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The Current Transcript for May 31, 2017

Host: Anna MariaTremonti

STORIES FROM THIS EPISODE

Listen to the full episode

Prologue

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Everyday we're cleaning up needles, drug packets, the little metal disk they used to cook it.

ANNA MARIA TREMONTI: She lives in a condo building where the evidence of homeless addicts using the stairwell is overwhelming.

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We’ve been bear sprayed, people have them hit with pipes, they threw smoke bombs into the shelter to try and flush everyone out.

He manages a shelter that sees homeowners targeting the homeless. Welcome to Maple Ridge B.C. where the issue of what to do about the homeless and drug addicted is so contentious., the mayor went into hiding at one point. An an hour the currents Liz Hope brings us the story of a small community with a big and very divisive problem. Also today,

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They stripped me down I'm on a heart monitor. I'm on oxygen. A whole team of doctors, my husband said doctors and nurses came running after my bed.

AMT: Rose Stinson's dramatic hospital encounter began with a trip to the E.R. when she was pregnant and thought she had the flu. What she really had was Sepsis a form of blood poisoning caused by infection, an illness responsible for one out of every 18 deaths in Canada. A new study says the faster diagnosis that can cut mortality rates, will tell you more in half an hour. And let's just stay with the upside of expedient medical diagnosis because in just a moment we're talking about Lyme disease an illness where far too many suffering from it just are not believed. And that includes the singer Avril Lavigne.

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This is what they do to a lot of people that have Lyme disease, they can’t... [crying] They don't have an answer for them, so they tell them like, you’re crazy.

AMT: As Ottawa announces a 4 million dollar fund for Lyme disease research. Critics weren't worried it will not do enough in a year when the tics appear to be thick. But before we get to that we are starting in Kabul. I'm Anna Maria Tremonti. This is the current.

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Kabul bombing kills at least 80 near city's diplomatic district

Guest: Franz Marty

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[Sound: Man shouting in unknown language]

AMT: Well, that is panic on the streets of Kabul as you've been hearing on the news. The death toll keeps rising after a massive bombing in the Afghan capital, right by an area that leads to the presidential palace and major foreign embassies. Franz Marty is a freelance journalist in Kabul and he joins us now. Hello.

FRANZ MARTY: Hi. How are you?

AMT: Well, from the pictures I'm looking at it looks so massive you must have heard this bomb.

FRANZ MARTY: Yes it was a pretty loud blast. I mean maybe 10 minutes walk, I live in maybe 10 minutes walk away from where it happened. And here at my place the windows stayed intact but in other parts of the city also quite far away from the blast windows got shattered.

AMT: So where did this happen, Franz, where in Kabul?

FRANZ MARTY: It is the center of the city. It was on the street right outside the so-called Green Zone, where most of the western embassies are located. It wasn't exactly clear where but it was close to the German embassy. But again it was on a street outside the blast [unintelligible] the German embassy. Nonetheless, from the pictures that I've seen all the windows and the whole facade of the German embassy is severely damaged. But there are no reports about wounded or injured people from the embassy. So, apparently, all the killed and wounded normal passers by on the road in front.

AMT: This was rush hour, though, so it killed a lot of people.

FRANZ MARTY: It was rush but it killed less than it would have if it wouldn't have been Ramadan, the Muslim fasting month. Because you know, in Ramadan less people are on the road. Usually the reports that come in range from 50 to 100 killed and over 300 wounded. And again it appears to be that virtually all of them are just average Afghan, who use this road that passes says by the embassies. The spot of the blast it does not seem to have had an exact target there. It was close to the German embassy but it wasn't that they drove into the German embassy. So, it could be that the bomb exploded prematurely while they wanted to drive into the effective target.

AMT: What kind of a truck was this?

FRANZ MARTY: I can't say for sure. One account mentioned that it might have been hidden in a tank wagon that transported usually water. But that's not confirmed so from the magnitude of the blast, it must have been a truck, because a normal car wouldn't have been able to carry that much explosives.

AMT: And give us an idea of what is happening politically in Kabul, that something of this magnitude would be done at this time?

FRANZ MARTY: Oh, that's difficult to say. And the insurgency is ongoing where the Taliban fights the government. They recently at the beginning of Ramadan and released a statement that calls for seizing fighting during the fasting month or ignorance of the Islamic faith. So they promised to continue their fight against the government that they see as a puppet government of an illegal occupation by western forces. However the Taleban officially said that they had nothing to do with today's incident. If this is true or not is hard to say, because the Taleban are known that if an attack goes wrong and only kill civilians that they then deny responsibility even though it might have been Taliban fighters that conducted it. During the past minutes some outlets reported that the so-called Islamic State has claimed responsibility. This seems unlikely especially as observers say through sources and official Islamic State channels there is no hints that the Islamic State was behind it. So, it is unclear who was the perpetrator. On the other hand, bombings are no rarity in Kabul. It was just the magnitude that set it apart from other attacks.

AMT: It's being identified as one of the bloodiest attacks that Kabul seen, huh?

FRANZ MARTY: That is true, since 2001. It is from the reports as I said the casualty figures are not definitive, but even if it would be like 50 killed in a single incidence, it would be one of the largest attacks in the city.

AMT: And again it appears as the casualties may well be the civilians who just happen to be in the wrong place, today.

FRANZ MARTY: Exactly, as I said probably premature explosion.

AMT: Franz Marty, thank you.

FRANZ MARTY: Thank you.

AMT: Franz Marty is a freelance journalist in Kabul, Afghanistan.

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'I was actually called certifiably crazy': Lyme disease patient

Guess: Arlene Rill, Janet Sperling

AMT: This is The Current on CBC Radio One. I'm Anna Maria Tremonti.

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I mean we don't really go back here very often just because it is tick country.

I think unless the authorities take action we may be getting a reputation like Lyme Connecticut, which gave its name to the disease and people who are thinking of moving here or starting a business here, which we really need to keep our economy alive, might just think twice.

AMT: That's Patty Lounsbury from beautiful Mahon, Bay Nova Scotia, afraid to go outside in case she gets bitten by Lyme disease carrying ticks. She has reason to be worried, Canada's Public Health Agency which tracks Canadians infected with Lyme disease reports numbers are rising rapidly as the climate warms. In 2015 there were over 900 Canadians diagnosed with Lyme disease that's up almost 600 percent from 2009. There are now predictions that by the early 2020s we may see as many as ten thousand new cases. Quebec and Ontario have seen the biggest increase in numbers but there is an uptick in Lyme infections in New Brunswick, Nova Scotia, Manitoba and Southern B.C. Across Canada there are patients struggling to cope.

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For me it's going to be five years in June of suffering in hell and doubts and fear and just having your life thrown upside down.

We know of four different that was transmitted to people.

It's a neurological disease and it really messed up my memory, short term memory.

It felt like my body was made out of lead. Pains in my muscles and my arm.

We had to really push for the tactic. We did get the testing done eventually but it took four months in order to get somebody to do it.

It is really important that people know what is in the environment so when we consult our health care provider, they get proper diagnosis and treatment.

When you're looking at testing and treatment, it's a in the thousands of dollars. And the longer you go undiagnosed the longer it's going to take you to treat it, and people are losing houses and their savings trying to get themselves better.

AMT: Yesterday Canada's health minister Jane Philpott announced that her government is directing $4 billion toward combating Lyme disease. There are concerns about how effective that will be to address what some are calling a looming health crisis. Arlene Rill is a retired teacher who's been living with Lyme disease for three years. She's in Montreal. Hello.

