 We have another amazing speaker joining us, Liz Evans. She arrived at 3 AM on a flight from Bogota, Columbia this morning and is here speaking with us. We're tremendously honored to have her. This is the last leg of a 60 day. I think she told me global whirlwind tour, so really a pleasure that she has her energy to be here with us today. Liz Evans trained as a nurse and in one of Canada's poorest postal codes worked for 23 years to envision and create services that change the way drug users are seen and treated. Liz is currently a fellow with the Open Society Foundation in New York and works as a consultant with Insight for Community Safety. Liz has received a number of awards and recognitions. Most recently in 2013, being awarded the Red Ribbon Award by CAHR and in 2012, the Queens Diamond Jubilee Award for Community Service. Please join me in welcoming Liz Evans. Thank you very much. Well, that was a tough act to follow, so... I'm just gonna first thank you for having me here. It's a really big honour to be around such incredible people and to be part of this struggle. And I feel like everyone's already said everything there is to know about the war on drugs, but I'm gonna share a little bit of my perspective on the human rights and how really the war on drugs has created the conditions to make it absolutely impossible for drug users to have their human rights acknowledged. And also how that has resulted in a situation where there's pretty much no public outcry of that fact. And I know you all know that, and many of you here are working tirelessly to create the kind of structural changes that we need to change things. While others of you who are here have had your rights stripped, so you know how fundamental this experience is because you're walking it every day in your lives. From my perspective, this war against drug users has raged on so long that the values of it have become almost like they've seeped into our societal DNA, and they afflict people around the world in every corner of the world every day, and yet the values that we've adopted make us blind to seeing it. Over 25 years ago, for the last 25 years, sorry, I've been working with people who use drugs. And some people have described me in the past as a harm reduction activist, but my feelings about this term are very mixed, and that's because I think that the violations have taken place against people who use drugs, can't really be remedied just by simple things like giving people clean needles. While I know that's part of the solution, the human rights abuses extend far beyond these sorts of interventions. Whether it's gun violence in the favelas of Brazil or torture in the name of treatment in Cambodia or mass incarceration in the US, I just really resent a monumental waste of resources being channeled into barbaric policies that only serve to oppress human beings. But what personally upsets me the most is that I've known so many and do know so many beautiful, kind, funny people who use drugs, who in their lifetime feel characterized by an utterable shame. They feel personally responsible for what is ultimately arbitrary and random, but an attack on people. In Bogota, two days ago, I was asked by a TV reporter why we should even help people who use drugs because they're delinquent, unproductive members of society. Like the refugees from Syria, we're blaming the victims the war has spat out. A war people are running from every day. Refugees of our drug war also seem to be threatening somehow by their very existence. We're afraid of them, we utter them, we treat them with contempt and we push them aside. For many people, simply using public spaces like a park bench is a problem. You can get hassled by a police officer or a security guard or even arrested. Community centers put on extra security guards to keep people who use drugs out. They can't walk into banks. They get refused service in restaurants. They get threatened by neighborhood vigilante groups and they're often just randomly beaten up. And none of this is grounded on anything real except for the brutalizing conditions that we've created and forced people to live in. Where there is a palpable fear of people who use drugs and it permeates everywhere. The start of my career is a nurse in a psychiatric emergency room in a very large hospital where I was young and idealistic and naive as a nurse. But I found I came very uncomfortable in this environment as I watched how certain patients would just annoy the staff. They do things irritating to the staff. And so the staff would respond with sarcasm or rudeness and sometimes even anger, which then created a series of reactions. The patient would slam a door or say something threatening. Proceeded by, followed by being jumped on by an orderly injected with heavy tranquilizers. And then the series of behavioral therapies. People being deprived of a towel, slippers, toothpaste or locked in a quiet room. Drug users typically were denied pain medication. They were accused that they were pill seeking. And by almost every care provider in the city we felt justified kicking drug users out of healthcare. This was seen as appropriate. They didn't serve help because they weren't quote treatment ready. We created these circumstances in which we dehumanized people from the very beginning. First, we robbed them of their rights. Second, we didn't provide them with any respect or dignity. And third, we blamed and punished them. So for the patients that came into the hospital with the most complex problems, we did almost nothing. In fact, we did the least. Can't medicate out poverty. Can't medicate homelessness. We don't have medicines that heal social exclusion or end racism. And medication doesn't replace the inhumanity of the war on people who use drugs. I couldn't really articulate at that point why I felt so depressed and angry, but I left the hospital and I went to work in the community directly with people in an area in our community, disparagingly known as Skid Row, where I started running a hotel housing project. And idealistically, I thought, oh, I can help people here. And we housed people that just didn't fit. But it was in this environment that I was forced to see my own human limitations. When I was confronted by very complex and intense human suffering and it was here that I had to embrace my own human frailty and pain because it was being mirrored back to me and everybody I met. Well, obviously people are not defined by their labels. 90% of the people that we housed were injection drug users and lots were involved in the sex trade. About 50% had HIV and everybody had a criminal record. Malnourished and suffering from third world diseases, I ran around trying to do stuff, but instead I just watched people dying. I found Freddie, who was hanging out of his bed, having aspirated on his vomit. And Joyce, who died of an overdose when she was working in the sex trade in another hotel. And Barb, who was Alexandria's grandmother, I found her alone in a rocking chair dead with the needle still in her arm. Each day I'd walk to work feeling nauseous, wondering what it was I was gonna find. Understanding I couldn't do much, but at the very least I could provide space. Space for people who were abandoned, people who were alone, people who I was watching suffer, but at least we could be with them together. And what was happening in our building was a microcosm of what was taking place across our community. With about 15,000 low income residents, 6,000 roughly were injection drug users and we had a very open public drug scene. We had very aggressive policing and by 1998 the infection rate to HIV had reached what was known as saturation point. Across our province in that