers.

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Yet, when it comes to drugs, our provincial and municipal governments figure they know better and pay little or no attention. It seems they’d rather give people what they want and damn the consequences.

The B.C. government’s announcements last week that cocktails can now be delivered along with meals and that cannabis stores can now legally do dial-a-dope were greeted enthusiastically. The same has been true of announcements by various municipalities that they are expanding their zones where people can openly drink alcohol.

Cannabis remains mostly a no-go for parks since it falls under the prohibition against smoking — one of the few legal vices deemed worthy of strictly regulating.

But is this good public policy?

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The Canadian Institute for Substance Use Research suggests that it’s not and especially not considering that its December research indicated that private liquor store sales in British Columbia rose 18.5 per cent between March and June 2020, while government liquor stores had an eight-per-cent increase.

At the time, lead researcher Tim Stockwell said, “We suspect part of this increase at private stores has to do with the fact they have been making alcohol more convenient to buy, by offering home delivery with a minimum order or listing its products on third-party delivery apps.”

On Tuesday, institute researchers led by Tim Naimi released Not a Walk in the Park: Alcohol Consumption on Municipal Properties in B.C. It makes recommendations to local governments for assessing and mitigating the risks of unsupervised consumption in public places.

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“This approach carries significant public health and safety risks, may add costs to governments and may divert sales away from regulated, licensed establishments,” they wrote. “Furthermore, this approach may not support the social connection goals of everyone in the community, as not everyone welcomes increased opportunities for alcohol consumption.”

Among the “second-hand harms” cited are increases in assaults, gender-based violence, vandalism and impaired driving. The report also cites an increased risk of drowning and potentially marring the enjoyment of others (including families) sharing public spaces and the higher risk of COVID-19 transmission.

Even before the COVID and the liberalization of liquor laws, the institute noted that B.C. consumption was already higher than the national average, steadily rising since 2013 along with the public costs.

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Those costs are substantial. There is a causal link between alcohol use and 200 types of chronic diseases and acute injuries.

The institute estimated the 2017 economic cost in B.C. of alcohol was $2.38 billion, or $483.10 per capita, surpassing tobacco ($277.80) and opioids ($257.04).

Coincidentally, on Tuesday when institute research was released, the Globe and Mail reported that later this week the B.C. government will be expanding its unprecedented experiment with providing pharmaceutical alternatives as replacements for street drugs.

The program was originally aimed at supporting people with addictions physically distance, self-isolate or quarantine in order to prevent the spread of COVID-19.

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Now, with widespread vaccinations and the reopening of the economy, British Columbia will require all health authorities and their clinicians to provide pharmaceutical grade opioids (including fentanyl), stimulants and other addictive substances to illicit drug users.

Out of hospital drug costs will be paid by Pharmacare, the provincial drug plan.

The expansion is coming even though the number of overdose deaths has continued to rise and is on track to hit a record this year.

But that’s no reason to stop, according to the draft update to the B.C. Centre on Substance Use’s safe-supply guidelines.

“The risk of overdose remains high due to the contaminated drug supply,” says the draft document. “(And) it may be appropriate to continue this prescribing for patients who have shown clear indication of benefit.”

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For evidence, the draft notes that it’s “challenging” to compare mortality rates to opioid-user-only data because safe-supply data mixes opioids, stimulants and alcohol.

Between March 27, 2020 and Feb. 28, 2021, there were 6,498 people in the program including 1,431 who were given alcohol withdrawal medication and 3,771 who were given opioid alternatives.

Of the 82 people in the program who died, the cause of death for 37 was not available “because of a delay in vital statistics data.”

Among the findings was that the urine samples of “many” who were prescribed oral hydromorphone (a narcotic) were laced with fentanyl, suggesting that those “many” were at very least topping up their safe supply with illicit drugs.

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According to the Globe and Mail, the final report notes that “health system partners” expressed “significant reservations” about the approach because their training does not include prescribing potentially fatal substances for other than their medically regulated use.

Still, the document’s unnamed authors concluded, “We recognize that we have been unable to address all concerns, but we also recognize that we have to start somewhere.”

Meantime, Addictions Minister Sheila Malcolmson is still sitting on an evidence-based proposal that would provide housing, addiction and mental health treatment for 1,500 people and whose $37-million cost would be offset by the reduction in hospitalizations and interactions with the police.

