Shayne Kilford and Fiona Vanhalen volunteered at the Northern Territory AIDS and Hepatitis Council (NTAHC) as a way of giving back for the help they received.
Their good deeds turned into full-time jobs that both love and find rewarding. Between them they have notched up more than two decades of dedication and service to the local community.
“I’ll do this for the rest of my life. It’s a great job, I really enjoy it. I’ve done a lot of different work -labouring in the building industry, a pest controller, a storeman at five star hotels – but this has been the best and definitely most rewarding,” Shayne says.
Fiona agrees: “It can be trying and upsetting sometimes, but when a client comes in looking miserable to be able to help them and see them leave walking a bit taller and with a smile on their face gives me great satisfaction.
“The clients are wonderful and very appreciative. I like that we are able to see the difference we make in people’s lives by offering a safe, comfortable space and giving clean injecting equipment without any stigma. When I used there were no NSPs around. I most likely wouldn’t have contracted hepatitis if there were.”
Fiona is a Needle and Syringe Program worker with NTAHC and its only peer educator. Apart from the usual duties of a NSP worker including dispensing needles, syringes and harm reduction information, she sits on several committees representing consumers as a peer educator.
“It’s hard to get injectors on these committees but as a previous injector, I’m their representative and voice,” she says.
The committees, including pharmacotherapy and harm reduction committees, meet regularly at NTAHC, the NT Department of Health, and the Sexual Health and Blood Borne Virus Unit at Royal Darwin Hospital. They discuss issues and push for legislative and other change to reduce harms.
Successes include recent legislative change enabling needles and syringes previously only allowed to be dispensed by a NSP to now be given out by nurses and other staff in hospitals and community health centres. This also reduces crime in remote areas where, due to no access to NSPs, people were breaking in to health centres to steal syringes and needles. Another proposal is outreach services for remote areas in the NT.
Fiona says the committees worked for several years to provide much needed after-hours sterile dispensing units (SDUs) and a 12-month trial funded by the NT Government is now underway and proving popular. SDUs provide 24 hour access at NTAHC’S three offices in Darwin, Palmerston and Alice Springs, and dispense syringes in disposable containers via tokens. There are hopes to extend this service to remote areas.
Another suggestion is for a register of disabled clients who cannot get out to access NSPs. This would enable a mobile outreach service to deliver sterile equipment and collect used equipment from them. Also on the agenda are outreach programs for itinerant ‘long grasses’ Indigenous people with limited NSP access.
Fiona has worked at NTAHC for eight years after her initial contact as a single mum with a history of injecting.
“I got to know the workers and they encouraged me to do some volunteer work. I really fitted in, and then they put me forward for full-time work,” she says.
Fiona was hepatitis C positive for 23 years after contracting the virus from her partner but successfully completed interferon treatment five years ago and is now virus free.
“The therapy was gruelling but I encourage clients to take up the new hepatitis C treatments by saying they are lucky because these treatments are much better. I can relate as I have that lived experience of being a poly-user of drugs and having had hepatitis,” she says.
Fiona has featured in news stories and government literature telling her story to reduce stigma, to tell a positive story and promote services and treatment. She does public speaking and has educated businesses, for example casino staff, on handling of spills and sharps.
Fiona’s tips for fellow NSP workers:
- Opening up about your story can help clients feel more relaxed. Letting them know what you have been through can open the door for them to talk and seek help.
- ‘‘It’s a great reward being able to help people turn their lives around. One client was very timid and I picked up on it and that she was feeling scared and stigmatised. Because I opened up and let her know what I had been through, she started talking to me and eventually started her own treatment. She is no longer injecting and is hepatitis free.”
- It can be challenging. People can be struggling with hepatitis, their drug use may be out of control and they might be beating themselves up over it. “My approach is to say don’t beat yourself up and I draw on my story and how long it took for me to get on top of it.”
- Be patient. “I’ve had clients on ice talk for an hour without taking a breath. Just bear with it.”
- Don’t take offence, no matter what they say.
- Try to put a positive spin on things, have a laugh with clients, always put a smile on your face and ask how their day has been, and ‘How can I help you today?’
- “I like interacting with clients and making them feel normal and comfortable,” she says.
- Engage clients in any way you can. Encourage them to sit down and have a drink of water and a chat if they want. Get to know them, ask how their kids are, which helps normalise things and reduces stigma. This helps you establish a relationship which may facilitate them asking for help.
- Never ask if they want rehabilitation because this is a suggestion from you that they should have it. Always wait for them to ask for rehabilitation.
- Sometimes it’s hard to turn off at night at home but leave work at work because if you toss and turn all night worrying about a client, you can’t do your job properly the next day.
Shayne started as a volunteer in 2001. He was questioning his sexuality and had been visiting NTAHC since 1998.
“Everyone was supportive and I got to know the staff who suggested I do some volunteer work because I’d lost my job,” he says. “I wanted to give back to the community so volunteered as a NSP worker and in the sex worker outreach program. I found it very rewarding and felt like I was giving something back to the community, a community I knew quite a bit about.”
A job became available and in November 2004 he started full time work as a NSP officer. Shayne works mainly at NTAHC’S Darwin and Palmerston offices, although he has done one stint at its Alice Springs office.
“I supply sterile needles and syringes to people who inject drugs so they don’t catch or spread blood-borne viruses among themselves or to the general community,” Shayne says. “It’s a community service and is really important work. The government supports us with funds and if it wasn’t for us, people who inject drugs would have a lot more HIV, hepatitis and be sicker.
“Our work also helps prevent spread of blood-borne viruses to the wider community. I provide education to businesses, clinic 34s (blood-borne virus clinics) and Aboriginal health services, and educate clients about safe injecting.
“In Darwin morphine pills are used because heroin is sparse and there’s no continual supply. There’s a lot of risk with morphine pills as fillers, colours or wax can clog the syringe so we teach how to inject only the morphine and mix it properly so they’re not injecting other stuff. There’s a lot of filtering involved.
“We educate about new hepatitis C treatments so clients can be treated and clear the virus, which is great.”
Shayne believes the main challenge is the way the public views this valuable work. “There is still a lot of opposition and stigma. Educating the public on what we are really about – trying to stop the spread of blood-borne viruses – is needed,” he says.
Media coverage that all drugs are bad and require a criminal response promotes this resistance, he says.
“Clients are very appreciative. They are never aggressive and it isn’t a stressful job. Before us, they were using syringes over and over.”
Shayne’s tips for fellow NSP workers:
- Attitude is everything. Be non-judgemental, kind and approachable. Treat clients with respect because they deserve it. Clients are individuals – there is no stereotypical person who injects drugs; they are from all walks of life.
- You may be the only service that clients see regularly so break down barriers and form a rapport as you then may be able to help with other health or social issues. This may include putting them in touch with health, support and mental health services if they want.
- It may take a while to build rapport until they feel comfortable and start to open up.
- Some clients might just want phone numbers of health or social services, others may want you to make the appointment while others may want you to attend with them.
- Be kind to service funders such as government.
– Helen Carter