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

譯者: Helen Chang 審譯者: Yanyan Hong

When you walk into your neighborhood public library,

當你走進你附近的公共圖書館時，

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

會期待圖書館員幫你找到 下一本你喜歡的書，

or some accurate information on a topic at interest.

或關於某個主題的準確信息。

You don't probably expect the librarian

你大概不指望圖書館員

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

拿著納洛酮（Narcan） 從參考諮詢服務臺後面跑出來，

ready to revive someone overdosing on heroin or fentanyl.

準備救醒過量使用 海洛因或吩坦尼的人。

But this is happening at some libraries.

但這正發生在一些圖書館裡。

Public libraries have always been about community support

一直以來，公共圖書館 以支持社區為目標，

with all kinds of services and programs

提供各種服務和方案：

from assisting with job seeking efforts

幫助找工作、

to locating resources for voter rights

找選民權利的資源，

to providing free meals to kids and teens even.

甚至提供兒童和青少年免費的餐點。

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

但處於類鴉片和過量危機之間，

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

帶來了新的社區支持急迫感。

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

我任職於費城免費的 麥克弗森廣場圖書館，

It's located in Kensington,

位於費城最低收入社區之一的肯辛頓，

one of the lowest income communities in Philadelphia,

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

與資源和機會隔絕的歷史悠久。

And because of that,

因此，數十年來，

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

它一直是該市毒品貿易 和毒品使用的中心。

And so inside the neighborhood,

位置在社區裡，

our library is nestled inside of a park,

我們的圖書館坐落在一個公園內，

which has unfortunately garnered a reputation

不幸的是公園已廣為人知

for being a place to find and use drugs,

是尋找和使用毒品，

especially heroin,

特別是海洛因的公開場合，

out in the open,

putting us and the community in direct contact

使我們和社區

天天直接接觸到毒品的交易和使用。

with the drug trade and use on a daily basis.

And so inside the library,

所以在圖書館裡

it is routine to see people visibly intoxicated on opioids:

常看到明顯恍神的類鴉片藥物吸毒者，

eyes closing, body swaying slowly.

他們眼睛閉著，身體緩慢搖擺。

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

問他們是否還好成了我的例行公事；

but at the same time remind them

同時還得提醒他們，

if they can't keep their eyes open,

如果他們睜不開眼睛

they have to go.

就必須離開。

It is routine for our volunteer, Teddy,

我們的志願者泰迪

在我們圖書館範圍和整個公園裡，

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

收集數十個丟棄的針頭也是例行公事。

And it is normal for kids to come into the library

常有孩子們進入圖書館

to tell me or our guard, Sterling,

告訴我或我們的守衛斯特林，

that someone is outside using,

有人在外面使用，通常意思是：

which typically means finding someone injecting on our front steps,

看到有人在我們前面的台階上、

benches

長凳上

or near the building,

或圖書館附近注射毒品。

then asking them to move along because kids see them.

我們得要求他們離開， 因為孩子看到他們用毒品了。

And it is normal for the community

社區常看得到處於各式 恍神和退縮狀態的人們，

to see people in various states of intoxication and withdrawal,

to see people buying and selling,

看到人們購買和出售毒品，

and to see people act and react violently.

和看到人們的暴力行為和反應。

I'm not sharing this to sensationalize Kensington.

我說這事不是要讓肯辛頓 聽起來危言聳聽。

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

而是因為這是

不斷努力前進的社區的現實；

that is constantly striving to move forward,

but due to factors like structural racism,

但是由於諸如結構性種族主義、

urban segregation,

城市隔離、

the cyclical nature of poverty,

周期性的貧困和創傷等因素，

of trauma --

the community has inequitable access

導致社區的機會不平等，

to education, health care, employment and more.

諸如受教育、

醫療保健、就業和其他的不平等。

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

當毒品的交易和使用

affects every aspect of life in the neighborhood.

影響到鄰里生活的 每個方面時就會是這樣；

And the opioid epidemic has only amplified that stress.

