Misdemeanours ... unclassified and otherwise (IJDP 9.4)
By Pat O’Hare
Ken Vail is a regular at the International Conference on the Reduction of Drug Related Harm. He is founder and Executive Director of the Xchange Point, Cleveland's second needle exchange program. If you have been to the Harm Reduction conference you will know who he is because he is extremely tall and wears his hair in a pony tail. He is one of the world's nice people. He is also one of the world of harm reduction's unsung heroes. A few days ago he spent six and a half hours in jail in Cleveland, Ohio for doing his job.
He was arrested on Tuesday 28th April and charged with an 'unclassified misdemeanour', the equivalent of a parking violation. Bail was set at $10000. He was arrested for violating the City's health emergency order on syringe exchange which was revised earlier this year. The revised regulations had asked the programmes to desist from syringe exchange until they demonstrated widespread community support through a variety of mechanisms such as community forums. Ken has been working on increasing the community support but has been vocal in criticising the 'desist' component of the order. A warrant was issued for his arrest and he turned himself in.
As in many of these things there was an element of farce in that the original summons was sent out on 23rd February to a 57-year-old man at a different address. The warrant for his arrest was issued on 20th April. Ken and his lawyers were told that it was an 'in-out process' at jail. Suddenly the bail bond was $10000 (later dropped to a personal bond) and he sat in jail for six and a half hours. At his hearing he pleaded not guilty.
On 19th May he appeared in court with his lawyer. The City Prosecutor informed his lawyer that undercover police saw him 'give a needle away without receiving one in exchange'. This was not true and in the words of his lawyer it was I more weak evidence to go with an already weak case'. Quite what undercover police are doing spying on outreach workers is another matter. His lawyer waived the right to a speedy trial and they decided to sit down with the City of Cleveland for a final time to resolve the problem.
On Ist June they met with city officials at the Health Department. Among those present were the City Health Director, HIV/AIDS Co-ordinator, Attorney and Prosecutor. William Patmon, the Council member that represents the district where the drop-in centre needle exchange site is located and who opposes the practice was not present. Eventually Ken met with him and arranged an appointment to sort things out. One meeting was postponed and Patman failed to turn up for the re-scheduled meeting.
As I have commented in the past, it is difficult to imagine that needle exchange, a public health strategy to reduce the spread of HIV and other infections, with proven results in doing so without increasing the prevalence of injecting drug use, can be so contentious that the city of Cleveland would risk more infections by calling a halt, however temporary, for their own political reasons. That someone can be arrested and spend time in jail because his public duty will not allow him to stop is beyond belief.
The situation in the USA, a country in which 35% of all new HIV cases are due to drug injection with unclean needles, is eccentric, to say the least. After many years of delay, the Clinton Administration announced recently that needle exchange programs are effective at reducing the spread of HIV and do not encourage drug use but refused to allow federal funding to be used for them. Health Secretary Donna Shalala urged state and local governments to implement their own programs because it is an effective public health strategy. Meanwhile one local government not only tells a project to suspend operations but it arrests a worker who is doing what the government has advised should be done.
Needle exchange programs are supported by the American Medical Association, the National Academy of Sciences, the Centers for Disease Control and Prevention, the American Nurses Association and American Public Health. In addition, the American Bar Association and the USA Conference of Mayors have urged the federal government to allow states and local governments to use federal HIV prevention funds to implement needle exchange programs.
Ken Vail was arrested for doing good public health. In Italy, harm reduction projects are harassed by police and sabotage attempts are made by staff who disagree with the policy. In Russia, a mobile needle exchange is raided by police and workers beaten up. People who are doing their jobs and being punished for it. As workers and policy makers in those countries where needle exchange is not a disputed strategy it is very easy to become complacent. Every now and then stories like this one come along to remind us that in many parts of the world this is a job that can only be done by brave and committed people. Ken Vail is one such person who doesn't want to go to jail and doesn't really want to appear in court. He is prepared to do so because of what he believes. He deserves our commendations and support.
