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inside: five-year anniversary of the drug poisoning crisis | primary care networks explained | research

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                                                                            Free Publication
                                                                         Summer 2021 Issue
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                       @vanislandhealth                                                                      A shadow has clouded our nation and             school to Indian Hospitals – including      across the province with the roll out
                                                                                                             we are filled with sadness with the             the Nanaimo Indian Hospital, where          of BC’s Restart Plan. In this edition of
                                                                                                             discovery of the remains of 215 chil-           the systemic racism and abuse contin-       Island Health Magazine, you will find
                                                                                                             dren on the grounds of a Kamloops               ued. For them, the two experiences          information about vaccination against
                                                                                                             residential school. These institutions          are the same.                               COVID-19. It’s important all those
                                                                                                             are the lived experience of Indigenous                                                      eligible for a vaccine register by visiting
              CONTACT US                                                                                     people. For non-Indigenous Canadians,
                                                                                                                                                             In Island Health, we recognize access-
                                                                                                                                                                                                or calling 1-833-
                                                                                                                                                             ing care in an institution has not been
              Island Health Magazine                                                                         it is time to be aware and understand the                                                   838-2323. Please see the article on page 6
                                                                                                                                                             a safe experience for Indigenous peo-
              —                                                                             dark mark of residential schools and the                                                    for more information. We are one step
                                                                                                                                                             ple. It is an experience layered with the
                                                                                                             individual and systemic changes neces-                                                      closer to the end of this pandemic because
                                                                                                                                                             feelings and encounters of discrimina-
              General Enquiries                                                                              sary across all institutions. In this region,                                               of the care you have taken to keep each
                                                                                                                                                             tion and judgment and continues to
              — 250.370.8699 (toll-free 1.877.370.8699)                                                      there were five residential schools:
                                                                                                                                                             contribute to poor health outcomes.
                                                                                                                                                                                                         other and our health system safe.
              —                                                                                 — Alberni Indian Residential                                                                I hope each of you is able to enjoy
                                                                                                                                                             I know I speak for our Island Health
              Compliments or Complaints                                                                        School – Port Alberni (1917 – 1973)                                                       summer in our beautiful region – and
                                                                                                                                                             family when I say we are committed
                                                                                                             — Ahousaht Indian Residential                                                               while you are taking in the activities
              — 250.370.8323 (toll-free 1.877.977.5797)                                                                                                      to working in partnership with
                                                                                                               School – Ahousaht (1901 – 1950)                                                           and stunning surroundings we are so
              —                                                             — Christie Residential School –
                                                                                                                                                             Indigenous patients, clients and
                                                                                                                                                                                                         blessed to live in, join me in offering
                                                                                                                                                             communities to build a culturally
                                                                                                               Meares Island (1900 – 1983)                                                               gratitude to the Coast Salish, Nuu-
                                                                                                                                                             safe health care system. When we
                                                                                                             — Kuper Island Indian Residential                                                           Chah-Nulth and Kwakwaka’wkaw
                                                                                                                                                             acknowledge culture and honour each
                                                                                                               School – Penelakut Island                                                                 cultural families, whose relationship
              HEALTHLINK BC                                                                                                                                  other, we strengthen relationships.
                                                                                                               (1890 – 1975)                                                                             with these lands remains unbroken.
              Contact HealthLink BC for health information on                                                — St Michaels Residential                       Despite the dark shadow cast by this
                                                                                                                                                                                                         With heartfelt good wishes,
              over 5,000 topics.                                                                               School – Alert Bay (1929 – 1975).             gruesome discovery and the challenges
                                                                                                                                                             we have experienced as we have grappled
              — Dial 8.1.1 or visit                                                          Many elders have shared stories
                                                                                                                                                             with COVID-19 over the past many
                                                                                                             about going directly from residential                                                       Kathy MacNeil.
                                                                Island Health celebrates Nursing Week 2021                                                   months, there is a glimmer of hope
                                                                                                                                                                                                          #IslandHealthMag  summer 2021                3

    Shawna Cadieux is a Communications             Andrea Zeelie-Varga works in Island        Shannon Marshall acknowledges with
    Advisor with Island Health’s Communications,   Health’s Research Department to            respect the privilege to live in the unceded
    Partnerships and Primary Care Strategy team.   enhance education, engagement, and         territory of the Coast Salish people. She is of
    Shawna has a background in broadcast           funding opportunities across the region.   Indigenous descent through Mother’s lineage
    journalism and communications. She and         Andrea is grateful to live, work, and      with ancestral connections to the Leidhl’I
    her family – her husband, two teens and        learn in Coast Salish territory.           Tenneh. Shannon is a retired Communications
    spoiled Goldendoodle – are honoured to live,                                              professional; she now provides consulting

                                                                                                                                                                                    10                                                  16                                                    22
    work and play on the traditional and unceded                                              services, most recently working on the men’s
    territory of the Cowichan Tribes people.                                                  harm reduction campaign.

    There is a lot going on in our world and this issue of Island Health magazine
    covers a wide range of topics.
                                                                                                                                                6 COVID-19 VACCINES                                 14 HEARTFELT WORDS                                      24 PRIMARY CARE
    First, in her column Island Health CEO Kathy MacNeil acknowledges the devastating                                                             EXPLAINER                                               From two of Island Health’s                          NETWORKS EXPLAINED
    discovery of the remains of 215 children on the grounds of the Kamloops residential                                                              Dispelling concerns about                            Harm Reduction team members.                           Bringing care resources and
    school and reiterates Island Health’s commitment to building a culturally safe                                                                   COVID-19 vaccines.                                                                                          strengthening support to our region.
                                                                                                                                                                                                    16 IT’S SUMMER – LET’S
    health care system.                                                                                                                         10 THE DRUG-POISONING                                  EAT OUTSIDE!                                         26 PLANNING FOR
                                                                                                                                                   CRISIS                                                 Tips and recipes for outdoor dining.                 RETIREMENT
    This issue includes an extensive feature on the drug poisoning crisis in our region                                                              At the five-year anniversary,                                                                               Thinking about more than finances
    along with a summary of some of the priority projects taking place as part of                                                                    an in-depth look at the crisis                 22 HOT FUN IN                                                when looking ahead to retirement.
    Island Health’s overdose response initiative. Included in this feature are heartfelt                                                             and some of the projects                          THE SUMMERTIME
    messages shared by two members of Island Health’s Harm Reduction team—you                                                                        taking place as part of Island                       Having fun at home.                               31 ISLAND HEALTH
    can’t read their words and not be moved.                                                                                                         Health’s response.                                                                                        RESEARCH
                                                                                                                                                                                                                                                                 Contact Identification—
    We also address a number of concerns raised about COVID-19 vaccines. We hope                                                                                                                                                                                 keeping patients and staff safe.
    that this information will answer any questions and encourage those who have
    not received their first vaccination to register today and get vaccinated.                                                                  With great respect and humility, Island Health acknowledges the Coast Salish, Nuu-Chah-Nulth and Kwakwaka’wkaw cultural families;
                                                                                              Susan Evans                                       whose relationship with these lands remains unbroken; whose homelands Island Health occupies. In making this acknowledgement,
    I enjoyed writing the article on planning for retirement and the opportunity to           Editor, Island Health magazine                    we commit to walk softly on this land and work to uphold self determination of the health of Indigenous peoples.
    interview a number of people who have already joined the ranks of the retired—  
    something I am considering myself.                                                                                                          Island Health magazine is an award winning free publication, produced in-house by Island Health’s Communications and Public Relations Department.
                                                                                                                                                EDITOR Susan Evans. PRINT Mitchell Press. No part of this publication may be reproduced without the written consent of Island Health. The information
    On a much lighter note, we also cover summer food and fun—there is much                                                                     in this magazine is not meant to be a substitute for professional medical advice. Always seek the advice of your physician or a qualified health professional
    to look forward to in coming months and I wish you and your family a safe                                                                   before starting any new treatment. We welcome all feedback about Island Health magazine at:
    and happy summer.

