Outreach Programmes as a harm reduction interventions in · Outreach Programmes as a harm reduction...

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 !