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A man walks past Pandora Pharmacy in Victoria, British Columbia on Nov. 25, 2010.Deddeda Stemler for the Globe and Mail

VANCOUVER-Vancouver Coastal Health directly provides and collects needles at nine locations in Vancouver and partners with more than 40 other organizations that do the same, including housing providers and community agencies. VCH and affiliated agencies report handing out 1,853,853 needles in the 2009 calendar year, and recovering 1,297,568 directly from clients. Another 170,759 needles were collected from 29 outdoor disposal boxes and 111,066 were picked up by community workers. Specialized cleanup crews sweep the streets on a daily basis, targeting needle "hot spots" and responding to hot line calls when a needle has been unsafely discarded in public. Most of the needles are found in alleyways in the Downtown Eastside. Since 2001, VCH has been handing out needles in accordance with demand, rather than trading on a one-for-one basis.

SURREY- The Fraser Health Authority directly runs one needle-management program through the South Fraser Community Services Society. Its clinic, which is west of King George Highway in central Surrey, does not have a one-for-one policy, operating instead as a collection and distribution service . Fraser Health purchased a total of 385,000 needles for distribution through approved agencies in 2009-2010 - 234,100 of which were designated for Fraser South, including Surrey. Representatives from Fraser Health could not provide exact figures for numbers actually handed out or collected, and said the number of needles found in the street is not formally recorded.

KELOWNA- Interior Health directly operates one primary needle distribution and collection service through Outreach Urban Health and arranges for other community agencies to receive needles and harm-reduction supplies. Interior Health spokeswoman Lannea Parfitt said there are no geographical restrictions on the service, noting that their sole location operates in the downtown core while other agencies serve other parts of the city. She was unable to say how long the program has been operating. Outreach nurses can also hand out and collect needles on the street. "Needle exchange" services are listed on the clinic's website, but the location does not have a mandatory one-for-one policy. There are also five needle drop boxes listed on the Kelowna Community Resources website, all of which are downtown. Between 2009 and 2010, there were 146,600 needles distributed in the Okanagan area - about 50,000 of which were distributed through Outreach Urban Health in Kelowna. How many needles have been left on Kelowna's streets? That's hard to tell: Neither Interior Health nor the city can say how many needles have been picked up - although 300 needles were collected by city staff in Kelowna parks between March and October.

Fabiola Carletti

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