Sheway

The Downtown East Side (DTES) of Vancouver, where Sheway is located, has been identified as the poorest neighbourhood in Vancouver, if not Canada. It is known for its sex and drug trade, violence and crime, alcohol and drug use, substandard housing and high rate of HIV-related illness.

Sheway was established in 1993 in response to a growing understanding of the needs of pregnant and parenting women living in the DTES. A report entitled Targeting High Risk Families (Lock et al., 1993) revealed that approximately 40% of infants born over two years to mothers living in this area of Vancouver were exposed to alcohol or other drugs in utero. The rate of low birth weight was 33% in the exposed infants, all of whom were apprehended by child protection authorities. In this same period, hospital health care providers identified an increasing number of socially high-risk pregnant, substance-using women arriving at emergency departments ready to deliver and with no history of prenatal care. The health outcome for these mothers and infants was poor.

In response to these concerns, a group of health and social service providers (including representatives of BC Children's Hospital, the Vancouver Health Department, and the YWCA's Crabtree Corner program) prepared a proposal for the development of a community-based integrated service that would meet the complex health and social needs of this population of women and children. In July 1992, funding for the project was approved, and the service began operation in March 1993.

Since its inception, the Sheway project has been made possible by the shared resources of agencies that today include Vancouver Coastal Health, The Ministry for Children and Family Development, the Vancouver Native Health Society, the Ministry for Housing and Social Development and the YWCA. These project partners contribute staff, program funding and governance to ensure that Sheway maintains comprehensive and coordinated service.

Harm reduction is a set of practical strategies intended to reduce the negative consequences of drug use, incorporating a spectrum of strategies from safer use, to managed use, to abstinence.

• Accepts, for better and for worse, that licit and illicit drug use is a part of our world. Harm reduction strategies work to minimize the harmful effects of drugs rather than  ignore or condemn drug use
• Understands drug use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from severe abuse to total abstinence, and acknowledges that some ways of using drugs are clearly safer than others.
• Establishes quality of individual and community life and well-being—not necessarily cessation of all drug use—as the basis of successful interventions and policies
• Calls for the non-judgmental, non-coercive provision of services and resources to people who use drugs and the communities in which they live in order to assist them in reducing attendant harm.
• Affirms drug users themselves as the primary agents of reducing the harms of their drug use, and seeks to empower users to share information and support each other in strategies which meet their actual conditions of use.
• Recognizers that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination and other social inequalities affect both people's vulnerability to and capacity for effectively dealing with drug-related harm.
• Does not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit drug use.

• To engage women in accessing prenatal care and a range of other supports during pregnancy
• To promote health and nutrition of women and their children accessing prenatal and postnatal care at Sheway from pregnancy up to 18 months following birth.
• To provide education, referral and support to women to help them reduce risk behaviors and, in particular, to reduce or stop use of alcohol and other drugs during pregnancy.
• To support mothers in their capacity as parents and caregivers.