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On the front lines of the other epidemic, Mainline Needle Exchange starts its 30th year

COVID-19 has challenged the social outreach organization, but it has survived and kept helping the community all along
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Mainline is a recognizable stop for many of the city's vulnerable populations, its iconic blue doorway having long been its home.
​​The front lines fighting a pandemic have been a near-constant focus for the past year, but it may not have seemed that unusual for the Mainline Needle Exchange team, who for the last 29 years have been frontliners in the other epidemic killing Canadians at an alarming rate — overdoses, which last year killed more people than COVID-19.
 
Over the course of those 29 years (they turn 29 on May 2), Mainline, which operates under the Mi’kmaw Native Friendship Centre, has served the province’s most vulnerable populations with a mandate that, as lead peer outreach worker Ashton Manktelow describes it, will cover “everything from A-Z” — clean needles and materials to use drugs safely, but they’ll also help with taxes, put minutes on cell phones, whatever.
 
“We go out to communities where substance users live, and we engage with them — we’ll give them clean supplies, we’ll take back their used supplies,” explains Manktelow. “We just engage with them and ask how they’re doing, check in, see if there’s anything we can do.”
 
One day a week, they fan out across the Western half of the province, Halifax to Yarmouth, to check in on their rural clients — a lot of ground to cover, since “as soon as you pass Bridgewater there’s basically nothing” in the way of harm reduction services, Manktelow says.
 
Unsurprisingly, COVID has simply complicated life for many of their clients, in many cases making it even more dangerous.
 
“It has contaminated the drug supply with the borders being closed. Unfortunately we’ve seen a rise in overdose deaths,” he says. “People’s mental health is just getting worse, they’re not sure what they’re using, and people have relapsed, because COVID has taken a mental toll.”
 
In the face of all of that, though, they have continued and persevered, and been able to help people even under challenging circumstances.
 
Though they can't be sure, as there are barriers to testing for vulnerable populations, none of their clients tested positive for COVID that they know of — “the general public might assume that our clientele would be the first group of people to get COVID, but they’re very resilient,” Manktelow says.
 
They’ve kept many cell phones loaded with minutes, and are helping people book vaccine appointments and COVID tests. Every day during lunch, they’re still able to hand out food to anyone who drops by, to check in.
 
For Manktelow, who has experienced what many of their clients experience, he knows that those things matter even when they may not be able to fix everything.
 
“It affects me,” he says. “I like my job, and I like to know how my clients are doing, and I know what it’s like to have someone ask ‘how are you, how’s your day?’”
 
So while its 29th birthday party has been called off (a shame — the party is a popular event for their clients every year, Manktelow says), Mainline is still looking to the future.
 
“While our programming has been cut [due to COVID], we’ve been able to think up other programs we’d like to offer in the future,” he says. “But that all comes down to money, it all comes down to funding.”
 
If there are silver linings in anything this year, it might be the sense that we will emerge from this pandemic with a greater awareness of who was already being left behind, and a new sense that in times of crisis there is a strong community that is willing and ready to be leaned upon.
 
“The community itself has really noticed our clientele a little bit more, and has really stepped up,” Manktelow says. “It’s unfortunate that in the most desperate times, it comes down to a small group of folks who are doing things that should have been done all along.”​
 
Correction: This article has been updated. A previously published version was inadvertently based on an early draft. A fact-checking process undertaken with Mainline identified three corrections and clarifications, and a typo, that were corrected in editing prior to publication but were unfortunately not reflected in the final, published version. Halifax Today and the author regret, and apologize for, the error.
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