The critical role librarians play in the opioid crisis | Chera Kowalski

翻译人员: janice zhu 校对人员: Tianji (Homer) Li

When you walk into your neighborhood public library,

当你走进社区的公共图书馆时，

you expect the librarian to help you find your next favorite book

你期待着图书管理员 帮你找到另一本你最爱的书

or some accurate information on a topic at interest.

或对你感兴趣的话题 查到一些准确信息。

You don't probably expect the librarian

你可能不希望图书管理员出现时

to come running out from behind the reference desk with Narcan,

带着Narcan（注：一种急救药） 从咨询台后面跑出来，

ready to revive someone overdosing on heroin or fentanyl.

准备去抢救某个 过量吸食海洛因或芬太尼的人。

But this is happening at some libraries.

但是这种事的确发生在某些图书馆里。

Public libraries have always been about community support

一直以来， 公共图书馆通过各种服务和项目

with all kinds of services and programs

提供社区支持，

from assisting with job seeking efforts

从协助求职者找工作、

to locating resources for voter rights

到为保证选民权利而寻找资源、

to providing free meals to kids and teens even.

到甚至为孩子和青少年提供免费用餐。

But what we think of as community support takes on new urgency

但当你处于鸦片类药物过量危机，

when you're in the middle of an opioid and overdose crisis.

我们所说的社区支持 就面临一种新的紧迫需求。

I work at the McPherson Square Library of the Free Library of Philadelphia.

我在费城免费图书馆下属的 麦克弗森广场分馆工作。

It's located in Kensington,

它位于肯辛顿，

one of the lowest income communities in Philadelphia,

费城收入水平最低的社区之一，

with a long history of being isolated from resources and opportunity.

那里长期财力匮乏， 没有发展机会。

And because of that,

正因为如此，

it has been the center to the city's drug trade and drug use for decades.

几十年来，肯辛顿一直都是 费城的毒品交易和毒品吸食中心。

And so inside the neighborhood,

所以在这个社区，

our library is nestled inside of a park,

我们的图书馆落脚在一个公园里，

which has unfortunately garnered a reputation

但不幸的是， 它已经成为远近闻名的“毒品窝”，

for being a place to find and use drugs,

人们到这里寻找和吸食毒品，

especially heroin,

尤其是海洛因，

out in the open,

完全公开，不加遮掩，

putting us and the community in direct contact

这让我们还有社区居民 每天都直接接触到

with the drug trade and use on a daily basis.

And so inside the library,

所以在图书馆里，

it is routine to see people visibly intoxicated on opioids:

经常能看到有人出现 鸦片类药物中毒的典型症状：

eyes closing, body swaying slowly.

双目紧闭，身体抽搐。

It is routine for me to ask them if they are OK,

我每次都要去问他们还行不行，

but at the same time remind them

同时也提醒他们，

if they can't keep their eyes open,

如果他们不能保持清醒，

they have to go.

就必须离开这里。

It is routine for our volunteer, Teddy,

而对我们的志愿者泰迪来说，

to pick up dozens of discarded needles on our property and throughout the park.

捡起图书馆内和公园里 大量的废弃针头已经是固定工作。

And it is normal for kids to come into the library

孩子们会走进图书馆，

to tell me or our guard, Sterling,

对我或者我们的保安斯特林说，

that someone is outside using,

有人在外面吸毒，

which typically means finding someone injecting on our front steps,

这样说通常是指他们发现 有人在图书馆门口台阶上、

benches

长椅上、

or near the building,

或是大楼附近注射毒品，

then asking them to move along because kids see them.

然后我们会要求这些人赶快离开， 因为孩子们看到他们了。

And it is normal for the community

对社区居民来说，

to see people in various states of intoxication and withdrawal,

看到人们处于吸毒和戒毒中的各种状态、

to see people buying and selling,

看到人们买卖毒品、

and to see people act and react violently.

看到人们的激烈行为和反抗 都是很正常的。

I'm not sharing this to sensationalize Kensington.

我分享这些不是为了耸人听闻， 夸大肯辛顿的情况，

I'm sharing this because this is the reality of a community

我分享这些， 因为这就是一个社区的现状，

that is constantly striving to move forward,

这个社区一直在努力向未来发展，

but due to factors like structural racism,

但是受一些因素限制， 例如结构性种族主义、

urban segregation,

城市隔离、

the cyclical nature of poverty,

贫穷的周期性、

of trauma --

挫折的周期性等——

the community has inequitable access

社区居民无法公平地获得

to education, health care, employment and more.

