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"high blows Heimdallr, the horn is aloft
Odin speaks with Mimir's head
trembles Yggdrasil's towering ash
the old tree wails when the ettin is loosed."
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I recently had the wonderful good fortune of traveling to Nepal with my partner and her close friend to go on the Three Passes trek. This is a 15 – 20 day trek throughout the Khumbu region of the stunningly beautiful Sagarmāthā National Park in northeastern Nepal. The Three Passes route is so called as it passes through three of the highest major passes within the park: Renjo La (5,360m), Cho La (5,420m), and Kongma La (5,545m) — several (like Nangpa La) are higher but pass into Tibet, or are barely used.
We did the trek without a guide or porters. We also opted to take the clockwise direction (more on that below) for a variety of reasons, which means we found even less information about how to do the trek. We benefited substantially from other trip reports from folks who've gone before us, and so we thought we'd try to help future travelers by making our own. Good luck, respect the mountains, and happy hiking!
- Food: vegetarianism and veganism
- Respect and responsibility
- Our packing list
- Additional reading
We chose the clockwise route for a variety of reasons:
- Traditional Buddhist direction of circumambulation
- Travels in the opposite direction of major foot traffic
- Spectacular views as you walk: looks up-valley through the gorgeous Bhote Kosi valley to Lumde, then into the Gokyo Valley as you crest Renjo La, and into the Khumbu Valley as you pass through Cho La
- Fog generally comes up from the lower elevations, so this direction maximizes the duration of your views
- Watches the sunrise as you come over the passes
- More side trips are available on the Dudh Kosi side (Tengboche, Ama Dablam Base Camp, Chukkung Ri, etc.): these can help you acclimatize, but if you go counterclockwise and save days in case of illness, poor weather, or just wanting to stay somewhere longer, having these trips in your future rather than your past allows you to adjust your itinerary more easily
- Crampons are less important: the snow and ice sides of the passes are generally on the west, and handling these on the ascent made crampons helpful but non-essential
The major downside is that this direction is generally considered to be harder, both overall and in terms of acclimatization. There's also far fewer resources on the Bhote Kosi side if you need them, and most of the trail markers and such expect you're traveling counterclockwise (so the routefinding is slightly harder). We found it manageable and felt that the trek is just hard in general, however you do it. Acclimatization is extremely important, however, and the clockwise direction means you need to be more intentional about it than you would otherwise.
There's a ton of ways to do this trek; this is just one. Most people take around 18 – 20 days to do the trek; we met people who did it in as few as 15. We wanted to do a lot of side trips, take our time, and enjoy it; for that reason we took 24, but you certainly don't need to. We did our trek in April – May of 2018.
As you plan your itinerary, I would recommend considering the following things (in addition to the obvious, like acclimatization, how many places you want to go to, and so on):
Weather can be dramatic, and snow — or rain showers at lower elevations — are common, at least in April – May. It's risky to count on being able to hike in the afternoon (although we often could and did), but even more importantly, you can't fly into or out of Lukla when the weather is bad. Planning several extra days on either side to handle cancelled flights is wise. Obtaining the earlist possible flight in the day, as there's usually an open window in the morning, is also a good idea.
Our flight, as you can see below, was cancelled and after much effort and luck we were thankfully able to leave the next day. We met a couple of trekkers who waited for 3 – 5 days in Lukla trying to leave, and dozens more who had to pay hundreds of dollars to be helicoptered out in the fog as they ran out of time before their international flights elsewhere out of Kathmandu.
Most airlines which fly to Lukla require that you check in in person the afternoon before you fly out, meaning you have to arrive in Lukla the day prior to your hopeful departure.
Having a few extra days for bad weather, feeling sick, needing another day to acclimatize, and so on, is really great if possible. We were glad to have them and used one or two when we needed them.