ARLENE RILL: Good morning.

AMT: When were you bitten by a tick?

ARLENE RILL: I was bitten in June 2014 and honestly at that point in time I had no idea about Lyme disease.

AMT: And what happened when you went to the hospital?

ARLENE RILL: Well, I researched the bite first because it happened on a Friday. I researched the bite realized it was a tick bite went to infectious diseases and they told me that yes it's a tick bite but there is no Lyme in Montreal, and sent me home.

AMT: What happened next?

ARLENE RILL: After that I went back three, four, or five times with migrating pains and inflammation and I was really sick. But I was only tested specifically.. I did have the ELISA serology but it is known to be false negative. It's approximately 60 to 65 percent false negative.

AMT: What do you call that? That's the Lyme disease test, the serology?

ARLENE RILL: Yes, the serology.

AMT: Okay, so you're testing negative but you've got these health issues. What are they? What's happening to you?

ARLENE RILL: Well, I know for sure I do have Lyme because I did send my blood to the states as most other people ended up doing but mine was a case for I guess you would call it having won the gold ticket because they saw the [unintelligible] in my blood. They saw the bacteria.

AMT: How long was this after the bite?

ARLENE RILL: Approximately 10 months.

AMT: And in that 10 months what was happening to your health?

ARLENE RILL: I deteriorated quite quickly. I ended up having massive headaches, palsy. I ended up in the emergency. They gave me anti-depressants instead of antibiotics. I ended up going to another infectious disease doctor who was highly suspicious of the fact that I had Lyme disease despite the negative serology and put me on antibiotics for six weeks which is a good amount of time, if it's caught rightaway, six months later it's too late.

AMT: Okay, but you've seen several doctors. What kinds of things were they telling you when you went and you told them how you were feeling, what was happening to you?

ARLENE RILL: I would say 90 percent of the doctors I saw, and I think I saw one for every single part of my body for every system. They did not know about Lyme disease.

AMT: But what did they say to you then?

ARLENE RILL: Well that I had.. let's say with my stomach, I have IBS or a rheumatologist said to me, Oh it's natural. You know you're getting older you have inflammation. Some inflammation, I couldn't even use my hands. I ended up in hospital because of my knees, having surgery this past winter, and I was I was housebound the entire winter.

AMT: At one point someone even questioned your mental health, didn't they?

ARLENE RILL: Yes.

AMT: What happened?

ARLENE RILL: I was actually called certifiably crazy because I was having all these migrating pains and nobody could understand, the doctor could not understand I guess, how these pains were just migrating everywhere must be in my head.

AMT: So how is your health now?

ARLENE RILL: It's deteriorated. It's deteriorated. I have a lot of pain. I have a tremendous amount of inflammation I find it really hard to do stairs. There's the inflammation in my knee has gone down enough that I can do physio but it is it's a grueling ongoing problem.

AMT: Arlene, so your diagnosis. The one you got actually came from a U.S. clinic, you said?

ARLENE RILL: Yes.

AMT: What does that tell you about Canadians being diagnosed here?

ARLENE RILL: I don't think doctors are educated here. We need to educate our doctors. If you go to a GP and the GP feels that perhaps you do have Lyme disease, a clinical diagnosis, then patients should be referred to a knowledgeable doctor who can treat.

AMT: The government has committed $4 million for Lyme disease research and education.What do you think of that?

ARLENE RILL: I think it will not help a lot of Lyme patients because I think it's going to go more into making people aware. It's not addressing the sick people, those who are infected.

AMT: Arlene Rill, we have to leave it there. Thank you for sharing your story with us.

ARLENE RILL: My pleasure.

AMT: Arlene Rill. She's been living with Lyme disease for three years. She joined us from Montreal. My next guest says there are still major questions when it comes to the way Lyme disease is diagnosed and treated in this country. Janet Sperling is a board member of the Canadian Lyme Disease Foundation. She's a Ph.D. candidate at the University of Alberta in the Department of Biological Sciences. She's in our Edmonton studio. Hi.

JANET SPERLING: Yeah. Good morning Anna Maria.

AMT: I should make the point that your Ph.D. is on ticks, is it not?

JANET SPERLING: Indeed. I'm just interested in more than just Lyme disease because I think that when you have a case of Lyme disease often you have a co-infection. So it's not just a simple case of having Lyme disease and that some of the confusion. And that's why people have different..They have a lot of variety in the ways that they present to the doctor. It makes it much more complicated to make the diagnosis and certainly much more complicated to actually treat the person and have them get better.

AMT: Now you know this as well because your son went through this.

JANET SPERLING: Yes indeed my son went through this. Fortunately he's made a complete recovery and that's why after a while I thought you know we're not really seeing the kinds of research where we can show that the tick here in Canada is probably carrying a variant. It's not exactly the same Lyme disease as it would be in the U.S. It seems to me that there would be Lyme disease in Nova Scotia and that would be Lyme disease in British Columbia. But why would they be exactly the same Lyme disease.

AMT: OK so she talks about an ELISA test, that U.S. test. Is it the test we need? What do you think of how we test now?

JANET SPERLING: Well the problem is that right now because it doesn't take very many of the bacteria to actually make you sick. We look at the body's response to the Lyme disease. So it's true that the ELISA is

adequate for some people but not for everybody. And we need to say first of all we have to have a response so the person has to mount an immune response that takes time. So in the very early stages the blood testing just doesn't work, don't even bother. It's a clinical diagnosis. And then as you get farther along in the disease some people just get so sick they're unable to mount a really effective immune response so they don't get any diagnosis. So that it's like a Catch 22?

JANET SPERLING: indeed, yeah.

AMT: What do you think of the government's $4 billion pledge to combat Lyme disease?

JANET SPERLING: Well, these are still early days. So I can see the paper that I have in front of me and I see some positive sort of forward motion. However, what I'm most concerned about is if we have exactly the same people following the exact same guidelines that we have for you know the last several decades. then I don't see that's actually going to change things for the patient,

AMT: Because things have to change because the disease is changing.

JANET SPERLING: Yeah indeed. The disease is changing the people are encountering it in different ways. There are a whole lot of unknowns. So for us to just sort of say we're going to use the American guidelines, but we live in Canada. I just don't understand why we aren't dealing with a Canadian guideline that looks at for example the gold standard might be Lunenburg Nova Scotia. You know you could choose maybe Long Point Ontario as our gold standard. I just sort of feeling that we're giving too much responsibility to an American guideline for a disease that's happening here in Canada.

AMT:I want to ask you as well about the treatment protocols. I've got a clip for you of Dr. Michael Libman an infectious diseases specialist and director of the Center for tropical diseases at McGill University Health Center. Yesterday he told CBC Montreal that doctors run the risk of being disciplined if they treat Lyme disease with antibiotics for more than four weeks. Here's why.

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Doctors refuse to prescribe it for more than two to four weeks because the available standard medical evidence suggests harm and no benefit to extended treatment. So the reason they're not getting it for more than two to four weeks, is that all the medical evidence says that prescribing it for longer than that does more harm than good.

AMT: Jane Sperling, a question here about how long it takes to get rid of this?

JANET SPERLING: Well, indeed that's something that we don't really have a good handle on. I just know that if you were to say two to four weeks that's pretty unrealistic.

