By Taylor Jordan (she/her), Dalhousie Medical Student (Class of 2023), Service Learning program participant
MainLine Needle Exchange is a North-End Halifax organization well known for their needle exchange service, but they also provide many additional services and supports that serve their goal of harm reduction. As participants in the Service Learning Program, my classmate Brianne Cruickshank and I designed 5 minute education/resource “huddles” on harm reduction in acute care delivery. These were to be delivered to acute care providers to increase awareness of community resources for hospitalized patients who inject drugs. Unfortunately, due to Covid-19 restrictions in 2021, we could not deliver the final product. The plans for our project were passed along in hopes that future Service Learning students will be able to deliver this type of efficient, concise, and accessible education within the acute care setting. The importance of this type of project was highlighted when we were working to identify hospital units that would allow us to deliver our huddles to their staff; hospital administrators informed us that only specific floors would benefit from education on harm reduction for patients who are hospitalized and who inject drugs. This highlighted the pervasive bias within the formal health care system that members of the People who inject drugs (PWID) community only experience health problems related to their drug use behaviors.
Through the medical school curriculum and Service Learning program material, I have been introduced to the theory of intersectionality. Intersectionality has provided me with a framework to better understand the experiences of the community MainLine serves. People who inject drugs (PWID) may not only experience discrimination related to their health behaviors, but many individuals belong to more than one minority social group, including groups related to gender, sexuality, class, economic status, and mental health status. Additionally, PWID are unique amongst social groups that are treated inequitably because they experience criminalization of their lifestyle, an additional intersectional axis shaping their lives and experiences. In some circumstances, informal and formal groups that should represent social support networks for PWID may consciously or unconsciously perpetuate stigma and inequitable access to resources for PWID. Intersectionality attempts to illustrate that there can be layers of discrimination felt by one individual due to multiple aspects of their identify which overlap and intensify one another. This is important information for me to be aware of as I move forward into my career as a physician, interacting with the health care system and diverse community members daily. I believe the art of medicine requires recognizing the unique location of each person within various intersectional axes of identity which influence their life and experiences.