4      Island Health     magazine                                                                                                                                                                                                                           #IslandHealthMag  summer 2021                       5
public health

                                                                                                                                                                       “I got vaccinated because last
                                                                                                                                                                        season my hockey team only
                                                                                                                                                                        played five games and no one
                                                                                                                                                                         from my family was allowed
                                                                                                                                                                        to watch. If everyone gets the
                                                                                                                                                                          shot we can have a full and
                                                                                                                                                                             fun season next year.”
                                                                                                                                                                             — Jake, 15, Saanich – Hockey Player

                                                        “I got vaccinated because my dad is 97 years old,
                                                          and I want to be able to visit with him safely.”
                                                                      — Nic, no age given, Victoria – Paramedic

                                                                                           “The COVID vaccines are what we were         WHAT’S HOLDING YOU BACK?                       CONCERN: The vaccines are too new. I          public-health/services/video/vac-
                                                                                           waiting for and we have the data to show     It isn’t fair to jump to the conclusion that   think I will wait and see how this goes for   cine-safety and read more about
                                                                                           that they are effective,” said Dr. Richard   someone is an “anti-vaxxer” if they don’t      others before getting the vaccine myself.     adverse events and side effects here:

                                                                                           Stanwick, Chief Medical Health Officer.      immediately get in line for a vaccine. Most                                        
                                                                                                                                                                                       FACTS: In Canada, before any vaccine
                                                                                           “I encourage everyone to get registered      often, their decision has nothing to do                                                      covid-19/vaccine-safety/.
                                                                                                                                                                                       is approved for use, all clinical data is
                                                                                           and get vaccinated as soon as you can.       with a distrust in science or data. Below
                                                                                                                                                                                       reviewed and then rigorous independent        CONCERN: I’m worried about the side
                                                                                           Our progress in Island Health is good,       we’ll look at some key reasons why people
                                                                                                                                                                                       testing is completed to make sure it is       effects – I can’t take time off work.
                                                                                           but we have a fair way to go to get          may decide to wait or bypass the vaccine,
                                                                                                                                                                                       safe and effective. By the time a vaccine
                                                                                           people fully vaccinated.”                    and we offer some factual information to                                                     FACTS: Like any medication or supple-
                                                                                                                                                                                       reaches the public, a safety profile for
    When the World Health Organization        was to follow recommended protective                                                      support encouraging conversations.                                                           ment, vaccines can cause side effects and
                                                                                           BC’s vaccination effort kicked off in                                                       common adverse events (i.e. vaccination
    declared the COVID-19 pandemic on         measures to keep ourselves, our fami-                                                                                                                                                  reactions. After being vaccinated, it’s
                                                                                           earnest in early 2021, targeting key         CONCERN: If the majority of people             site reactions or mild symptoms) is well
    March 12, 2020, people around the         lies and communities safe.                                                                                                                                                             common and normal to have temporary
                                                                                           priority populations before moving into      are getting vaccinated, then I don’t           known and shared with each individual.
    globe knew very little about the virus.                                                                                                                                                                                          side effects. These usually last from a few
                                              Over the past 16 months, the health          the general population in April. By the      have to worry about it.                        The vaccine is then continually monitored
    We wanted to know exactly how it                                                                                                                                                                                                 hours to a few days. This is natural and
                                              and safety mandates and recommenda-          first week in June, 70 percent of eligi-                                                    by health agencies and regulators to
    was transmitted, how it attacked the                                                                                                FACTS: While it is important to look                                                         means the body is working hard to build
                                              tions have evolved as we learned more        ble Island Health residents (aged 12                                                        report and track any medical occurrences
    body, who was most susceptible, and                                                                                                 at our vaccination numbers right across                                                      immunity against the disease. Most side
                                              about COVID-19 and experience showed         and older) had been vaccinated with                                                         that are severe or unexpected. Of the
    what impacts it would have on our                                                                                                   Island Health, vaccination rates in                                                          effects don’t disrupt daily activities and
                                              us what works and what doesn’t. Without      one dose, and 5.5 percent were fully                                                        23 million doses of COVID vaccine
    communities and our lives. What was                                                                                                 communities really matter. Lower levels                                                      you can take medicine to help with any
                                              a vaccine or an effective treatment, these   vaccinated. While these numbers show                                                        administered in Canada by the end
    becoming very clear, through daily                                                                                                  of vaccine uptake in specific geographic                                                     pain or feelings of sickness. Known
                                              safety measures were all that we had. And    that we’re well on our way – and there                                                      of May 2021, 0.006% reported serious
    announcements from health officials                                                                                                 regions can lead to pockets of resur-                                                        symptoms can include:
                                              then, with the introduction of approved      is increasing optimism that widespread                                                      adverse events following immunization,
    and media reports, was how fast the                                                                                                 gence. Not getting the COVID vaccine                                                         — Pain, redness or swelling
                                              COVID-19 vaccines in late December           and lasting immunity can be achieved                                                        which makes it clear that the risks of
    virus was spreading and how critical it                                                                                             puts the individual at risk, and it puts                                                        at the injection site
                                              2020, the path forward shifted.              through COVID-19 vaccination – not all                                                      getting COVID disease far outweigh
                                                                                                                                        people who can’t get the vaccine or who                                                      — Tiredness
                                                                                           communities have high vaccination rates.                                                    any risks of the COVID vaccine. Watch
                                                                                                                                        don’t have a strong immune response                                                          — Flu-like symptoms (i.e. chills, joint pain,
                                                                                                                                                                                       Health Canada’s video about vaccine
                                                                                                                                        to the vaccine at risk for the disease.                                                         headache, mild fever, muscle aches)
                                                                                                                                                                                       safety here:
6      Island Health   magazine                                                                                                                                                                                                       #IslandHealthMag  summer 2021                  7
who do get COVID-19 after vaccination,          maintain all safety measures until your
                                                                                                                              their likelihood of becoming very sick or       body has had time to produce immunity.
                                                                                                                              dying is also extremely low. Consider the
                                                                                                                                                                              CONCERN: I am afraid of needles.
                                                                                                                              first dose a primer for your immune
                                                                                                                              system and the second dose as the               TIPS: Don’t let a fear of needles stop you
                                                                                                                              long-lasting barrier of protection.             from getting protection from COVID.
                                                                                                                              Together they will protect you and              Speak with any of the clinic staff at your
                                                                                                                              your community from COVID-19.                   scheduled appointment to let them know
                                                                                                                                                                              you have anxiety around needles. This
                                                                                                                              CONCERN: Will I get COVID from the
                                                                                                                                                                              is a common fear and our experienced
                                                                                                                              COVID vaccine?
                                                                                                                                                                              teams have strategies to support you
         “I chose to get
                                                                                                                              FACTS: None of the approved vaccines            and make your experience better. It can
      vaccinated because                                                                                                      contain the live virus that causes              help to stay hydrated and eat before your
       I want to help my                                                                                                      COVID-19. This means that a COVID-              appointment. You can numb an upper
                                                                                                                              19 vaccine cannot make you sick with            arm (needle site) with some over-the-
           community.”                                                                                                        COVID-19. It takes a few weeks for the          counter lidocaine cream to eliminate
                                                                                                                                                                                                                                “I got vaccinated
          — Harmony, 38,                                                                                                      body to build immunity after vaccination,       pain. You can distract yourself by looking         to keep my baby
        Duncan – Law Student
                                                                                                                              so it is possible that you could be infected    around the room or humming your                     daughter safe.”
                                                                                                                              with the COVID-19 virus just before or          favorite song. Tensing your muscles
                                                                                                                                                                                                                             — Kelly, 36, Cowichan – Teacher
                                                                                                                              just after vaccination and still get sick.      can also help to raise your blood pres-
                                                                                                                              This is why it is important that you            sure and counteract feeling lightheaded.