AMT: How long did it take your son?

JANET SPERLING: He ended up with nine months of antibiotic and we had to switch the antibiotics around. So, me the idea that you can even take one look at a person say this person this individual has Lyme disease therefore they get between two and four weeks of antibiotic. To me that's cookbook medicine. You know people all are a little bit different people have different co-infections. That’s the whole story. It is supposed to be a professional judgment. So you need to find a doctor who's going to work with you, and you can say OK I made a lot of progress when I did this antibiotic but I still have the symptoms remaining.

AMT: So, when you're raising two questions here though, that one is the diagnosis and the different kinds of diagnosis and then the actual treatment it sounds like doctors have their own challenges to face and [unintelligible]

JANET SPERLING: Oh, indeed. And that's why it's really important. I would prefer to deal with the family doctors because they're the person at the end of the day who's left with a sick patient. Often the family doctor if they make a referral to the infectious diseases doctor they can't even get the patient seen unless the patient already has the positive two tier serology. So they have to have the positive blood test before they can even go to the infectious diseases doctor. But if they already have a positive blood test, they're already in that nice little box that says you're two tier positive, therefore we know what to do with you.

AMT: And you're saying you can't really tell before six weeks, but then you ..

JANET SPERLING: Indeed. T is just one of these things that there still are a lot of questions. And everybody's different. We have to have a diversity of viewpoints out there. Right now there are too many decisions that are being made behind closed doors. So you see this idea that somebody can say an individual will respond two to four weeks. Well some people do and some people don't. What are you going to do about the people who don't respond with just two to four weeks of antibiotics.

AMT: Okay, so before I let you go this $4 million project from Ottawa not going to cover it all?

JANET SPERLING: It's a start, it's a step in the right direction but they have to make sure that there are patient advocates represented, or we're just going to keep going down the same path that we've been on for the last decade. And you saw that if we turn the entire file over to the people who have allowed a 600 percent increase then I think you know we need to think again.

AMT: Okay. Thank you for your thoughts.

JANET SPERLING: Thank you.

AMT: That is Janet Sperling.

She's a board member of the Canadian Lyme Disease Foundation. She's a Ph.D. candidate at the University of Alberta in the Department of Biological Sciences. She is in our Edmonton studio. Stay with us. The CBC News is next. And then we're talking about a grim tally of a major Canadian killer.

You probably haven't heard of it. It’s called Sepsis and it's hard to diagnose as well. As well our producer Liz House takes us to Maple Ridge B.C. where threats and tensions over housing the homeless are dividing a community. I'm Anna Maria Tremonti. This is The Current

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Why time is of the essence in treating sepsis — a growing killer in Canada

Guests: Rose Stinson, Christopher Seymour, Chip Doig

AMT: Hello I'm Anna Maria Tremonti and you're listening to The Current. Still to come.

SOUNDCLIP

From an integrity perspective, I was really offended that I knew what I did to both the population in the shelter, having such a high degree of need and that government would walk away from them and leave us with no solution. It disgusted me.

AMT: How the battle over housing the homeless is tearing apart a community in B.C. but first Sepsis takes its terrible toll. Well this is a medical killer most people haven't even heard of, Sepsis. According to Stats Canada in 2011 it was involved in 1 in 18 deaths in this country. It's caused when an infection gets into the bloodstream. Many doctors say despite how widespread it is it doesn't get nearly as much attention as other causes of death such as heart attacks or car accidents. New research published in The New England Journal of Medicine shows that when treated early, Sepsis doesn't have to be as deadly. In a few moments we'll talk to one of the study's co-authors. But first we are going to hear from Rose Stinson. She was 11 weeks pregnant with twins when she developed a high fever. In the end her battle with Sepsis left her with lasting physical and psychological scars. Rose Stinson is in our Toronto studio. Hello.

ROSE STINSON: Hi.

AMT: Have you ever even heard of Sepsis before for this.?

ROSE STINSON: No not at all.

AMT: So when you first went to the hospital, what was it that sent you there?

ROSE STINSON: I had a high fever and I I thought I had the flu, and it wasn't until my husband contacted Telehealth and they suggested that my husband takes me to the closest emergency hospital and so he did.

AMT: They first diagnosed you with a urinary tract infection, right?

ROSE STINSON: Yes. I was diagnosed at the hospital with a urinary tract infection and following that they gave me two bags of I.V. Then they released me.

AMT: Sent you home.

ROSE STINSON: They sent me home. They said that they were waiting for other tests. So in the meantime they sent me home.

AMT: When they call you and tell you to come to the hospital, they found something in your blood culture, correct?

ROSE STINSON: Yes.

AMT: What have they told you?

ROSE STINSON: They told me that my blood culture was positive.

AMT: What does that mean?

ROSE STINSON: I don't know.

AMT: They didn't tell you.

ROSE STINSON: No.

AMT: Okay, so you go back?

ROSE STINSON: I go back to the hospital and they told me my file was going to be at ER at triage. And it was. But the lady there the nurse there sent me to minor the treatment. But I waited at least five hours until a doctor called my name and he had a puzzled look in his face. He looked at my file he looked at me and he said, why are you here? And I said to him, well I said I have a high fever. I'm pregnant with twins. They told me I have a urinary tract infection and that my blood cultures are positive. He was shocked. He was like, I don't know why they sent you here this is very serious. You need to go into emergency.

AMT: Here means that other department, the minor treatment.

ROSE STINSON: Minor Treatment.

AMT: He wanted you to go to someplace where you get fast care.

ROSE STINSON: Yes emergency.

AMT: So then what happened?

ROSE STINSON: So he walked my husband and I, over to the nursing station outside of emergency. We waited at least an hour until a doctor came to see me.

AMT: At some point you hit a crisis point, what happens?

ROSE STINSON: I started getting shivers and my husband kept on covering me with blankets and he kept on walking out saying, could a doctor come to see my wife? She's not well. My husband waited, waited then he went out another time and he's like, did somebody ordered the Tylenol? Did the doctor ordered the Tylenol for my wife? And so finally the nurse came with the Tylenol. And when my husband came to lift me up the nurse just screamed and she's like we need oxygen here right now.

AMT: What was happening?

ROSE STINSON: I turned blue. I couldn't breathe. I went into septic shock.

AMT: So they rushed to the intensive care unit?

ROSE STINSON: Yes. They rushed me to intensive care they stripped me down. I got a heart monitor. I'm on oxygen. A whole team of doctors my husband said doctors and nurses came running after my bed, and the doctor who saw me in emergency said this should not have happened.

AMT: So, are they saying sepsis yet at this point, have they diagnosed it as Sepsis?

ROSE STINSON: No.

AMT: So you were in the ICU and they still don't know what you've got.

ROSE STINSON: They don't know what I've got. The whole time I was in the hospital for two weeks I was never told the word Sepsis or that I went into septic shock.

AMT: So at some point they did tell you E. coli.

ROSE STINSON: Yes. In the morning the doctor came to see us and told my husband that I had E. coli. They found E. coli, severe E. coli in my blood.

AMT: But you're pregnant with twins what's happening there?

ROSE STINSON: So, they send me for blood we're sorry for ultrasound. And there was only one baby with a heartbeat. The other baby had died. So they started antibiotic treatment in I.V. I was then a few days later I was released from hospital. And I just so happen to have an appointment with my family doctor. She checked my temperature right away and she's like I don't know why they released you still have a fever. You need to go back to emergency so she called for an ambulance and back to emergency. I went.