Following the evidence worked with COVID. So, maybe with these other longer term and wickedly expensive problems, politicians should give it a try — even if drinking wine and beer from glasses rather than paper bags in parks seems like a good idea.

dbramham@postmedia.com

Twitter: @bramham_daphne

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Comments

Postmedia is committed to maintaining a lively but civil forum for discussion and encourage all readers to share their views on our articles. Comments may take up to an hour for moderation before appearing on the site. We ask you to keep your comments relevant and respectful. We have enabled email notifications—you will now receive an email if you receive a reply to your comment, there is an update to a comment thread you follow or if a user you follow comments. Visit our Community Guidelines for more information and details on how to adjust your email settings.

13Jul

Daphne Bramham: When it comes to drug policy, politicians aren’t following the evidence

by admin

Opinion: Why are our politicians ignoring exports on booze and drugs?

Article content

Every day since COVID-19 struck, we’ve been told that evidence matters, that we need to listen to the scientists and researchers.

Advertisement

Article content

Yet, when it comes to drugs, our provincial and municipal governments figure they know better and pay little or no attention. It seems they’d rather give people what they want and damn the consequences.

The B.C. government’s announcements last week that cocktails can now be delivered along with meals and that cannabis stores can now legally do dial-a-dope were greeted enthusiastically. The same has been true of announcements by various municipalities that they are expanding their zones where people can openly drink alcohol.

Cannabis remains mostly a no-go for parks since it falls under the prohibition against smoking — one of the few legal vices deemed worthy of strictly regulating.

But is this good public policy?

Advertisement

Article content

The Canadian Institute for Substance Use Research suggests that it’s not and especially not considering that its December research indicated that private liquor store sales in British Columbia rose 18.5 per cent between March and June 2020, while government liquor stores had an eight-per-cent increase.

At the time, lead researcher Tim Stockwell said, “We suspect part of this increase at private stores has to do with the fact they have been making alcohol more convenient to buy, by offering home delivery with a minimum order or listing its products on third-party delivery apps.”

On Tuesday, institute researchers led by Tim Naimi released Not a Walk in the Park: Alcohol Consumption on Municipal Properties in B.C. It makes recommendations to local governments for assessing and mitigating the risks of unsupervised consumption in public places.

Advertisement

Article content

“This approach carries significant public health and safety risks, may add costs to governments and may divert sales away from regulated, licensed establishments,” they wrote. “Furthermore, this approach may not support the social connection goals of everyone in the community, as not everyone welcomes increased opportunities for alcohol consumption.”

Among the “second-hand harms” cited are increases in assaults, gender-based violence, vandalism and impaired driving. The report also cites an increased risk of drowning and potentially marring the enjoyment of others (including families) sharing public spaces and the higher risk of COVID-19 transmission.

Even before the COVID and the liberalization of liquor laws, the institute noted that B.C. consumption was already higher than the national average, steadily rising since 2013 along with the public costs.

Advertisement

Article content

Those costs are substantial. There is a causal link between alcohol use and 200 types of chronic diseases and acute injuries.

The institute estimated the 2017 economic cost in B.C. of alcohol was $2.38 billion, or $483.10 per capita, surpassing tobacco ($277.80) and opioids ($257.04).

Coincidentally, on Tuesday when institute research was released, the Globe and Mail reported that later this week the B.C. government will be expanding its unprecedented experiment with providing pharmaceutical alternatives as replacements for street drugs.

The program was originally aimed at supporting people with addictions physically distance, self-isolate or quarantine in order to prevent the spread of COVID-19.

Advertisement

Article content

Now, with widespread vaccinations and the reopening of the economy, British Columbia will require all health authorities and their clinicians to provide pharmaceutical grade opioids (including fentanyl), stimulants and other addictive substances to illicit drug users.

Out of hospital drug costs will be paid by Pharmacare, the provincial drug plan.

The expansion is coming even though the number of overdose deaths has continued to rise and is on track to hit a record this year.

But that’s no reason to stop, according to the draft update to the B.C. Centre on Substance Use’s safe-supply guidelines.

“The risk of overdose remains high due to the contaminated drug supply,” says the draft document. “(And) it may be appropriate to continue this prescribing for patients who have shown clear indication of benefit.”

Advertisement

Article content

For evidence, the draft notes that it’s “challenging” to compare mortality rates to opioid-user-only data because safe-supply data mixes opioids, stimulants and alcohol.

Between March 27, 2020 and Feb. 28, 2021, there were 6,498 people in the program including 1,431 who were given alcohol withdrawal medication and 3,771 who were given opioid alternatives.

Of the 82 people in the program who died, the cause of death for 37 was not available “because of a delay in vital statistics data.”

Among the findings was that the urine samples of “many” who were prescribed oral hydromorphone (a narcotic) were laced with fentanyl, suggesting that those “many” were at very least topping up their safe supply with illicit drugs.

