Staff: The program has 6 positions with 3 frontline positions being held by nurses (2 RNs and 1 LPN) and 2 by outreach workers. The program manager is a Registered Nurse as well. There are also ‘associate staff’, which includes a physician who holds a medical clinic 1 day per week. The program is involved in the training of students from the Faculties of Nursing, Medicine, Law, and Social Work. There are other staff associated with the many projects Streetworks hosts – see below.
Sites: Streetworks has 5 daytime fixed sites. The 2 primary sites are at the Boyle McCauley Health Centre and the Boyle Street Community Services, as well as HIV Edmonton, the George Spady Centre, and the Sexually Transmitted Infections Clinic. The program has a van which operates 7 evenings per week. As well, staff members go out on foot to provide outreach to clients during the day and pick up stray needles.
In order to meet the goals, the program is very broad-based and comprehensive.
People often think of Streetworks as being only about needles. In many ways, the needles and
condoms are a strategy to get people connected with the program, so the staff can assist individuals
with making positive changes. The following is a synopsis of services:
Nursing Services: Nurses on the team do health assessments, testing (such as HIV and Hepatitis, STI), screening (TB), immunizations (such as Hep B, pneumovax, flu shots), health education and advice, minor treatments, and emergency care. They also follow women through their pregnancies, and check on the chronically ill. Many people come to the program are not needle users or sex trade workers, but simply individuals who want to see a nurse.
Natural Helpers: Staff are aware that many people take care of each other if they are street-involved, rather than accessing mainstream services. Often, people who come to the van do not use drugs themselves, but are exchanging for their friends or family who are involved with drugs or the sex trade. The Natural Helpers initiative is a strategy to help those care providers remain safer and healthier themselves, as well as ensuring that appropriate information and education reaches the hidden groups they are helping. These folks also help inform, teach and support the Streetworks program. This work goes beyond peer education in recognizing and strengthening health work in the community which is at the grassroots level.
Resource Development: Streetworks has worked in partnership with the downtown community members. These projects have resulted in 8 booklets – The Vein Care Book, Street First Aid, The Germ Book, The STD Book, Uptown, Downtown: The Drug Handbook, The Flu and You, Oh Shit, I’m Pregnant , I’m Sick Now What? and TB and the Inner City. As well, Streetworks has been created a video on Hepatitis C (Clean Points), and been a co-creator of 2 others – Pieces to the Puzzle and Getting Out, Staying Safe. The resources have been requested for places around the world, and 2 videos have won international awards.
Ridealongs: Physicians, nurses, social workers, outreach workers, and others from specific agencies come out on the van to provide services to people who have difficulty accessing services otherwise. They come out monthly in an effort to become known and trusted amongst the population. Getting to know a worker from an agency through the van makes it easier for the clients to go into the agencies that are represented.
Referrals: The Streetworks staff make a large number of referrals to places such as treatment centers, physicians, detox, legal services, social services, methadone clinic, STD Clinic, safe houses, mental health services, housing services, and others in order to help people make positive changes in their lives. Staff will often go with the clients to the place of referral.
Supplies: Streetworks will provide individuals who are involved in drug use or the sex trade with the tools they may need to remain safer and healthier. These include needles, alcohol wipes, condoms, lubrication, tourniquets, pregnancy test kits, sharps containers, mouthpieces, Health for Two coupons, feminine hygiene products, first aid and general health supplies, Bad Date Sheets (from Crossroads), etc.
Health Education: All Streetworks staff provide information to agencies, groups or individuals on various topics such as HIV/AIDS, hepatitis B&C, Harm Reduction, universal precautions, the Streetworks program, injection drug use, sexual health, street drugs and others. As well, Streetworks provides culturally appropriate education for the target group. On average, the staff provide education to 2,600 people per year.
Advocacy: Staff will advocate for clients if the need arises. This may take the form of “going with” someone to an appointment, or working with agencies to help them become more effective in meeting the needs of street-involved individuals. Staff members serve on committees at the regional, provincial, national and international level.
Prison Program: Streetworks works to assist individuals with criminal justice system involvement, helping them stay safer and healthier, both while incarcerated and after release. The staff sit on many committees which address the issue of blood-borne pathogens and incarceration at both the local and provincial level. Staff do regular presentations at local Remand and area correctional facilities in an effort to transition more smoothly upon release.
Research and Evaluation: There is very little information about the practices and social networks of injection drug users. Streetworks has been involved in many studies which provide a clearer picture of the population, the strengths they display, and the challenges they encounter. Annual evaluations and statistic keeping are routine. There is an ongoing research partnership with the Centre for Health Promotion Studies at the University of Alberta.
Special projects –
1) Streetworks is one of the host sites of the provincial Drug Users Network, AAWEAR (Alberta Addicts Who Educate and Advocate Responsibly)
2) Streetworks has been running an Overdose Prevention Project that focuses on preventing accidental drug overdose, and preventing death from overdose since 2005. Streetworks is the first agency in Canada that runs a community-based naloxone program.
3) Youth to Youth – Keeping Kids Safer and Healthier – this is project in it’s 4th year doing outreach to street-involved youth, providing drug education. One youth from the community has been hired to assist the staff to do outreach to this specialized group.
4) H.E.R. Pregnancy Project (Healthy, Empowered, Resilient) – Three year funding from Alberta Health will provide intensive outreach to street-involved pregnant women. Brings 4 outreach workers, 1 social worker and 2 RNs to enhance the services to pregnant women who are not accessing prenatal care or receiving less than adequate prenatal care.