Streetworks is one of Edmonton’s most essential programs. It is dedicated to inner city health and is a cornerstone of support for vulnerable populations, addressing critical health issues with compassion and innovation.
Originally known as Needleworks, Streetworks began as Edmonton's first needle-exchange program in the 1980s. It was created in response to the global HIV epidemic and continues to focus upon HIV prevention, care and support, targeting those using criminalized substances and those involved in the sex industry, and their social organizations. It has always worked hand-in-hand with Boyle Street and operated out of our former downtown community centre. With a change in governance in 2022, Streetworks moved fully under the Boyle Street umbrella, formalizing our longstanding partnership and providing more protection for Streetworks.
The work Streetworks does includes harm reduction and health services, overdose prevention, and sexual health. Although there are several teams with their own specializations, the realities of community health mean that everyone does a bit of everything.
Harm Reduction/Health services
Harm reduction is a non-judgmental way of building strengths and seeks to reduce harm that may be caused to an individual through certain behaviours. The people Streetworks serves are often denied access to medical care, housing, and many other fundamental rights because of fear, stigma, and structural barriers. One of the main tenets of harm reduction is the meaningful involvement of those with lived experience to find solutions that work to enhance health and safety.
Few practice this better than Streetworks: approximately 50% of their staff have lived experience with extreme poverty, chronic homelessness, and criminalized substance use. Sadly 30% of their staff have lost five or more family members to drug poisonings or overdoses.
The Streetworks core team focuses on harm reduction activities such as clean supplies, outreach, and nursing, as well as providing essential services like wound care and education on safer substance use and safer sex. There is a van that operates 7 evenings per week and multiple on-foot outreach teams.
Overdose Prevention
Streetworks approaches overdose prevention in multiple ways: there are the overdose response teams, which provide immediate response to overdoses, distribute naloxone, and offer education and support to the public, including vulnerable populations. Streetworks was the first group in Canada to provide community naloxone, beginning in 2005. Since 2020, they have responded to over 2,000 incidents of drug poisoning and overdoses. All staff support access to recovery and provide information, encouragement and referrals.
The post-overdose recovery team finds people who’ve experienced drug poisoning or an overdose in the last 24 - 48 hours. They assess how people are physically and mentally, look for opportunities to prevent future drug poisonings, and provide meaningful referrals including through connections to other programs at Boyle Street such as our housing programs.
Another central part of overdose prevention - and all of Streetworks - is data analysis. Pulling together information about where drug poisonings and overdoses occur and the composition of the current drug supply, the Streetworks data analyst is vital. Their work helps Streetworks allocate their resources efficiently and serve the community effectively.
Sexual Health
Streetworks addresses sexual health through projects like the H.E.R. (Healthy, Empowered, Resilient) Pregnancy Program, which supports pregnant women who are street-involved.
It is composed of nurses, a social worker, and pregnancy supporter workers, and provides health education and nursing services including pregnancy and STBBI testing, systems navigation, referrals, and accompaniment to health and social services.
This program, along with the STI team focused on syphilis and other infections, provides critical health services to some of the most vulnerable populations in Edmonton. They are also heavily involved with Streetworks’ robust research component: H.E.R. is involved in ongoing partnerships and research nationally around pregnancy and drug use, and the STI team works with the Canadian Institute of Health Research, looking into point of care testing for syphilis and HIV.
Research is a critical part of everything Streetworks does (harm reduction, overdose prevention, sexual health, and more), with multiple projects aimed at understanding and addressing health issues in the inner city. These projects are often conducted with meaningful community member involvement, ensuring that the solutions developed are relevant and effective. Streetworks and the University of Alberta in partnership are currently studying people’s health needs and experiences in the downtown core. okimaw peyesew kamik will contain a research office for the University of Alberta, ensuring that research can be done directly with community on site.
Conclusion
Despite the challenges, including funding uncertainties and the politicization of health issues, Streetworks continues to innovate. The recent acquisition of a decommissioned ambulance allows for more dignified and effective delivery of health services, particularly in challenging environments like back alleys and tents. This mobile unit provides privacy and better conditions for procedures such as STI testing, significantly improving the quality of care.
Streetworks' impact extends beyond immediate health interventions. By involving community members in educational and support activities, the program fosters a sense of community and mutual aid. One notable initiative is the writing of community health booklets. Community members participate in the research and creation process of these booklets, which ensures relevancy and leads to greater engagement and dissemination of health information.
Streetworks is a vital program that embodies our mission to provide dignified, inclusive, and holistic support. Through its comprehensive and compassionate approach, Streetworks is saving lives and showing us the way forward.