Every other Thursday, Elvis Harry Wilson steps into a windowless bunker of a room that shuts out the traffic noise and open drug dealing in Vancouver's Downtown Eastside. Mr. Wilson is short and nimble at 56, with shaggy grey hair and dark eyes that crinkle when he smiles. He never learned to read, but knows his numbers well enough to join the bingo game that's about to start. The smell of popcorn fills the air as 50 men crowd around the folding tables for a shot at the prize – a $10 Starbucks gift card. But that's not the only reason they are here.

The makeshift bingo hall is the headquarters of the Dudes Club, a health group for men living in one of Canada's poorest postal codes. In the club, men of all ages gather to share a hot meal, get a free haircut and swap stories about topics that make most men shudder: gallstones, erectile dysfunction, sexual abuse.

More than two-thirds of them are indigenous. Like countless other First Nations men, they struggle with poverty, addiction and disease. Across the country, men have left their reserves in search of work, only to find that jobs and social connections are hard to come by in the city.

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Watch How a ‘Dudes Club’ in Vancouver is helping homeless men feel human again 2:33

The unlucky ones wind up in Canada's roughest neighbourhoods, penniless and alone. As they sink into a life of petty crime and substance abuse, or fall ill with diseases such as AIDS and hepatitis C, they abandon their roles as fathers and spouses. They avoid contacting their families, often for years, out of shame. They join the ranks of Canada's "missing" indigenous men.



But here, at the kind of place where men don't hesitate to say, "I love you guys," the Dudes are taking steps to improve their health and turn their lives around.

Now in its sixth year, the program is beginning to spread. It has sparked three satellite groups in British Columbia, and is drawing interest from communities across the country and around the world.

Could male bonding be the key to helping indigenous men heal – or is the club's success rooted in something deeper?

Mr. Wilson lives across the street from the Dudes Club, which is housed in the Vancouver Native Health Society (VNHS), established in 1991 to provide medical and social services to the indigenous community. His room is the size of a walk-in closet, but he counts himself lucky to have snagged a spot at the Orwell, a century-old hotel that has been converted into a housing facility.

He was homeless when he started joking around with the front-door staff. "I nagged at them every day, asking if they had my room ready." He grins. "I love it here."

He has a hot plate, TV, mini-fridge. On the wall above his narrow bed hangs a drawing of a wolf – his father was from the Wolf Clan of the Gitxsan tribe in northern B.C. Beside it is a sketch of his namesake, Elvis Presley. Yes, Elvis is his real name. He whips out his medical card as proof.

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Mr. Wilson started taking part in the club a couple of months before his last time in hospital: Two years ago, after a bender, he tumbled down 18 steps and blacked out for three days. "I was lucky I didn't break my neck."

This time, he did not go back to drinking. "I started taking those antidepressant pills," he says, pausing for a sip of tonight's meal, hamburger soup. Now, he continues, "I don't have no anger for anybody. I talk to people, help them out."

While he credits his doctor for putting him on antidepressants, many of his fellow Dudes members say the meetings have encouraged them to try something new – and to take better care of themselves than they ever have before.

Member Paul Michaud greets a fellow Dude: The program helps the men recapture their inner ‘warrior.’ Rafal Gerszak for The Globe and Mail

Getting help, and giving it

The Dudes Club delivers health care with a healing-circle vibe. Volunteer organizers, including the group's medical director, Paul Gross, offer the meeting every two weeks on a budget of just $15,000 a year. Elders offer guidance and lead prayers in Musqueam, the language of the First Nation whose unceded territory includes Vancouver. Dr. Gross then asks the men to name a health topic they would like to discuss. A team of social workers, physicians and street nurses circulate to answer any questions the men may have between bites of bannock frybread.

The Dudes Club grew out of a 2010 forum at the VNHS that was organized to determine the health needs of men in the area. Those who attended, having learned of the event by word of mouth, identified loneliness and isolation as their top concerns.

"The men wanted this group," Dr. Gross says. "That's why it works." They chose the club's name, which is short for Downtown Urban Knights Defending Equality and Solidarity.

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Having their own group helps men let their guard down – and learn to both give and receive help, says Henry Charles, the club's official elder.

"Here," he says, "the guys don't have to be macho."

Movember money helps

Since joining the group, many of the Dudes have found stable housing, enrolled in detox programs, reconnected with family members on reserves, and sought treatment for medical conditions such as HIV, Dr. Gross says. "Many had not seen a doctor in years."