Those caveats aside, this was our route:
|6||↪||Upper Bhote Kosi valley||↑||4,420m||14,497'|
|8||↪||Lower Gokyo lakes||4,700m||15,415'|
|9||↪||Upper Gokyo lakes||↑||4,980m||16,334'|
|↪||Ev-K2-CNR (Italian Pyramid)||↑||5,050m||16,564'|
|14||↪||Everest Base Camp 1||↑||5,364m||17,593'|
|19||↪||Ama Dablam Base Camp||↑||4,570m||14,989'|
|20||↪||Tabuche "Base Camp"||↑||4,600m||15,088'|
|↪||Tenzing Hillary Park||2,900m||9,512'|
- ↑: net elevation gain
- ↪: side trip
- ✈: flight
- )(: pass
- ^: peak
More details on each of those below.
While we were in Nepal, the exchange rate between United States dollars (USD, $) and Nepalese rupees (NPR, Rs.) was $1 ⇌ Rs. 102.25. For ease, I've just used a rough exchange rate of Rs. 100 = $1 throughout this post.
Most lodges costed approximately Rs. 100 – 300 ($1 – 3) per night for a room. Meals ranged from Rs. 500 – 1,000 ($5 – 10) depending on how much you wanted to eat and what you choose (for example, the standard dal bhat was generally Rs. 600 – 800 ($6 – 8) depending on where we were). We budgeted $25 (Rs. 2,500) per day and were under budget when we finished our trek.
You can easily spend more or dirtbag harder than we did. Although we didn't eat much more than dal bhat, Sherpa stew, and chow mein, we occasionally got some cookies or a pot of tea, if that gives you a sense of what this would buy. We stayed in simple but comfortable places and had a lovely time.
Food: vegetarianism and veganism
I'm vegan, and my fiancée is vegetarian. This raised questions for us about what foods would be available, and we couldn't find much information online, so hopefully this is useful to someone.
First, the easy one: vegetarianism. You can't kill in Sagarmāthā, and many locals (Sherpa and otherwise) are vegetarian. Vegetarian food is everywhere and not a problem. Just go and enjoy!
Veganism is harder. There's vegan food everywhere, but it's more limited. Throughout the places I traveled, the only common vegan protein is dal — which is fortunately available everywhere. If you'd like to expand your diet past dal bhat, fried rice, and chow mein, I hope these notes are useful:
- Porridge, whether from oats or tsampa, is usually with milk. However, it was always really easy to simply write "no milk" next to the order, and I never had problems.
- 'Black tea' is milk-free, 'masala tea' isn't. 'Black coffee' is (perhaps obviously) milk-free as well.
- As far as I can tell, the ubiquitous coconut cookies found everywhere are vegan.
- Aloo paratha (essentially a potato pancake) is itself generally vegan, but as some places may cook it in butter you may have to check.
- Soups — other than the obviously-locally-made, like Sherpa stew — are generally canned and often "cream of", unfortunately.
- The instant noodle soups (usually called "Rara" or "Wai Wai" after the brands) are not very nutritious but delicious and vegan.
- Many (but not all) vegetarian burgers are vegan, but they seemed to always come with mayonnaise, so just know to order without if you decide to chance it.
The one thing I wished I had brought was a jar of peanut butter. We had a small amount, but not enough for nearly a month, and it's almost impossible to find in most places. It'd delicious on chapatis and would have offered a nice alternative protein source. We brought a few pounds of nuts, bars, and vegan jerky, and we were really happy we did.
I've never been a pushy vegan, and I'm uncomfortable for a lot of reasons with interrogating people about food that they're feeding me in their home. My personal feeling is that acting that way with people that earn less than $1,000 / year, who are from radically different cultures (which, while far from perfect, are generally superior in their treatment of animals to my own), and are being hospitable and kind despite everything is colonialist and more importantly just kind of shitty. (There's lots of ways that veganism meshes perfectly with indigenous cultures, but acting arrogantly and patronizingly towards anyone, but especially people who can't and maybe shouldn't adopt your preachy message doesn't seem like it to me.) I adopted the standard that if something seemed reasonably likely to be vegan that I accepted it as such. I know not everyone will be satisfied by that, hence this paragraph, but I hope the above information is useful anyway.