                                                                                                                              For more information about the COVID-19 vaccines, visit

                                                                                                                                  “I registered for my vaccine because I want to travel and work on some exciting
                                   If you or someone in your care experiences     and trends and are working on strategies
                                                                                                                                   video projects overseas. I also have family members that I want to hug again.”
                                   any unusual symptoms after vaccination,        to better reach people in communities                                                      — Mark, 33, Comox – Professional Mtn. Biker
                                   call your doctor or nurse practitioner,        where better access is required.
                                   HealthlinkBC at 811, or a local health
                                                                                  Please know that the process to regis-
                                   unit to report it and seek advice.
                                                                                  ter is very easy. You can register online
                                   If you are concerned about needing time        at or by
                                   away from work due to side-effects, try to     phone at 1-833-838-2323 (7am-7pm).
                                   schedule your appointment before your          Translators are available and/or you can
                                   regular days off so that you have a few days   dial 7-1-1 for the deaf or hard of hear-
                                   to adjust. It is also important to consider    ing. At our clinics, we are scheduling
                                   that the side effects of the vaccine are far   people at intervals to maintain physical
                                   less severe than symptoms of virus, and        distancing and appointments generally
                                   will result in much less time off work.        run 20 minutes from start to finish.

                                   CONCERN: I can’t get to an immuniza-           CONCERN: If we get good coverage
     “I’ve been vaccinated         tion site easily and the process is            from the first dose, why do I need to
                                   inconvenient for me.                           get the second dose?
        so that I can hug
                                   FACTS: These are very valid concerns           FACTS: After the first dose, antibody
         my friends and            for many. Island Health has delivered          levels (immunity) will go down over
         family again as           vaccines at mass immunization sites,           time. The second dose (booster) will
        soon as possible.”         in whole communities, in care and              give the highest-level of protection for
                                   correctional facilities, in easy-access        a much longer period. Canada’s sur-
       — Shannon, 40, Cowichan –
           Massage Therapist
                                   sites for targeted populations and in          veillance data continues to indicate
                                   the homes of people who are home-              very low rates of COVID-19 infection
                                   bound. We continue to monitor stats            following full vaccination. For those

8   Island Health   magazine                                                                                                                                                                                               #IslandHealthMag  summer 2021       9
public health
                                                                                                                                REACHING THOSE                             PARTNERSHIP WITH VANCOUVER ISLAND
                                                                                                                                WHO USE ALONE                              CONSTRUCTION ASSOCIATION
                                                                                   Last year, an average of six people died     In 2020, 263 people died from toxic drug   Across North America, workers in the       “The stakeholder engagement included
                                                                                   every single week in Island Health from      poisoning in Island Health. The major-     construction and transport industries are   21 one-on-one interviews with mem-
                                                                                   poisoned drugs, giving 2020 the dubi-        ity of those people were male, aged        over-represented among those who lose       bers of the construction industry on
                                                                                   ous distinction of being the worst year      30–59 years, who died alone in a private   their lives to overdose. In recognition of Vancouver Island, the vast majority of
                                                                                   in history for lives lost to drug poison-    residence and were found to have had       this loss and concern for all members of    whom have lived/living experience of
                                                                                   ing. Sadly, it would appear this year will   previous encounters with health care       our community, Island Health partnered      substance use,” said Emily Percival-
                                                                                   see even greater numbers as we mourn         resources. The “Using Alone” project       with the Vancouver Island Construction Paterson, VICA’s Harm Reduction
                                                                                   the loss of 72 people in Island Health       sought input through interviews and        Association (VICA) to develop resources Project Manager. “Many of the inter-
                                                                                   during the first three months of 2021.       an online survey from a number of          and education material for employees and views were emotional and included
                                                                                                                                sources across the health care system,     employers in trades and affiliated pro-     incredible stories of resilience and often
                                                                                   The crisis is the result of an unpredict-
                                                                                                                                including people with lived and living     fessions, such as aquaculture or logging. honoured someone who has been lost.”
                                                                                   able, highly toxic drug supply, and it
                                                                                                                                experience of drug use as well as care
                                                                                   continues to have a staggering impact                                                   VICA undertook a stakeholder                Percival-Paterson went on to say that after
                                                                                                                                and service providers. Findings indi-
                                                                                   on individuals, families and communi-                                                   engagement campaign that led to the         years in activist roles, they have seen too
                                                                                                                                cated the following opportunities for
                                                                                   ties across the province.                                                               development of a “Tailgate Toolkit” that    many projects and programs get created
                                                                                                                                better reaching people who use alone:
                                                                                                                                                                           will feature four components: Toolbox       without input from the people they are
                                                                                   While the origins of the epidemic are        education and training to the entire
                                                                                                                                                                           Talks for onsite introductory conversa-     aiming to serve. “We refused to do that
                                                                                   complex, there has been an awareness         workforce, including outside of health
                                                                                                                                                                           tions around substance use, mental          here. I’m really proud of and extremely
                                                                                   switch over the past several years due to    care (e.g., hospitality, construction/
                                                                                                                                                                           health and harm reduction; a training       humbled by the members of the construc-
                                                                                   who is affected. Thirty years ago, many      trades); access points for services that
                                                                                                                                                                           module for supervisors on mental health     tion industry on Vancouver Island who
                                                                                   people believed addiction to be a dis-       enable clients/people to be anonymous;
                                                                                                                                                                           first aid, naloxone and referral to ser-    shared their stories and their ideas with us.”
                                                                                   ease of choice. We now know that is          normalize asking about drug use along-
                                                                                                                                                                           vices; print and online resources for
                                                                                   not the case, and addiction has been         side other health questions; resources                                                 VICA will now be turning its attention
                                                                                                                                                                           both employees and employers to
                                                                                   redefined as a disease of the brain—a        and support for family and friends of                                                  to building out the toolkit, starting

     Diving deep
                                                                                                                                                                           increase links to services; and an
                                                                                   chronic illness not unlike diabetes or       people who use drugs; and prevention                                                   the training programs, and getting
                                                                                                                                                                           industry-specific support group.
                                                                                   heart disease.                               and early interventions for youth.                                                     the support group up and running.
                                                                                   It’s an epidemic fuelled by an aggressive

     into the drug
                                                                                   marketing campaign by big pharma
                                                                                   that promoted widespread use of opi-
                                                                                   oids to treat pain and minimized the

     poisoning crisis
                                                                                   risk of addiction. Prescription opioids
                                                                                   include Oxycontin, Vicodin, Percocet,
                                                                                   Demerol, Dilaudid, Codeine and
                                                                                   Fentanyl, to name a few. Prescribing
     by Shannon Marshall                                                           practices, though perhaps well inten-
                                                                                   tioned, have inadvertently contributed
                                                                                   to the crisis as people sought treatment
     Today—maybe even as you sit reading this article—
                                                                                   for pain following an injury or surgery.
     one person in the Island Health region will die from
                                                                                   Island Health continues its efforts
     toxic drug poisoning.                                                         to respond to this public health crisis.
                                                                                   Through a series of opioid response
     It’s been five years since the Provincial Health Officer declared a public    initiatives, and through the hard work,
     health emergency in response to the significant rise in opioid-related drug   dedication and compassion of our care
     poisonings and deaths in BC. Since then, we’ve lost more than 7,500 people    providers, key partners and commu-
     in the province to toxic drug poisonings, and thousands more have felt the    nity action teams across the region, the
     devastating impact in their own lives. Toxic drug poisoning is the leading    goal is to build a network of services       MULTI-PLATFORM MEDIA CAMPAIGN
     cause of unnatural death in BC, surpassing the combined total of deaths       that will help connect people to treat-
                                                                                                                                Based on data provided by the BC           Who Use Alone work, this campaign           launched in early May and ran for eight
     from motor vehicle collisions, suicides and homicides.                        ment, save lives and end stigma.
                                                                                                                                Coroners Service and information           was aimed at men, primarily those           weeks in a variety of media including
                                                                                   Here’s a summary of some of the priority     gleaned from the partnership with          who use alone and who may be                radio, social media, streaming platforms
                                                                                   projects taking place as part of Island      the Vancouver Island Construction          employed in trades/transport and            and display ads in transit shelters.
                                                                                   Health’s overdose response initiative.       Association and the Reaching Those         affiliated industries. The campaign
10      Island Health   magazine                                                                                                                                                                                         #IslandHealthMag  summer 2021                  11
“We can make it easier for people to get support by letting them know they are
                                      not alone and that substance use does not define who they are. Every person
                                        lost to overdose was someone’s child: forever loved, forever remembered.
                                      They matter—and we owe it to them, and to ourselves, to dig deep into our
                                          hearts to see and remember them with compassion, not judgement.”