AMT: And while you were there I lost a second baby. I was released from the hospital labeled as just having a miscarriage and being depressed.

AMT: At one point did you find out it was Sepsis?

ROSE STINSON: From my hospital records I requested my hospital records. It wasn't until about two or three weeks later my sister in law who works in the medical field asked me if I had any medical information from my hospital stay. And I handed her a folder. And when she opened the folder and she read the first page she said you had Sepsis. She's like, oh my goodness. She goes, You're lucky to be alive because she saw it was Sepsis from E. coli.

AMT: How long ago was this?

ROSE STINSON: Three and a half years ago.

AMT: How are you doing today? That was a lot to go through.

ROSE STINSON: I’m struggling. I'm struggling with my health. I'm in pain. I struggle with weakness. I struggle with severe fatigue. I was diagnosed with severe chronic fatigue and fibromyalgia in August of 2015 two years after my incident. I struggle with faint feelings, lightheaded. It's been a real struggle because my son now is five years old and I struggle to take care of myself, to take care of him, to take care of my home.

AMT: And you lost the twins.

ROSE STINSON: I lost the twins.

AMT: Did anyone tell you that the side effects would linger this long”

ROSE STINSON: No not at all. When we actually went to see the infectious disease doctor two weeks after I was released from the hospital, my husband asked about recovery and how long it would take me to recover because I was bedridden. The doctor said six to eight weeks she should be fine, she should be able to you know get back into her normal life. And we belief that.

AMT: What was your health like before all this happened?

ROSE STINSON: I was in great health. Actually before I became pregnant with my son, I ran a 10K marathon. And you know I trained for that. I actually you know would run every morning before going to work. You know I was in good health.

AMT: And what do you want the rest of us to understand about this?

ROSE STINSON: The seriousness of Sepsis. You can get Sepsis from you know, a paper cut you can get sepsis from a scrape on your knee. Mine developed from a urinary tract, so you know if anyone has a urinary tract infection they need to get it treated right away. It can happen from you know a surgery, something gone wrong from a surgery it's an infection. And it's your body's overwhelming response.

AMT: It's important to hear your story thank you for coming in.

ROSE STINSON: Thank you for having me. I really appreciate this.

AMT: Rose Stinson, she survived sepsis. She joined us in our Toronto studio. A new study in the New England Journal of Medicine has found that time is of the essence when it comes to diagnosing and treating sepsis. Dr. Christopher Seymour is the study's lead author. He's an assistant professor of critical care and emergency medicine at the University of Pittsburgh School of Medicine and he's in Pittsburgh. Hello.

CHRISTOPHER SEYMOUR: Hello.

AMT: Before we get to your research explain what Sepsis is.

CHRISTOPHER SEYMOUR: Sure. Well, I think we heard a great example of how tragic sepsis can be from our guest, Rose. Sepsis is a life threatening infection where the body's response to that infection injures its own tissues and organs and when quite severe can lead to multi organ failure or even death.

AMT: So the first infection can it be something that would be relatively like you would think nothing of it and then it just goes haywire?

CHRISTOPHER SEYMOUR: Well, in some patients as mentioned something as simple or simple as a Paper cuts or even a scrape can lead to a severe infection. And it demonstrates a lot of what we don't know about why Sepsis occurs in some patients and not in others.

AMT: And what are the main symptoms?

CHRISTOPHER SEYMOUR: Sepsis as it's an infection plus a threat to one's organs is usually identified by the symptoms of the infection that's causing the problem. So as we heard from Rose this was a urinary tract infection. And so there might be the initial symptoms of that but in others who may have pneumonia the most common cause of Sepsis this could be a cough that's productive of sputum or phlegm. But it's when the patient feels more sick that we might expect that. We're thinking the patient may have organ dysfunction and this can be evidence with confusion, low blood pressure, with dizziness signs that something just isn't going right.

AMT: And it's still considered a medical mystery, huh?

CHRISTOPHER SEYMOUR: Well, there's no single test for Sepsis and that's what makes it so particularly hard to diagnose and perhaps why many clinicians have some delays in initiating treatment and getting things started. Unlike heart attacks where we can measure a troponin test in the blood and have a very specific answer as to whether their heart attack is present. That's not the case for Sepsis. We have to put together both our suspicion for infection and then evidence that the organs are under threat.

AMT: Why did you want to study how hospitals handle sepsis?

CHRISTOPHER SEYMOUR: Well, there was a tragic case in the state of New York of an adolescent boy who was otherwise healthy and his name was Rory Staunton and he had a case of septic shock that he ultimately passed from as a result again of an otherwise benign injury on his skin. This case led to a profound change in policy in the state of New York where hospitals were required to have protocols to get treatment started right away. But yet there's been a lot of controversy in the medical community about how fast is fast enough. Should we be giving antibiotics within the first hour or maybe it's hour three or hour six after Sepsis is recognized. After these regulations were started in the state of New York., we had a lot of data on thousands of patients in which we could try to get to the bottom of that question. How fast should be treating patients with Sepsis.

AMT: And what did you find?

CHRISTOPHER SEYMOUR: Well, we found a couple interesting things. The first is that a bundle of care that includes a lactate measurement which is how we measure the severity of Sepsis, a blood culture to look for the source of the infection and the type of bacteria that might be present and administration of antibiotics. Those three things in the bundle if we do that one hour faster, compared to a patient who might have that finished one hour later, the patients who got that bundle faster had associated with the lower mortality in the hospital.

AMT: Well but how do you get them to be faster if in fact it is hard to diagnose if someone comes in with something that can't be an automatic assumption that's what they have?

CHRISTOPHER SEYMOUR: There's two parts to that question. The one is how do we improve recognition. And that's the harder part that's by educating our clinicians and our nurses and even the public about what Sepsis is perhaps the easier part might be the protocols either through regulation or incentives. We can try to drive clinician behaviors so that they administer treatments in a timely way to the patients who they recognize with Sepsis.

AMT: And so what happened to the chances of survival when the hospitals were following the rules in New York state?

CHRISTOPHER SEYMOUR: Yes, hospitals that were more adherent to the bundle and could get antibiotics into patients with sepsis sooner had patients that had lower odds of mortality and that their risk was decreased with every hour sooner that they got treated.

AMT: Okay, so that's a big deal.

CHRISTOPHER SEYMOUR: Well there are hundreds of thousands of patients with Sepsis that die every year in the U.S. and Canada. And so there's this large population whom we can try to reduce avoidable deaths.

AMT: And now what about those who contract it in the hospital, what's the danger there?

CHRISTOPHER SEYMOUR: Right so that's different. Sepsis in the hospital, which we call nosocomial or healthcare acquired Sepsis often has different bacteria and comes from a different source. So unlike most cases of Sepsis which arise from the community from the causes we've discussed like an ammonia or a urinary tract infection or a skin infection, Sepsis in the hospital often comes from patients who have had surgery but may have had a chronic illness and therefore bacteria that's all around them in the hospital leads to new infections and these often have more resistance to antibiotics and require a different treatment regimen.

AMT: But the bulk of your research focuses on those who show up with severe symptoms in an emergency room care and it needs to be dealt with.

CHRISTOPHER SEYMOUR: That's right. The issue of timing has been most controversial in patients in the emergency department. And so that's where we focus our study.