Respect and responsibility
Our packing list
There's a lot of ways to do this trek, and you can certainly bring more or less depending on your safety standards, desire for comfort vs. a light pack, willingness to wash clothes (or wear dirty socks), etc. That said, this is what we brought with us. We laundered our clothes by borrowing a basin from our lodge and hand-scrubbing everything about halfway through and really recommend it: it felt amazing afterwards.
- 0 – 20° mummy sleeping bag 2
- Thick, warm socks (1 pair)
- Sleeping mask + earplugs
Each of the below are one each unless otherwise noted.
- Synthetic underwear (6 total)
- Synthetic hiking socks (6 total)
- Synthetic liner socks (3 total)
- Synthetic hiking pants
- Base layer, top and bottom
- Waterproof boots 3
- Sandals 4
- Lightweight puffy
- Thick puffy/parka
- Lightweight gloves
- Rain jacket and rain pants
- Card games (we liked Fluxx and Race for the Galaxy)
- Books (I was hoping to get through Infinite Jest, finally, and Orwell's Homage to Catalonia / Down and Out in Paris and London)
- Journal, pen, marker, mechanical pencil
- Handkerchiefs (6, since I have a chronically runny nose)
- photocopies of passport, traveler's insurance, itinerary
- debit/credit card
- USD ** **; NPR ** **
- Toothbrush, toothpaste, floss, deodorant
- Personal medications (enough for 35 days)
- Miscellaneous medications — don't use these if you don't know what you're
doing; reckless antibiotic, antidiarrheal, and headache medicine use can
have bad consequences in the mountains
- Ibuprofen (non-steroidal antiinflammatory drug)
- Diphenhydramine (antihistamine)
- Acetaminophen/phenylephrine/dextromethorphan (cough/cold, daytime)
- Acetaminophen/doxylamine/dextromethorphan (cough/cold, nighttime)
- Ciprofloxacin (emergency antibiotic)
- Loperamide (emergency diarrhea relief)
- Ondansetron (antinausea)
- Topical over-the-counter steroid (for rashes)
- First aid kid
- SAM splint
- Climber's tape
- ACE wrap
- Alcohol wipes
- Chamois butter (for chafe)
- Triple antibiotic ointment
- Nitrile gloves (several)
- Pee bottle
- Half roll toilet paper
- Hand sanitizer
- Biodegradable camping clothing detergent
- Small microfiber towel
- Large trash bag
- Resealable plastic bags
- Duct tape, small roll
- Backpack (ours were ≥ 50L)
- Trekking poles
- Sighting compass
- Headlamp + spare batteries
- Map (note: the National Geographic Everest Base Camp map doesn't include the entire trek, although it might be useful for the eastern sections; inconsistencies in Nepa map, e.g. altitudes on foldout vs. map, 3rd lake higher than Gokyo, trekking times)
- 1L canteen (necessary, bladder tubes freeze)
- 3L hydration bladder
- Gravity-fed water filter (large is better, bottled water Rs. 100 – 150 ($1 – 1) in Namche, Rs. 350 – 500 ($3.50 – 5) further in)
- Chlorine tablets (as backup)
- Snacks (vegan jerky, bars, nuts, gummies)
- jelly beans
- Haribo berries
- ginger candies
Other people have found the below helpful, but we did not carry:
- Sleeping pads — not needed in the teahouses
- Electronics, other than a headlamp
- Fleece pants
- Mug/cup or bowl
If we'd thought more about it, we might have brought metronidazole (an antiprotazoal, antiparasitic antibiotic).