Researchers at the University of British Columbia are evaluating the program as part of a three-year, $270,000 study financed by Movember Canada, the mustache-powered charity dedicated to men's health. While it would be impossible to prove that the Dudes Club alone has changed men's lives, the researchers have conducted surveys and interviews with 150 of those who have taken part in recent years. Based on this data, they have identified a "dose effect" – the more the men take part, the higher they rate in their confidence to address their own health issues and to support others in need.

One-third of the club is non-native – of Asian and African as well as Caucasian descent. The UBC survey shows that all report their well-being has improved. But the indigenous men express even greater trust in the group's health-care team, and greater motivation to connect with their cultural and spiritual heritage.

The Dudes model is unique, says Barry Lavallee, director of the Centre for Aboriginal Health Education at the University of Manitoba. Health services for indigenous people typically focus on women, says Dr. Lavallee, a physician and member of Manitoba's Saulteaux and Métis communities. "What this program demonstrates is that these men don't want to be ill and, quote-unquote, marginalized."

Tapping into an age-old notion

Indigenous men, especially those who have suffered abuse, tend to avoid such institutions as hospitals and medical clinics, even when they urgently need care, Dr. Gross says.

Two months ago, researchers at the UBC's Okanagan campus released a study examining why indigenous people tend to be wary of Canada's health-care system. Those who had received primary care in the B.C. Interior said they felt they weren't being listened to or believed, and weren't permitted to include traditional healing practices. Health-care buildings even reminded them of residential schools. Instead of seeking medical attention, many suffer in the streets.

In the Downtown Eastside, marginalized residents are dying at eight times the rate of other Canadians, and the majority are indigenous. More often than not, their early deaths are due to treatable conditions such as psychosis and hepatitis C, and not drug overdose, according to a study published last fall in the medical journal BMJ.

The Dudes group bridges two worlds, says Sandy Lambert, an adviser who acts as the group's external liaison. The club draws men to the VNHS walk-in clinic, where care workers can become familiar faces. They also encourage Dudes to take advantage of nearby services that offer support for substance abuse, housing and job training, Mr. Lambert adds, "but we don't force them to do anything."

The Dudes' support team talks about health in terms of the aboriginal medicine wheel, which describes a state of physical, mental, emotional and spiritual balance. Wellness is a powerful concept for indigenous men, with deep roots in their heritage, says Mr. Lambert, a member of the Tallcree First Nation in Northern Alberta. At the Dudes Club, "men seem to understand that."

Richard Teague, a club facilitator, polishes off an ice cream sandwich. Rafal Gerszak for The Globe and Mail

Won't 'victimize myself again'

Dudes meetings have a laid-back feel, but there are ground rules: no intoxication and no weapons allowed. What happens here, stays here, says Richard Teague, one of the group's facilitators. "And we don't want to hear no discrimination or snide remarks about the colour of your skin."

Tonight, instead of the usual talk about diabetes or flu shots, the Dudes have a guest speaker: Wilfred Sampson, a 58-year-old Gitxsan carver who sells his work in some of Vancouver's finer art galleries.

Mr. Sampson stands up and shares his memory of being pulled out of his mother's arms at the age of 4, "kicking and screaming," and being put into a residential school. He describes his rage as a teenager who wound up an alcoholic in juvenile detention.

It's a familiar story for these men, but they listen, spellbound, especially when he gets to the part about deciding to prove that people who said things like "dirty drunken Indian" were wrong. "I was always stubborn," he says, "so I quit drinking 31 years ago, and I haven't been back to jail."

"Way to go, brother," someone pipes up. Mr. Sampson waits for the clapping to stop. Then he tells the men that wood carving helped him focus on the beauty in the world instead of the abuse he had suffered at home and at school. "I don't want to victimize myself again by thinking of the bad memories."

He pulls out a smooth cedar sculpture shaped like the sun and holds it up with a wide smile. The men move in for a closer look. "That's really good," one of them says. "Awesome, awesome," another chimes in.

After the excitement dies down, Dr. Gross takes the floor. Carving helped Mr. Sampson turn his life around, he says, and then asks: "What gives you a sense of meaning and purpose in your life?"

No one has a ready answer. It's a question that some may never have asked themselves before.

