Homelessness, injection drug use and alcohol abuse are taking a huge toll on Aboriginal people in Prince George, British Columbia. The Fire Pit Cultural Centre is attempting to address these determinants of health, and prevent new infections of HIV and hepatitis C, by helping at-risk Aboriginal people reconnect with their culture and understand how the process of colonization has impacted their lives and risk for HIV.

Operated by Positive Living North (an Aboriginal AIDS service organization in Prince George) in partnership with the Central Interior Native Health Society, The Fire Pit is a place where Aboriginal people - and their friends - can gather to learn, share and understand culture, health and community.

«As an Aboriginal person, I recognize that culture needs to be integrated into what we do in terms of HIV prevention,» says Catherine Baylis, coordinator of The Fire Pit. «This project brings the notion of culture and healing to the street level for HIV and hepatitis C prevention.»

According to Ms. Baylis, adult Aboriginal males account for the majority of new HIV infections in Prince George, and injection drug use is the primary mode of transmission. However, injection drug use and unsafe sex practices are also putting other Aboriginal people at risk, especially women and youth.

«By helping people connect with their culture and understand historical processes, we are actively engaging in a process of decolonization and healing. This helps to move people away from risky activities.»

The Fire Pit opened its doors in October 2003 with project funding from the AIDS Community Action Program and the provincial Ministry of Health (In its second year of operation, The Fire Pit was also supported by Public Health Agency's Non-Reserve First Nations, Inuit and Métis Communities HIV/AIDS Project Fund). It is currently open three afternoons a week and is visited by 70 to 80 people a day.

«Because we are working with people who are often homeless, and because poverty is an increasing social reality, The Fire Pit experiences a large need for food,» says Ms. Baylis. «This was not part of the original plan, but the needs of the people who come here drive our services.» In a cultural context, food is considered medicine and part of the healing process. But while food is often what draws people into The Fire Pit, once there they are encouraged to participate in «talking circles» and other cultural activities, such as doing beadwork and making dream catchers.

Being physically located in the same building as the Native Health Centre (which pays a portion of the rent for the drop-in centre) has enabled The Fire Pit to develop strong relationships with the centre's health care professionals.

«In addition to having an HIV counsellor on-site in The Fire Pit, we have access to a drug and alcohol counsellor, a mental health support worker and an outreach nurse through the Native Health Centre,» explains Ms. Baylis. «Physicians from the Native Health Centre are also close at hand, often at a moment's notice. In fact, we see The Fire Pit as being the cultural foundation of primary health care for Aboriginal people in Prince George.»

As a result of its integrated approach to service delivery, The Fire Pit has been able to attract funding from other government departments, including the provincial Ministry of Human Resources. At the federal level, Human Resources and Skills Development Canada contributes to the centre's food budget and helps pay the salary of a nutrition coordinator.

«Other agencies support us in other ways,» says Ms. Baylis. «For example, literacy is a problem for some at-risk people, so we approached the Prince George Friendship Centre to see what could be done about it. In partnership with the Prince George Nechako Aboriginal Employment Training Association, the Friendship Centre has donated three computers to The Fire Pit, each with literacy programs installed.»

The Fire Pit won a 2005 Accolades Award from the British Columbia Persons with AIDS Society for innovative programming in HIV prevention. Its integration of culture, food and health has also attracted attention from other AIDS service organizations.

«It's difficult to measure our immediate impact on HIV prevention,» acknowledges Ms. Baylis, who stresses that non-Aboriginal people at-risk of HIV infection are also welcome at The Fire Pit. «But a measure of our success is that other service providers in the community have deemed The Fire Pit to be an essential health service, and people from other communities are interested in implementing this model.»

For more information on The Fire Pit, visit www.positivelivingnorth.ca.