Advertisement

Article content

According to the Globe and Mail, the final report notes that “health system partners” expressed “significant reservations” about the approach because their training does not include prescribing potentially fatal substances for other than their medically regulated use.

Still, the document’s unnamed authors concluded, “We recognize that we have been unable to address all concerns, but we also recognize that we have to start somewhere.”

Meantime, Addictions Minister Sheila Malcolmson is still sitting on an evidence-based proposal that would provide housing, addiction and mental health treatment for 1,500 people and whose $37-million cost would be offset by the reduction in hospitalizations and interactions with the police.

Following the evidence worked with COVID. So, maybe with these other longer term and wickedly expensive problems, politicians should give it a try — even if drinking wine and beer from glasses rather than paper bags in parks seems like a good idea.

dbramham@postmedia.com

Twitter: @bramham_daphne

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Comments

Postmedia is committed to maintaining a lively but civil forum for discussion and encourage all readers to share their views on our articles. Comments may take up to an hour for moderation before appearing on the site. We ask you to keep your comments relevant and respectful. We have enabled email notifications—you will now receive an email if you receive a reply to your comment, there is an update to a comment thread you follow or if a user you follow comments. Visit our Community Guidelines for more information and details on how to adjust your email settings.

13Jul

Smoky conditions pose risk for pregnant women’s babies

by admin

Pregnant people are uniquely vulnerable to the effect of microscopic smoke particles due to wildfires and should stay indoors if possible on smoky days.

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Summer in Western Canada now has a subtitle: Wildfire season.

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More than 300 wildfires are burning across the province, Environment Canada says hot, dry conditions are continuing in central and south B.C., and the B.C. Environment Ministry is warning everyone who may be exposed to smoky conditions, particularly older adults, those who are pregnant and those who are immune-compromised or have health conditions to exercise caution and limit outdoor activity if breathing becomes uncomfortable or causes a person to feel unwell.

“Pregnant women are particularly vulnerable, in addition to other groups like the young and the very old,” said Dr. Wee-Shian Chan, head of medicine at B.C. Women’s Hospital. “Studies suggest that there is an impact on pregnancy, including smaller and earlier babies, in addition to the stress which comes with having a forest fire near where they live.”

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Chan said it is difficult to run controlled studies of the affect of smoke on pregnant women because it is not safe to expose pregnant women to smoke, but studies have been conducted on pregnant women who were exposed to wildfires in California showing that “smoke particles of a certain size do get deep into the lungs, and can affect the body systemically, and the impact is not negligible.”

Chan advises pregnant women to “minimize exposure to smoke, and to try not to leave the house if possible, have an air filter, and if you do have to be outside, use a properly fitted mask.”

She added that women with lung problems such as asthma should keep their medications close at all times, and should not hesitate to use their inhalers or seek medical help if they feel short of breath or light-headed. She said keeping hydrated is also important.

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A peer-reviewed article in Environment International said maternal exposure to wildfire during late pregnancy is linked to reduced birth weight and preterm birth, and according to the U.S. Environmental Protection Agency, fine or microscopic particles from smoke can penetrate deep into the lungs and cause a range of health problems to anyone exposed, including burning eyes and a runny nose, to aggravation of chronic heart and lung diseases.

Anyone with a concern about air quality can monitor the daily air quality index at https://www2.gov.bc.ca/gov/content/environment/air-land-water/air/air-quality/air-advisories

dryan@postmedia.com


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Is there more to this story? We’d like to hear from you about this or any other stories you think we should know about. Email vantips@postmedia.com.

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Postmedia is committed to maintaining a lively but civil forum for discussion and encourage all readers to share their views on our articles. Comments may take up to an hour for moderation before appearing on the site. We ask you to keep your comments relevant and respectful. We have enabled email notifications—you will now receive an email if you receive a reply to your comment, there is an update to a comment thread you follow or if a user you follow comments. Visit our Community Guidelines for more information and details on how to adjust your email settings.

13Jul

$860-million upgrade and expansion approved for Richmond Hospital

by admin

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The province has approved a major expansion and improvements to Richmond Hospital,

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The four-phase project includes a new nine-floor patient tower that will add 113 new beds to the hospital, more operating rooms and an expanded emergency department.

The eight year-long project’s estimated cost ballooned from $375 million to $860.8 million due to plan changes over the past 18 months.

Health Minister Adrian Dix said the expansion is long overdue.

“This hospital was built in 1964, the year I was born,” he said. “Here in Richmond, in acute care, they deserve a hospital built for the 21st century and that’s what they’re going to get.”

The emergency department will expand from 60 spaces to 82 spaces. The new and larger operating rooms will allow for space for high tech equipment.  Pre and post-surgical care spaces will more than double from 26 to 69.

