outreach programmes as a harm reduction interventions in · outreach programmes as a harm reduction...
TRANSCRIPT
Outreach Programmes as a harm reduction
interventions in Cracow
Mr. Marek Zygadlo
Director of Monar Krakow, Poland
MONAR Krakow Drugs Project was established in 1993
We have had:
1/ Out Patient Clinic for drug users and their families,
2/ Monar House – rehab center (therapeutic community model)
Out – Patient Clinic in Krakow
Monar House – 40 beds
Now we have
in Krakow also :
Detoxification Center – 15 beds
Shelter
Hostel
In 1995 Mr. Jean-Paul Grund –Director of IHRD - visited our project – with proposal of his support for the needles & syringes exchange (NEP) in Krakow
In 1995 we sent two persons from our staff to Frankfurt for a site visit
Friends from „Drogen Hilfe” –Mr. Urban Veber & Mr. JoschStainmetz showed us their HR activities
In 1996 we set up needle & syringes exchange program in Krakow „Planta Park”
Before we started our work on the street we made:
1/ Training for street workers,
2/ Agreement with police
We made researches:
Really useful in our contacts with City Authorities
“The needle & syringe life”
The comparison of results the research
Q: Do you use somebody's needle or syringe ?
July 96
42%
58%sometimes
never
January '97
12%
88%
sometimes
never
July '96
67%
33% More often
than once
Only once
January '97`
40%
60% More often
than once
Only once
Q: How many times you use the same needle?
July '96
24%
76%
yes
no
January '97
9%
91%
yes
no
Q: Do another persons use from Your needle
and syringe ?
July '96
P: Co robisz z brudna igla ?
97%
3% I throw out it
I keep to
exchangeJanuary '97
12%
88%
I throw out it
I keep to
exchange
Q: What do You do with dirty (used) needle?
Needles & Syringes Exchange
Programs
protect Local Community
Families
& IDU’s
before HIV and HCV infections
Mr. Dan Bigg from Chicago & Mr. Josch Steinmetz from Frankfurt made The Safer Injection GuideAnd Mr. Grzegorz Wodowski from Monar Krakow adopted it in to Polish context
Important question of the quality of life…
Slowly we understand – what HR is?
Work for people undergoing methadone treatment
Close to outreach work existingour Drop-in Center(it is a part of Krakow HR Center)We employing there Clients using methadone
960Number of secondary exchanges
12.000Number of alcohol swabs handed out
7.500Number of injecting water handed out
2.600Number of condoms handed out
36.200 (59%)Number of collected used syringes
61.000Number of syringes handed out
48.500 (56%)Number of collected used needles
86.500 Number of needles handed out
17.000Number of contacts
800Number of clients
Methwork 2005-2006
Any positive change makessense
HR principles
A Harm Reduction approach to the HIV epidemic threat or problem should include all activities among all target groups – undertaken with the aim of harm reduction or risk reduction for persons involved in risky behavior, their families and their community.
This is a philosophy and practical approach to problems, including HIV epidemics - for persons involved in risky behaviourand environments. It is based on several principles:
HR principles
1. Harm Reduction knows that abstention from risky behavior is not always the most important and most suitable manner of helping target groups.
HR principles
2. Harm Reduction helps in identifying situations in which the Client finds him or herself at present.
HR principles
3. Harm Reduction finds that
persons involved in risky
behavior can direct their own
behavior and can changethemselves as well.
HR principles
4. Harm Reduction finds that some types of risky behavior are safer than others.
HR principles
5. Harm Reduction includes Clients in the creation of strategies and of methods of help for themselves.
HR principles
6. Harm Reduction takes into consideration the Client’s environment and circumstances, when planning the maximum benefit for the client, their family and community
HR in practice
IV pillars of HR
Drug Education
Needle exchange (Outreach)
Substitution Treatment
HR Therapy
HR Therapythis is new!
http://www.andrewtatarsky.com/publications/
outreach – work
Good space
to set up & keep
contact
with Clients
IDU in any room = injection room
INJECTION ROOM
Equipment
disinfections
Service for Client
Injection
Cleaning
Before…
Finally we see that:
If you do not know what to do ask to the Client,
If you are specialist –you will „Know – How”
Integrated approach
"The Integrated Approach ( IA)is the philosophy and practice of
help for drug addict persons,
which respect the patient’s rights
and needs, and admit that the patient and his therapist
Integrated approach
- they decide together about range
and speed of a positive changes in
convictions, the attitudes and the
patient's behaviors.
The IA gives the same rights for Drug
Free and Harm Reduction solutions."
(Marek K. Zygadlo)
THANK YOU FOR YOUR KIND ATTENTION !