Notes on directions
- helicopters in Gokyo, EBC regions (Khumbu Sky Taxis per one guide)
We found the following trip reports helpful:
Everest is named, as you might expect, by one British colonialist after another British colonialist in 1865. Prior to that point, it was known (by the British, anyway) as Peak XV. Neither of these dead white men had anything to do with the mountain or figuring out that the peak was the tallest on Earth (which was deduced by the Bengali mathematician Radhanath Sikdar, who calculated this while working on the British Great Trigonometric Survey. Incidentally, when he reported abuse of employees of the Survey, he was severely fined). Everest, to his credit, actually opposed the name, noting that his surname is hard to pronounce for people from the region, cannot be transliterated easily into Hindi, and that the peak was already named locally.
The peak's oldest known name is ཇོ་མོ་གླང་མ (Tibetan and Sherpa), meaning "Goddess Mother" or "Holy Mother" and commonly romanized as Chomolungma. (The commonly-used academic Wylie transliteration is Jomo Glangma, and the occupying People's Republic of China's Tibetan pinyin is Qomolangma.) The Chinese government, despite its horrific positions on most things related to Tibet, Tibetan language, and Tibetan culture, supports the name being Chomolungma and has recognized the mountain being named such for centuries. Much later, the Nepalese government named the mountain सागरमाथा, romanized Sagarmāthā, from the Nepalese सगर् (sagar, "sky") and माथा (māthā, "head").
For decades prior to its eventual renaming in 2015, climbers, Alaskans, environmentalists, and anticolonialists refused to call the tallest mountain in North America, Denali, anything other than that, its original indigenous name. I'd like to do the same here, but during my entire time in Nepal, I didn't hear a single person (Sherpa, Tibetan, Nepali, trekker, or otherwise) call the mountain anything other than Everest, at least in English. I wanted this to be useful and not confusing, so I've done the same here.
Maybe it's a lost cause, maybe not. Either way, I can't help myself but to at least comment on the name's colonialist roots, note that colonialism and oppression of indigenous cultures continue to this day, and encourage opposing those forces whever you can, in Nepal and elsewhere. ↩
Every lodge we visited had blankets, and while these weren't enough for us, you can often ask for or buy more. My fiancée used a 20° bag and a liner and didn't feel like the liner was necessary; I used a 0° bag; our friend used an in-between bag and we were all warm enough. ↩
The waterproofness is amazing. We were happy to have them. Our friend wore trail runners the whole time and did great, but she didn't mind having wet feet in the snow and waiting for her socks to dry as she walked. ↩
I initially didn't bring any, thinking they were a luxury, and that was a mistake. Waterproof boots get a foul odor quickly and it's wonderful to have them off in the lodge. Moreover, once you're deeper into the park, most toilets are squat toilets, and either way most are flushed by dumping a pitcher of water into them and thus water is everywhere. Having sandals means being able to use the bathroom at night without getting your feet wet or having to put your boots back on.
If you don't have any, or didn't bring any, you can buy cheap, lightweight sandals in Kathmandu for Rs. 300 – 500 ($3 – 5), or on your trek for a few hundred rupees more. ↩
My girlfriend and I were blessed to spend an amazing month of our summer in 2015 studying Spanish in Oaxaca and Mexico City, DF. During our time there, we walked for about 7 – 10 miles each day, wandering around the cities we were in and trying to soak in everything. We fell in love with the many spectacular murals we saw there and set a goal to find as many as we could. Eventually, we photographed these and bound them in a small book to give to our hosts as a thank you — some of the best fun I've had traveling.
It's hardly complete — there's an incredible amount of spectacularly wonderful art in Oaxaca and DF, let alone the rest of Mexico. But since we loved them, we hope you might too. Here's some of our favorite murals and street art, everything that made it into our little book. Given our interests, we enjoyed the political material a lot, and so that's especially represented.
The captions include the district each were found in, and any information that we could find to help understand the pieces.
poco a poco: una vista pequeña del arte en la calle
Eje 1 Norte (José Antonio Alzate), Santa María la Ribera, Cuauhtémoc. Mono Sappiens is a DF-based band; 'mono' means 'monkey'.
