I met two wonderful professional women recently who both are in recovery and they asked me, ‘what do you do and why do you do it?’ I started off by saying, ‘well I’m not actually a nurse, I’m a trained mathematician!’ I explained that I always knew I wanted to do more with the skills and training that I had, and that the archetypal view of a mathematician was never going to be me. I was fortunate in that I met a Scottish Biomathematics Professor, Alastair Woods, and he introduced me to the contribution mathematical modelling can play within epidemiology. This was an area where I could use both my problem solving skills and my need to make a meaningful contribution.
When I met Alastair, the HIV/AIDS crisis had just hit Dublin Ireland and there was a need to look at how possible interventions might impact upon the spread of the epidemic. Ireland was a very different place back in the late 1980’s early 1990’s and condom distribution and needle exchange was unheard of. Ireland had been forewarned about the epidemic from the news coming out of the United States. The community of men who have sex with men were well prepared and prevented an epidemic breaking out amongst the Irish population. However, the people who used drugs were not so well prepared. Treatment options were limited and city centre based. Free needle distribution did not exist and women with children who used drugs were doubly stigmatised, hidden and burdened. Women accessing services were trying to cross the city centre on costly double decker buses with perhaps a baby in a buggy and a toddler balancing on the back.
Fortunately at that time, there was a wonderful group of outreach workers based in the then AIDS clinic in Baggot St. They walked the streets of Dublin, reaching out with low threshold support services for men and women in need of clean needles, condoms and support. It was this team who were instrumental in helping me obtain the data I needed for the mathematical models. Together we designed a very brief survey and captured the lives of people using drugs and what best would help them. Using my models we found that if there was only money for one intervention investment, then investing in needle exchange services would have greater benefit than distributing condoms. My mathematics had made sense and contributed in a practical way to both policy and practice.
Now that I am fortunate enough to be the Professor, I continue today to use my skills to work on practice and policy problems among people who use substances. Recently, one of my doctoral students and I, had the privilege to work with one region in devising their strategic plan for parents who use drugs. An excerpt from one of the women we interviewed is below. When I read this, I know I personally can’t help this lady directly but I can use my skills to help plan the services or practice to support her.
It is ladies like this and the two ladies who prompted this blog who inspire me. You have heard some of my story here is Mary's, she is now 38 and has three children. She is in recovery.
‘I thought I was functioning, I thought you know it was all recreational, and, like obviously my partner, well he’s not my partner now…, it’s all we knew, like we done it all the time through being parents, every time, and my parents didn’t even know what drugs were, so it wasn’t that it came from home, but he had a difficult upbringing so he’d a lot of baggage with him and he, there was domestic violence on his side, and I always thought I was the one to fix him, but uh, no I wasn’t, and I just stayed there for so long, because I wanted, I wanted the family, and I thought you just stay quiet, you take the beatings, you take the abuse, the kids will be ok because I’m ok, and if you don’t show these bruises and this that and the other, but crashed and burned and I couldn’t take any more, and, he couldn’t accept the breakup,…, , so I took more, and drank more, and, but alcohol wouldn’t be my problem, I could always socialise, but it’s just the substances… ‘
Professor Catherine Comiskey will be speaking at iCAAD Dublin on the 29th January