                                LOUD IN THE ED                                                                       A TIME TO PAUSE
                                The Learning about Opioid Use Disorder     of stigma faced by people who use         The drug poisoning crisis continues
                                in the Emergency Department (LOUD          substances by some health care provid-    to devastate too many families and too
                                in the ED) collaborative is a provincial   ers, and how we ensure people who         many communities across our region.
                                quality improvement project focused        use substances are not treated differ-
                                                                                                                     It’s important to pause to honour and
                                on emergency department care for           ently than people who present for
                                                                                                                     remember those who have died as a
                                people who use opioids. The initiative     other health issues.
                                                                                                                     result of this crisis and to gain some
                                was led by the BC Patient Safety &
                                Quality Council in partnership with
                                                                           CASCADE OF CARE –                         understanding of the complexities of
                                the Overdose Emergency Response            STRENGTHENING                             addiction. Every single person lost to
                                                                           RETENTION FOR THOSE                       drug poisoning has a story. Nobody
                                Centre and the BC Centre on Substance
                                                                           ON OPIOID AGONIST                         starts out wanting to become addicted
                                Use to shift how emergency depart-
                                                                           THERAPIES (OAT)                           to opioids. Addiction is a disease that
                                ments care for people who use opioids
                                                                                                                     knows no boundaries. It is a treatable
                                and improve the experience of care for     Opioid agonist treatment provides
                                                                                                                     medical condition, not a choice.
                                both patients and care providers.          people who are addicted to opioids
                                                                           with a prescribed daily medication        We also recognize the health care
                                The project will expand access to peers,
                                                                           (e.g., methadone or suboxone) to          providers who have been impacted by
                                starting in the Campbell River Hospital
                                                                           help with withdrawal and cravings.        this public health crisis and who con-
                                Emergency Department, by including
                                                                           Research tells us the discontinuation     tinue to show up at work and do their
                                people with lived and living experience
                                                                           of therapy puts a person at higher risk   very best to provide compassionate
                                in the development of education and
                                                                           of death from overdose. The Cascade of    care despite having their own experi-
                                service design, and will work to
                                                                           Care work is aimed at better under-       ences of loss when the people they
                                strengthen partnerships with peer-
                                                                           standing why people “drop off” OAT,       serve die in this tragic way.
                                based community organizations.
                                                                           what approaches might be most effec-
                                                                                                                     Family members, beloved friends,
                                CHART REVIEW                               tive in reducing drop-off rates and
                                                                                                                     neighbours, co-workers, employees,
                                The medical charts of 101 men between      strategies to support individuals to
                                                                                                                     teammates, health care providers—
                                the ages of 20 and 64 who died in a        remain on service.
                                                                                                                     thousands of individuals have been
                                private residence due to drug toxicity     PEER ENGAGEMENT                           impacted and experience all too pain-
                                between January 1 and November 30,
                                                                           FRAMEWORK                                 fully the devastation of this public
                                2020, received an in-depth review and                                                health crisis in their own lives.
                                                                           People with lived and living
                                analysis to advance understanding of
                                                                           experience need to be recognized and      We can make it easier for people to get
                                missed opportunities for service deliv-
                                                                           engaged as partners throughout the        support by letting them know they are
                                ery, coordination, follow-up care and
                                                                           design and delivery of health services.   not alone and that substance use does
                                links to services. The chart review has
                                                                           Island Health is developing a Peer        not define who they are. Every person
                                resulted in a number of recommenda-
                                                                           Employment Framework as a resource        lost to overdose was someone’s child:
                                tions, including how to ensure patients
                                                                           for increasing equity, safety, autonomy   forever loved, forever remembered.
                                with substance use disorders are iden-
                                                                           and inclusion of people with lived        They matter—and we owe it to them,
                                tified and more closely followed through
                                                                           and living experience in diverse          and to ourselves, to dig deep into our
                                their care encounters. A question that
                                                                           employed roles.                           hearts to see and remember them with
                                has woven itself throughout the pro-
                                cess of the chart review is the concept                                              compassion, not judgement.

12   Island Health   magazine                                                                                         #IslandHealthMag  summer 2021            13
Griffin Russell works for Island Health as the     who use substances are all someone’s           Sheena Campbell was Island Health’s
                                                                                               Regional Harm Reduction Coordinator for            beautiful child—their baby boy, their          original Harm Reduction Coordinator.
                                                                                               Central Island. He has been in this position       baby girl—and they matter.                     She’s rejoined the team as Regional Harm
                                                                                               since October 2014, working throughout the                                                        Reduction Coordinator, North Island.
                                                                                                                                                  I could hardly imagine another health
                                                                                               entire drug poisoning crisis.                                                                     Along with her experience with Island
                                                                                                                                                  care crisis where five people dying a day
                                                                                                                                                                                                 Health, Campbell also brings a wealth
                                                                                               Russell has over 20 years’ experience in           (in BC) would be allowed to persist for
                                                                                                                                                                                                 of experience from her time as a Harm
                                                                                               mental health and substance use services,          this long in our country. Yet, because this
                                                                                                                                                                                                 Reduction Coordinator with Vancouver
                                                                                               and he is both deeply passionate and               is about substances, the crisis continues
                                                                                                                                                                                                 Coastal Health.
                                                                                               fiercely committed towards safe access to          to be plagued by ignorance and misunder-
                                                                                               health care for all people, believing that it is   standing, and perpetuated by 100+years         I have worked in the field of Harm
                                                                                               the greatest responsibility accompanying the       of drug policy rooted in prohibition.          Reduction in both Vancouver and on
                                                                                               beautiful privilege of working in health care.                                                    Vancouver Island and have watched
                                                                                                                                                  How many of us understand the history
                                                                                                                                                                                                 drug use cycles in our communities
                                                                                               At times there is a pain in my chest, a            of Canadian drug policies or the racist
                                                                                                                                                                                                 for the last 25 years.
                                                                                               weight making it difficult to breathe;             motivations underpinning them? How
                                                                                               the weight is often accompanied by a               many of us understand the historical           I don’t see this as simply an overdose
                                                                                               lump in my throat and watering in my               underfunding of substance use services,        crisis—overdoses have consistently
                                                                                               eyes, making it difficult to see.                  resulting in a scarcity of specialized         happened amongst people who use
                                                                                                                                                  resources, an over reliance of non-profit      substances. What is happening today
                                                                                               The gravity of the enduring drug-poison-
                                                                                                                                                  organizations, volunteer-based 12 step         is an unrelenting drug poisoning crisis.
                                                                                               ing crisis on Vancouver Island, and across
                                                                                                                                                  programs, and fee-for-service treatments?
                                                                                               British Columbia, is with me regularly.                                                           Today, people reliant on substances must
                                                                                               I have shed many tears at my desk, in              How many of us understand the preva-           assess the likelihood of being fatally poi-
                                                                                               my truck or while sitting near the ocean,          lence of trauma driving this health care       soned by their substances. As soon as we
                                                                                               wondering how it is possible for this              issue, the stain of stigma propagating the     learn how to manage one contaminant
                                                                                               tragedy to continue on in the ways it has.         public’s perspectives in much the same         (Fentanyl), a new, cheaper contaminant
                                                                                                                                                  hateful and harmful ways as systemic           is used, many with heinous results
                                                                                               The pain is deeply personal. I cry for
                                                                                                                                                  racism? Stigma and shame around the            (e.g., Etizolam). As service providers,
                                                                                               my dear friend who lost her brother.
                                                                                                                                                  use of substances was and continues to         we try to adjust, but we can’t contend
                                                                                               I cry for the mothers whom I have sat
                                                                                                                                                  be a major driver in this crisis.              with the current reality—an unregulated
                                                                                               with in their pain, a pain as a parent
                                                                                                                                                                                                 and unpredictable supply chain.
                                                                                               I hope to never know. I cry for the people         Three years ago, I sat on a panel at
                                                                                               I hold dear who are no longer here. I cry          the University of Victoria, alongside          The results are obvious—we are in
                                                                                               for the passionate people trying their             a prominent epidemiologist who had             year five of an emergency response.
                                                                                               damnedest to signal safety, to build trust,        worked at the highest spheres of public        Despite our best efforts, people whose
                                                                                               and to offer anything and everything of            health, supporting a Provincial Health         substances are illicit continue to die at
                                                                                               value to people living this tragedy out.           Officer. We were asked what the hard-          an alarming rate.
                                                                                                                                                  est part of our careers had been.
                                                                                               I cry for all the children who have lost                                                          We need a safe supply that meets the
     On the anniversary of the opioid                                                          a parent, a grandparent, an aunt or                This wise, solid, and esteemed man got a       needs of the patient/client. The research
     crisis, Island Health employees                                                           uncle. I cry for those who watch help-             quivering in his lower lip, a misting in his   related to pharmaceutical alternatives to
                                                                                               lessly as their friends and community              eyes, and he said something along the          the toxic drug supply is overwhelmingly
     working in Harm Reduction share                                                           die these preventable deaths. I cry as a           lines of, “The hardest part for me has         positive. Key social determinants of
     their heartfelt thoughts.                                                                 man, knowing this crisis is killing four           been to witness time and time again            health are addressed and people’s lives
                                                                                               men every day in British Columbia. I               people separating themselves from social       are markedly improved.
                                                                                               cry as a father for fear my twin boys will         issues, like the overdose crisis, as though
                                                                                                                                                                                                 We have choices that many do not,
                                                                                               suffer in such ways. I cry because some            the people who are suffering such social
                                                                                                                                                                                                 so we must use our voices to raise
                                                                                               days it seems like it will never end.              ills somehow deserve it, like they made
                                                                                                                                                                                                 this issue. I hope you will join me
                                                                                                                                                  the wrong choices, as though the social
          “Substance use is a health care issue, often occurring alongside other health        Substance use is a health care issue,
                                                                                                                                                  determinants of health don’t matter, as
                                                                                                                                                                                                 in using your voice to compel our
          issues, such as loneliness and isolation, homelessness and poverty, pain and         often occurring alongside other health                                                            governments to move forward
                                                                                                                                                  though access to health care, gender, pain,
                                                                                               issues, such as loneliness and isolation,                                                         with the policy changes and actions
           trauma, racism and stigma. People who use substances are all someone’s                                                                 poverty, race, stigma and trauma don’t
                                                                                               homelessness and poverty, pain and                                                                needed to provide a safe supply
                                                                                                                                                  matter. They matter. These people matter.
         beautiful child—their baby boy, their baby girl—and they matter.” — Griffin Russell   trauma, racism and stigma. People
                                                                                                                                                  Context and circumstances matter.”
                                                                                                                                                                                                 and to decriminalize drug use.

