The continuing, rippling impact of the Great War that ended 100 years ago isn’t difficult to see, if you know where to look. The demise of Three Arms, for example, began with an explosion — though no-one in the Newfoundland fishing town could hear it.

A young lieutenant from the community watched the blast bury one of his men on a blood-and-crater-filled battlefield in northern France. Instinctively, Stephen Norris ran to help — but a second shell would catch him, too.

Weeks later, word of the 24-year-old’s death finally reached Three Arms, triggering the community’s eventual eradication from the Newfoundland landscape.

“There were only three survivors,” read the dispatch from Lt. Norris’s commanding officer. “He was a most promising officer and I deeply regret his loss.”

In Newfoundland, that loss would be most profoundly felt by the fallen soldier’s father, James.

The merchant of Three Arms, he owned and ran the only store, the fish cannery and the flotilla of fishing schooners. James was the sole employer in the bustling community of 140 people.

This poem was written in the early 1900s by a resident of Three Arms:

There is romance in the moonlight,

There is magic on the sea,

There is beauty in the starlight,

Three Arms is the place to be,

Glorious sunsets, dreamy twilights,

All in perfect harmony,

Seem to blend the Earth with Heaven,

And fill one with great ecstasy.

Yet everything in the town reminded James Norris of his now dead son, his heir, the one who would take over the businesses. And so, he left — gradually closing his businesses over a few years following his son’s death in 1916.

“That was the end of it,” Eric Moore, who grew up in the community, explains.

“When the Norris family left, the town started to fade. There wasn’t any point in anybody coming here.”

Lt. Stephen Norris’s death happened nearly a decade before Moore was born. When Moore was young, the population had already started moving away.

Moore’s own family was the last to leave in the 1940s. Today, at the age of 93, he’s one of a handful of people alive who ever lived in Three Arms.

Since then, nature has been slowly taking back the landscape.

A living museum

“It’s kind of sad now when you see it compared to when it was alive,” Moore said on a recent visit to Three Arms by boat with a CBC News crew. “It’s dead now.”

It’s the first time he’s visited in 25 years.

With the aid of a walker and a number of friends, Moore climbed a hill, nearly breathless, to see the grave marker installed for Stephen Norris (like so many other soldiers killed in 1916, his body was never found). Moore paused where the church once stood, now a pile of rotting wood.

There is no sign at all of the large Norris family cannery on the shoreline, where schooners would deposit rich harvests of cod.

The foundations of a few homes are still visible through the long grass. Next to one is a square depression in the earth, at one time a vegetable garden.

“It’s almost like a living museum,” says Nancy Verges, a resident of nearby Harry’s Harbour. She grew up visiting Three Arms, which is now only accessible by boat.

“I see the house that was there, and you think about the kids that were running around. Or the church threshold and you think about how many people walked through there.”

An individual’s impact

First World War battles claimed thousands of men from Newfoundland and across Canada, permanently altering the future of hundreds of towns. Many saw half their population go to war and never return — or return with physical and psychological wounds so fierce, they could no longer do the type of work they’d done before. Some communities would eventually shutter.

Three Arms, though, is somewhat unusual. Its life was so intertwined with that of one man, Lt. Norris, that its death was the direct result of his.

“It’s quite something to think about, how the loss of one individual can change the landscape here 100 years on,” says Maureen Peters, curator of a First World War exhibit at the The Rooms in St. John’s, part museum and part provincial archive.

“You see the echo of history.”

Nancy Verges need only think of her husband. Now retired, he served 25 years in the Canadian Army, including a particularly violence-filled tour in Afghanistan.  

“I can see the change in him,” Verges says. “It just carries on through the years. What happened back then [in the First World War] is still happening now. It’s still war. It’s still having effects.”

It will likely be his last trip home.

The boat engine, roaring to life, masks the tears of his final departure from a town erased by a battlefield death an ocean away.

Canadian Prime Minister Justin Trudeau and dozens of other world leaders gathered in Paris on Sunday to mark 100 years since the end of the First World War — also attending a peace forum after the Remembrance Day ceremony led by French President Emmanuel Macron.

Macron and German Chancellor Angela Merkel launched the three-day peace forum aimed at encouraging multilateralism, using their countries’ reconciliation as a global example.