AMT: Now I am a bit confused because there are there are other statistics that say sepsis related mortality is actually declining throughout the U.S., not solely in a state like New York where they've got this protocol.

CHRISTOPHER SEYMOUR: All right. I think there are there are clinical practice guidelines that have been recommended by multiple professional societies in Canada the U.S. and Europe that have promoted early antibiotic treatment and early recognition of Sepsis that have affected the mortality rate over the past 10 years. And I think it's a consistent signal that Sepsis mortality is improving. But what we particularly asked in New York was whether a difference in matter of hours could change the outcome rates and that's what we found.

AMT:It's quite incredible thank you for sharing your results.

CHRISTOPHER SEYMOUR: My pleasure.

AMT: That is Dr. Christopher Seymour. He's an assistant professor of critical care and emergency medicine at the University of Pittsburgh School of Medicine. He joined us from Pittsburgh. This is The Current on CBC Radio One and Sirius XM. I'm Anna Maria Tremonti. Now according to Statistics Canada between 2009 and 2011 sepsis contributed to more than half of all deaths from infectious diseases. As the population ages the number of sepsis cases is increasing. So for a closer look at what Canadian doctors and hospitals are grappling with we've reached Dr. Chip Doig. He is a critical care physician at Calgary's Foothills Hospital. He's a team co-leader of the Alberta sepsis network and he's in our Calgary studio. Hello.

CHIP DOIG: Good morning, Anna Maria.

AMT: So last week's New England Journal of Medicine contained an [unintelligible] that describe Sepsis as a public health crisis. Is that what you see in Canada?

CHIP DOIG: Well Ann Maria it's certainly, First off listening to Rosa's story was a very, very difficult and very poignant. And unfortunately it is a reality that some individuals who develop infections and go on to develop Sepsis suffer lifelong complications if they survive. And the mortality rate of Sepsis has been aligning overall but it's still very high. So we talk about all cause mortality and the 28 day all cause of mortality for sepsis or severe sepsis is between 20 and 30 percent, depending on site of infection and organs involved that's much higher than the all caused mortality for example from trauma or for acute myocardial infarctions. But as you said in your introduction most people understand the emergency situation with a heart attack or all of us worry when we see a motor vehicle collision on our streets. But Sepsis is less known for sure by the general public.

AMT: And it sounds like it's less known by the medical public as well.

CHIP DOIG: Well I think most individuals know that infections in the medical community that some infections go on to cause severe and organ damage or problems. The issue is trying to make certain that we identify infections that can be life threatening early and to ensure that we have adequate therapy for those patients.

AMT: And so what's your reaction to what we just heard from Dr. Seymour. How important is speed when it comes to diagnosing and treating Sepsis?

CHIP DOIG: Well absolutely important. And if I if I could, there's one of the first studies that demonstrated the importance of early antibiotic therapy was a study led by a Canadian Anan Kumar in Winnipeg . Anan’s work demonstrated that hour by hour the delay in appropriate antibiotic therapy increased the mortality rate for individuals that have severe life threatening infections.

AMT: And so and when did that study come out?

CHIP DOIG: That was about 2003 2004 if I remember correctly.

AMT: And what grade would you give Canadian hospitals now when the when it comes to how they treat and diagnose sepsis?

CHIP DOIG: Well it's difficult to talk to off all hospitals [laughing].

AMT: Very true. [laughing] That's a bit of a sweeping question.

CHIP DOIG: But I have very good relationships with many physicians across Canada both Emergency Physicians, infectious disease specialist, ICU specialists, and I think what we experienced in Calgary is probably very similar to other places in Canada. So we're probably very good now at identifying patients who have that life threatening infection that present to emergency department with what I'd say are classic symptoms in a classic presentation. And so instituting the bundle like Christopher mentioned of early antibiotics, blood cultures, other appropriate blood tests, we are good at. What becomes more difficult is identifying those individuals who don't have classic symptoms or individuals from the hospital who might be in with that other medical problem and may have symptoms or signs of their other medical problem that are similar to the symptoms and signs of infection.

AMT: It is interesting because we do know that an emergency room can be a very hectic place and people can get lost. How do you how do you confront that kind of thing?

CHIP DOIG: So first there are a few things that are important. On one hand we have advice to individuals don't go to the emergency department if you have a minor problem. But there's certainly some symptoms that people have and Rose highlighted a few of them that if you do have them that you should go. So, if your temperature is very high. If you're not having chills but you're having fairly vigorous shakes where your body is moving and perhaps your bed is moving. If you're blue, if your breathing is fast, you know if you're confused. Those are all symptoms that that suggests that a minor infection is actually far more severe and far more worrisome. And so attending the emergency department is important. One of the reasons Sepsis is increasing is the use of medications or therapies that might affect your immune system. So if you do have a chronic health problem you should have a plan with your health care team and providers that if you're on a drug that lowers your immune system what do I if I develop a fever. And then of course common sense is an important thing. So I think Rose said something that's very important if things seem out of proportion to what you've normally experienced common sense would say you should seek advice.

AMT: Hmm. Now she experienced a lot of complications afterward. How difficult is it for patients to recover from this?

CHIP DOIG: So this is one of the most surprising things, and again there's been a lot of Canadian research in this led by Margaret Herridge in Toronto. By other individuals cross the world as well. So our term for this now is post intensive care syndrome. But certainly individuals who survive Sepsis and a stay in the ICU they tend to experience a number of different long term effects from it. So first it's as Christopher said some of the organs fail as part of the sepsis syndrome and it can take a while for organ recovery. So people can be, for example, on dialysis for renal replacement for a number of months after they've been discharged from hospital. The second is there are certainly some neurocognitive the neuro-psychological effects from Sepsis. So, I remember an individual that I followed an architect who told me that she had lost her ability for spatial orientation. Her nickname for herself was the hot wheels mama, cause she used to build all the fancy Hot Wheels tracks in the family and she lost her ability to play with her kids because of that spatial orientation, well at least play Hot Wheels with them. And then the third is there are certainly some physical effects as well. Most patients experience a fair amount of muscle loss and loss in muscle strength and these effects can last individual organs three to six months. Neurocognitive effects up to a year, and the weakness syndrome up to a year. Now one of the studies that was done in Canada demonstrated that about 70 percent of individuals that had been in ICU survived the course of Sepsis only about 70 percent had returned to work at about a year.

AMT: Is that right? Well we have to leave it there but I guess that just brings us back to our main point about the ability to diagnose quickly and treat quickly. Chip Doig, we have to leave it there. Thank you for your thoughts today and your insights.

CHIP DOIG: Thank you.

AMT: That is Dr. Chip Doig critical care physician at Calgary's foothills hospital. He's a team co-leader of the Alberta Sepsis Network and he joined us from our Calgary studio. Let us know what you think of these discussions we're having on health today on Lyme disease, Sepsis. You can tweet us at The Current CBC find us on Facebook go to our Web site cbc.ca/thecurrent. And stay with us in our next half hour. A B.C. mayor faces the polarizing politics of dealing with homelessness and drug addiction. We take you to Maple Ridge British Columbia for that story. I'm Anna Maria Tremonti. This is The Current on CBC Radio One Sirius XM, online on cbc.ca/thecurrent and on your radio app.

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Maple Ridge: B.C. town divided by homeless crisis

Guest: Liz Hoath

Hello I'm Anna Maria Tremonti and this is The Current.

