The Hepatitis C Frontline: The Struggles and Suggestions of a Support Worker in Helping Marginalized Persons Access Hepatitis C Treatment in British Columbia

Part One: The Housing Crisis

I’ve always wanted to be a helper. Ever since I was a child, I knew that it didn’t matter what I was doing when I grew up, as long as it involved helping others. As a person who has had hepatitis C, it seemed like a natural progression to move into a job helping marginalized populations navigate hepatitis C .

Starting my work

I never stopped to consider the challenges for people accessing treatment who are homeless, addicted, and/or mentally ill until it became my job. In the typical 'Emma' fashion, I jumped in with both feet, making appointments left, right, and center to get my client base started on the medication to cure their hepatitis C. I was so excited and that excitement started to wane with missed appointments, medication not being taken for a multitude of reasons, and some of the clients stopped treatment altogether.

Barriers to treatment

Puzzled and desperate for an answer as to why I couldn’t seem to get my clients to keep up treatment, I started noting similarities in the barriers they were experiencing. With some clients, I struggled even to get them to the first doctor's visits. It was not because of the client's lack of willingness or wanting treatment. It was due to social, mental, and economic instability.

It dawned on me that treating the marginalized populations was not as simple as just getting them to a doctor's appointment. The problem is more complex, it has many layers: Lack of available social supports, food insecurity, insanely long waits to get a counselor, and lack of housing at the very core.

How could I expect someone who didn’t even know where they were going to sleep that night to adhere to 12 weeks of treatment, attending blood testing, attending doctors’ appointments, and all that comes with seeking the cure?

The importance of reliable housing

The problem is larger than that, and it has changed the way that I go about helping my client base access treatment. The ‘housing first,’ model has become my mantra. I realized how important stability is before we subject them to 3 months of treatment. We want to make sure they are safe, have reliable access to food, and have mental health supports.

When you have no home and no food, the last thing you are concerned about is treating your hepatitis C. I have learned a valuable lesson in working to build social and economic supports for my clients and then working with them to start treatment. Every job has it’s learning curves and this one is no different. I believe that as long as I keep plugging away, advocating for my clients' rights to shelter, food, and medicine, that I will be able to do my share to eradicate the hepatitis C virus. One client at a time!