Some of the Dudes Club’s central tenets appear on the back of a T-shirt during a group bingo game. Rafal Gerszak for The Globe and Mail

Alternate model of masculinity

For indigenous men, getting support to think about what they value in life – and what it means to be a man – is a crucial step in healing, says the University of Manitoba's Dr. Lavallee. Spending time with First Nations elders helps to remind them that "warriorship is not what you see in Hollywood," he adds. "The roles are really around family."

Recently, the Dudes put together what Dr. Gross calls a "masculinity flip chart." Under the heading "real man," they wrote: "fierce," "sex god," "master/control." But a second list, labelled "good man," included such ideas as "raising kids," "non-violence," "compassion" and "no fear of emotions."

When aboriginal men reclaim this alternate model of masculinity, there are ripple effects, Dr. Lavallee says. In Canada, nearly half of children under 14 in foster care are indigenous. To reduce those numbers, "we need to not only support mothers," he says, but also "create space for the dads to go back to their ancestral responsibility to care for family."

Many of these men grew up with little experience of family. Elvis Wilson was born on a reserve to alcoholic parents. "Mom and Dad made home brew," he says. "I started drinking at four years old." He developed tuberculosis around the same age, and local authorities took him away. "I don't hardly remember my mother."

Mr. Wilson spent seven years in a residential school in Port Alberni, on Vancouver Island. He lost every word of the Gitxsan language. "They would put soap down your throat when you'd talk it." He got the strap on his hand every day, and says he was sexually assaulted by men who worked at the school.

In 2005, he received $203,000 in compensation for residential-school abuse. He spent $145,000 of it to buy a house in Victoria for his older sister Margie, the only family member who had looked after him on school holidays. "She was having trouble paying her rent."

He had his own struggles. For decades, he abused alcohol and crack cocaine. He had nightmares of people screaming, and frequent thoughts of suicide. He was diagnosed with post-traumatic stress disorder (PTSD). "I had so much hate and anger inside me." One night in 2007, he swallowed 50 sleeping pills. "I almost died."

Today, he says, "I'm proud I'm still alive."

Health by association

David Joseph Hauck also considers himself lucky. The retired construction worker of Cree and Métis descent recently began treatment for hepatitis C, a disease he had ignored for more than a decade while he was using intravenous drugs. "I used to think, 'I'll just die of it.'"

Mr. Hauck, 64, is suave and well-spoken, and wears blue-tinted glasses that give him a hipster look. He also has a Grade 8 education, stopped using street drugs just five years ago, and admits alcohol is still a problem. "I can easily go through a two-litre bottle of cider every day of the week."

Unlike most of the Dudes, he has never lived in the Downtown Eastside; for 12 years, he has rented the same basement apartment in a neighbourhood farther east. But it was through the club that he learned about a hepatitis-C support group that meets on the floor below. This eventually led him to a nearby clinic offering a fully subsidized, $95,000 treatment for the disease.

"It's because of the Dudes Club that I was even in the building."

Members of the Dudes Club form a circle as they conclude a meeting in Vancouver’s Downtown Eastside in October 2015. Rafal Gerszak for The Globe and Mail

Speaking to a global need

The program's three spinoff groups have been running for more than a year in Northern B.C. – in Smithers and nearby Moricetown as well as in Prince George, several hours to the southeast. While they differ slightly (one has younger members; another does not explore a health topic at every meeting), all are showing successes similar to that of the original, says Dr. Gross, who hopes to take the concept national.

At 35, he has worked as a physician in the Downtown Eastside for seven years. His gentle manner and Pierrot-shaped face belie his grit. Although he has two toddlers at home, he has volunteered more than 15 hours a month for the past five years to support the Dudes as they "address their demons," he says.

Now he is working with members to create an online toolkit to help other communities set up similar programs far and wide. The interest is there. Last November, in New Zealand, UBC researchers presented the Dudes model to an international gathering of indigenous leaders.

They were accompanied by Bill Mussell, author of Warrior-Caregivers: Understanding the Challenges and Healing of First Nations Men. He says leaders in New Zealand kept asking for more details about the Dudes Club, because "around the world, very little programming is done that addresses the challenges facing [indigenous] men."

Social connection is the key to the model's success, says Mr. Mussell, also an adviser to the First Peoples Wellness Circle (formerly the Native Mental Health Association of Canada). When indigenous people are disconnected from their cultural identities and languages, he says, "we are totally lost."