Porfirio Díaz. This stencil of a mohawked Frida Kahlo has become an iconic piece of Yescka's work. Text reads 'Workshop Siqueiros', likely referring to the famous Mexican muralist David Alfaro Siqueiros.
De Progreso. Text reads 'liberty, equity, respect'.
Los Reyes. Graffiti reads 'this ground'.
Walkway behind workshop on Murguía.
Melchor Ocampo. Text reads 'Experimental Graphics Workshop of Oaxaca'.
Porfirio Díaz. The letters spell 'mercado', meaning 'market'. Note the woman in Guelaguetza dress wearing a gas mask and the police forces attacking the men waving a socialist flag. Mural painted by ASARO (asamblea de artistas revolucionarios de Oaxaca).
clockwise from upper left: Xochitl, Macedonio Alcalá, Manuel San Crespo, Manuel San Crespo. Many political posters adorn the walls of Oaxaca. The first of these is by the CNTE and SNTE Sección XXII teachers' union, who are here opposing the elections for governor. The second reads 'not one more death! Justice for sweet ...', with the rest cut off. The bottom left features a campesino holding a single peso coin, while an obese businessman vomits a paper on which can be barely read 'REFORMAS', likely referring to the educational cuts opposed by the militant teachers' unions. The final reads '2ND MEETING OF REJECTED APPLICANTS', again opposing government education reforms, this time from the UJRM, a youth socialist organization.
Murguía. Text reads 'Workshop of Lithography'.
Periférico (Eduardo Mata).
Melchor Ocampo. A torta is a type of sandwich.
La Noria. Text roughly translates to 'occupy your destiny'; an okupa is a squatter. The mural clearly depicts the famous 1968 Olympics black power salutes by athletes Tommie Smith and John Carlos in México, DF.
Porfirio Díaz. Text reads 'Liberty to the political prisoners of June 7!' The photos are of people jailed after participating in protests in Oaxaca.
Biblioteca Henestrosa, Porfirio Díaz. Note the fusion of traditional patterns with anarchist and other modern symbols in the tattoos and dress of both women.
A geometric drawing with the text 'con el fuego en las manos' connects the two women; translated, this means 'with fire in their hands'. On the bottom right is painted in English 'smile now cry later'. Mural by Oaxcan artist collective Tlacolulokos.
Cine Tonalá, Tonalá, Roma Sur, Cuauhtémoc.
Tepeji, Roma Sur, Cuauhtémoc.
Centenario, Del Carmen, Coyoacán. Text reads 'machete al machote', a feminist call for self-defense against male harassment.
Debussy, Guadalupe Victoria, Gustavo A. Madero.
Pilares, Colonia del Valle, Benito Juárez.
Chiapas, Roma Norte, Cuauhtémoc. The cat is a maneki-neko, a Japanese good luck symbol.
Tonalá, Roma Norte, Cuauhtémoc.
Querétaro, Roma Norte, Cuauhtémoc.
Eje 1 Poniente (Cuauhtémoc), Santa Cruz Atoyac, Benito Juárez. Mural by El Grand Chamaco; chamaco is a slang term for kid.
Durango, Roma Norte, Cuauhtémoc.
Doctor García Diego, Doctores, Cuauhtémoc. Text reads 'Hasta la vista, pobre', meaning 'see you later, poor person'. This alludes to the well-known Terminator lines 'hasta la vista, baby', spoken before Schwarzenegger kills the film's villain. The Doctores neighborhood is rapidly gentrifying along with other areas of Cuauhtémoc.
Eje 1 Poniente (México - Coyoacán), Xoco, Benito Juárez.
Eje 1 Norte (José Antonio Alzate), Santa María la Ribera, Cuauhtémoc.
Parque Lira, Daniel Garza, Miguel Hidalgo.
Insurgentes Sur, Hipódromo, Cuauhtémoc.
Centenario, Del Carmen, Coyoacán.