Trudeau sat in the front row at the opening session. Before the event started, Russian President Vladimir Putin came and sat beside the Canadian prime minister. Canadian media in the room covering Trudeau on Sunday afternoon reported that the two shook hands and appeared to make small talk, but were unable to hear what was said. 

‘Lack of communication and unwillingness to compromise’ can have deadly consequences.– Angela Merkel , German chancellor

Macron opened the forum by saying the world’s stability is threatened by nationalism, racism, anti-Semitism and extremism as well as by economic, environmental and refugee challenges.

In a speech inaugurating the conference, Macron said “what is important for the future is the way this image will be interpreted,” as the “symbol of durable peace between nations” or as “a picture of a last moment of unity before the world goes down in new disorder.”

“It depends only on us,” he added.

Merkel made an impassioned plea for world peace, saying “we must not simply stand by and watch” as more conflicts continue to unfold around the world.

She denounced the “national vaingloriousness and military arrogance” that led to the “senseless bloodshed” of two world wars.

In a veiled dig at U.S. Donald Trump’s America-first policies and skepticism toward multilateral co-operation, Merkel warned that “lack of communication and unwillingness to compromise” can have deadly consequences. 

After attending the morning Remembrance Day ceremony, Trump skipped the peace forum, moving on to his own itinerary in the afternoon, delivering a speech at the Suresnes American Cemetery, which is near Paris.

The Paris Peace Forum’s aim is to promote concrete actions toward peace and should be repeated every year, Macron said.

Earlier in the day, more than 70 heads of state and government gathered — silent, sombre and reflective — gathered under the Arc de Triomphe at the Tomb of the Unknown Soldier, the mute and powerful symbol of sacrifice to the millions who died from 1914-18.

With cellist Yo Yo Ma and the European Union’s youth orchestra performing, the leaders heard high school students recalling the joy felt by soldiers and civilians alike when the fighting finally stopped at 11 a.m. on Nov. 11, 1918.

“I only hope the soldiers who died for this cause are looking down upon the world today,” American soldier Capt. Charles S. Normington wrote on Nov. 11, 1918, in one of the letters read aloud by the students. “The whole world owes this moment of real joy to the heroes who are not here to help enjoy it.”

Macron also spoke at the morning ceremony, warning about the fragility of peace and the dangers of nationalism.

“The traces of this war never went away,” he said. “The old demons are rising again. We must reaffirm before our peoples our true and huge responsibility.”

Macron also said: “Patriotism is the exact opposite of nationalism. Nationalism is a betrayal of patriotism. In saying, ‘Our interests first, whatever happens to the others,’ you erase the most precious thing a nation can have, that which makes it live, that which causes it to be great and that which is most important: Its moral values.”

Commemorations start late

The ceremony started late, overshooting the centenary of the exact moment when, 100 years earlier at 11 a.m., the eerie silence of peace replaced the thunder of guns in western France. 

Under a sea of black umbrellas on a grey and rainy day, a line of leaders led by Macron and his wife, Brigitte, marched in silence on the cobbles of the Champs-Élysées, after dismounting from their buses.

Trump arrived separately, in a motorcade that drove past two topless female protesters with anti-war slogans on their chests who somehow got through the rows of security and were quickly bundled away by police. The Femen group claimed responsibility.

Last to arrive was Putin. Merkel was positioned in pride of place between Trump and Macron, a powerful symbol of victors and vanquished now standing together, shoulder to shoulder. Overhead, fighter jets ripped through the sky, trailing red, white and blue smoke.

The geographical spread of the leaders in attendance showed how the “war to end all wars” left few corners of the Earth untouched but, little more than two decades later, was followed so quickly and catastrophically by the even deadlier Second World War.

Macron, Trudeau and other leaders came to Paris hoping to use the 100th anniversary of the end of the First World War to renew calls to quash festering tensions across the globe.

“There is a general sense and desire among many countries, including Canada, to do whatever is possible to sustain the institutions of the international order and practical, multilateral co-operation. And so you see that in Canada, you see that in Germany,” said Roland Paris, Trudeau’s former foreign adviser.

“Macron [is] essentially making that point; that we can sustain co-operation, we must sustain co-operation.”

