Many women working as prostitutes in Vancouver's Downtown Eastside have lives so marred by poverty, abuse and violence that they suffer from posttraumatic stress disorder, a public health nurse has testified.
Catherine Astin told the inquiry into the Robert Pickton case on Wednesday that drug addiction among those women is simply an effort to self-medicate their condition, and sex work a way to pay for their habit.
Ms. Astin told the inquiry she has worked with residents of the Downtown Eastside for more than a decade. She painted a dire picture of life for women such as those Mr. Pickton brought back to his farm to murder – several of whom Ms. Astin had met.
She said many of the women she encounters in her work tell of being sexually abused as children and of traumatic childhoods in foster care. They often lived on the streets in their early teens.
Their world is one in which violence – whether rape or assault – is a daily reality, she testified.
"A lot of them use the drugs because they're self-medicating, because nothing else makes them feel better," said Ms. Astin, who works at a program called Sheway, which provides health and social services to pregnant women and mothers in the Downtown Eastside.
"The women didn't really have an education that would allow them to access work. They had a history of posttraumatic stress disorder, and the first time they used the drugs they're addicted to, it made them feel better."
The hearings are looking at the failure of police and prosecutors to stop Mr. Pickton before his arrest in 2002, but the first set of witnesses has dealt with the broader social issues facing women living in the Downtown Eastside, from drug addiction and poverty to Canada's prostitution laws.
Ms. Astin, who worked as a street nurse from 1997 to 2005 before joining Sheway, said women in the troubled neighbourhood ply their trade in isolated back streets, which she described as dark, gloomy and "Dickensian."
When they are finished, they return to low-income housing. Some are in and out of jail.
"Would you agree that the women from the Downtown Eastside involved in the sex trade with whom you dealt were living in the most inhumane, squalid conditions?" asked Cameron Ward, a lawyer who represents the families of 18 of Mr. Pickton's victims.
"For the most part, I would say yes," Ms. Astin replied.
Ms. Astin said the women were afraid of law enforcement and didn't see the point of contacting police if they were attacked.
Ms. Astin had encountered several of the missing women linked to Mr. Pickton's farm in Port Coquitlam, although she couldn't recall ever hearing about Mr. Pickton or his property before the serial killer's arrest in 2002.
Ms. Astin said she and other workers in the Downtown Eastside noticed women were disappearing, although she admitted she never contacted police.
Some of the staff got in touch with the coroner's office, she said.
She said she had vivid memories of Sereena Abotsway, with whom she had regular contact with until she disappeared in August, 2001.
"Sereena had been on the streets a long time. She was just lovely, she was a very kind-hearted, playful person," Ms. Astin said.
"She just disappeared. She didn't fade away; she was there one minute and she was gone. It was quite dramatic."
Thomas Kerr, a researcher with the BC Centre for Excellence in HIV/AIDS, agreed that using drugs on the street can push women and girls into prostitution.
He cited a study in which 63 per cent of sex workers surveyed said they would give up prostitution if they didn't need the money for drugs.
"Because people are often in need of a means to survive and generate money, and because they are already entrenched into the local drug scene, they avail themselves of the methods of generating income that are most available," Mr. Kerr told the inquiry. "For many, that includes sex work or drug dealing."
Wednesday was the 10th anniversary of the day Diane Rock vanished from the Downtown Eastside. Mr. Pickton was charged with her death, but her case was among 20 that were dropped after Mr. Pickton's six second-degree murder convictions were upheld.
Ms. Rock's sister, Lillian Beaudoin, was in the hearing room wearing a T-shirt emblazoned with Ms. Rock's photograph.
"Ten years is a long time to sit there and wait to be hearing what we're hearing now," Ms. Beaudoin, who has been attending the inquiry with her husband, said in an interview.
"It's just devastating, and hearing all these facts is horrible."
Ms. Beaudoin is expected to testify next week.
Mr. Pickton was arrested in 2002, setting off a massive search of his sprawling farm, where investigators found the remains or DNA of 33 women. He was eventually convicted of six counts of second-degree murder, but claimed to have killed 49.
Commissioner Wally Oppal is also conducting less formal hearings known as a study commission to examine broader issues surrounding missing women, including the so-called Highway of Tears in northern B.C.