14     Island Health   magazine                                                                                                                                                                   #IslandHealthMag  summer 2021                15
healthy eating

     Let's eat outside!
     Eating outdoors is one pandemic trend           — Salads are great for picnics. Choose
                                                                                                                            by Susan Evans

                                                                                                    — Bug spray, sunscreen, hats and a             oil-soaked paper towel: hold it with        from other raw foods like vegetables          WIRE GRILL BRUSH ALERT
     that might linger. Over the past few              options like pasta, potato or quinoa           first aid kit. Nothing ruins a picnic        tongs and rub it over the rack. (Do         and fruit during storage. Pack foods          Canadian surgeons are warning
     months, I’ve met inside-the-bubble                salads as they hold up better than             faster than itchy bug bites or a sun-        not use cooking spray on a hot grill.)      for your cooler in leak-proof plastic         against the use of wire grill brushes.
     friends at our local park with takeout            leafy greens. Check out our recipe             burn. Be sure to prepare for the           — Marinating does more than infuse            bags or airtight containers, placing
     coffee and muffins; had brunch with my            section for a couple of salad recipes.         sun and for unexpected mishaps.              food with flavour; it also inhibits                                                       The thin, sharp wires can come off
                                                                                                                                                                                               meat in the bottom of the cooler first.
     family at our favourite restaurant on their     — Think about grilling skewers of                                                             the formation of potentially carcino-                                                     the brushes, stick to barbecue grills
     newly-installed patio and even had some           chicken or salmon ahead of time and
                                                                                                    One of the joys of summer is not only                                                      KEEP IT COLD                                  and cling to food without being
                                                                                                                                                   genic HCAs (heterocyclic amines)
                                                                                                    eating outside but cooking outside as                                                      Keep cold food cold—at or below 4°C           noticed. If swallowed, it can cause
     of our ‘safe-six’ over for socially distanced     serve cold with tzatziki. Buy a rotisserie                                                  which form when cooking meat at
                                                                                                    well. Grilling on the deck or in the back-                                                 (40°F). Use an insulated cooler with          damage to the mouth, throat and
     drinks on our deck. My 20-something son           chicken from the supermarket—you                                                            a high temperature like on a grill.
                                                                                                    yard is a great way to prepare a delicious                                                 freezer packs or blocks of ice to store       even the stomach.
     has turned our backyard into a vegetable          can often find chilled roasted chickens                                                     According to the American Institute
                                                                                                    meal without messing up the kitchen.                                                       perishable foods. Be sure to throw
     garden and we are spending more time              in the deli section.                                                                        for Cancer Research (AICR), mari-                                                         If you choose to use a wire brush,
                                                                                                    Here are a few tips for grilling success.                                                  away any perishable foods that are
     in the yard, enjoying watching vegetables       — Fill containers with cut veggies,                                                           nating can reduce HCA formation.                                                          there are things you can do to keep it
                                                                                                                                                                                               left in your cooler once freezer packs
     (instead of dandelions) grow. Eating with         olives and pickles, and then chill.          USING A GRILL?                               — The best way to know if protein is fully                                                  in good condition:
                                                                                                                                                                                               or ice have melted.
     friends and family in the great outdoors        — For dessert, try fresh fruit or bake         — Preheat your grill 15 to 25 minutes          cooked is to research the optimum                                                         — Inspect the brush each time you use
     has become a welcome new habit.                   good-for-you cookies or squares.               before you start cooking to make sure        internal temperature for safety for the     COOK PROPERLY                                     it and look for loose bristles. If the
                                                                                                      it reaches the right temperature (and        type of meat you are cooking (tempera-      If you are grilling, make sure meat               bristles look worn down or clogged
     Most Vancouver Islanders love nature            EATING AWAY FROM HOME?
                                                     REMEMBER TO BRING:                               to kill any bacteria). Your grill should     tures can vary depending on the meat)       and poultry are fully cooked by using a           with grease, replace the brush.
     and are embracing the idea of moving
                                                     — Items to eat with and on. Bring plates,        be 400-450°F for high, 350-400°F             and then check the internal tempera-        digital instant-read food thermometer.        — If the brush looks ok, grill maker
     mealtime outdoors. Set up dinner at
                                                       cutlery and drinkware (if using                for medium-high, 300-350°F for               ture with an instant-read thermometer.      Place it in the thickest part of the meat         Weber suggests taking a pair of
     a picnic table at the park, head to the
                                                                                                      medium and 250-300°F for low heat.                                                       for a correct reading, and cook to the            pliers and tugging on a bristle
     beach and pull up a log, fire up the grill        disposable, aim to buy recyclable                                                         FOOD SAFETY FIRST
                                                       items), napkins, serving utensils                                                                                                       following temperatures:                           about as hard as you would pull
     in your backyard and spread a blanket                                                          REMEMBER—always open the lid                 Your main goal is outdoor fun so be
     on the grass—the possibilities are                and a bottle opener. Wrap any                on your gas grill before turning it on.      sure to follow these food safety tips from    GROUND MEAT / 71°C (160°F)                        on a blade of grass. If the bristle
     endless. And whether you are planning             breakables in tea towels.                                                                 Health Canada to keep everyone safe.          GROUND POULTRY / 74°C (165°F)                     comes out, it’s a sign it’s time to
                                                     — If you are going to a beach or park          — It’s easier to remove debris when the                                                                                                      replace the brush.
     an elaborate meal or grabbing takeout                                                                                                                                                     WHOLE MEAT CUTS / 71°C (160°F)
                                                       without picnic tables, bring something         grill is hot, so after preheating, use     KEEP IT CLEAN                                                                               — After scrubbing with a brush,
     from your local food truck, here are a                                                                                                                                                    for Medium
                                                                                                      a (carefully inspected) long-handled       Always wash your hands, cooking sur-                                                            wipe the grill with a damp cloth
     few tips and ideas for picnic perfection.         to sit on. Folding camp chairs are                                                                                                      WHOLE POULTRY / 82°C (180°F)
                                                                                                      wire grill brush or other type of grill    faces and utensils well with soap and                                                           to get rid of any loose bristles that
                                                       perfect, along with a blanket or                                                                                                        LEFTOVERS / 74°C (165°F)
     WHAT TO EAT?                                      tablecloth to spread on the ground—            scraper on your grill rack to clean        hot water before and you handle food,                                                           may have been missed.
     The most important thing to keep in                                                              off charred debris from prior meals.       especially raw meat, poultry and seafood,     For a full list of doneness temperatures      — Don’t leave your brush outdoors
                                                       a red-checked tablecloth still sets
     mind is to follow safe food handling                                                             Scrape again immediately after use.        or raw vegetables and fruit. Wash and         visit:               since it will wear down faster
                                                       the mood for eating outdoors.
     rules. When planning your menu,                                                                  See sidebar for tips to ensure your        sanitize your cooler before using it. Use a   ada/services/general-food-safety-tips/            when exposed to the elements.
                                                     — Hand wipes and sanitizer. Soap and
     think about preparing foods in advance                                                           wire brush is safe to use.                 clean, safe source of water for washing.      safe-internal-cooking-temperatures.html       — If you’d prefer to ditch the brush
                                                       running water are best for washing
     that are easy to handle and don’t need                                                         — Even on a clean grill, lean foods                                                                                                          altogether, there are nylon and
                                                       your hands, but if not available, these                                                   SEPARATE FOODS                                Learn more about safe food handling at
     cooking. Chill cold foods before put-             items will come in handy for cleaning          may stick when placed directly on                                                                                                          stainless steel pads, and scrubbing
                                                                                                                                                 Keep raw foods like meat, poultry and
     ting them in your cooler.                         hands before and after eating—and              the rack. Reduce sticking by oiling                                                                                                        blocks available too.
                                                                                                                                                 seafood (and their juices) separate           vices/general-food-safety-tips.html.
                                                       for the inevitable bathroom breaks.            your hot grill rack with a vegetable