Trudeau is scheduled to participate at a side event at the peace forum, which was organized by Reporters Without Borders. Macron, Merkel and four other leaders representing Tunisia, Costa Rica, Senegal and Norway will all announce their countries’ support for a new declaration by Reporters Without Borders on information and democracy, a six-page document that sets out “democratic guarantees for the freedom, independence, pluralism and reliability of information at a time when the public space has been globalized, digitalized and destabilized.”

Trudeau will then stop at a new Peace Library established at the forum, to hand deliver two copies of Canadian books: Romeo Dallaire’s J’ai serré la main du diable: La faillite de l’humanité au Rwanda (Shake Hands with the Devil)  and Margaret MacMillan’s Paris 1919: Six Months that Changed the World.

The final event on the prime minister’s schedule Sunday evening is a one-on-one meeting with Macron on the sidelines of the forum. 

Reject a ‘culture of war,’ Pope says

For his part, Pope Francis said from Italy that the First World War should serve as a severe warning to reject a “culture of war.” 

But Francis observed that the war’s lessons have been ignored, saying “it seems we never learn” as he addressed faithful in Vatican City’s St. Peter’s Square on Sunday. 

The Pope, who often decries the arms industry, added: “Let’s invest in peace, not war!” 

Dignitaries and guests at the official ceremony in Paris weren’t the only ones honouring the fallen. On the streets, people from around the world said it was important to honour their sacrifices.

It’s a good opportunity to look back at what actually happened 100 years ago and how many people actually died in some pretty grave circumstances.– Paul Thomson, Guelph, Ont., resident in

Christopher Federico, a Toronto school teacher, said he was a lieutenant-colonel in the Canadian army reserve and “as a soldier and a veteran, to be able to remember all the soldiers who died in World War I and since, it’s obviously very important to me personally and to us as a country.”

Paul Thomson of Guelph, Ont., said he was in Belgium to visit the grave of his great-uncle, who was killed in the First World War, so went to Paris as well.

On the other side of the globe, Australia and New Zealand held ceremonies to recall how the war killed and wounded soldiers and civilians in unprecedented numbers and in gruesome new, mechanized ways.

Those countries lost tens of thousands of soldiers far away in Europe and, most memorably in the brutal 1915 battle of Gallipoli, in Turkey. 

In London, Queen Elizabeth, dressed in black, watched from a balcony in central London as her son Prince Charles laid a wreath on her behalf at the foot of the Cenotaph, a memorial honouring the fallen. The solemn act marked by two minutes of silence was repeated in dozens of towns, cities and villages throughout Britain. Prince William and Prince Harry were among Royal Family members who also laid wreaths. Canada’s national ceremony will be held in Ottawa.

In Scotland, veterans and members of the armed forces community attended a ceremony at the City Chambers in Edinburgh.

Remembering Canada’s contributions

Kareen Rispal, France’s ambassador to Canada, says Trudeau’s appearance at the ceremony in Paris is a reminder of Canada’s contributions during the First World War that aren’t always recognized.

Some 650,000 Canadians served in the First World War, and more than 66,000 of them lost their lives. About 172,000 more were injured. Others served behind the front lines, working with locals to aid the war effort.

“We as French, we as Europeans — I think we don’t value enough the effort made by the Canadians,” Rispal said.

With files from CBC’s Janyce McGregor, The Associated Press

Five cars of a freight train carrying an industrial chemical derailed in Toronto early Sunday, but no one was injured and nothing harmful was leaked, according to CN and a federal official.

Three of the derailed cars contained vinyl acetate, but the chemical was not spilled, according to Julie Leroux, spokesperson for the Transportation Safety Board of Canada. Two derailed cars were carrying grain and only the one carrying rice leaked, she added.

The federal government says the chemical, not considered harmful to human health, is used in the production of latex paints, adhesives, sealant material and glues. It is found in cosmetics, personal care products and food packaging.

Emergency crews were called to the scene of the derailment on Kennedy Road, south of Eglinton Avenue East, in Scarborough, Toronto’s easternmost district, at about 2:43 a.m. ET.

Firefighters found the cars off the tracks and they tried to determine whether any harmful material had spilled, according to Capt. Adrian Ratushniak, spokesperson for Toronto Fire Services. They found nothing harmful had spilled, he added.