教育和医疗资源、工作机会、 以及其他更多东西。

And this is also what it's like when the drug trade and use

而毒品交易和使用 对社区生活的各个方面

affects every aspect of life in the neighborhood.

也会带来这样的不良影响。

And the opioid epidemic has only amplified that stress.

鸦片类药物的盛行 更是加剧了这种影响。

When I was hired by the Free Library in 2013,

当我在2013年被免费图书馆雇用时，

I specifically chose to work at McPherson

我特意选择去麦克弗森工作，

because I understand what it's like to grow up in an environment

因为我知道生长在一个

where substance use disorder shapes the everyday,

日常生活被滥用药物 主导的环境里是什么样，

and I wanted to use those personal experiences

我想利用那些个人经历

as a guide for my work.

指导我的工作。

But before I get to that,

但是在说那个以前，

I want to share what it was like

我想分享亲眼见证

to witness this epidemic grow in Kensington.

毒品在肯辛顿日益盛行是什么感觉。

Like many other communities, we were just not prepared.

跟其他许多社区居民一样， 我们还没准备好。

We began to take notice of IDs we were seeing:

我们开始去留意 我们看到的那些身份证：

addresses from nearby and upstate counties

上面的地址从周边或州北边的县，

and then slowly out-of-state ones.

慢慢扩大到州以外的县。

People from Arkansas, Ohio, South Carolina, Alabama

来自阿肯色州、俄亥俄州、 南卡罗来纳州、阿拉巴马州的人

coming to Philadelphia for cheap heroin.

为了廉价海洛因来到费城。

People began to linger longer and longer in our public restroom,

人们开始在我们的公共厕所长时间逗留，

causing us to pay more attention to the restroom

因为那里可以吸食刚买到的毒品，

than to our daily responsibilities

如此一来，我们对厕所的关注

because it was an accessible place to use drugs just purchased.

比对日常工作的关注都要多。

One day our toilet clogged so badly in the restroom,

有一天，厕所里的马桶严重堵塞，

we were forced to close our library for two days

我们被迫闭馆两天，

because the culprit of the clog was discarded needles.

而导致堵塞的罪魁祸首就是废弃针头。

For a while prior to that incident,

在那次事件不久前，

we had been asking for a sharps container for the restroom,

我们已经申请给厕所配一个锐器盒，

and after that,

事件发生后，

the library administration quickly approved installing one

图书管行政处很快就批准了安装申请，

along with hiring bathroom monitors.

同时还批准租用厕所监控器。

And as the weather warmed,

而随着天气转暖，

we struggled to respond.

我们也在尽全力应对。

People began camping out in the park for days, weeks.

人们开始连日连周地在公园里露营。

You could walk outside on a sunny, warm day

如果在一个暖和的晴天走出图书馆，

to find multiple groups of people in various states of intoxication

你会发现一群群形态各异的吸毒者，

and children playing in between them.

孩子们就在他们中间玩耍。

The amount of needles collected by Teddy on a monthly basis skyrocketed

泰迪捡到的针头数量按月急剧增长，

from 100 to 300 to 500 to 800,

从100，到300、500、800、

to over 1,000,

再到1000多，

with many found on our front steps and the playground.

其中很多都是在 图书馆前门台阶和游乐场发现的。

Then there were the overdoses.

再就是吸毒过量。

So many occurred outside in the park,

很多都发生在馆外面的公园里，

some inside the library.

还有一些发生在图书馆里。

Sterling, our guard, would spend his time walking in and out of the building

我们的保安斯特林， 会花时间在大楼里外

and throughout the park,

以及整个公园里巡视，

constantly making sure everyone was safe,

时刻确保每个人都没事，

because at times,

因为时不时地，

our fear of having someone overdose and die came close.

我们就会担心有人吸毒过量而死。

One overdose in particular occurred after school,

有一例吸毒过量很特别， 是发生在放学后，

so the library was full of kids, noise and commotion.

当时图书馆里都是孩子， 叽叽喳喳、吵吵闹闹。

And in all of that,

而在嘈杂声中，

we heard the thud from inside the public restroom.

我们听到从公共厕所里传来砰的一声。

When we opened the door, we found a man on the floor, unresponsive.

我们推开门，看到一个男人 躺在地上，失去了知觉。

He was pulled out in plain sight of everyone --

他在众目睽睽之下被拖了出来——

kids, teens, adults, families.

小孩子、青少年、大人、一家人， 每个人都看着他。

Someone on staff called 911,

工作人员有的拨打了911，

someone else escorted the kids and teens downstairs,

有的疏散小孩子和青少年下楼，

somebody went to flag down the ambulance in the park.