16      Island Health     magazine                                                                                                                                                                                                         #IslandHealthMag  summer 2021              17
Rainbow Potato Salad
          Makes 5 servings

          INGREDIENTS:                                       Chicken Souvlaki with Dill Tzatziki
          1½ lbs (680 g)        multicolour                  Makes 4 servings
                                baby potatoes
                                                             INGREDIENTS:                                     DIRECTIONS:
                                Kosher salt
                                                             1 lb (500 g)       boneless, skinless            1. Cut chicken breasts crosswise into 1-inch (2.5 cm) strips and cut
          ⅓ cup (80 mL)         2% Greek yogurt
                                                                                chicken breasts                  each strip into 1½-inch (3.5 cm) chunks. Place in bowl. Add oregano,
          ⅓ cup (80 mL)         olive oil mayonnaise,
                                                             1 tbsp (15 mL)     dried oregano leaves             garlic, lemon rind, lemon juice and pepper and stir to coat well.
                                or light mayonnaise
                                                             2                  large cloves garlic, minced      Cover and refrigerate for up to 30 minutes.
          1 tsp (5 mL)          yellow mustard
                                                             ½ tsp (2.5 mL)     grated lemon rind             2. Meanwhile, in bowl, stir together yogurt, cucumber, garlic, dill and
          1½ tsp (7.5 mL)       fresh dill, divided
                                                             3 tbsp (45 mL)     lemon juice                      lemon rind until combined. Cover and refrigerate for up to 24 hours.
                                freshly ground black
                                                                                pinch freshly                 3. Preheat broiler to high, or if using grill, preheat grill to medium high.
                                pepper, to taste
                                                                                ground pepper                 4. Skewer chicken onto 4 metal or soaked wooden skewers (see tip
          1                     dill pickle spear,
                                                             TZATZIKI:                                           below). If broiling, place on foil-lined baking sheet and place sheet
                                finely chopped
                                                             ⅔ cup (160 mL)     0% Greek yogurt                  in oven, about 6 inches (15 cm) from broiler. Broil, turning once, for
          1                     medium celery stalk,
                                                             ⅓ cup (80 mL)      shredded cucumber,               about 8 minutes or until golden brown and no longer pink inside.
                                finely chopped
                                                                                squeezed dry                  5. If grilling, place skewers on greased grill over medium heat for
          2                     small green
                                                             1                  small clove garlic, minced       about 10 minutes. Turn once.
                                onions, chopped
                                                             1 tbsp (15 mL)     chopped fresh dill            6. Serve with tzatziki.
          1 tbsp (15 mL)        pickle juice
                                                             ½ tsp (2 mL)       grated lemon rind
                                                                                                              TIP: Soak wooden or bamboo skewers in water for about 15 minutes
          DIRECTIONS:                                                                                         before using to reduce flareups.
          1. Place potatoes in a large pot of salted
             water and bring to a boil. Boil for 10–15
             minutes, or until fork-tender. Drain and
             set aside to cool.

          2. Meanwhile, in a small bowl, combine the
             yogurt, mayonnaise, mustard, 1 tsp (5 mL)
             dill, pinch of salt and pepper. Set aside.

          3. When potatoes are cool enough to handle,
             set aside half. Peel the other half by gently
             pinching the skin and pulling it away.
             Place peeled potatoes in a medium bowl
             and mash with a potato masher. Dice the
             remaining potatoes into 1-inch (2.5-cm)
             cubes and add to the bowl with the
             mashed potatoes.

          4. Add pickle, celery, ¼ tsp salt, pepper and
             all but 1 tbsp (15 mL) of the green onion.
             Add the yogurt mixture and pickle juice
             to the potatoes and toss gently to evenly
             coat. Garnish with remaining dill and
             green onion.

              Recipe adapted from

                                                                                                                                    Recipe adapted from the Heart and Stroke Foundation
18   Island Health   magazine                                                                                                                  #IslandHealthMag  summer 2021              19
Corn Tomato Avocado Salad
     Makes 4 servings