SOUNDCLIP

They think that we want to be this way. We didn't all grow up saying I'm going to be homeless when I get big. It's kind of silly don't you think. Everybody in this earth is one paycheck away from being where we stand today. If people need to realize that, you know you're not better than us just because you got a house you're just better and you got money.

AMT: Well that's a resident of a tent city that sprung up last month in the city of Maple Ridge a community of more than 75000 people about an hour's drive east of Vancouver. It's an area described as the urban interface where the city meets the country. It's bordered by mountains on one side and the Fraser River on the other and it's a city where the issue of what to do with homeless and drug addicted people has boiled over. The numbers of homeless is increasing across Metro Vancouver. A recent count showed a 30 percent increase over what it was in 2014. It's a problem that has been complicated by the high cost of housing the lack of addiction treatment spaces and treatment for the mentally ill. Not to mention the opioid crisis that's gripped the region but nowhere has the debate over solutions been quite as contentious as in Maple Ridge. Last month the mayor went into hiding after the RCMP warned her there was a credible threat to her safety. This comes after months of the debate raging on social media and on the streets of the city. Today a temporary shelter is set to close and homeless advocates are planning a rally outside to protest saying the homeless are left with nowhere to go. The Current’s producer Liz Hoath has spent some time out in the valley and she joins me from our Vancouver studio. And just a warning this story does contain some strong language. Hello Liz.

LIZ HOATH: Hi Anna Maria.

AMT: So what led to the conflict in Maple Ridge?

LIZ HOATH: Well the last couple of years have actually seen a real debate raging about what to do about what's seen as a growing population of homeless and addicted people in the city. And I'll get to the history of that in a minute. But first let's get a sense of the frustration of the residents who are on one side of this issue. So I went to Southridge Terrace and this is a condo unit in downtown Maple Ridge. Ramona Stemple has lived in the city her whole life and she's been here in this building for five years. So she and some of her neighbors took me down along the side of the condo down a staircase.

SOUNDCLIP

Will come down here and we'll show you what we deal with every day. Yeah there is a heroin packet so it's empty but it had heroin in it or crack. Not really sure. So it's empty which we'll have to clean up that pipe that they used to smoke crack with, it’s end of a pen. They take everything out and it's now a crack pipe. So they just leave it lying in the dirt. And we have families that live here with children that use this stairwell. Everyday we're cleaning up needles, drug packets, the little metal just used to cook it, because they're given a packet when they do their drugs, in that packet is all of this stuff. And when they do their drugs they just leave it, and feces, human feces every day.

LIZ HOATH: So Ramona says she actually only lives less than two blocks to her work. But she says after a couple of men confronted her outside the tent city which is on her way to work. She doesn't even walk anymore. She drives.

AMT: It sounds so difficult. Why is this happening now Liz?

LIZ HOATH: Well Ramon says that this staircase and all around her building has become something of a thoroughfare for people traveling between two places. So there's the temporary homeless shelter on the main highway running through Maple Ridge. And then this tent city that was set up last month, and her building is pretty much right in the middle.

AMT: And this is the temporary shelter that's supposed to close today right.

LIZ HOATH: Yeah that's right it's run by Rain City housing and it's what's called a low barrier shelter. So that means that the people staying there don't have to leave during the day. Their pets are welcome their space for carts and bikes and the residents also don't have to be drug or alcohol free to be there. So this was supposed to be a temporary measure for six months while the city and the province worked on more permanent solutions. But now it's been open a year and a half. So it's in an old mattress store and you can actually still faintly see the little stickers advertising beds and sofas on the windows but those windows are now completely covered because inside there are 40 beds one next to another. Belongings piled on them or underneath there’s bikes and clothes there's bags full of recycling. The shelter manager, Ash showed me around.

SOUNDCLIP

I mean there's our office in the corner. So you can see the walls don't go to the ceiling so it's not really anywhere to have deep conversations.. There's nowhere to call your dad or there's nowhere to cry. There's no to let your guard down even for a second. And you can see up how closed quarters this is. So, people like you and I wake up in the morning and go hey it's time to get dressed every day. It's awful. I wouldn't do it. I couldn't do it. I don't think. It's terrible.

AMT: The place was not designed to be a shelter, huh?

LIZ HOATH: No, obviously not. It's an old mattress store so, the bathroom and the shower or outside in a Brit Co. trailer. Dwayne is one of the people that's been living there. He's 47. He says there's a series of events that have left him homeless. It started with a car accident that meant he couldn't work and then his child support started building up and slowly the debts meant that he lost everything his tools his truck and here's how he describes living in this shelter city.

SOUNDCLIP

Shitty [laughs] It's 40 people in one room is a little bit more that you can handle at times but. I'll miss it when I go. Really good people you know, I have people I've known all my life that I really don't talk to anymore because I've lost everything you know, everybody here at the lowest point are really, really good. They'll steal from you [laughs]. But they're good people. Good people do bad things, right?

AMT: So what happens to Dwayne today when the shelter closes?

LIZ HOATH: Well it's actually the other residence that he's more worried about because he's pretty young He's pretty fit. He actually put his bed by the front door so that he could keep an eye on who was coming and going in and out of the shelter in case there was any trouble. And frankly he says he's just not really sure where he'll go next.

SOUNDCLIP

Day by day is the best I can do, right now. I have the [unintelligible] I'm used to it. I can handle it. I just worry everybody else, because they can't protect themselves as much as it should. You know, they should be able to, they shouldn't have to be able to, really. There are a lot of angry people here. So, I don’t’ understand what they are angry about. Because I used to have what they have. God forbid they ever come to my position where[unintelligible].

LIZ HOATH: And we'll get to that anger a little bit later but I just wanted to mention that when I was leaving the shelter I went around to the front and that's where I found the manager Ash at the front door.

SOUNDCLIP

There was an overdose. Staff came and just naloxone the person. The ambulance’s arriving and we'll see if they go.

[Sound: Sirens]

Are they unconscious or conscious?

In and out

AMT: Ash sounds exhausted.

LIZ HOATH: Yeah. I mean he estimates that they've actually reversed more than 150 overdoses in this mattress shop alone. And it's tough on the workers on all of them.

AMT: You mentioned that Ramona lived between the shelter and the tent city what's the story behind the tent city?

LIZ HOATH: Yes. So if you head a block in the other direction from Ramona's condo you'll find this open area a green space that's now filled with tents. It was supposed to be turned into a community park but instead last month people started pitching tents in amongst the trees. There's a large sign by the entrance that reads homes not shelters. And when I went there was a huge box of Naloxone kits waiting to be taken in.

AMT: And who did you meet?

LIZ HOATH: Well there's about 40 people in tents now and Eva Bardeneggs is one of the?

SOUNDCLIP

I actually have a pretty well organized tent. I don't have a door but I have a bed. This is my tent. This is tent number 10. It’s a little disorganized.

LIZ HOATH: So Eva has propped up a red and white golf umbrella to act as a door and there are some candles outside there's a pinwheel stuck into the mud for decoration. She's put a bird ornament up in the tree and Eva herself is wearing full makeup. She's wearing a colorful dress and black pumps.

SOUNDCLIP

I told myself the first time I was homeless. I can be homeless. I just don't have to look it. You know, Some people would give this stigma that if you're homeless you're dirty or whatever. But even living down the river I'd come out in this six inch heels in flowing dresses. And I mean really that's me. That's just me, that's who I am. I will always be this. When I'm not this way, there's something wrong with me.