而鴉片類疫情只會放大這種壓力。

When I was hired by the Free Library in 2013,

在 2013 年免費圖書館雇用我時，

I specifically chose to work at McPherson

我特別選擇在麥克弗森任職，

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

因為我了解在這樣的環境裡長大，

where substance use disorder shapes the everyday,

日常使用毒品所造成的紊亂感覺。

and I wanted to use those personal experiences

我想以個人的經歷

as a guide for my work.

作為工作的指導。

But before I get to that,

但在談那之前，

I want to share what it was like

我想分享在肯辛頓

to witness this epidemic grow in Kensington.

見證這種流行病的增長是什麼樣子。

Like many other communities, we were just not prepared.

像許多其他社區一樣 我們就是還沒準備好。

We began to take notice of IDs we were seeing:

我們開始注意到這樣的景況：

addresses from nearby and upstate counties

先是州北部的附近幾個郡，

and then slowly out-of-state ones.

然後慢慢地有外州的，

People from Arkansas, Ohio, South Carolina, Alabama

來自阿肯色州、俄亥俄州、 南卡羅來納州、阿拉巴馬州的人

coming to Philadelphia for cheap heroin.

來費城購買便宜的海洛因。

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

人們開始在我們的公廁裡 逗留的時間越來越長，

causing us to pay more attention to the restroom

導致我們得更關注洗手間，

than to our daily responsibilities

而不是我們的日常工作責任，

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

因為廁所是使用 剛買的毒品的便利場所。

One day our toilet clogged so badly in the restroom,

有一天我們的廁所馬桶被嚴重堵塞，

we were forced to close our library for two days

使得圖書館被迫關閉了兩天，

because the culprit of the clog was discarded needles.

因為堵塞的罪魁禍首是廢棄的針頭。

For a while prior to that incident,

在事件發生前一段時間，

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

我們一直在尋求在廁所裡 裝個放尖物的容器；

and after that,

在那之後，

the library administration quickly approved installing one

圖書館的管理部門 迅速批准裝了一個，

along with hiring bathroom monitors.

也裝了廁所的監視器。

And as the weather warmed,

隨著天氣變暖，

we struggled to respond.

我們努力因應。

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

人們開始在公園裡露宿幾天、幾週。

You could walk outside on a sunny, warm day

在陽光明媚、溫暖的一天外出散步，

to find multiple groups of people in various states of intoxication

會看到各式各樣恍神的人們，

and children playing in between them.

以及在他們之間穿梭玩耍的孩子。

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

泰迪每個月收集的針頭數急遽增加，

from 100 to 300 to 500 to 800,

從 100 增加到 300、 到 500、到 800，

to over 1,000,

到超過 1,000，

with many found on our front steps and the playground.

發現許多針頭棄置在 我們前面的台階和操場上。

Then there were the overdoses.

還有吸食過量。

So many occurred outside in the park,

很多發生在圖書館外的公園，

some inside the library.

有些發生在圖書館內。

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

我們的守衛斯特林

會花時間進出大樓和整個公園，

and throughout the park,

constantly making sure everyone was safe,

不間斷地確保每個人都安然無恙，

because at times,

因為有時候我們所害怕的

our fear of having someone overdose and die came close.

有人會吸毒過量致死差一點發生了。

One overdose in particular occurred after school,

有次的過量事件發生在放學後，

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

當時圖書館裡滿是孩子、 噪音和騷動。

And in all of that,

就在這一切聲音當中，

we heard the thud from inside the public restroom.

我們聽到了公共洗手間內 有人倒地的聲音。

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

我們打開門時， 發現地板上有個人昏迷不醒。

He was pulled out in plain sight of everyone --

每個人都看得到他被拉出來──

kids, teens, adults, families.

孩子、青少年、成人和家庭。

Someone on staff called 911,

有個圖書館員打電話給 911，

someone else escorted the kids and teens downstairs,

另一個陪著孩子和青少年們下樓，

somebody went to flag down the ambulance in the park.