Firefighters then created a “safe perimeter” of about 300 metres surrounding the derailment to contain the scene before handing it over to CN staff, Ratushniak told CBC Toronto.

“There is no threat. There is no danger. And there were no injuries at the scene. At this time, our fire crews have cleared.”

About 25 firefighters and six trucks responded to the call, he said.

Two ambulances went to the scene, but no one was transported to hospital or treated at the scene, according to James Burgin, deputy commander for Toronto Paramedic Services.

CN ‘regrets’ impact on local residents

Jonathan Abecassis, spokesperson for CN, said in a statement that CN is investigating the derailment.

“Current reports indicate that five cars have derailed in various positions, that there are no injuries or release of any dangerous goods and that the train is blocking a crossing on Kennedy Road,” he said.

“We regret any impact this incident may have on local residents.”

That train has since been removed and the roadway has been reopened, according to Toronto police.

The cause of the derailment hasn’t been determined.

Const. David Hopkinson, spokesperson for the Toronto Police Service, said they were told there was “hazardous material” on the train and police were ready to evacuate the area, but nothing leaked from the derailed cars and an evacuation was not necessary.

Hopkinson declined to say what kind of hazardous material was reportedly on the train. 

“There was no leak,” he said. “Traffic has resumed in the area.”

Transportation Safety Board not sending team

Leroux, based in Gatineau, Que., said the board was notified about the derailment at 5:37 a.m. She said cleanup is underway.

“We are still gathering information but we have decided not to deploy,” she said.

The derailment occurred close to the Salaheddin Islamic Centre, a mosque in Scarborough, and Kennedy subway station.

The Toronto Transit Commission suspended passenger pickup service at the station and closed access to its south parking lot, but service and access have resumed.

Maybe Jay McArthur would never have had a chance to start his Brighton, Ont., home inspection business had he not stopped on the way to the shower in 2007 to use the phone at his military base in Afghanistan.

As it turns out his call home went unanswered, and McArthur, who would later retire with the rank of master corporal, left a voicemail message. But that short delay was just enough.

When the enemy rocket hit the shower stalls, killing one person and injuring another, McArthur was a first responder instead of being on the casualty list.

Military business advantage

While still suffering from the delayed effects of his time in the service, McArthur is convinced that his ready-for-anything military experience has given him a business advantage.

“Absolutely,” says McArthur, on the phone between appointments. “One of the biggest things with the military is attention to detail.”

One of the biggest things with the military is attention to detail.– Jay McArthur, veteran and owner of Rest Easy Home Inspections 

That is paying off in the business he started called Rest Easy Home Inspections.

McArthur’s venture is just one of hundreds listed as part of a service of the Prince’s Trust, called Prince’s Operation Entrepreneur (POE), a scheme to assist and publicize the efforts of veterans who are trying to start their own businesses.

Each veteran I contacted through the POE directory of business services, searchable by location and by industry sector, credited the military with a big part of their own business success. A lot go into security, but if anything, the surprising thing is the variety.

New Brunswick archeologist Jason Jeandron credits his military experience with preparing him for working outdoors in cold, mucky or buggy conditions. Business coach Peter Lepinsky credits the military with teaching him leadership skills, which he says are sorely lacking in modern business.  

“For most of us when we come out, it comes down to, well, we’re taught a lot of leadership and taking initiative,” says Chantale Lefebvre, who served for 16 years, leaving as an avionics technician with a rank of master corporal.

Working from her Fort Saskatchewan, Alta., home so that she could look after her family, Lefebvre set up business as an online sales contractor to make a few hundred bucks a month, “and it just ended up exploding from there.”

The tough conditions in military operations mean service personnel often retire relatively young, but Lefebvre says having a pension — even a relatively small one — is a big advantage for an aspiring entrepreneur, something she thinks contributes to the success of veteran-owned new businesses.

“It definitely helps because it takes away that financial strain, so you can actually put the focus you need on it without having to worry so much about the financial side,” she says.

