Framework

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Dr. Marc Lasher, who runs the Fresno Free Clinic, leans out the window of his converted school bus to confer with a colleague. Fresno Needle Exchange and the Fresno Free Clinic operate out of a converted school bus every Saturday.

PHOTOGRAPH BY: Michael Robinson Chavez / Los Angeles Times

Gay Uvina, who was a longtime heroin user, has been clean for over a year. She now picks up needles for those that are too afraid to come to the exchange. Uvina credits Dr. Marc Lasher and the Fresno Free Clinic with saving her life on multiple occasions. She receives a bag of clean needles outside the converted school bus that the clinic uses to treat patients.

PHOTOGRAPH BY: Michael Robinson Chavez / Los Angeles Times

Fresno Needle Exchange and the Fresno Free Clinic operate out of a converted school bus every Saturday. Fresno County, despite staggeringly high rates of intravenous drug use, is a lone holdout opposing free needle exchanges to prevent disease transmission. This leaves a small group of defiant activists to provide the service incognito. Dr. Marc Lasher sees patients in his converted school bus and is assisted by pre-med students, many from Fresno State University like Megan Zwetsloot, center.

PHOTOGRAPH BY: Michael Robinson Chavez / Los Angeles Times

Dr. Marc Lasher, left, drains an absesce on the arm of Marti Clark. Clark had been clean for over a year and then used heroin again during the last week. Absesces are common occurrences amongst intravenous drug users.

PHOTOGRAPH BY: Michael Robinson Chavez / Los Angeles Times

Pre-med student Megan Zwetsloot, left, administers a hepatitis A shot to a patient.

PHOTOGRAPH BY: Michael Robinson Chavez / Los Angeles Times

Thousands of needles are dumped each Saturday.

PHOTOGRAPH BY: Michael Robinson Chavez / Los Angeles Times

Dr. Marc Lasher and his group of volunteers ready the converted school bus for patients prior to the opening of the mobile clinic.

PHOTOGRAPH BY: Michael Robinson Chavez / Los Angeles Times

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Fresno’s underground needle exchange program

Fresno has one of the highest per-capita rates of intravenous drug use in the country and its rates of needle-contracted AIDS and hepatitis C are climbing. Public health experts agree that needle exchanges — services that collect dirty syringes and supply clean ones to addicts – curb disease, and they have been permitted in San Francisco, Los Angeles and cities throughout the country for years.

With state officials scrambling to rein in rates of new hepatitis C infections, the public-health response to the Fresno County supervisors most recent ‘no’ vote was “a sense of ‘you’ve got to be kidding,’” said Meghan Ralston, a Los Angeles coordinator for Drug Policy Alliance.

But one place where the board’s actions produced barely a shrug was at Fresno’s outlaw needle exchange.

In an isolated cul-de-sac on a recent Saturday afternoon Dr. Marc Lasher and a small band of once-again renegade volunteers were collecting dirty needles, doling out clean ones and providing medical care from a yellow school bus — the same way they have for 15 years.

Read Diana Marcum’s story

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