For younger men, too

The Dudes Club is not all good times, though. At one meeting, two men in charge of making cheeseburgers grumble in the kitchen. "These facilities aren't big enough," one of them says. "The stove is no good."

Meanwhile, a man in his 20s with a black tuque pulled low to his eyebrows stomps up and down the meeting room. He punches a balloon taped to the wall. Startled, a dog in the room starts barking.

The guy is a regular, says Mr. Teague, the facilitator. "He's always like that, half drunk." Tonight the young man is yelling things like "You fuckin' nigger."

One of the Dudes shuffles over to report him for violating the club's code. "Did you see that shit?" he asks.

Mr. Teague points out that wrestling a man out of the room could damage the club's open-arms reputation. "We've never had to do that, not in five years." He leaves it up to outreach worker Eric Schweig to talk the guy down.

Mr. Schweig volunteers in the neighbourhood in between acting roles, such as that of a corrupt chief on the APTN series Blackstone. Of mixed descent (Inuit, Chippewa, Dene and European), he made his name as Uncas in the 1992 movie version of The Last of the Mohicans. But at 48, with his scruffy jeans and tattooed biceps, he does not stand out here.

The drunk man's father has been dealing drugs for 25 years, Mr. Schweig says. The son is 27, "and he's fucking his life away." People tend to give men like him a wide berth, he adds, "but that's not what they need." Instead, "you get closer."

So, Mr. Schweig walks up to the man and makes small talk, asking about his dad. They chat. He gives him a hug. Before long, the younger man strolls away, stops to pet the dog, and sits down. Later, he gives Mr. Schweig a fist bump as he leaves.

Several weeks later, the lad shows up at another meeting, drunk again. Dudes members caution against talking to him alone. He has a reputation for drinking "rubby" (rubbing alcohol). "It changes you – you get angry, bolder," one man says.

But it turns out that, one on one, "Carl G" – he won't give his full name – likes to chat. He doesn't remember acting up the last time he was here. He loves dogs, rap music. He takes out his phone to play Real Native, a music clip he composed in a friend's studio. "I made the beat, I made the hi-hat."

Mr. Schweig is not related to him, but when he walks by, Carl calls out: "Hey, Uncle, come show me some love real quick."

Carl was a latchkey kid, Mr. Schweig says later. "He's lonely."

Asked why he hangs out in a group of mostly middle-aged men, Carl says simply that "it's a place to go."

But as Mr. Schweig points out, "he keeps coming back."

Dudes Club members pose for a group photograph. Rafal Gerszak/for The Globe and Mail

'We're just like brothers'

David Hauck, the 64-year-old with hep C, has good news. He was nervous the day before, because his doctor's office had left a message for him to call. But when he did, he learned that his viral load for the disease had dropped to zero. "I was so surprised," he says, "I started to cry."

A month later, Mr. Hauck is thinking about his next step. He has been asked to join the steering committee of VANDU (Vancouver and Area Network of Drug Users), a group that works on harm reduction. Since his health has improved, he says, "I'm getting to enjoy the peer role."

He doesn't live nearby, but Mr. Hauck spends most of his time in the Downtown Eastside, checking out local services, reading at the library, and hanging out at the Dudes Club, "because I enjoy the friendships I've made. … Even a high-five to me means a lot."

Mr. Wilson says the bonding is real: "We're just like brothers, all of us." Back when he had nowhere to sleep but a bedbug-infested mattress in a nearby church, other men used to steal from him, he says.

Now, like Mr. Hauck, he runs into friends wherever he goes, whether lining up for a free meal (sausage and eggs are his favourite) or washing windows for $5 an hour at the Life Skills Centre around the corner.

As Mr. Wilson finishes a last bite of an ice-cream sandwich, one of the Dudes starts sweeping the floor. Then, the men gather in a circle, arms linked to shoulders. Dr. Gross thanks everyone who helped tonight.

Mr. Charles, the elder, says a prayer in Musqueam (he is one of only six Musqueam people still fluent in their language). The Dudes lower their heads – the gentle sounds, such as hych'ka (thanks), have meaning to these men even if they don't understand all the words.

Mr. Charles closes the meeting in English. "Take care of each other," he says. "It's cold out there."

Adriana Barton is a Vancouver-based reporter at The Globe and Mail who focuses on health issues.

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