Founder, janitor, bookkeeper, receptionist

Having a pension has certainly helped Kevin Moore, founder, and, according to his website, “janitor, bookkeeper, repairman, receptionist , etc.,” at Two Sergeants Brewing, an already successful Alberta craft brewer just about to open — “within the week” — a new bar and restaurant in Edmonton’s entertainment district under the same name.

“Myself and my business partner are both retired so we have pensions and medical pensions, so we don’t have to take a salary from the business,” says Moore, one of the two sergeants in the company’s name.

Moore says his favourite military quote is from the 19th century Prussian general Helmuth von Moltke that, “No battle plan ever survives first contact with the enemy.” And that has been repeatedly proven to be true in his business career.

The military ethic of resourcefulness and drive drilled into the two partners during their service careers has really made the difference in overcoming business obstacles, but sometimes, he says, it has put them into conflict with civilian business “that goes at its own pace.”

Moore and his partner have learned from trial and error. With good management and good luck, the two sergeants have been selling their award-winning brews around the province, each container telling a tale from Canadian military history.

But veterans just starting out often struggle with the business basics.

Business bootcamp

That’s why as well as setting up a business directory, the Prince’s Operation Entrepreneur also runs training programs, including a one-day kick-the-tires sessions at military bases across the country and a seven-day business bootcamp run at one of four universities.

The programs, free to veterans, are intended to help them brush up their entrepreneurial skills says Janet McCausland, head of programs at Prince’s Trust Canada. And she says they have been proven to work.

“Sixty per cent of the people who go to the bootcamp start their own business,” says McCausland and, according to their followup program, between eight and nine per cent of those businesses don’t succeed. That beats the national average where the majority of businesses fail after two years.

McCausland says people suffering from PTSD and other post-military symptoms of stress are better off working for themselves where they can control their hours and environment.

“Almost 70 per cent of the people who come to our bootcamp are medically released. They have physical and mental-health issues,” she says. “And so entrepreneurship can be an especially good fit because it can accommodate any issues they have.”

Almost 70 per cent of the people who come to our bootcamp are medically released. They have physical and mental-health issues. And so entrepreneurship can be an especially good fit because it can accommodate any issues they have.– Janet McCausland, head of programs at Prince’s Trust Canada

McArthur, who has suffered from PTSD since his harrowing experience in what he thought was the safety of his base camp, is a graduate of the bootcamp program in 2016. He said it made a huge difference, for his health and for his business.

“It was phenomenal, like drinking through a fire hose,” says McArthur, of the weeklong course. 

And he says the Prince’s Operation Entrepreneur training worked for him.

“My business since POE? I’ve had a 30-per-cent increase every year.”

Follow Don on Twitter @don_pittis 

Remembrance Day ceremonies on Parliament Hill in Ottawa, and at city halls, places of worship and military bases across Canada today are commemorating the end of the First World War a century ago.

Defence Minister Harjit Sajjan headed the ceremony, which began around 10:55 a.m. in sub-zero temperatures, as Prime Minister Justin Trudeau is in Paris on Sunday for events with other world leaders.

Among those Payette greeted Sunday as the ceremony got underway was Winnipeg resident Anita Cenerini, who was named as the 2018 National Silver Cross mother, representing all military mothers who have lost a child to war. Cenerini fought for her son, Pte. Thomas Welch, to receive full military honours after his suicide. This is the first time the legion has chosen a mother who lost a child to suicide for the year-long designation. After serving in Afghanistan in 2003, the 22-year-old ended his life on May 8, 2004, at the army base in Petawawa, Ont.

At 11 a.m. Sunday, a sombre silence was broken by the beginning of a 21-gun salute and the deep tolling of a bell marking the solemn occasion. A flyover of five CF-18 Hornet aircraft from Cold Lake, Alta., also soared over the crowd at the National War Memorial in a “missing man” formation. The crowd paused at 11 a.m. to reflect on the sacrifices of Canadians who gave their lives in conflict around the world.

During the First World War, more than 66,000 Canadians died on the battlefields of Europe and more than 45,000 lost their lives during the Second World War. The Remembrance Day ceremonies acknowledge the contributions of all Canadians who have served and are still serving today.

Trudeau’s wife Sophie Gré​goire Trudeau accompanied Sajjan at the ceremony, and was joined by Senator Peter Harder, Jonathan Vance, chief of the defence staff, Liberal MP Karen McCrimmon representing Veterans Affairs Canada and Thomas Irvine, national president of Royal Canadian Legion.