有的去公园里拦急救车,

And the rest of us --

剩下的——

we just waited.

就在现场等。

This had become our overdose drill

这已经成为我们的吸毒过量演习，

because at the time, it was all we could do.

因为在这种情况下， 我们能做的就是这些。

So we waited and we watched this man lose air --

我们等啊等， 眼看着这个男人失去呼吸——

seize up.

全身僵硬。

He was dying.

他快死了。

I don't know how many of you have witnessed an overdose on opioids,

我不知道你们中有多少人 亲眼见过鸦片类药物过量，

but it's horrific

太恐怖了，

because you know the gasping for air,

因为你知道呼吸困难，

the loss of color in someone's face,

脸上失去血色，

is a timer running down on the chances of this person surviving.

意味着这个人的生存时间所剩无几。

But luckily for this man,

但是这个男人够幸运，

the ambulance arrived

救护车来了，

and he received a dose of naloxone through injection.

他接受了一剂纳洛酮注射。

And I remember he jolted like he was electrocuted,

我记得他就像被电击一样突然苏醒，

and he pulled the needle out,

接着他拔出针头，

and he told the paramedics to back off.

让急救人员后退。

And then he stood up, and he walked out.

然后他站起来走了。

And we --

而我们——

we went back to work

继续回去工作，

because people were still asking for time on the computers,

因为还有人在请求使用电脑，

kids still needed help with their homework

孩子们的家庭作业还需要帮助，

and this was our job --

而这才是我们的工作——

our purpose.

我们的目的。

I think that incident stays with me because of the waiting.

我认为那次事件让我难忘是因为等待。

It made me feel helpless.

等待让我感觉无助。

And it was that feeling of helplessness that reminded me so well of my childhood.

那种无助感让我回想起自己的童年。

Before I was born, both of my parents began using heroin.

在我出生前， 我的父母就开始吸海洛因。

It made our lives chaotic and unstable:

把我们的生活搞得 一团混乱，动荡不安：

promises being made and constantly broken,

许下承诺，又不停的违背承诺，

their fighting, the weight of their secret --

他们争吵， 他们吸毒这个秘密——

the weight of our secret kept so much so-called "normal" out of our lives.

我们家有人吸毒这个秘密 让我们的生活失去所谓的“正常”。

Every time we'd be dropped off at our grandparent's house,

每次我们被丢在祖父母家，

I'd be stuck on the thought that I was never going to see them again.

我都固执地以为 以后再也见不到他们了。

Every time we'd be left in a car, at a house, at a store,

每次我们被丢在 车里、房子里、商店里，

I'd cry.

我都会哭。

And every time I saw those El tracks --

每次我从汽车后座——

the same ones I take to work now to McPherson --

看到那些EL型轨道——

from the backseat of a car,

跟我现在去麦克弗森上班的线路一样，

I'd be angry,

我都会愤怒，

because even kids know

因为连小孩子都知道

when their parents are trying to score drugs.

什么时候他们的父母要去买毒品。

There was so little I could do to control what was going on around me,

我对身边发生的一切都无法控制，

that that feeling of helplessness was overwhelming.

那种无助感极其强烈。

I struggled in school, struggled to read,

我上学和读书都很吃力，

I was prone to anger and depression.

我容易发怒和沮丧。

When I was 11 years old, I started smoking,

11岁时，我开始抽烟，

which shortly after led to my own experiences with drugs and alcohol.

这导致之后不久 我又开始滥用药物和酗酒。

I convinced myself that my parents' past would be my future.

我说服自己相信 我父母的过去就是我的未来。

But eventually both of my parents entered recovery

但是最终他们都戒掉了毒瘾，

and maintained recovery from opioid use.

而且再也没碰过鸦片类药物。

And their strength and their commitment

他们的意志和承诺

provided support and stability for me and my siblings,

给了我和我的兄弟姐妹 支持与坚定信念，

and it was those personal experiences that brought me to McPherson.

正是这些个人经历让我来到麦克弗森。

Choosing to be a librarian

选择做一名图书管理员，

and choosing to be at McPherson

选择来到麦克弗森图书馆，

was me letting go of that feeling of helplessness

就是为了释放我心里的那种无助感，

and finding ways to be supportive to others.

想方设法去帮助支持他人。

And one way to provide support

而提供支持的一种方式

was learning how to administer Narcan.

就是学会使用Narcan.

Public libraries respond to the needs of their communities,

公共图书馆要响应社区的需求，

and not knowing how to utilize Narcan

而不知道如何使用Narcan

was a disservice to the needs of our community.

