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A rural island's access to health services in the opioid crisis

Though the geography comes with natural struggles, Bowen Island has been employing methods which have held the worst of the opioid crisis at bay
light and fog in the trees

Living on an island brings with it unique challenges in many areas, but perhaps nowhere is the isolation more felt than when medical attention is needed.

This can manifest in both urgent care situations and when basic services are being sought. For small communities such as Bowen Island, at just over 4,200 people, it typically means leaving the island for a doctor or specialist appointment, and certainly a departure in emergency cases, when patients are typically transported to Lions Gate Hospital in North Vancouver.

Regarding the widespread urgent care situation currently gripping the province, the community hasn’t been ravaged by the ongoing drug and opioid crisis to the extent of its mainland neighbours – or even similar sized communities in British Columbia. But local data, including from Vancouver Coastal Health and overdose response calls from Bowen Island Fire Rescue, show that the Metro Vancouver municipality has not been immune to the epidemic. And that can make for an unsettling reality in cases where the response time may need to be in minutes to save somebody’s life.

Nowhere was this more apparent than during last year’s paramedic shortage on the island, including a period in March where dozens of shifts were missed due to staffing issues. “Even one day having that insecurity that it (ambulance service) isn’t on-island, that is really concerning,” said then-councillor Rob Wynen.

Bowen’s volunteer fire department, which responds to medical calls along with paramedics, handled all medical calls during the ambulance absence. The Bowen Responder, a specially outfitted boat used to transport patients to Horseshoe Bay, is operated by local company Cormorant Marine and continued to operate during this period.

While full-time BC Ambulance Service was eventually restored to the island, it was a reminder of the fragile relationship Bowen Island has with many services which are a given on the mainland – despite only being 20 minutes away by ferry.

A transportation service which, as all Islanders know, presents its own challenges. While BC Ferries sailings are not typically used in medical emergencies, the often overloaded, behind schedule, or sometimes outright cancelled trips between Snug Cove and Horseshoe Bay can make booking a specialist appointment in the city an all-day adventure.

But despite the challenges of both going off-island, and delivering services here on Bowen, island options geared toward tackling the crisis are more than might be expected, and cover a range of resources from recovery, to prevention, to life-saving medicine. Some of these have been in operation for years, some are being implemented, and one eagerly-awaited facility is expected to open this fall.  

While Bowen’s remote setting may hamper access at times, it also provides an idyllic opportunity to step away from the distractions and pitfalls of a metropolis like Vancouver. And that’s why venues such as the Orchard Recovery Centre have been able to thrive for more than 30 years. Nestled away on the island, the centre offers longer-term care for people recovering from addiction, with specialized treatment provided for anyone battling drug addiction, including detox programming.

Many more resources will be available to Bowen residents in the coming months with the opening of the Bowen Island Health Centre. In addition to providing on-island professionals such as family doctors and nurses, the centre will also include a patient area where people who have experience a medical episode, such as an overdose, can be treated while waiting for transport to the mainland. While not quite at the level of an emergency room, currently anyone injured on the island has to wait either on-site or in the ambulance until transport can be arranged.

The Health Centre will also be the new home of the Caring Circle, a Bowen organization which provides residents with information on accessing health and social services for a range of issues including drug addiction. This can include placement in local anonymous support groups.

Kids struggling with substance issues have a dedicated outlet as well through the municipality’s Youth Centre. John Stiver is the Youth Services Coordinator and is always willing to take to kids about drug problems (and other issues) in a confidential setting.

Naloxone awareness is also growing on the island, and is now employed by officers of the local RCMP detachment, in addition to firefighters and paramedics. The medicine, also known as Narcan, can counter the effects of an opioid overdose if administered quickly enough. The municipality and other local organizations are also exploring ways to provide more Naloxone training and kits in the community.

The reality of island living, particularly a small one, is a trade-off of services which are more rapidly available in a big city. But in managing a crisis which has reached even the smallest corners of B.C., Bowen has so far been successful in staving off the rampant and wide-spread effects of opioids which have devastated the province, especially the island’s Vancouver neighbours.


This article is part of an in-depth, provincewide journalistic effort by Glacier Media to examine the scope, costs and toll of the opioid and toxic drug crisis in British Columbia – a public health emergency that has taken at least 11,807 lives since 2016. If you or someone you know is in an emergency, call 911. If you need help with substance abuse, call the B.C. government's alcohol and drug information and referral service at 1-800-663-1441. It's available 24 hours a day.