Scott Elliott: Harm reduction, food for thought

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      By Scott Elliott

      Every day when I get up in the morning, just like millions of Canadian across the country, I don’t have to think about where my next meal is coming from. We don’t like to talk about privilege—and when your next meal is taken for granted—you have privilege.

      Without food we will all die. Food is medicine. And the privileged get their medicine.

      At the Dr. Peter Centre we work some of the city’s most marginalized people living with HIV, mental illness, and substance use. We have many clinical resources and food is our primary medicine and “harm reduction” tool. Normally when we think harm reduction, we think about clean needles, supervised injection sites, and a safe drug supply. The Dr. Peter Centre provides these, but without addressing the most basic need, these tools are simply not sufficient

      Each year, our kitchen staff serves two meals daily for our 400 day-health participants and three meals daily with access to snacks for the 24 people who live in our full-time care facility. In total this equates to around 96,000 meals a year, with our in-house dietician and chef working diligently to ensure high nutrient, tasty, and cost effective meals that ensure participants have a balanced diet.

      But this is only a part of the story. We also know everybody’s name and all are treated with dignity and care. To do this, we must fundraise intensely to ensure we have adequate resources, as food makes up an essential part of our clinical program. The reason is HIV treatment works best with a healthy, well-nourished body.

      Meals at the Dr. Peter Centre are also social and communal. No longer fearful of where the next meal is going to come from, participants have time to take care of their physical health, and have time to make connections and develop community. 

      As one participant recently shared, “This is my community…the meals are my reason to get out of bed, take a shower, and put on clean clothes if I have them. They are the reason I’m alone less.

      The Food as Harm Reduction study examined the relationships between HIV, drug use, and diet. This 2018 study found that 88 percent of survey respondents reported some level of food insecurity, with 47 percent experiencing severe food insecurity, meaning that they reduced their food intake or experienced disrupted eating patterns.

      For one participant in the study (a Dr. Peter Centre client with the pseudonym “Paul”), the researchers described that “sometimes the meals Paul eats each day at the Dr. Peter Centre are his only food. Yet, for him, the importance of the Dr. Peter Centre is as much to do with the people working there, the other participants in its programs, [and] the multiservice nature of the [organization] as it is with the quality and amount of food provided.”

      The math is simple: good food means better health and better health means less cost to the health-care system. That’s true for everyone, and at the Dr. Peter Centre it’s no different. Our latest figures for 2019 show that 91 percent of the day-health participants in our Intensive HIV medication support program attained a suppressed viral load. This means that the HIV virus is less present in their body and makes it impossible to transmit the virus sexually to others.

      Our program proves that providing the resources to create safe, stigma-free supportive spaces for people to have daily meals—including meals on weekends and evenings—creates better health outcomes.

      Marginalized populations, such as our participants, have the right to food without barriers and increased stigma (like waiting in the rain, listening to a sermon, or needing to be “drug-free” to access). Food should be the cornerstone of all government initiatives addressing HIV, mental health, and addiction.

      Food is medicine. So why is it not an integral part of our health care system for those who don’t have privilege?

      Scott Elliott is executive director of the Dr. Peter Centre.

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