则会给我们的社区帮倒忙。

We were on the frontlines

我们身处一线，

and desperately needed access to this lifesaving tool.

迫切需要用到这种救生装置。

So finally in late February of 2017,

所以在2017年2月底，

after much advocating,

经过多方倡议，

we finally received training from Prevention Point Philadelphia

我们终于参与了费城预防点的培训，

and about a month of so later,

在大概一个月后，

I utilized Narcan for the first time to save someone's life.

我第一次用Narcan救了一个人的命。

It was after school again,

那还是在放学后，

and Teddy came into the library

泰迪走进图书馆

and said someone was overdosing on a front bench.

说前门外的长椅上有人吸毒过量。

Someone on staff called 911 again,

工作人员再一次拨打了911，

and I grabbed the Narcan kit.

而我抓起了Narcan急救装置。

The woman was barely in her 20s and barely breathing.

那个女人只有20出头， 几乎停止呼吸。

Her friend was frantically slapping her in the face

她的朋友当时正狂扇她的脸，

in hopes of reviving her.

希望可以以此唤醒她。

I administered the Narcan nasally,

我朝她鼻子里喷了Narcan,

and thankfully she came to.

然后，谢天谢地，她醒过来了。

But before the ambulance arrived,

但是在急救车来之前，

she and her friend ran off.

她和她的朋友就跑了。

And when I finally turned around,

当我终于转过身时，

I saw the kids --

我看到孩子们——

kids that come into the library on a daily basis,

那些每天都来图书馆的孩子们，

some that I have known for years --

有些我都认识好几年了的孩子们——

standing on the steps of the building.

站在大楼的台阶上。

They saw everything.

他们看到了一切。

And they didn't seem like they were visibly upset or in shock,

他们看起来并没有不安或震惊。

and so I walked into the building,

我走回了图书馆，

right into our workroom, and I cried.

走进了办公室，然后我哭了。

I cried partly from the shock of what just happened

我哭，某种程度上是因为 还没从刚发生的一切缓过来，

because I never thought I'd be saving anybody's life ever,

因为我从没想过我会救了一个人的命，

but I mostly cried because of the kids.

但是我哭，主要还是因为这些孩子。

This is their normal.

这是他们生活的常态。

This is the community's normal.

这是社区的常态。

This is a catastrophic normal,

这是一种灾难性的常态。

and in that moment,

在那一刻，

I was forced to confront once again that this should never be normal,

我再次被迫认识到， 类似的事情应该永不显得稀松平常。

and as with my childhood,

而在我的童年时代，

when you're in it, you just accept it.

当你遇到这种事， 你只要接受就好了。

The opioid epidemic is not just about those living

鸦片类药物的盛行不仅仅关乎

with opioid use disorder

那些有鸦片类药物使用障碍的人，

because the reach of the epidemic goes well beyond those living with this

因为这种盛行影响到的范围 远远超出了那些吸毒者

and their families.

还有他们的家庭。

It impacts the entire community.

它影响整个社区。

Kensington was a community in crisis before this

肯辛顿在毒品盛行前也曾处于危机，

for reasons that are endemic and intertwined,

因为一些特有的、错综复杂的原因，

任何一个熟悉这里的人都能想到原因：

and anyone familiar with the neighborhood can think of why:

racial disparities,

种族差异、

failure of local and federal government to properly fund schools,

当地以及联邦政府 未能合理筹资修建学校、

lack of economic opportunity.

缺乏经济发展机会。

And what we're trying to do at McPherson

而我们试图在麦克弗森做的

is find ways to support this community out of crisis.

就是设法帮助社区脱离困境。

And perhaps now, because of the epidemic,

也许现在，因为毒品盛行，

more people are paying attention to Kensington.

越来越多的人正在关注肯辛顿。

But regardless of that,

但不管怎么样，

at McPherson,

在麦克弗森，

we will continue to do what we can with the resources we have

我们将继续利用现有资源 做力所能及的事

and we will continue to provide whatever help we can

也将继续提供 任何我们能提供的帮助，

in hopes of keeping our community safe and healthy

希望以此保持我们的社区平安、健康，

because public libraries have always been more than just books.

因为一直以来， 公共图书馆不仅仅只是与书有关，

We are physical shelter,

我们还是一个实实在在的收容所、

a classroom,

一间教室，

a safe haven,

一个安全的避风港、

a lunch room,

一间午餐室、

a resource hub

一个资源中心、

and yes,

并且是的，

even a lifeline.

甚至还是一条生命线。

Thank you.

谢谢。

(Applause)

（鼓掌）