Bella Rivera ’20 discerns the impact of social, genetic, and environmental factors surrounding drug use at Blue Mountain Heart to Heart in Walla Walla, WA

Every two years, the state of Washington does a public health survey through syringe service programs. As an intern at Blue Mountain Heart to Heart, part of my job is to do these surveys with people who come through the exchange. One of the questions on the survey reads: “How old were you the very first time you injected any drug?” I remember reading this question aloud to someone and hearing an answer I did not think was possible. “Wait, sorry I didn’t get that,” I had to clarify. And then he repeated, “Nine years old.”

My name is Bella Rivera and I’ll be a senior at Whitman this fall. I have been passionate about health and social justice since arriving at Whitman, and I’ve been lucky enough to capture these interests through the creation of my own major in global health. My internship this summer at Heart to Heart has taken me out of the abstract, theoretical realm of my studies, and instead brought me into the real world of providing healthcare services to underserved populations.

Heart to Heart is a non-profit based in Walla Walla that works to prevent HIV and Hep-C among the communities of Southeast Washington. This is done through wraparound case management for individuals living with HIV, free HIV and Hep-C testing, multiple syringe exchange sites, and a new medication assisted treatment program for people with Opioid Use Disorder – among many other services.

As an intern for Heart to Heart, one of my main jobs is to work the syringe exchange at our Walla Walla office. This means I assist people who come in to exchange dirty needles for clean ones, along with all the supplies needed to shoot up safely: waters, alcohol pads, cookers, band-aids, etc. The people who use the syringe exchange are not always PWIDs (people who inject drugs) but may also simply be concerned family members or friends.

Interactions with clients through the syringe exchange have challenged my preconceptions and understanding of drug use, but more importantly, they have reconfigured my perception of this town. After the survey with the exchanger who said he first injected at 9, I went to tell someone else in the office about his answer. Raul, who has worked with Heart to Heart for over 20 years, asked me, “Well, what were your expectations?”

In truth, I expected that people are not introduced to drugs until at least their teenage years. I know the choice to use drugs is often influenced by environmental, social, and genetic factors. But in truth, these facts existed for me in a world separate from my own life. The reality is, these issues exist in my town, among my neighbors, and even among my family. However, it took these conversations with exchangers for me to see that this should not be such a distant, invisible issue. There are real things we can do to help people, and Heart to Heart is doing just that.

A big theme I’ve been learning here is how little I know about drug use. Many people might say that’s a good thing, but I disagree. From my experiences, stigmatization around injection drug use often stems from ignorance, which transforms into assumptive and disrespectful behavior. We are often quick to classify injection drug use as a choice, especially in our individualized society. But something my supervisor, Everett, first told me when I started at Heart to Heart, was that I would discover how people doing heroin generally do not want to be doing heroin. It turns out, he’s right.

I cannot fathom what it would take for a nine-year-old boy to decide to inject drugs. Can you even call it a decision if someone is too young to fully understand the consequences of drug use? Injection drug use is a complex issue, and moreover, it is a societal issue. It is only right that it is treated as such, and it is amazing to see how Heart to Heart is accomplishing just that. I am honored to be working with this incredible organization that manages to provide valuable health services to people that are too often forgotten in our community.


Experiences like Bella Rivera’s are made possible by the Whitman Internship Grant, which provides funding for students to participate in unpaid internships at both for-profit and non-profit organizations. To learn how you could secure a Whitman Internship Grant or host a Whitman intern at your organization, click here or contact Assistant Director for Internship Programs Mitzy Rodriguez

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