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The new tower will also include an intensive care unit, a fully equipped medical imaging department with four CT scanners and two MRIs, a pharmacy and a short-stay pediatrics unit.

The existing south tower will be redeveloped to create new inpatient psychiatry and psychiatric emergency units so existing services will be in one location and brought up to modern standards. The south tower will also have a maternity ward and neonatal intensive care unit.

Premier John Horgan defended the budget increase. He said the delay was to allow for consultations with health practitioners to ensure the project would meet the needs of the people of Richmond for decades to come.

“We shouldn’t be in a place where we’re spending $860.8 million dollars to ‘make it work’ or ‘to get by’ or to find a way to use duct tape and baling twine,” said Horgan. “We took the time to get it right.”

11Jul

Cycling across Canada for the homeless was worth it for Vancouver duo

by admin

“What really helped was knowing it was for a cause, that me not giving up would help others have something to eat — it was something bigger than myself.” — Osa Hawthorne

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Vancouverites Keenan Macartney and Osa Hawthorne faced black flies, bears, semi-trucks, injuries, loneliness and a deadly heat dome biking across Canada, but never gave up.

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The duo, who have raised nearly $13,000 for Vancouver’s CityReach Care Society, said that knowing they were raising money for a good cause helped keep them going on their cross-country trek.

Macartney has volunteered for CityReach’s Club Freedom, a soup kitchen which provides food, prepared meals and recovery services to low-income families, since he was 13. He wanted to find a way to do more.

He and Osa are best friends, inseparable since the age of nine, and accustomed to doing adventurous things together: skydiving or hiking the west coast trail or, when they were kids, longboarding the hills in the West Van neighbourhood where they grew up. Note to kids reading this: longboarding is not allowed on the streets of West Van.

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How hard could it be to cycle across Canada? Very hard, as it turns out.

“We are ambitious and naive,” said Macartney.

Osa Hawthorne and Keenan Macartney biked across Canada to raise funds for the homeless in Vancouver.
Osa Hawthorne and Keenan Macartney biked across Canada to raise funds for the homeless in Vancouver. Photo by photo submitted /submitted

The friends started their journey in Quebec City on June 1 as COVID-19 restrictions prevented them from starting in the Maritimes. Each carried 20-30 pounds of gear in three panniers, including tents, sleeping bags, cookware, food, water and a couple of pairs of bike shorts.

Echelon Wealth management signed on as a sponsor, pledging to match the first $1,000 raised, Landyachtz Bike store, donated the wheels: a sturdy cross between a road bike and a gravel bike.

Their plan was to cover 180 km a day, unsupported, riding on the road or on the shoulder of the Trans Canada highway. They soon discovered that sometimes there is no shoulder on the highway. They had to ride on the white line in the far right travelling lane while semi-trucks barrelled past with alarming frequency. One, carrying an excavator, roared past so close that Macartney could feel the excavator’s blades whistle past his head.

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“I’ve never felt anything more terrifying than the draft of air that shoots up and pushes you around as the semi goes by, the blades of the excavator inches away,” said Macartney.

The duo were only about 500 km into the journey, still trying to figure out how to deal with the trucks and SUVS, to learn when to hold the line, and when to ditch in the gravel, when Macartney’s knees gave in to a painful tendon injury and he had to take a break for about a week.

Oso was left on his own to cross the long, desolate stretch north of Lake Superior.

“Being by myself was the hardest part. I was by myself for about seven days, no cellphone reception, totally isolated,” said Oso.

He battled on, through swarms of black flies, and, one night while camping under a bridge, he had a sleepless night listening to the heavy breathing of a bear outside his tent.

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Oso wondered, briefly, whether he should pack it in.

“It’s very, very uncomfortable being in the saddle eight to 12 hours a day,” said Oso. “But what really helped was knowing it was for a cause, that me not giving up would help others have something to eat — it was something bigger than myself.”

The kindness of strangers who bought meals, shared water and offered showers and encouragement, helped.

Macartney was able to rejoin the ride after getting treatment for his knee, and the pair sailed through the Prairies, survived a heat wave in Alberta, made it through the Rocky Mountains, and finally, on Saturday, arrived in Victoria.

To donate or learn more about the journey, go to ko-canada.com

dryan@postmedia.com

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Postmedia is committed to maintaining a lively but civil forum for discussion and encourage all readers to share their views on our articles. Comments may take up to an hour for moderation before appearing on the site. We ask you to keep your comments relevant and respectful. We have enabled email notifications—you will now receive an email if you receive a reply to your comment, there is an update to a comment thread you follow or if a user you follow comments. Visit our Community Guidelines for more information and details on how to adjust your email settings.

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