還有一個去公園指揮救護車。

And the rest of us --

而我們其他人只是等著。

we just waited.

This had become our overdose drill

這已成為我們的過量演習，

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

因為當時我們只能如此。

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

我們等著、看著這個人吸不到氣、

seize up.

痙攣，

He was dying.

他快死了。

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

我不知道你們之中有多少人 目睹過鴉片類藥物的過量使用。

but it's horrific

它真可怕。

because you know the gasping for air,

因為正如你所知，掙扎著要吸到氣、

the loss of color in someone's face,

臉色變蒼白，

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

是這個人生命流逝的倒數計時。

But luckily for this man,

但這個人很幸運，

the ambulance arrived

救護車到了，

and he received a dose of naloxone through injection.

給他注射一劑納洛酮。

And I remember he jolted like he was electrocuted,

我記得他像被觸電一樣震起，

and he pulled the needle out,

他拔出針頭，

and he told the paramedics to back off.

告訴醫務人員退後，

And then he stood up, and he walked out.

然後站起來，走了出去。

And we --

而我們──

we went back to work

我們繼續工作，

because people were still asking for time on the computers,

因為人們仍要求使用電腦，

kids still needed help with their homework

孩子們仍需協助完成作業，

and this was our job --

這是我們的工作、我們的用途。

our purpose.

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

我認為是因為等待 而使我忘不了這件事。

It made me feel helpless.

等待讓我感到無助。

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

那種無助感讓我憶起童年。

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

我出生前父母開始吸食海洛因，

It made our lives chaotic and unstable:

使得我們的生活變得混亂不穩：

promises being made and constantly broken,

許下的諾言不斷地被打破，

their fighting, the weight of their secret --

他們的爭執和秘密的重量，

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

我們秘密的重量

把我們大多的生活 排除在所謂「正常」之外。

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

每當我們被丟在祖父母家時，

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

認為我再也見不照他們的 想法揮之不去。

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

每當我們被留在車裡、 在房子裡、在商店裡，

I'd cry.

我都會哭泣。

And every time I saw those El tracks --

每當我看到那些高架列車── （註：市區載客通勤的高架列車）

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

我去麥克弗森工作 日常搭乘的那些列車──

from the backseat of a car,

在車的後座

I'd be angry,

我都會生氣，

because even kids know

因為即使孩子們也看得出

when their parents are trying to score drugs.

他們的父母正打算要吸毒。

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

我幾近無法控制周圍發生的事情，

that that feeling of helplessness was overwhelming.

那種無助感壓垮了我。

I struggled in school, struggled to read,

我掙扎於學業、讀書之中，

I was prone to anger and depression.

我很容易生氣和沮喪。

When I was 11 years old, I started smoking,

我 11 歲時開始吸煙，

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

不久後導致我自己吸毒和酗酒。

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

那時我相信 父母的過去將會是我的未來。

But eventually both of my parents entered recovery

但最終我的雙親戒毒了，

and maintained recovery from opioid use.

並且一直維持著不再用鴉片類藥物。

And their strength and their commitment

他們的力量和承諾

provided support and stability for me and my siblings,

為我和兄弟姐妹提供了支持和穩定，

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

正是那些個人的經歷 將我帶到麥克弗森。

Choosing to be a librarian

選擇成為圖書館員，

and choosing to be at McPherson

並且選擇在麥克弗森工作，

was me letting go of that feeling of helplessness

讓我摒棄了那種無助的感覺，

and finding ways to be supportive to others.

並且設法幫助別人。

And one way to provide support

一種提供幫助的方法

was learning how to administer Narcan.

是學習如何施用納洛酮。

Public libraries respond to the needs of their communities,

公共圖書館回應社區的需求，

and not knowing how to utilize Narcan

而不知道如何利用納洛酮

was a disservice to the needs of our community.

有損我們社區的需求。

We were on the frontlines

我們站在前線，

and desperately needed access to this lifesaving tool.

