More Harm Than Good?

Meghan MacIver in an article in the November 28th issue of the National Post, wrote a powerful piece on the realities of “trying to make a difference.” For those who wish to change their part of the world, however modest and small,  should enter into such an avocation with eyes wide open. It is easy to imagine transforming the lives of others; it is harder to deal with the reality of change. MacIver wrote:

This might sound crazy, but I was pretty excited when I first got my job as a woman’s housing support worker in Vancouver’s Downtown Eastside.

The neighbourhood has been pegged “Canada’s poorest postal code” because of its high density of heroin addicts and homeless people. I got a job with ATIRA Women’s Resource Society, the largest feminist housing agency in the area, which managed housing projects that other organizations wouldn’t touch, and used the profits to fund the women’s housing they operated. They made a point to hire women from all backgrounds who could bring expertise from life experience, placing value on experiential knowledge, rather than formal certifications. Even though I was getting my master’s degree, I wanted to have a career in that kind of environment.

I believed I had gotten a progressive job that I could grow in, learn from, contribute to and, most importantly, use to actually make a difference in someone’s life. Nothing could have been further from the truth.

Within the first few weeks on the job, I discovered that any difference I made was probably going to be made through cleaning. I thought i’d be counseling the women, but it was like being a glorified janitor. But I’d never worked in a job like this though, so at first, I thought, who knows? Maybe cleaning up the women’s rooms would help them with their self-esteem and give them a clean place to sleep.

Even though I didn’t interact with the clients as much as I’d thought, I eventually got to know a few of them quite well. When I met Rita, we hit it off immediately. Despite being one of the most hardcore addicts in the neighbourhood, Rita remained quick-witted and charming. I was happy to have her to talk to on my shifts because I figured I would learn something from her about addiction, or at least about how she’d ended up down there. She made me feel reassured that there was more to the job than just cleaning, and that I would learn more as I went along.

I soon discovered that the other main part the job was to break up fights and suppress acts of violence between residents. ATIRA made a big deal of talking about how we were keeping the women safe from outsiders, but a lot of the time, I was keeping the peace between the tenants, and keeping myself and the other staff members safe from them as well.

Once, a client cornered another staff member in the kitchen with a knife. I heard my colleague cry for help and I ran over and distracted the resident so the other staff member and I could run back to our office.

I slammed the door to our office as tight as I could, while the resident started to throw all of her weight into it to get at us with her knife. We yelled at her to calm down, which she eventually did. We kept the door locked until she forgot what she was doing and we heard her sit down on the stool outside our door. When we finally opened the door, she had passed out, and we just left her there for the remainder of our shift because we were too tired to deal with it.

Nobody liked to talk about how we were actually in danger on the job, but the truth is we were totally helpless in the face the ferocity of some of the women. We wouldn’t call the police because we were instructed to handle emergencies ourselves — the police were considered untrustworthy because of their historically oppressive attitude toward our clients. It was a fair enough point, but the unfortunate result was that staff members sometimes ended up acting like wardens of a jail — but without the ability to properly protect ourselves, or the residents. Even if we had called the police, there wouldn’t have been much they could do. They wouldn’t have put the residents in jail, and we wouldn’t have kicked them out — we were their home. We were the only place left for these women.

What most of the women in the house really needed were full-time doctors, nurses and psychiatrists. The area mental institution was dismantled in the late 1970s, but all that’s been allowed to replace it is a transient and flexible work force. Instead of a hospital or healthcare facility for the neighbourhood, you get us — part-time musicians, artists, single moms, former addicts and a lot of social-work students who work here for slightly better money than what Starbucks has to offer…

Of course, you always heard about the next big project for the Downtown Eastside, announced by the directors of the community non-profits, the edgy new art galleries in the neighbourhood or even some academics, all trying to outdo each other for funding and attention. But those projects were so removed and distant from the reality of my day-to-day work — it seemed no one involved in them talked to anyone who actually worked or lived in the neighbourhood.

Once, I suggested to one of these project coordinators that she actually spend time in our building to better understand what it was like. She was from an outside agency, and hadn’t spent any time in the neighbourhood, let alone the housing. Her eyes widened as if I’d said something downright frightening.

“I really see myself as an ideas person, you know,” she replied defensively. “I’m not so into the practical side of work, like you.” She said this carefully, trying not to sound above me, but failing miserably.

At the end of the day ATIRA is still doing what very few are willing to do: work with poor, drug addicted women who are hard to house and extremely vulnerable. So these new projects kept getting funded, while no one from the government, other NGOs or the university were willing to check if they were actually working, or what alternative approaches there might be.

One day, when Rita nearly stopped breathing, we called the paramedics for her. While we were waiting for them to arrive, I reached out to touch her hand for the first time ever. I had never touched a client before, but she just seemed so small, and frightened.

“Everything is going to be OK,” I whispered to her as we waited for the ambulance to arrive.

I tucked my hand into hers, but as I touched her, she flinched sharply, and then her hand went limp. A deep sadness engulfed me in a surprising way. She was just so cold and unfeeling. I thought I meant something to her, but she was too far gone for that now. Maybe she always had been.

I don’t know if I ever made a difference in Rita’s life, but I knew that without any training or support, it was unlikely I ever would in anyone else’s. There were a lot of reasons to quit the job, but when Rita finally passed away, it was like something switched off in me and I no longer felt there was a point in continuing. Of all the challenges I faced down there, the thing I couldn’t handle anymore was the dishonesty of carrying on working, when I knew what I was doing wasn’t working at all.

MacIver’s writing is powerful; it is direct and without adornment. There are several all-to-familiar statements in this story for those us familiar with the difference between the theory and reality of change at the frontlines of life. Perhaps the most revealing is “I really see myself as an ideas person, you know.”

Changing the environment or health care or any of a number of causes is laudable but often is subverted by energetic but ill-equipped advocates. Change is not only difficult but runs against the grain of the nature of things. Nature does not change until it does, and then it does very quickly.