Iztaccihuatl, Hipódromo, Cuauhtémoc.
Eje 1 Poniente (México - Coyoacán), Xoco, Benito Juárez.
Vegan restaurant Coco y Chia, Pilares, Colonia del Valle, Benito Juárez.
miriam + kyle
méxico, verano 2015
My brilliant girlfriend had the idea to get pairs of Chuck Taylors and paint them. Turned out to be a huge amount of fun; would recommend it to anyone. Here's the outcome!
God, I love Keith Haring. Don't you?
And it's just as true as ever: IGNORANCE = FEAR, SILENCE = DEATH. Fight AIDS, ACT UP!
Published in the Huffington Post, February 13, 2016
Last Thursday, the California Department of Public Health approved the first ever needle exchange in Orange County — a major victory for public health and safety. Orange County has long opposed needle exchanges, despite decades of evidence demonstrating that these programs save lives and prevent the spread of infectious disease. However, due to the hard work of a team of community members and medical students, the Orange County Needle Exchange Program (OCNEP) will open on February 20.
What are needle exchanges, and why are they important? Most simply, needle exchanges are public health programs where people who inject drugs can safely dispose of their used syringes and obtain clean injection supplies. In the United States, millions of people inject drugs every year. Many of them are denied access to the most basic social services, including housing and addiction treatment. Even more face violence, stigma, homelessness, and disease. In this setting, needle exchanges are one of the only places where injection drug users are reliably treated with kindness, dignity, and respect.
Needle exchanges are known to reduce hepatitis C rates by up to 65% and HIV rates by up to 33%. Opponents argue that needle exchanges facilitate illegal drug use, but in fact they have been proven to decrease drug use and connect users to the services they often desperately need. By providing a safe place to dispose of syringes, needle exchanges protect communities by reducing the number of syringes found in public areas, such as parks or in the street. Not a single scientific study has demonstrated that needle exchange programs yield negative consequences.
Despite the overwhelming evidence supporting needle exchanges, current regulations mean that establishing a program is incredibly difficult. 64% of California counties lack even one needle exchange, even though they are cheap, easy to administer, and require no technical staff. Supporters of OCNEP — the recently approved Orange County needle exchange — include academic faculty, law enforcement, physicians, businesses, the California and Orange County Medical Associations, public health experts, and some of the largest HIV prevention organizations in the United States. Yet implementation took 17 months of struggling against unjustified threats of arrest, multiple and contradictory demands that the program change locations, endless red tape even after demonstrating levels of community support unheard of for other public health programs, excessive fundraising requirements, and other major obstacles. This meant 17 months of new HIV cases; 17 months of unnecessary overdoses; 17 months of Orange County failing its most vulnerable citizens.
Needle exchanges are simple. They are safe, proven to work, and cost almost nothing. By approving a needle exchange program for the first time in its history, the California Department of Public Health has taken a brave step forward. But that step isn't enough. Government officials and public health authorities must not just regulate, but actively facilitate, the development of new needle exchanges. They must streamline the approval process, which required thousands of hours of organizing and multiple rounds of applications to establish even a bare-bones program. Although unwritten, the de facto requirements impose near-impossible hurdles for the majority of people interested in starting a program. Instead of these barriers, public health departments should provide early and frequent assistance to community organizers who want to build needle exchanges in regions that currently lack them, thereby ensuring that their efforts build sustainable, successful programs. Promoting community leadership in this way would guarantee the health of everyone, not just those who live in well-funded areas with well-networked organizers.
Everyone can contribute to this mission. If you want to support public health and drug policy reform efforts in your community, volunteer with your local needle exchange program. If you are in Orange County, join the team at OCNEP. The program is entirely volunteer run and democratically organized. If your county doesn't currently have a program, or enough programs to serve the population, consider starting one. If you need help, contact us — we would love to support your efforts. And if you are a healthcare professional, ensure that your patients are aware of local harm reduction services, including needle exchange programs.