急需獲得這種救生的工具。

So finally in late February of 2017,

終於在 2017 年 2 月下旬，

after much advocating,

經過多次倡導之後，

we finally received training from Prevention Point Philadelphia

我們終於接受費城預防點的培訓，

and about a month of so later,

大約一個月後，

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

我首次用納洛酮拯救別人的性命。

It was after school again,

那又是放學後，

and Teddy came into the library

泰迪走進圖書館，

and said someone was overdosing on a front bench.

說前頭的長椅上有人吸毒過量。

Someone on staff called 911 again,

有個館員再次打電話給 911，

and I grabbed the Narcan kit.

我一把拿起納洛酮工具箱。

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

那女人剛 20 歲出頭， 幾乎沒呼吸。

Her friend was frantically slapping her in the face

她的朋友瘋狂地拍打她的臉頰，

in hopes of reviving her.

希望拍醒她。

I administered the Narcan nasally,

我通過她的鼻腔注入納洛酮，

and thankfully she came to.

幸好她醒了過來。

But before the ambulance arrived,

但在救護車到達之前，

she and her friend ran off.

她和她的朋友跑走了。

And when I finally turned around,

當我終於轉身時，

I saw the kids --

看到了那些孩子──

kids that come into the library on a daily basis,

那些每天進圖書館的孩子，

some that I have known for years --

有些我已經認識多年了──

standing on the steps of the building.

站在大樓的台階上。

They saw everything.

他們看到了一切。

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

他們看起來並未 明顯的不安或受到驚嚇，

and so I walked into the building,

於是我返回大樓，

right into our workroom, and I cried.

進入我們的工作室，哭了起來。

I cried partly from the shock of what just happened

我哭的部分原因是剛剛發生的事情，

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

因我未曾想過會拯救任何人的性命；

but I mostly cried because of the kids.

但我更為孩子而哭，

This is their normal.

這是他們的日常所見，

This is the community's normal.

是社區的常態。

This is a catastrophic normal,

這是個災難性的正常情況，

and in that moment,

在那一刻，

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

我被迫再次面對這種 永遠不該是日常的情況，

and as with my childhood,

就像我的童年一樣，

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

當你身處其中，就只能接受它。

The opioid epidemic is not just about those living

鴉片類物質的流行不僅是因為

with opioid use disorder

有鴉片類藥物使用障礙的患者，

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

因為這種流行的範圍

遠超出和這些患者 及其家屬一起生活的範圍，

and their families.

It impacts the entire community.

它影響到整個社區。

Kensington was a community in crisis before this

在這之前肯辛頓 已是個處於危機之中的社區，

for reasons that are endemic and intertwined,

因為地方性和交織性的原因。

and anyone familiar with the neighborhood can think of why:

熟悉鄰里的人可以想到是為什麼：

racial disparities,

種族的差異、

failure of local and federal government to properly fund schools,

地方和聯邦政府沒適當地資助學校、

lack of economic opportunity.

缺乏經濟機會。

And what we're trying to do at McPherson

而我們在麥克弗森嘗試

is find ways to support this community out of crisis.

找方法來幫助社區擺脫危機。

And perhaps now, because of the epidemic,

也許現在由於疫情的影響，

more people are paying attention to Kensington.

更多的人關注肯辛頓。

But regardless of that,

但不管如何，

at McPherson,

在麥克弗森，

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

我們將繼續盡我們所能 利用現有的資源，

and we will continue to provide whatever help we can

我們將繼續提供任何協助，

in hopes of keeping our community safe and healthy

以期保持我們的社區安全和健康，

because public libraries have always been more than just books.

因為一直以來 公共圖書館不僅僅是書籍；

We are physical shelter,

我們是實體的庇護所、

a classroom,

教室、

a safe haven,

安全的避風港、

a lunch room,

午餐室、

a resource hub

資源中心，

and yes,

是的，

even a lifeline.

甚至還是生命線。

Thank you.

謝謝。

(Applause)

（掌聲）