Working with drug addicts in New York City, Robert Childs started noticing a disturbing trend among people who came from southern states.
Lacking programs aimed at reducing such problems, southerners were more likely to be infected with HIV or Hepatitis C. Many had suffered from multiple overdoses, and had untreated abscesses or mental illnesses.
So Childs, who has spent much of his career helping people infected with the HIV virus, looked south for his next step, taking over as director of the N.C. Harm Reduction Coalition in 2009.
The group works at helping vulnerable groups including people who suffer from drug addiction, are involved in sex work or are HIV-positive, through both direct assistance and advocacy. At a time when opioid addiction is on the rise, it has been credited with establishing a number of programs to help prevent deaths from overdose and infection.
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The coalition has just earned the Public Health Partners Award from the N.C. Association of Public Health Directors. The award recognizes groups that have “made significant contributions to the advancement and promotion of public health in North Carolina.”
Dr. Colleen Bridger, a past president of the health directors’ association, says the coalition was nominated multiple times for the annual award after it played a key role in the passage of a state law last year that legalized syringe exchange programs.
The work that the coalition is doing under Robert’s leadership is literally saving lives.
Dr. Colleen Bridger, director of the Orange County Health Department
Those programs help cut down on the rates of HIV and Hepatitis C infections. Another law that passed in 2013 with the coalition’s backing made it easier to administer the anti-overdose drug naloxone. Since then, more than 5,000 overdose reversals have been reported statewide.
Bridger says the coalition has helped usher in a cultural shift statewide that has made state and local officials more receptive to harm reduction measures that the public health community has long advocated.
“The work that the coalition is doing under Robert’s leadership is literally saving lives,” says Bridger, director of the Orange County Health Department. “They have been absolutely magical in their ability to help people understand why these types of programs work for everyone’s benefit.”
Helping in his genes
Childs grew up in a family with an international flavor and a deep dedication to advocacy. His mother was born in South Africa, his father in Tanzania, and both were involved in the fight to end apartheid during the 1980s and early 1990s.
The family moved frequently; Childs was born in Germany but spent most of his youth in rural Illinois.
Both of his parents were social workers, so it was no surprise that he chose that field in his own work – after meandering through early jobs such as farmer, English as a second language teacher for refugee students, and German translator.
“Helping people was in my genes,” he says.
Childs started his career in social work in Oregon, as a case manager for people with severe mental illnesses.
He went on to a larger provider that worked closely with jails, hospitals and government agencies. It was there that he began to see persistent issues in the way people with addiction problems were handled in the public health system.
Often, he says, they fall into addiction after some sort of crisis or mental health issue, but were treated like criminals when they continued to relapse, which would create more crises.
“You have these people who are trying to make themselves feel whole, and we just keep punishing them, and their problems get worse and worse,” he says. “It’s crazy.”
His reflections led him to work on health systems on a larger scale. He earned a master’s degree in public health from the University of New Hampshire, and would go on to a role as a health educator focusing on HIV.
In Portsmouth, he headed outreach to HIV patients, from going into the streets to educate heroin users on the risk of HIV infection through needles to creating the state’s first support group for women who were HIV-positive.
In New York, he again worked directly with clients but increasingly helped create and implement large-scale programs to help them. It was there that he noticed the increased problems of addicts from the south.
“It was easy to tell if people were from states without harm reduction,” Childs says.
His move to North Carolina was partly personal – a better place to raise his young family. But it was also a chance to bring harm reduction methods to a place that needed him.
Support from law enforcement
The harm reduction movement seeks to help intravenous drug users to stay healthy and safe even if they continue using – an idea that runs contrary to an abstinence-only approach. While many areas in the Northeast and West Coast have embraced these methods, they have proven more controversial in the South.
But with drug addiction and related problems on the rise, groups such as the coalition are pushing these measures as a way to stem a public health crisis. The coalition’s small staff works directly with drug users and local agencies, as well as advocating for initiatives that help them.
The support of law enforcement has also been crucial to the group’s success.
When the coalition first started pushing for the needle exchange law in 2011, for instance, the effort failed in part due to opposition from law enforcement.
But the coalition increased its collaboration with local agencies, working on efforts such as educating officers on how to avoid HIV infections and creating diversion programs that send low-level drug offenders to treatment instead of jail.
Another piece of common ground came through the medication naloxone, which can reverse an overdose. Many law enforcement officers wanted to administer the life-saving drug, but departments were concerned about liability.
A 2013 law pushed by the coalition removes liability to anyone who administers the drug, and the coalition has since helped equip state law enforcement with nearly 40,000 doses of it.
Over time, they continued to press for the syringe exchange, in part for the safety of law enforcement officers, who frequently come into contact with needles.
“Most officers will be in contact with a needle, and one in three will be stuck,” says Childs. “If we can lessen the rate of HIV infection, then fewer of those officers are at risk.”
In July, the needle exchange law passed in a bi-partisan vote with support from nearly two dozen police chiefs and sheriffs. Since then, the coalition has been busy helping to set up exchanges statewide and to distribute hundreds of thousands of syringes they secured through grant funds.
Since Childs took over the coalition, it has grown from two to eight employees across the state, and he’s worked on initiatives in Georgia and South Carolina as well.
Tessie Castillo, the coalition’s advocacy and communications coordinator, says Childs’ supportive leadership style has allowed the group to remain efficient and innovative.
“We’re all very passionate and dedicated to the job, and we’re always thinking of better ways to do it,” Castillo says. “He encourages innovation in all of us. There’s no fear of putting an idea out there.”
Born: August 1979, Germany
Career: Director, N.C. Harm Reduction Coalition
Awards: Grassroots Campaign of the Year, ADAP Advocacy Association, 2013; Recognized as “One of Five People in the USA Who Made a Difference in HIV,” The Body, 2011
Education: B.S. History and Religious Studies, Lewis and Clark College; M.P.H., University of New Hampshire, Manchester