same year we had one drug related death every single day. Our neighborhood was called four blocks of hell by the media. Over an eight year period, over 60 women went reported missing. Women, mostly Aboriginal, mostly drug users and mostly working in the sex trade. Angela, I knew well. When I filed the missing persons report I was told by the police that she'd probably gone on holiday to Florida. Instead we discovered that a serial killer for almost a decade had been driving women out of our community onto his farm where he slaughtered them and threw them away with his pigs. Angela's DNA was found on the farm. In this brutalizing context we struggled with what we could do. But creating space was actually radical and controversial because we made a commitment to house people regardless. We created a non eviction policy because we said our goal was just to create space where we didn't allow people to keep on running. Here we talked openly about drug use rather than trying to hide it. We handed out needles, we trained staff to do CPR, we used Narcan and we equipped ourselves with ambi bags and airways. But just creating this space was controversial and challenging because it went against all of the dominant values and beliefs people had about addiction. We were told that people on crack were crazy, out of control, prone to violence, incapable of reason, that we should be careful not to house people on crack. And we housed many and this was never our experience. We were criticized by doctors who called our approach dangerous. They said we were doing something grossly irresponsible. We should force them to leave the neighborhood, not let them live in our project. We were making them more likely to use drugs. We had to move them into an abstinent environment. But counter to this, our community was a place where people felt accepted. While we were bereft of institutional supports or care, it was a community of misfits who were able to find friendships. And when we were able to provide this space of acceptance, they're well being improved. And over the years we opened many other such spaces, places like a community bank, a dental clinic, hundreds of housing units, a drop in center, crack pipe with a crack pipe dispensing machine, alcohol maintenance programs, an emergency shelter with a crack inhalation room, a women's specific low barrier treatment program, art gallery, grocery store, a soccer team, which is, we were able to open insight. Both their drug use patterns, why they're here, why they need to use the site. And we tell them what the site could offer. And we make sure that they know that the site is for them. It's for their healthcare. It's an important social contact for people. It's an important place of respite. So after we've had that conversation, if they decide to sign up, we'll sign them up quickly and we'll give them a code name that they can use so they can use the site anonymously. After that, people can go into the wait room where they wait to get into the injection room. And there's staff there to chat with them to find out how they're doing and make sure they feel comfortable in the site. They'll go into the IR, they'll be given a booth. They'll be shown the array of clean equipment that we have, which is broader than most needle exchanges can offer. We'll show them things like where the sinks are so they can wash their hands with some soap and water before they use. It's incredibly important, small things like that. They can talk to a nurse while they inject. They can learn safer injection techniques. They can see the nurse after they're done for some wound treatment if it's necessary. Then they can go grab a cup of coffee afterwards in the chill lounge or a cup of juice. And we can talk about some of the broader issues. We can talk about what it's like to live in the downtown East Side. If this person's homeless, we can talk about housing. If this person needs methadone, we can get them in touch with that. If a person wants to talk about detox, we can tell them about onsite upstairs. Great, great, you know, great site for people to go to where we can just look at them, treat them as human beings, treat them with respect and say, what are your needs? These spaces, these spaces together created what we sometimes think about as like a state within a state. This was essential to be able to legitimate the lives of the people that we were surrounded by. In a community where almost everybody felt a profound sense of self-hatred and a deep sense of shame, having this approach replaced punishment with kindness and coercion just simply with space. One day, my friend, Bud, who was on those previous slides, he was doing a writing group at our hotel and he came to me with tears in his eyes and he said, I've had enough. Whether it was the murdered missing women, the daily funerals or the generalized horror of watching so much suffering, our paths and frustrations converged. We realized that talking about these things was no longer good enough. The action was required. We had to do something and this was the beginning. We blocked traffic, we burnt reports, we built banners, we disrupted meetings, we found many flash points for activism. Lots of them, whether it was police abuses in the media where they wrote weekly salatial columns against drug users or when our mayor put a moratorium on funding for drug use programs or when there weren't enough needles being distributed and HIV was still raging. We decided to focus on opening an injection site as our goal and the journey to keep this site open, to open it and keep it open required unbelievable tenacity and an enormous commitment right up until the end. But in spite of hundreds of opposing forces in the form of politicians, community business leaders, scathing media articles and a federal government that we had to fight all the way to the Supreme Court, Insight opened 14 years ago and it remains in North America the only legally sanctioned demilitarized zone on this continent. It redefines the concept of inclusion for drug users because it tells drug users that above everything else it's your life that matters. When I walked into that rundown hotel 25 years ago, I had no idea what I was getting into. But just opening up that space and fighting back was all we could do. Our community has always been a place of resistance and the battle continues. However, there's some key shifts that we can celebrate that have taken place as a result of this approach. We now have hundreds of housing units. Some of them are new. We have some innovative and creative healthcare services that have specifically been designed to create space for drug users. Police now in our neighborhood don't arrest people for possession, but instead they direct them to Insight and they give them access to now what is a pretty big array of housing and supports because they know what police, what people need is access to care and support. HIV transmission in our community has been virtually eliminated and the life expectancy of people in our community has increased by 10 years. However, all of this is a drop in the bucket in the face of how much work we obviously have left because we have to move human rights forward everywhere for people who use drugs and this shift has to happen by us. I wanna thank everybody here for the work that you're doing and as a tribute to all of you as brave warriors in this war who show your love and dedication to a more humane world because we are taking action. I'm going to show you a little video because I don't believe any of us can fully live in the spaces that we call home until everyone has a home and because we can't ever fully find peace until we have declared an end to this war.