     INGREDIENTS:                                                      Fudgy Flourless Crinkle Brownie Cookies with Sea Salt
     1 cup                  corn kernels from 1 large                  Makes 18 cookies (9 servings)
                            steamed corn on the cob
     5 oz (140 g)           diced avocado,
                                                                       2                       large egg whites                                 5. Refrigerate 2–3 hours or overnight (the dough must
                            from 1 medium
                                                                       ¾ cup (175 mL)          raw sugar                                            be chilled before baking).
     1½ cup (350 mL)        diced baby cucumbers,
                                                                       1 tsp (5 mL)            vanilla extract                                  6. Preheat the oven to 350°F (175°C). Line 2 cookie
                            about 3 small
                                                                       1 cup plus 2 tbsp                                                            trays with parchment.
     1 cup (250 mL)         halved cherry tomatoes
                                                                       (250 mL + 30 mL)        finely ground almond meal,                       7. Working with 1 dough ball at a time (leave the other
     2 tbsp (30 mL)         diced red onion
                                                                                               such as Bob’s Red Mill                               in the fridge), roll the dough into balls, about 2 level
     2 tbsp (30 mL)         fresh lemon juice,
                                                                       ½ cup (125 mL)          unsweetened cocoa powder                             tbsp (30 mL) or about 1 oz (30 g) each. Flatten the
                            from 1 medium lemon
                                                                       1 tsp (5 mL)            baking soda                                          dough slightly into a round.
     2 tsp (10 mL)          extra virgin olive oil
                                                                       ¼ tsp (1.25 mL)         kosher salt                                      8. Place 2” (5 cm) apart on the prepared baking
     ¼ tsp (1.25 mL)        kosher salt
                                                                       ¾ cup (175 mL)          chocolate chips                                      sheet and sprinkle with flaky salt, if desired.
                            fresh black pepper, to taste
                                                                                               flaky sea salt, such as Maldon,                  9. Bake for 10–11 minutes, until just set on the edges.
     DIRECTIONS:                                                                               as needed                                        10. Let the cookies cool on the baking sheet at least
     1. Toss all ingredients together and serve                                                                                                     15 minutes. They will continue to cook slightly
        immediately. Enjoy!
                                                                       1. In a medium bowl, whisk the egg whites, sugar                             as they sit on the baking sheet.
        Recipe adapted from                               and vanilla with a mixer until frothy, 1½–2 minutes.                  11. Eat warm or let cool and store in an airtight container
                                                                       2. In a large bowl, whisk together the almond meal,                          for up to 4 days. Refrigerate up to 7 days.
                                                                          cocoa powder, baking soda and salt.
                                                                                                                                                TIP: If the dough softens, stick it in the freezer for
                                                                       3. Add the egg white mixture and stir with a spatula
     Avocado and Beet Wrap                                                until combined. Fold in the chocolate chips.
                                                                                                                                                a few minutes to re-chill it. Cookies may turn out flat
     Makes 1 serving                                                                                                                            if the dough is not chilled enough. Chilling also makes
                                                                       4. With a spatula, roll into 2 balls, then wrap each
                                                                                                                                                dough less sticky and easier to work with.
     INGREDIENTS:                                                         with plastic.
     1                      multigrain wrap
     1                      red beet
     ¼ cup (60 mL)          feta cheese
     1                      avocado
     2 tbsp (30 mL)         lemon juice
     1 tbsp (15 mL)         sunflower seeds
                            handful of arugula
                            pinch of sea salt
                            ground pepper, to taste
     1. Pour water into a pot and bring to boil. Add salt
        and cook the beet until tender. Cooking time
        will vary depending on the size of the beet.                                                                                                                          Recipe adapted from
        Once the beet is well cooked, take out of the pot
        and let cool on a cutting board before peeling.
     2. Mix beet with feta cheese in a food processor
        until smooth and set aside.
     3. Spread beet purée on the wrap.                      NUTRITIONAL INFORMATION | Recipe images do now show exact recipe.
     4. Cut avocado in quarters lengthwise and brush        Rainbow Potato Salad           Corn Tomato Avocado Salad       Avocado and Beet Wrap          Chicken Souvlaki with             Fudgy Flourless Crinkle Brownie
        with lemon juice to prevent discolouration.         (per svg):                     (per svg):                      (per svg):                     Dill Tzatziki (per svg):          Cookies with Sea Salt (per svg):
                                                            Calories                 178   Calories                 128    Calories                 613   Calories                    166   Calories                   207
     5. Arrange avocado quarters, sunflower seeds,          Protein                  4g    Protein                2.5 g    Protein               18.5 g   Protein                    32 g   Protein                     6g
                                                            Fat                      7g    Fat                    8.5 g    Fat                    40 g    Fat                          2g   Fat                        12 g
        and arugula on the wrap.                            Cholesterol            7 mg    Saturated Fat             1g    Saturated Fat          9.9 g   Saturated Fat                1g   Saturated Fat               3g
     6. Season with salt and pepper to taste before         Carbohydrate            24 g   Carbohydrate            14 g    Cholesterol           35 mg    Cholesterol              73 mg    Carbohydrate              30 g
                                                            Fibre                    3g    Fibre                    4g     Carbohydrate          53.2 g   Carbohydrate                4g    Fibre                       8g
        rolling up.                                         Sugars                   2g    Sugars                 3.5 g    Fibre                 16.2 g   Fibre                       0g    Sugars                   16.5 g
                                                            Sodium               373 mg    Sodium               83 mg      Sugars                 9.3 g   Sugars                       2g   Sodium                 189 mg
        Recipe adapted from                                                                              Sodium               853 mg    Sodium                   78 mg

20      Island Health   magazine                                                                                                                                        #IslandHealthMag  summer 2021                          21

     Hot fun in the
     summertime                                                                        by Susan Evans

     While the outlook for this summer is positive, it does look like many of us will be sticking                                         course). There is something to be         — Check out parks you haven’t visited         there’s something for everyone
                                                                                                                                          said for entertaining without having        before—look for play parks in differ-       – mountain biking in Nanaimo,
     close to home again this year.                                                                                                       to clean your house first.                  ent neighbourhoods or regional              Cumberland and behind the Hartland
                                                                                                                                                                                      parks with easy hiking trails.              landfill and extended road cycling
     I’m not going to use the word “staycation”   — Grow your own veggies or flowers in      available for your phone to help iden-     COMMUNITY ACTIVITIES                        — Head to the beach but try a different       trips from Metchosin to Sidney and
     because we’ve heard that too often the         your backyard. Or get involved with      tify birdsong. Install a hummingbird       There will be some community activities       time of day—go for a picnic dinner          beyond. Check online for route
     past few months. Instead let’s celebrate       your local community gardens.            feeder (remember to keep it filled).       available this summer and many are free       or first thing in the morning with          ideas to hit the pavement and trails.
     the fact that we live on Vancouver           — Set up outdoor games that kids and     — Camping: set up a tent and have a          or very inexpensive. Check your local         your coffee.                              — When allowed, how about a road
     Island, one of the most beautiful places       parents can play together like bocce     family sleepover in your own back-         community guide and look for things like:   — Go berry-picking then head home             trip? Whether for a weekend or a
     on earth and a holiday destination for         ball, croquet and badminton.             yard. Make it feel like camping—eat
                                                                                                                                        — Outdoor movie nights.                       to bake a pie.                              couple of weeks, explore our beauti-
     people around the world—all available        — Try setting up your very own out-        outside, use flashlights in the dark
                                                                                                                                        — Free concerts—in parks                                                                  ful province and make family
     by just walking out our own front door.        door movie theatre. Use a projector      and tell (not too) scary stories.                                                      ENJOY THE GREAT OUTDOORS
                                                                                                                                          and urban centres.                                                                      memories that you will talking
     Let’s make the most of our “backyard”          unit and hang a sheet for a screen.    — Sprinklers, Slip ‘N Slides and water                                                   — Hiking, kayaking and canoeing are
                                                                                                                                        — Free days at local museums                                                              about for years to come.
     this summer.                                 — Have a picnic. Instead of eating at      tables – this one is probably geared                                                     all great outdoor activities that allow
                                                    your patio table, throw a blanket on     more to little kids but who doesn’t love     and art galleries.
                                                                                                                                                                                      for social distancing.                    At the time of writing, BC residents
     START AT HOME                                  the grass and bring a picnic basket.     a good Super Soaker on a hot day?          — Visit the farmers market—find
                                                                                                                                                                                                                                will soon be allowed to travel around
                                                                                                                                                                                    — Vancouver Island has an abundance
     Summer is all about doing stuff out-                                                                                                 one new food to try.
                                                  — Learn about birds and bird calls and   — Host an impromptu backyard pot-                                                          of beautiful and varied cycling routes.   the province. There are many interest-
     side and what better place to be than                                                                                              — Go for a drive and an ice cream cone
                                                    explore your neighbourhood listening     luck with neighbours and friends                                                         From a short jaunt on a dedicated trail   ing places to visit—find information on
     your own backyard.                                                                                                                   after dinner. Especially fun if little
                                                    and looking. There are (free) apps       (within public health guidelines of                                                      to a 100km tour of Greater Victoria,      Tourism BC’s website at
                                                                                                                                          ones get to go in their PJs.

