The opioid crisis is claiming increasing numbers of lives from Surrey’s South Asian population, and cultural barriers to accessing treatment are compounding the problem, according to health experts and city officials.
On Monday, representatives from the BC Centre on Substance Use presented the findings from a series of dialogue sessions in March with families who have members suffering from problematic substance use. Surrey is one of six communities across the province selected to host the sessions.
Facilitator Parmvir Matharu, who grew up in Surrey, said his city has always celebrated its vibrant diversity, “but [in] these dialogues, we didn’t have representation from people of colour whatsoever, and that was really disheartening to see and we definitely need to focus on bringing those voices up.”
Glenda Coelho, BCCSU stakeholder engagement support worker, suggested the lack of attendance from visible minorities is representative of a larger, systemic problem in Surrey.
“A few priorities from our perspective is that, one, there be greater attention to South Asian communities impacted by the overdose [crisis] because there was a severe underrepresentation from this demographic,” she said.
Nearly half of B.C.’s South Asian population lives in Surrey, according to 2016 census data.
Councillor Brenda Locke said Surrey needs more health facilities tailored toward the South Asian community.
“We also know there’s an increase in the number of deaths in the South Asian community — we must be dealing with that,” she said. “We must be talking not just to the users but to their families and supporters.”
Next week, stakeholders from organizations including Fraser Health Authority, Statistics Canada, BC Coroners Service and the city will be meeting for a closed summit to discuss the current state of the overdose crisis in Surrey. At the summit, officials will review new data with the goal of developing policy and operational responses to reduce overdoses and overdose deaths.
Surrey’s Roshni Clinic ‘one of a kind’
Roshni Clinic in Quibble Creek is one of a kind in working to addressing the lack of attention to the crisis within the South Asian community, according to Coelho.
Lead physician Nitasha Puri said one of the foundational principles of the clinic is to minimize barriers to engagement in health services. As part of this ethos, staff at the clinic mirror their patient population in terms of appearance, language and understanding of worldviews that are embedded within cultural communities.
Dr. Puri gave the example of a person who came into the clinic with problems controlling their alcohol use.
“And they’ll come to us and say, you know, ‘I’m trying really hard to control my alcohol use, but then when I go to a wedding, it’s all over,’” she said. “That kind of statement is something that we can understand knowing the worldview that in South Asian culture, generally when a person attends a wedding, due to some ideas of masculinity, means that you’re supposed to drink a lot of alcohol at times.”
Rather than the patient having to explain how their cultural worldview affects their behaviour, Dr. Puri said, the clinician’s immediate understanding helps the therapeutic process.
Within the South Asian community, problematic substance use impacts established residents and recent immigrants differently.
“Recent immigrants are coming from a Punjab that also has a lot of addiction issues, and there’s lot of drug use in that province at this point in time,” Dr. Puri said. “And so this is a generation that has been exposed to substances quite early on, in an environment that’s very unregulated.”
Those immigrants then are forced to translate those experiences when they move to Canada, and can easily fall prey to people selling and using drugs here, according to Dr. Puri.
On the other hand, South Asians who are not new to the country have to cope with intergenerational trauma from years of racial discrimination.
Roshni Clinic began as a physician-only pilot project in 2017, but expanded to full-service operations with nurses and counsellors last fall. However, the clinic is only open four half-days a week and Dr. Puri said they are extremely busy.
In the short term, Dr. Puri said it would be very helpful to explore what the clinic could look like full-time, but eventually she hopes approaches that have been incubated at the clinic are expanded to the health care system at large.