To celebrate the International Day of the World’s Indigenous Peoples (9 August), we are raising awareness of Indigenous Peoples’ stories of living with viral hepatitis.
To say the life of Sandy-Leo Laframbroise has been eventful is somewhat an understatement. Sandy-Leo’s father is Non-Status Algonquin, and mother is Cree/French and Irish, therefore Sandy-Leo is Metis, one of the First Nations Peoples of Canada. Now aged 58 years, Sandy-Leo is transgender, having transitioned from male to female in the early 1980s. Today, Sandy-Leo identifies as both gender or ‘two-spirited’ since the Matis culture allows both genders to co-exist.
The journey from childhood to maturity was a painful one for Sandy-Leo; childhood was marked by poverty, violence, abuse and drug addiction. As a young boy, Sandy-Leo begin using drugs and entering prostitution, before ending up living on the streets of Montreal.
Assigned male at birth, Sandy-Leo underwent gender reassignment surgery in Montreal in 1981, before moving in with a now-estranged husband. While Sandy-Leo continued with prostitution, the husband sold drugs, and their partying and drug-taking lifestyle was frantic and exposed them to all kinds of risk. When the relationship ended in the late 1980s, Sandy-Leo made the decision to get clean, and sought therapy to overcome drug problems; a move to Vancouver also took place in 1987.
Sandy-Leo also decided it was time to begin a career, becoming a registered psychiatric nurse in 1993, working to help others with their mental health issues. Sandy-Leo secured government funding to launch the “High Risk Project Society”, a drop in centre for transgender people who were HIV positive, and sex trade workers. These communities continue to be the ones that Sandy connects with most, calling them brothers and sisters.
Sandy-Leo’s experience with hepatitis C came most likely after a relapse into injecting drug use in the mid-1990s. One day in 1996, Sandy-Leo’s appearance was so jaundiced, that friends insisted a visit to the doctor was necessary. Sandy-Leo was subsequently diagnosed with hepatitis C. But there is uncertainty over whether the relapse was linked to the hepatitis C infection, because earlier drug use in the 1980s, a blood transfusion during gender reassignment, and a needle stick injury while working as a psychiatric nurse could all have been the cause.
Sandy-Leo was prescribed ribavirin for 3 weeks, which caused unpleasant sickness. However, a visit to a healer resulted in other medicines being recommended along with other behavioural and dietary changes that really helped relieve symptoms. Despite a high RNA hepatitis C viral load during a subsequent test, Sandy-Leo’s most recent hepatitis C test came back completely negative being the blood has been naturally cleared of the infection. This meant Sandy-Leo is one of the lucky 30% or so of patients who can spontaneously clear the infection without treatment. And despite the previous high-risk lifestyle, Sandy-Leo has remained HIV negative. Unfortunately, many of Sandy-Leo’s friends in Vancouver’s transgender community have not been so lucky.
Sandy-Leo is happy to see that the First Nation communities across Canada are opening up and have started to tackle the problem of hepatitis C in an Indigenous healing way, incorporating land-based healing (involving reconnecting with your tribal land) in all aspects of this disease, including research done in a positive way involving Indigenous people in all stages.
Sandy-Leo is happy that new directly acting antiviral (DAA) treatments are available in British Colombia, Canada, and many friends in Vancouver have been successfully treated. “I just wish these new drugs had been available earlier, and why did we have to fight so hard to get the prices down?” Sandy-Leo asks, also emphasising the province of British Colombia must completely rethink its harm reduction strategy, including hepatitis treatment, to reach those most vulnerable. “Even with these new hepatitis treatments, we are not reaching my brothers and sisters who are living on the streets and injecting drugs. These people won’t be able to comply with treatment, because we are not doing enough to help them with their lives. We need to open our minds and understand some people may never quit drug use.
Today, Sandy-Leo is happy and continues to live in the East side of Vancouver, the hub of the city’s drug issues, and doesn’t want to be anywhere else. Sandy-Leo has had breast reduction surgery, comfortable to identify as both genders. Today, the health problems Sandy-Leo faces relate to fatigue, arthritis, and post-traumatic stress disorder. “I’m not sure how my hepatitis C diagnosis may have contributed to any of these problems,” concludes Sandy-Leo. Yet despite everything that has been faced so far in life, Sandy-Leo is facing the future with a smile.