TORONTO — In filmmaker Elle-Maija Tailfeathers' southern Alberta community of Kainai First Nation, everyone knows someone who has died from an overdose or drug poisoning.
The powerful pain medication fentanyl ravaged the reserve in 2014, resulting in hundreds of deaths since then.
Conventional abstinence-based treatment has not been effective in saving lives, says Tailfeathers, and so the grief-stricken Blackfoot community turned to a harm-reduction strategy in recent years.
As Tailfeathers' documentary "Kimmapiiyipitssini: The Meaning of Empathy" shows, that shift in strategy saved lives, in part through supervised consumption and the Blackfoot practice known as "kimmapiiyipitssini" – pronounced "GEE-maa-bee-bit-sin" and meaning "giving kindness to each other."
Tailfeathers said many on the reserve initially weren't open to the concept of harm reduction, which doesn't necessarily require users to abstain.
Some felt methods such as opioid agonist therapy, which treats addiction through medications, were a form of enabling.
But attitudes started to change when residents saw "an instant shift just in terms of saving lives" through naloxone, a life-saving drug that reverses opioid overdoses, Tailfeathers said.
"There have now been hundreds of people in the community, if not over 1,000, who have been on opioid agonist therapy and have had really positive results," she said in an interview.
"Witnessing the change that exists within individuals, and people being able to see their loved ones do better, I think has shifted attitudes. But it's still something that requires a lot more education. And I'm hoping this film offers an opportunity to educate people who might have misconceptions about about harm reduction and what it is, and that it can take on many forms."
"Kimmapiiyipitssini: The Meaning of Empathy" will debut at the Hot Docs Canadian International Documentary Festival on opening day Thursday. The festival runs through May 9 online at hotdocs.ca.
On Saturday, Tailfeathers will take part in a free, live Hot Docs Q-and-A on Zoom, presented by the doc's co-producer, the National Film Board of Canada.
The Vancouver-based director, producer and writer started the project about five years ago after witnessing the fentanyl crisis unfold in British Columbia and Alberta, the two hardest-hit provinces.
She also heard daily stories about the drug-poisoning epidemic from her mother, Dr. Esther Tailfeathers, a medical doctor on the Kainai reserve and a tireless community harm-reduction advocate.
"My mother is a total force of nature, she doesn't ever stop," said Tailfeathers, who co-directed and co-wrote the acclaimed 2019 film "The Body Remembers When the World Broke Open."
"She is always working for the community and trying to work towards building a better future for everybody."
The filmmaker said she wanted to show the valiant efforts on the front lines and also counteract misrepresentations of the community in the media, where stories have often focused on the tragedy, poverty and trauma.
Cameras capture the recovery journeys of residents including a mother and a couple with substance-abuse disorders and how Dr. Tailfeathers and others, including first responders, employ a holistic approach that involves helping them with their life goals.
The doc also connects the ongoing substance-abuse crisis to the legacy of colonial violence on Blackfoot land.
The filmmaker herself appears in the doc, which also looks at harm-reduction methods used in Vancouver's Downtown Eastside neighbourhood.
Harm reduction strategies can also include safe consumption sites, distribution of clean needles and naloxone.
In Kainai, harm-reduction services have also prescribed the opioid substitute suboxone.
Tailfeathers said she was astutely aware of the power and privilege that comes with being a director navigating such a sensitive subject.
"I consistently asked myself, 'In making this decision, is this going to have a negative impact on this person five or 10 years down the road? Are they going to feel different about the content or material five or 10 years down the road? And how do I implement the idea of kimmapiiyipitssini through the work?'" she said.
"So I thought about kimmapiiyipitssini as harm reduction and also how to implement kimmapiiyipitssini into the filmmaking process. And how do I take care of my community and my participants? How do I do as little harm as possible to my community and participants? Because it is a huge risk to take in telling a story like this."
Tailfeathers said she hopes viewers understand "drug users and alcohol users deserve dignity and respect and deserve to be treated with humanity and compassion."
"And that they also need to be centred in this conversation about how we move forward," Tailfeathers said.
"They are the ones who have the lived experience and the knowledge necessary to know what we're missing and what changes need to happen."
This report by The Canadian Press was first published April 27, 2021.
Victoria Ahearn, The Canadian Press