OCNEP's approval has implications that reach far beyond California, as it demonstrates that with dedicated activism, community health efforts can overcome misinformation, stigma, and fear — even in one of the most conservative places in the world. There is a grave need for the expansion of needle exchange services. Needle exchanges respect the dignity and worth of their clients, protect the health and safety of their communities, and do so without any known downsides. Successfully establishing a program in Orange County is something to celebrate, but it is only part of a much larger and longer effort to make harm reduction services available to anyone who needs them. Barriers to establishing needle exchanges must come down. More people must stand up for the rights of themselves and their loved ones by launching programs where none presently exist. In this mission, the path is lit ahead — we hope you join us in walking down it.
Published in the Huffington Post, October 22, 2015
Talking about injection drug use is not comfortable for many people. Yet nearly 7 million U.S. citizens inject drugs every year. For those who suffer from debilitating addictions, our silence is deafening. The majority of injection drug users are infected with either HIV or hepatitis C, both devastating illnesses with life-long consequences. Medically, they are at high risk for overdose and a multitude of diseases. Socially, they face enormous stigma, homelessness and violence. Each of them is someone's family. All of their lives matter.
What is there to be done? The good news is that for decades, both injection drug users and doctors have been advocating for harm reduction, a rational and proven way to reduce infections. The idea is simple: lower the risks associated with using drugs. Doctors use these principles every day in the clinic, such as when they encourage patients to use condoms and birth control. We've learned the hard way that abstinence-based methods actually increase risky sexual activity. By instead providing knowledge and safer-sex supplies, they make the behavior safer. Drug use is no different.
The main example of harm reduction for injection drug users is needle exchange, and like harm reduction in general, it's easy to understand. A needle exchange provides a safe, anonymous way for needle users to throw away old syringes, thus keeping them out of public parks and trash cans, where they may wind up otherwise. Next, needle exchanges provide a way to obtain clean injection supplies, so that clients are protected from disease. These simple operating principles have incredible, proven results among clients: a 33% reduction in the risk of contracting HIV, a 61% reduction in hepatitis B, and a 65% reduction in hepatitis C. If needle exchange was a prescription, it would a blockbuster.
But there's more to needle exchange than syringes. Programs provide HIV testing, hepatitis C testing, health education, and referrals to drug treatment and medical services for clients who want them. Studies show that needle exchanges decrease drug use and injection frequency among clients, and some programs report that 49% of their referrals result in successful admission to programs, an unbelievably high number in a world where drug treatment facilities often close their doors to poor, uninsured clients. Furthermore, research has proven that programs don't increase crime or connections among injection drug users. To understand why, try the following thought experiment: how many free needles would someone need to offer you before you used them? Most people would find that having access to syringes does nothing to increase the appeal of injecting.
Thanks to the hard work of activists and public health advocates, needle exchanges have growing acceptance, but the challenges are far from over. There remains a federal funding ban for needle exchanges in all states. Orange County, California, is the 6th largest county in the United States, but has no needle exchange. My colleagues and I have been working hard for the last 18 months to establish a program, but have been mired with bureaucracy and a lack of empathy. It is easy for politicians and officials to forget about their constituents if they are voiceless. This means that we, citizens, have the responsibility to demand the implementation of harm reduction programs or our families will continue to face the consequences of the addiction epidemic.
Fortunately, we know what steps we need to take. The federal ban on funding needle exchanges must be lifted. Public health authorities must stop obstructing these essential services, instead finding the courage to lead their communities and help organizers build harm reduction programs. We must put pressure on public health departments and governments to make harm reduction a priority. In Orange County, our program is presently in a 90-day public comment period. We encourage all of you to contact the California Department of Public Health and tell them that harm reduction is not optional, but an essential public health service that everyone in Orange County and elsewhere deserves access to. This process might not be easy, but if we do not overcome our reluctance to speak out now, we will continue to find our communities damaged by the endless consequences of drug addiction.