AMT: Liz, how did Eva end up at that tent city?

LIZ HOATH: She first found herself homeless in January of 2015. She's got four grown kids and she says she has PTSD. So the house she was living in at the time was sold and she had nowhere to go and ended up living at the river. She eventually did find housing after she was living at another tent city camp in Maple Ridge. But two months ago Eva was kicked out of that situation. She said she was accused of having too many visitors and not going to counseling. But whatever the reasons, she finds herself once again without a home. And she says this tent city is better than living at the river.

SOUNDCLIP

At least people are watching, they are watching me either watching my stuff when I go out. I don't have to worry about somebody coming and ripping things off, or wrecking things, or cutting up my tent or anything like that. I don't have to be arrested for having myself cross the tracks. It's a lot better in a group, a lot better, a lot safer.

AMT: It sounds as if the tent city is filling a real need for her.

LIZ HOATH: Yeah for sure it is. But it is controversial because that's not actually true for everyone. There are some people at this camp who have homes but have come back to the tent city to live in a tent just to protest. And it's no coincidence that this sprung up just before the B.C. election. Ivan Drury is one of the organizers of the tent city. He's a pretty well known activist who usually focuses on issues of gentrification, displacement, you usually find him in Canada's poorest neighborhood, Vancouver's downtown east side. And many of the people I spoke to from The Mayor right on down to the residents kind of resent the way he's brought this protest to their city.

AMT: Why did he come out to Maple Ridge?

LIZ HOATH: Well he says this community is just one example of something that's playing out throughout B.C. He points out that in the last homeless count they documented 70 tent cities. Most of them are more temporary than this one. But here in Maple Ridge he wants to send a message to government that more permanent solutions are needed. But he also says that there's actually a real need right now for people in Maple Ridge that they need a safe place to sleep.

SOUNDCLIP

The idea that this is orchestrated by people outside is completely fabricated. And it's an intentional mischaracterization of the fact that people here have had enough. Yeah I'm playing our group and we are playing a role in helping organize that and get it together and give it a clearer articulation and a stronger backbone, so that when it gets attacked it can come back and can keep standing. The political motive comes from the dynamics in Maple Ridge. There's no way to manufacture that. If it wasn't there, would be no way to start a tent city.

AMT: So there's a shelter closing today, a tent city in a residential neighborhood. How did it get to this point?

LIZ HOATH: Well for the recent history we need to go back two years and that's when another tent city sprang up on another residential street. This time Cliff Avenue and this was just a couple of months after newcomer Nicole Reed was elected mayor of this city and Mayor Reed says at the time no matter how hard they tried they couldn't reduce the numbers in that camp. Every time they housed somebody that tent that empty tent would be filled by somebody else.

SOUNDCLIP

At the same time there were some real safety risks to the people in the tent city. Gasoline poured on the street comments on social media, this was going to go down there and flick about on the tents. and you know this was on a residential street. So we also had the residents nearby who were literally seeing people be revived from drug overdoses on a near nightly basis. Right? Huge traumatic experience for people. . Had children on the street. This was not a good fit to have a homeless camp on a residential street for anybody.

AMT: That all sounds familiar.

LIZ HOATH: It does. But remember she's talking about the camp back in 2015. And so the solution back then, and this is where the mattress shop comes in, the plan was to bring everyone inside and connect them to housing from there. So the tents came down voluntarily and she's quite proud of that. But once everyone was inside it quickly became obvious that many of the people were hard to house. That market housing wasn't going to work. These are people who are very sick with addiction mental health issues may be both.

AMT: So with market housing isn't an option then what?

LIZ HOATH: So that's when the ideas for building more permanent solution started to be considered. There were two proposals. The first one was to convert a quality inn into supportive housing. The second one was to build a brand new facility on a piece of land that the city had bought, and the city thought that they had the support of the province in both cases. But in the end, the community held rallies opposing the sites. There were petitions. Some people didn't like the locations that were proposed. Others didn't like the idea of having supportive housing. And in the end both proposals were turned down after the local Liberal MLAs wouldn't support them.

SOUNDCLIP

I mean at the end of the day we don't go to the community and ask them if it's okay if we locate a cancer facility in their backyard. You know, the reality is that these people they need housing and they need health care supports. And the city was prepared to really fight hard with the province to make sure that we had a guaranteed level of health support wrapped around these people. Because we knew that they were sufficiently vulnerable and would need for an extended period of time. From an integrity perspective, I was really offended that I knew what I did to both the population in the shelter having such a high degree of need and that government would walk away from them and leave us with no solution. It disgusted me, as a human being and I've never backed away from these types of issues. I've always showed courage, I may not be the most politically expedient thing but at the end of the day I need to be able to put my head on the pillow at night, as opposed to being concerned about being re-elected.

AMT: Liz, were there any alternative proposals?

LIZ HOATH: Well a couple of months before the election the two local MLA who rejected the two proposals and announced a plan to close the Rain City shelter and send the people across the street to the Salvation Army where the plan was to set cots up in the dining room. They also hired a special team to help the residents in the shelter connect to housing and other supports. And in the meantime it sounds like tensions are rising.

LIZ HOATH: Well yeah. I mean if there's one word that almost everyone seems to use, it's frustrated. They're frustrated that nothing is changing. They're frustrated that they're picking up needles and trash and they're frustrated that government can't seem to do anything about it. On social media, it seems like much of that frustration is focused on Mayor Nicole Reed. There are Facebook groups, there's petitions, there’s even a Website all calling for her to resign.

AMT: Then again it's not unusual for politicians to have opponents.

LIZ HOATH: No that's true. But some people say that this went to a whole new level. I mean at one point there was a local candy store that was offering two for one ice creams. But you had to say a secret phrase when you were in there to get it. The phrases included ‘the mayor must go’ or ‘no junkie safe house’ or ‘get them all out of here’.

AMT: Really?

LIZ HOATH: Yeah. At one point someone took a picture of a man with obvious health issues walking down the street naked. It ended up on social media and there was a caption reading ‘Nicole's Tinder date’.

AMT: And it got so bad that she went into hiding?

LIZ HOATH: Well the RCMP did say that there was a credible threat to her safety and this went beyond what was happening on social media and it's not known if it had anything to do with this issue. But she did pull her kids from school. She didn't go out in public without an escort for a couple of weeks in fact. She is back at work now but she has curtailed her public appearances and wasn't at council last week.

AMT: So in this case someone obviously crossed the line in issuing a threat. But what about other residents who are just not happy with the way this is playing out?

LIZ HOATH: Well for people like Ramona's Stemple and she's the woman we heard from earlier that lives between the temporary shelter and the tent city. And just to be clear she's not involved in any way in the personal attacks on Mayor Reed but she does feel like the mayor is just too focused on people with addictions and is ignoring the concerns of the residents

SOUNDCLIP

That tent city has to go. They need to be put into treatment. When they're caught doing something illegal like shooting heroin, smoking crack. They should be picked up they should be given two choices jail or treatment. There shouldn't be oh you can go stay in a tent on private property. They have to get clean. Yes. They're all homeless people. Those homeless people yes get them into homes. But if you put an addict into a home they're going to do what they're doing right now. There's no respect. They don't respect us enough not to do this on our property.

LIZ HOATH: In fact Anna Maria just yesterday the city of Maple Ridge started legal action. They're looking for an injunction to dismantle the tent city. They say it's been generating a lot of complaints similar complaints to the ones we've been hearing from Ramona.