22      Island Health    magazine                                                                                                                                                                                                #IslandHealthMag  summer 2021            23
island health
                                                                We know that PCNs are meant to support          high priority which means that no             Care Network helps PCN stakeholders          One of the biggest challenges that
                                                                healthcare, but what are they and how           one PCN is the same as another.               to engage in learning about Indigenous-      people report is finding a doctor or
                                                                can they help to create healthier outcomes                                                    specific racism and implement practices      nurse practitioner to provide ongoing
                                                                                                                These services might include:
                                                                for Island Health residents?                                                                  and processes that are experienced as        care – approximately 18 per cent of
                                                                                                                — increased access to primary
                                                                                                                                                              culturally safe by First Nations, Inuit      British Columbians don’t have a pri-
                                                                PCNS WILL OFFER                                   care supports;
                                                                                                                                                              and Métis peoples.                           mary care provider and for those who
                                                                TEAM-BASED CARE                                 — increased attachment to a
                                                                                                                                                                                                           do, fewer than half are able to get a
                                                                PCNs are not buildings made of bricks             primary care provider;                     “My work supports Indigenous patients,
                                                                                                                                                                                                           same-day or next-day appointment.
                                                                and mortar. Rather, they are geographi-         — increased access to urgent care;            family and community by recognizing
                                                                cally-based networks of resources and           — improved access to mild to moder-           the impacts of colonization,” he says.        In each PCN, health care professionals
                                                                providers that plan and deliver the               ate mental health and substance            “I also advocate for health provider           have been or are being hired to provide
                                                                primary care needs of a community or              use services; and                           relationships that are patient and family     people with better access to primary
                                                                region. PCNs include existing family            — better co-ordinated services for fami-      centred, promote culturally safe engage-      care. At some clinics, patients are
                                                                doctor offices, nurse practitioners, ser-         lies and seniors who are frail and          ments and are trauma informed.”              ‘attached’ to a physician or nurse practi-
                                                                vices offered at health authority facilities,     people with complex health issues.                                                        tioner. As PCN services continue to
                                                                                                                                                             PCNS WILL REDUCE THE                           expand and more care providers are
                                                                community health service organizations                                                       BURDEN ON HOSPITALS
                                                                                                                PCNS WILL OFFER                                                                             hired at clinic sites, attachment will
                                                                and more. And, within each PCN are
                                                                                                                CULTURALLY SAFE SUPPORT                      By linking people with primary care            continue to grow, as well.
                                                                groups of teams located throughout the
                                                                network whose members work together
                                                                                                                FOR INDIGENOUS PATIENTS                      providers and making it easier to
                                                                                                                What all PCNs have in common is the          access care, PCNs are helping people          TRANSFORMING PRIMARY
                                                                to understand their patients’ needs and
                                                                                                                commitment to providing culturally safe      to avoid unnecessary hospital visits,         CARE IN BC AND ON
                                                                provide the most appropriate care.
                                                                                                                primary care for Indigenous people.          including to emergency departments.           VANCOUVER ISLAND
                                                                Team-based care offers a patient and            Indigenous partners, including commu-                                                      To summarize, Primary Care Networks
                                                                                                                                                             Some PCNs include urgent and pri-
                                                                family-centred model where patients             nity leaders, have been involved in the                                                    mean that patients:
                                                                                                                                                             mary care centres (UPCCs), which are
                                                                receive care from a strong and con-             development of primary care networks,                                                      — who do not have a doctor or nurse
                                                                                                                                                             open to all patients and offer improved
                                                                nected interdisciplinary team of health         from planning to governance, and advise                                                       practitioner will be able to get one
                                                                                                                                                             access to same-day, urgent but
                                                                care providers who are also able to link        on the implementation of primary care.                                                        by calling HealthLinkBC at 8-1-1
                                                                                                                                                             non-emergency health care, including

     Primary Care
                                                                patients within the network to other                                                                                                          to find a primary care provider in
                                                                                                                 All PCNs on Vancouver Island will           during evenings and weekends. People
                                                                services they may need, such as specialty                                                                                                     their community;
                                                                                                                 employ Indigenous liaisons who work         who require medical attention within
                                                                or surgical services. Your team might                                                                                                      — once attached, will have an ongoing
                                                                                                                 with Indigenous patients and the com-       12-24 hours for sprains, minor cuts or
                                                                include your doctor and/or nurse practi-                                                                                                      relationship with their primary

                                                                                                                 munity to provide access to culturally      burns or other conditions can visit an
                                                                tioner as well as other providers like                                                                                                        care provider;
                                                                                                                 safe services. For other services within a  urgent and primary care centre.
                                                                Indigenous health professionals, mental                                                                                                    — will get access to faster, more conve-
                                                                health counsellors and social workers.           PCN such as urgent and primary care        “As a working parent with young children,         nient care from their doctor or nurse
                                                                                                                 centres, community health centres and

                                                                                                                                                             the Nanaimo Urgent & Primary Care                practitioner and the care team;
                                                                “We are excited to be one of the first           First Nation-led primary care centres,      Centre has been an invaluable resource.       — will be provided and connected
                                                                 clinics in the area to really embrace           complementary providers such as             Whether dealing with potential mastitis,         with a range of appropriate and
                                         by Shawna Cadieux       team based care and the Primary Care            traditional wellness providers are          a strep test, suspicious rashes, or various      accessible services and supports;
                                                                 Network model,” says Dr. Matthew Ward,          included in team-based care delivery.       injuries, there are so many things that       — will be informed about all aspects
                                                                 Medical Director, Eagle Creek Medical
                                                                                                                                                             have come up that cannot wait for an             of their care including services
     Primary Care Network. It’s a term we are hearing more       Clinic, a primary care clinic that belongs     “My role is to ensure we apply an
                                                                                                                                                             appointment with our family physician,
                                                                                                                 Indigenous lens to all aspects of our                                                        within their community; and
     often as government transforms everyday health care         to the Western Communities PCN.
                                                                                                                 strategic priorities, planning, direction   but  also aren’t severe enough to require     — will know where to go to get the
     for communities across British Columbia by establish-      “Our clinic is going to serve as an              and activities carried out by the PCN,”     an  ER  visit,” says Caitlin Boutin.             care they need, even during
                                                                 example, a blueprint, of how team              says Amy Rosborough, Indigenous                                                               evenings and weekends.
     ing Primary Care Networks or PCNs. Here on Vancouver        based care can evolve and flourish
                                                                                                                                                             “Being able to deal with a matter urgently
                                                                                                                Leader with the Cowichan Primary              without a lengthy wait is such a relief      PCNs bring together a variety of part-
     Island, PCNs have been formed in several communities        in the Western Communities.”                   Care Network.                                 when also having to juggle so many other     ners who are committed to supporting
     including Saanich Peninsula, Western Communities, Co-      PCNS WILL INCREASE ACCESS                       “Most importantly, my role is to honour       family responsibilities. In one instance,    better health and wellness journeys for
     wichan, Oceanside, and the Comox Valley and over time      TO PRIMARY CARE                                  and consistently lend voice to our           I realized my son had an angry sore throat   people, families, and communities. By
                                                                PCNs provide a full range of accessible,         Indigenous stakeholders, patients and        at dinnertime, was able to have him seen     working in partnership, we are discover-
     will bring additional resources and strengthened support                                                                                                 by a doctor and was home with antibiot-      ing how to provide team-based care to
                                                                everyday health services that will better        families to ensure we consistently
     to our region. These PCNs are a result of a partnership    support patients and providers. The              deliver high quality services to all         ics for his strep throat by bedtime.”        meet the health and care needs of Island
     between the Ministry of Health, Island Health, Divisions   networks were developed to better meet           patients we may serve”.                                                                   Health residents - including vulnerable
                                                                                                                                                             PCNS WILL MAKE IT EASIER                      patients and those with complex health
                                                                the specific needs of the community and
     of Family Practice, and local Indigenous partners.                                                         Alex Jules, an Indigenous Wellness           TO GET ATTACHED TO A                          conditions – faster and closer to home.
                                                                to strengthen services identified as
                                                                                                                Liaison within the Comox Primary             PRIMARY CARE PROVIDER
24     Island Health   magazine                                                                                                                                                                              #IslandHealthMag  summer 2021              25
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