Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
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Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
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Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
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Uganda Harm Reduction Network (UHRN) and IDPC visit to progressive harm reduction services in Dar es Salaam, Tanzania.
Uganda harm reduction is member of Global Network of Sex Work Projects (NSWP) exists to uphold the voice of sex workers globally and connect regional networks advocating for the rights of female, male, and transgender sex workers. It advocates for rights based health and social services, freedom from abuse and discrimination, and self determination for sex workers.
Uganda Harm Reduction Network conduct study visit to Tanzania
In November 2012, the Uganda Harm Reduction Network (UHRN) sent a delegation of three staff to visit the progressive harm reduction services in Dar es Salaam, Tanzania. The study visit was coordinated and funded by the International Drug Policy Consortium (IDPC) and Harm Reduction International (HRI) as part of the on-going network development in Africa. Two IDPC staff also took part in the visit.
We first visited the state-run methadone programme, housed in the Psychiatric Department of the Muhimbura Hospital in the north of the city. There are nearly 600 clients in this pilot programme and the uptake is growing exponentially. All clients are referred by NGO outreach workers. Upon registration, they provide photos and finger prints for their identity cards and are then assessed by doctors, social workers, psychologists and a psychiatric nurse – providing a comprehensive examination of general health, mental health, drug use (confirmed via urine tests), legal issues, social issues, and support networks. Clients are also regularly tested for HIV, tuberculosis and hepatitis, and the service has naloxone available in case of any overdoses. However, the service only enrols people who inject drugs, and there have been reports of clients beginning to inject just to access the programme.
One key feature of the methadone programme was the integration of occupational therapy in order to help clients transition out of the programme and into work. This also helps reduce the stigma associated with drug use and the clients under methadone. Many clients were engaged in gardening work on the grounds of the hospital, and have helped make the whole facility look beautiful – this has, in turn, helped to change people’s perceptions of the programme itself. Other clients assist with painting and bed-making as part of this programme.
We then visited one of the community-based outreach NGOs that refer clients into the methadone programme – an organisation called Youth Volunteers Against Risky Behaviours (YOVARIBE). This team of outreach workers operate as part of the US-funded Tanzania AIDS Prevention Programme (TAPP). They provide information and support across one area of the city, reaching people who use drugs, sex workers and men who have sex with men, and also work with the broader community to reduce stigma. YOVARIBE also has a social worker who works closely with the methadone programme to assess, support and prepare the 50 clients that they have referred to the hospital.
Finally, we visited a drop-in centre and needle and syringe programme in the Temeke District, operated by Médecins du Monde . The Temeke District is one of the most affected areas of Dar es Salaam in terms of poverty and drug use. Following a situation assessment conducted in 2011, they opened their service to fill an identified gap for harm reduction services – although they do not currently provide opioid substitution therapy, but refer clients into the existing hospital programme. They have a team of outreach workers, peer support workers, nurses and psychologists, and have also provided sensitisation training to around 150 police officers in the city. They have a well-resourced drop-in centre and office building, but also operate an outreach bus which travels across this vast District to provide harm reduction services to people who use drugs. They also work with clients on films and music videos to help reduce stigma, and provide basic services such as showers, food, laundry facilities and a comprehensive package of support (clean needles, condoms, sterile water, etc.).
The study visit was deemed a big success by UHRN staff, who learned a lot about how these programmes operate, the challenges and benefits that they create, and the importance of fully engaging people who use drugs in service delivery and design (read the UHRN report on the visit ). The challenge now is to advocate for similar services to begin in Uganda, where the government has thus far been much less supportive of this life-saving work.
Jamie Bridge, IDPC Policy and Operations Manager
Wamala Twaibu, Uganda Harm Reduction Network
For more information, please visit the IDPC website .
Human Rights and Advocacy
We advocate against human rights abuses committed in the name of drug control and promote the full realization of the human rights of people who use drugs and those affected by drug use, the drug trade and drug policies. Our vision of a human rights-based approach to drug policies is based on ethical, legal and public health grounds.
From an ethical perspective, no one should be denied their human rights due to drug use, drug dependence or because they have been convicted of a crime. Our work is about the reduction of drug related harms without judgment and with respect for the inherent dignity of everyone, regardless of whether they use drugs (licit or illicit).
We promote the application of international human rights law to drug policies and for the interpretation and implementation of the international drug conventions in full compliance with international human rights law. Human rights law serves as a counter-balance to international and national drug control laws that can and do act as barriers to the reduction of drug related harm and to the realization of the rights of people who use drugs and affected communities.
Health – HIV/AIDS education and prevention
Targeted intervention (TI) project
Objective
· To focus our HIV transmission prevention efforts on the highest-risk groups, namely truckers, workers (SWs), men who have sex with men (MSMs), substance Drug users and intravenous drug users (IDUs)
UHRN has been implementing a comprehensive HIV/AIDS prevention programme through targeted interventions with the mobile population of truckers and their families since 2011 we have been working with injecting drug users; SWs, MSMs, the transgender population and young people.