‘Very special Remembrance Day’

As the Ottawa Children’s Choice sang In Flanders Field, wreaths were laid at the foot of the war memorial to remember the fallen. Payette put down the first wreath, followed by Cenerini on behalf of “The Mothers of Canada,” then Sajjan on behalf of the government, as well as others representing various federal departments, and even one representing the young people of Canada and another on behalf of Indigenous people.

In an interview before the ceremony began, Sajjan told CBC’s Hannah Thibedeau that this is a “very special Remembrance Day” because of the 100th anniversary of the signing of the armistice, ending the so-called Great War.

“Even today our men and women in Armed Forces are deployed all over the world. And let’s not forget the families as well who serve alongside them.”

Sajjan also stressed the important role of peacekeepers.

“World War I was a consequence where peace was not found … when we look at the work they do, we’re proud of the resilience in not only reducing conflict, but also preventing it.”

Honouring the fallen

In a statement Sunday from the Prime Minister’s Office, Trudeau emphasized the role Canadians played in the First World War.

“One hundred years ago today, the Armistice between Germany and the Allies ended the First World War. As we commemorate the 100th anniversary of the armistice, we also mark Canada’s Hundred Days,” his statement says, in part.

“During the ‘100 Days Offensive,’ Canadians spearheaded attacks that overcame the last lines of German defences and paved the way to final victory. These soldiers were the face and strength of a young country that sacrificed beyond measure and never faltered in its duty.”

Trudeau also encouraged people in Canada to take time out at 11 a.m. for two minutes of silence, to “remember every Canadian who has sacrificed their future for generations beyond their own. We stand today, free and at peace, because of them.

“Lest we forget.”

In Toronto, among the events across the city, there will be a military parade through the downtown streets, with the primary ceremony set for Old City Hall starting at 10:45 a.m. ET, with Mayor John Tory in attendance.

Premier Doug Ford hosted Ontario’s official Queen’s Park Remembrance Day ceremony in Toronto, where he encouraged Canadians to remember soldiers past and present as they reflect on the centennial anniversary.

After a ceremony that saw as many as 500 troops march towards the Ontario Legislature while John McCrae’s poem In
Flanders Fields was read aloud, Ford told the crowd that “Canadian heroes span every conflict and every generation.”

On the East Coast, ceremonies included ones in Nova Scotia, where crowds of people filled the square at Halifax’s Grand Parade. As the clock struck 11 a.m. AT, the gun on nearby Citadel Hill fired the first of 22 shots.

And in Prince Edward Island, hundreds gathered in Charlottetown to honour the fallen. The sombre crowd stood in near silence as it reflected on the battles that ended a century ago, and those that have come since.

Montreal’s main ceremony began at the Quebec Provincial Command at 10:30 a.m. ET, at Place du Canada. Quebec City’s event was set to start at the Plains of Abraham at 10:30 a.m. until about noon, with Premier Franç​ois Legault in attendance.

With files from The Canadian Press

Kelly White kicks used needles to the side of the path where she walks to work in Toronto’s east end. Nearby, she can see people tucked behind cars, in alleyways, and even out in the open using drugs at all times of the day.

White is one of four front-line workers at an overdose-prevention site in the Moss Park neighbourhood at the crossroads of Sherbourne Street and Dundas Street East. The temporary site is operated by a non-profit organization called Street Health, which provides nursing care and harm-reduction services from 11 a.m. to 4 p.m. Monday to Friday.

Every day she hopes to bring drug users off the streets and into safer spaces, where they can use under the supervision of both medical professionals, and support workers like herself who have been trained on the job. But unlike safe-consumption sites, which are permanent and offer a wider range of support, overdose-prevention sites across Ontario were emergency, pop-up solutions to an escalating crisis that were never meant to be long-term.

In December 2017, Health Canada announced that it would allow temporary prevention sites like Street Health’s to operate across the country. The sites were given limited provincial funding for up to six months. But White says sites like hers are understaffed and under resourced given the size of the crisis they face.