AMT: So you've got a community divided. What does that mean for life in Maple Ridge for the people in the shelters and then the tent city?

LIZ HOATH: Well the living conditions were obviously not ideal but many of them say that it's not as bad as how they get treated when they're on the streets. Ash, the manager of the temporary shelter doesn't even want his last name used because he's worried about backlash.

SOUNDCLIP

We've been bear sprayed, people throw full cans of pop at us. Our workers have been slandered on line, staffs cars have been keyed. People have been hit with pipes. People have been run off the road on their bicycles. Smoke bombs have been thrown. They threw smoke bombs into the shelter to try and flush everyone out. I think it's been disgusting. I don't know how anyone could turn their backs on that on the most vulnerable members of their own community. Like, we don't want them here. Well, you went to high school with them, ay? These are the kids who aged out of care. These are just the people who were thrown away. I don't know how anyone could do that and I've never seen anything like it. I live in East Vancouver man. Can't imagine East Vancouver like that. No one would ever act that way. Throw garbage at people. It's horrendous. I can't. It's the worst thing I've seen in my life, man.

AMT: It's heartbreaking to listen to him.

LIZ HOATH: And he's not the only one that tells these kinds of stories. Back at the tent city Eva had her own story to tell.

SOUNDCLIP

It makes me think of the guy who got out of his truck he almost ran me over in his driveway. I was just going by on a bike. That incident is probably one of the most scary ones I've had, where he got our and screams at me, get out. I wasn't allowed in his neighborhood and all I was doing was riding my bike I didn't have my cart. I didn't have anything with me no bags, just me and my bike, and get out of my neighborhood you don't belong here. And I was like, I’m allowed to go. But you don't need to try to run me over or I'm allowed to cut through here I'm going to this place down over here. And he was like we're going to take care of you. Me and my buddies are going to come and take care of you. He's a 300 pound man and he went back to his vehicle and he was grabbing a bat. He was going to bat me out. A 300 pound man. I'm a hundred and fifteen pounds at the time. I just said do whatever you think is right. I walked away. He got back in his truck. He went back to his truck, got in and drove away.

AMT: That's incredible.

LIZ HOATH: But there are people who are skeptical of stories like this and just about how widespread these incidents are. So Jessie Stretch is another resident of Maple Ridge and he's been involved in this issue for a number of years now. And I asked him about these kinds of confrontations.

SOUNDCLIP

Well I don't agree with that. I've not seen anything like that. I mean you hear stories. But hey, my step kids still believe in Santa Claus, so how's that for stories, right? I will say that it probably does happen. Maybe not as frequently as said and it just shouldn't happen. Again it boils down to frustration and anger. And it's okay to be mad. We should be mad. All of us the whole community should be pissed off about this but that doesn't give you warrant or an excuse to be mean, or violent. It's not productive. It's not going to solve this issue.

So Jessie Stretch actually originally started a Facebook group called Concerned Citizens of Maple Ridge and this is where the issue of homelessness is discussed. But it's the name that the group has come to be known by that has been more controversial.

SOUNDCLIP

I had a certain individual who is, one of these professional protesters, actually. He was barking on social media that I'm a vigilante and I do this and I do that and I jokingly said I'm a Ridgilante I just pick up needles, right? And we our group all got a really good laugh out of that. Probably not the wisest thing they didn't name ourselves because it can be so easily translated to vigilante but it started out as a joke right. I'm not a vigilante. I'm a Ridgilante. I'll pick up your needles I'll try and find a solution for your problems. It's one of those things where you say something humorously and it just sort of snowballs on you.

AMT: So, vigilante, Ridgilante, Maple Ridgilante. I get why you know that it stuck.

LIZ HOATH: You can see why people started calling them that. And they you know they called themselves that too. You heard him talking about the needles in that clip there too and that's how his involvement in this whole issue actually started. I met up with him at horseman's park in Maple Ridge where he picks up needles and he drives this big Ford pickup truck and in the back is a yellow sharps container. And it actually has thousands of needles in it right now.

SOUNDCLIP

This looks like trash from somebody having a bit of a party but [sniffs] the smell of that fire is pretty fresh, probably from the weekend. But, oh here we go…Ah, crack pipe. Oh, here we go, that is an alcohol swab and that is definitely a pack of drugs. What scares me is I'll come into a place like this and I'll find, like, the protective cover for the short part. But I won't find the needle. And that just tells me that there's an unprotected needle out there somewhere.

LIZ HOATH: So Jesse's a mechanic but he's actually just recently started an acting career and he's landing roles is things like an outlaw biker and a Viking. So you get the idea of what he looks like long dark hair matching bushy beard.

AMT: That sounds like he might look intimidating to a lot of people.

LIZ HOATH: Yeah. And he gets that. He admits that he understands that's how he might look.

AMT: What does he think should be done?

LIZ HOATH: Well he doesn't personally agree with the mayor. He opposed both of the proposals for the supportive housing. Now when the MLAs decided to strike this citizen’s committee to find a new location, they appointed Jesse to that group. And this by the way is something that Jesse thinks should have been done way earlier in the process. He thinks the mayor's biggest mistake was not consulting the community earlier. So that group has made recommendations he can't talk about the location they're suggesting because it's not actually public yet, but the group is recommending an abstinence based facility something that wasn't in the previous two proposals.

SOUNDCLIP

Well we want to get you up on your feet. I don't want to just enable these ill and addicted people to just continue in that lifestyle. I don't think it is right.

LIZ HOATH: So Jesse is saying that now is the time for all of the groups to get together he says all the sides just need to come up with a solution. He actually says everybody just needs to grow up. And that's what people like Catherine Wagner are saying too. Now she has been watching this debate from a different position. She's the moderator of yet another Facebook group. This one's called Maple Ridge Council Watch and she's a supporter of the mayor.

SOUNDCLIP

You know I like living here and I like to think that we're a welcoming and open community to everybody. And that we may have had a false start, but that we can come together and work together and in finding ways to get past this.

AMT: How does the outcome of the provincial election NBC play into what's happening in Maple Ridge, Liz?

LIZ HOATH: I think it just means that everything is still up in the air. So the two local Liberal MLAs, both lost their seats. We still don't really know who will form the next government. In the meantime I'm told that residents of tent city will be at the temporary shelter today protesting its closure. As I mentioned the city of Maple Ridge is working on this injunction to get rid of the tent city. But there was a similar bit in Vancouver a couple of weeks ago that was rejected by the courts so now here we are two years after the first tent city emerged. And many people in Maple Ridge feel like they're back to square one.

AMT: And the people pushing for a wider solution still don't see anything.

LIZ HOATH: Not yet.

AMT: Liz Hoath, thank you.

LIZ HOATH: You're welcome.

LIZ HOATH: Liz Hoath, our producer for The Current based in Vancouver. Let us know what you think. You can tweet us at The Current CBC go to our website cbc.ca/thecurrent. That's our program for today's stay with Radio 1 for Q and today Bonnie Raitt has Broken Barriers Crossed Genres won 10 Grammys. Just released her 20th album. One thing she never does she never listens to her own music. Coming up Tom Power takes a musical trip down memory lane with folk, rock, blues, powerhouse Bonnie Raitt. That's next on cue. I'm Ana Maria. Thank you for listening to The Current.

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May 31, 2017 Full Episode Transcript

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