Services
· Counseling for STDs/HIV/AIDS prevention
· Condom promotion
· Awareness generation regarding STDs/HIV/AIDS through Behavior Change Communication session i.e. One to One and One to Group, Audio visual shows, Street outreaches, Sensitization Programmes and various other methods.
· Counseling for improving couple relationship
· Counseling on issues related with sex and sexuality
· Peer education
· Partner management
· Referral network and linkages with drug demand reduction programs, HIV testing, DOTS and various other care & support services.
Research and capacity building
Objective
· To develop the capacity of the service providers, Drug users who are working in the area of drug demand reduction & HIV/AIDS.
Activities/Services:
· Identification of the training needs, and the provision of this training
· Organization of advocacy networks
· Initiation of the convergence and integration of services for better delivery of services from NGOs and the government
· Region-by-region assessment of the general vulnerability to drug abuse and HIV/AIDS
· Capacity building (in IT, counseling, documentation, etc.)
· Exposure visits to various best-practiced projects in sub-Sahara Africa
· Preparation of training and education materials (like flip charts, resource books, exhibition panels) and translation of this material into regional languages
· Assessment of training needs among and working in the area of drugs and HIV/AIDS in Uganda With this information, UHRN develops and the development of training modules for the capacity building of service
· Monitoring the trends of drug abuse and HIV in the whole Regions of Uganda
· Creation of behavior communications change materials e.g exhibition panels, flip charts, guide book on peer education and communication, Resource books on harm reduction for HIV/AIDS prevention among IDUs and HIV/AIDS & preventive options etc.) On drugs, HIV/AIDS and sexual health issues.
· Exposure visits to various best-practiced projects in the region
· Initiation of the convergence and integration of services for better delivery of services from NGOs and the government.
Responsive rehabilitation services
We recognize that substance abuse is a widespread affliction; the personal, social and economic costs are borne by the individual and the community as a whole. Drug dependency leads to productivity loss, domestic violence, depletion of family resources, increased street crime, etc. To address this menace,
Objective
· To provide a well-formulated de-addiction and rehabilitation program covering motivational counseling, detoxification, sustained rehabilitation, relapse prevention and after-care.
Services
· Psychotherapy, family work and recreational therapy
· Home visits
· Individual/group counseling and family counseling
· Input sessions
· Counseling and de-addiction Places
· Anti-drug film shows
| Activities
· Doctor consultations and referrals to other free medical services · Referrals to ICTC for blood tests · Abscess treatment · Mobile exhibitions, for the sensitization of the local population concerning drug use, STIs and HIV/AIDS · Educational games · Condom education and distribution · Counseling and follow-up visits for drug users · A consistent monitoring program for drug users, to ensure a successful treatment regime
Harm Reduction Education
Harm reduction can be defined as ‘policies, programmes and practices that aim primarily to reduce the adverse health, social and economic consequences of the use of legal and illegal psychoactive drugs without necessarily reducing drug consumption. Harm reduction benefits drug users, their families and the community’. One of the basic principles underlying this approach is that people have always used drugs, and will use drugs, and as such there will never be a drug-free society. Harm reduction accepts that some people who use drugs are often unable or unwilling to stop, and seeks to provide care, support and resources in a non-judgmental environment. The most humane, compassionate and effective approach is therefore to attempt to alleviate the worst of the harms associated with drug use. Harm reduction promotes safer use and options that help to minimize the risks from drug use and of causing harm to themselves or others, without requiring the cessation of use. It is a pragmatic approach that is based in public health and human rights. There is a large and ever growing body of evidence that demonstrates harm reduction as an effective approach for preventing drug related harms including HIV, Hepatitis C, and overdose. In addition to individual benefits, harm reduction interventions also benefit the community, for example by reducing crime. Harm reduction in practice
There are a number of examples of harm reduction in practice. Some interventions include, but are not limited to:
Harm reduction and young people
Despite overwhelming evidence of its effectiveness in reducing drug related harm, harm reduction approaches are yet to be accepted as a viable and effective way to reduce harms among youth. The predominant approach to drug use among young people remains drug prevention, ‘just say no to drugs’ campaigns, forced treatment and law enforcement. UHRN believes a more balanced approach is urgently needed, which involves non-judgmental service provision and which recognizes the need to reduce harms among young people who use drugs |
http://www.ihra.net/files/2012/07/24/GlobalState2012_Web.pdf
In 2008, Harm Reduction International released the Global State of Harm Reduction, a report that mapped responses to drug-related HIV and hepatitis C epidemics around the world for the first time. The report has since been published every two years.
The Global State of Harm Reduction 2012 presents the major developments in harm reduction policy adoption and programme implementation that have occurred since 2010, enabling some assessment of global progress. It also explores several key issues for developing an integrated harm reduction response, such as building effective harm reduction services for women who inject drugs, access to harm reduction services by young people, drug use among men who have sex with men, global progress toward drug decriminalisation and sustainability of services in challenging environments.
This report, and other global state of harm reduction resources, are designed to provide reference tools for a wide range of audiences, such as international donor organisations, multilateral and bilateral agencies, civil society and NGOs, including organisations of people who use drugs, as well as researchers and the media.