As a result, the job can be stressful and demanding for those who work there. And when it comes to dealing with the mental toll of being on the front line of an opioid epidemic each day, workers like White say it feels like they’ve been left to help others without much help for themselves.

The reality is that it’s constant loss. It’s tough for this community. It’s tough for the people that work here.— Kelly White

“A lot of people that talk to me about the work that I do always ask how I do it,” said White from inside the small room where she sees clients everyday, surrounded by stockpiles of clean syringes and drawers labelled ‘crack pipes.’ “Honestly, to me, the hard part is bashing your head against a system that isn’t designed to help people.”

Although the Ontario government recently announced a new plan to replace existing overdose-prevention sites with more permanent safe-consumption sites, it’s not clear that it will provide any more support for front-line workers.

Reality is ‘constant loss’

White was one of the four original workers at the volunteer-run Moss Park tents that popped up last summer during a spike in overdose deaths. She has seen the devastation the Toronto community has faced with the continued loss of life to unsafe drug use.

Since the Street Health overdose-prevention site opened at the end of June, White said it has helped over 500 users by giving them access to a safe space and clean supplies. As the co-ordinator of the facility and one of the hands-on workers tending to clients, she’s also responsible for greeting visitors, prepping tables and responding to medical emergencies.

Workers like White respond to overdoses daily, and some of the losses have been personal.

Holding back tears, she talks about her frustration and the difficulty of taking on an avalanche of problem that she believes requires more government intervention. Data from the federal government shows that, on average, more than 11 Canadians die because of opioids each day.

In Toronto alone, more than 300 people died of opioid overdoses in 2017, and the city has recorded 120 suspected deaths this year.

“The reality is that it’s constant loss. It’s tough for this community. It’s tough for the people that work here,” she said. “But at the same time, we wouldn’t want to be doing anything else.”

Donations only go so far

How do front-line workers cope with the work they do everyday? White says, “I’d say that primarily our support comes from being united in this battle, the relationships we build with clients and each other.”

Street Health has extended comprehensive benefits coverage to overdose-prevention site staff so that that they can get coverage for things like prescription drugs and dental care, White said.

Not all front-line workers are as lucky. In lieu of more comprehensive support, a GoFundMe page was set up to support staff at other Toronto area sites. The donations can be used toward massages, counselling, and acupuncture, but donations can only go so far.

“I’ve lost people to overdose, and one of the hardest parts is that people are not talking about this. … We need to bring things out of the shadows,” White said.

She has tried to hold daily briefings to help process what staff witness. She said some days they barely have time to debrief because the demand to meet client needs is so high.

“One of the more difficult things here is that the work is so precarious. We’re only funded for six months,” she said. Funding for Street Health’s overdose-prevention site ends Nov. 30.

New model, new concerns

Last month, Ontario Health Minister Christine Elliott announced that it is capping supervised drug-consumption facilities at 21 sites province-wide, and will spend just over $31 million a year to fund these sites.

But how these sites will be distributed across Ontario is unknown. Also missing from the new model is any mention of support for front-line workers.

The current overdose-prevention sites will be expected to re-apply under the new provincial model to become permanent supervised-consumption sites, and White fears that will force established overdose-prevention sites like Street Health to compete for one of the limited spaces.

“We are currently worried about losing the flexibility, responsiveness, lack of bureaucracy and red tape, and client-centredness that we have worked hard to maintain,” White said.

Steady funding would allow Street Health to hire more staff, and perhaps operate more than two stations for safe drug consumption. It would also allow a facility like Street Health’s to be open more days — like weekends — and later at night.

‘It’s extremely stressful’ on front line

One health industry expert suggests that going a step farther and putting safe-consumption sites under the umbrella of the Canadian health-care system would alleviate some of the stress that front-line workers experience, and provide them more help.

Paul-Emile Cloutier is the CEO and president of Ottawa-based HealthCareCAN, an association representing health-care providers in Canada. ​He says that if front-line workers burn out, the health-care system would be there to take care of them.

Cloutier says the injection site in Ottawa on Murray Street receives over 45,000 patients a year and cares for about 135 people a day. He says this safe-consumption site deals with about four to five overdoses a day.

“Front-line providers always work in a crisis environment and of course it’s extremely stressful,” he said. “We have to ensure that they are also well taken care of.”