harm reduction program sensitization to harm reduction (tanzanie)

Presentation 4 « The organization of the administration of thedistrict and police Services and their relation with the IDUs”, Dr.Mashombo Mkamba, Health Research Coordinator/Municipal Directorrepresentative Temeke district CouncilPresentation was about- Probable factors leading to drug use- Handling of drug abuse crisis at municipal level- Challenges caused by drug use- Way forward for drug useAfter all those presentations, a film was shown, which describes the real life of drug users,especially those who are injecting, how they inject drug in their body, what they feel andexpress concerning their life as injecting drug users, what challenges they face in thecommunity and support they need in their life as drug users.Presentation 5 « The police and Injecting Drug Users in Temekeregion”, Mr Misime, Regional Police Commissioner at Temeke Zone.Before starting presented his presentation, RPC congratulated MdM for its program whichwill serve most of IDUs in Temeke district because it is a leading region for drug users, andthe most affected people are youth who shall support the production of the nation.Presentation was about- Causes of drug use- How polices handle drug addicts or user.Questions after presentationi. How are outreach workers able to reach easily drug users in their camps, discusswith them avoiding drug users running away?ii. How can police control corruption to drug dealers?iii. As a police station when drug luggage caught, is it taken to chemist for check upand testing in order to know which kind of drug?iv. Why do policemen treat drug users as a criminal? Which punishment?v. Policemen always use law when a drug user is caught, but as the police when doyou use law and counseling with drug user?Comments and answersThere should be a special department at police station that deals with drugs.We have to work cooperative in each organization in order to combat drugproblem.Immigration officers at country borders have to work seriously with drug dealers.Everybody should be responsible to fight against drug use.

Drugs when caught, are tested with kits that identify what kind of drugs can beheroin, marijuana or cocaine or can be sent to general chemist for checking.Presentation 6 « Drug Abuse and HIV/AIDS”, Mr Alpher Kiloti,TAYOHAG (Tandiaka Youth Handcraft Group)Presentation was about History of TAYOHAG and its activities in the community at TandikaWard.Questions after presentationi. How TAYOHAG can work together with MdM without any conflict that might rise inorder to serve IDUs?ii. Is your program (TAYOHAG) reaching to schools in order to educate pupils?Because most of them starting while at school.iii. How does Temeke hospital try to provide services to IDUs without stigma?iv. How does FHI support TAYOHAG and in which areas?v. Are IDUs telling outreach workers who/ and where they get drugs? Becauseoutreach workers can reach them easily.vi. What plan TAYOHAG may have to show the film to the community in order tosensitize the parents?vii. What makes you as TAYOHAG to deal with drug users?Comments and answersTAYOHAG deals with drug users because, most of TAYOHAG workers were drugusers before and got enough education on drugs , that’s why they decided to initiatethe organization that will help their fellow youths who are drug users to quit fromusing drugs.MdM may help TAYOHAG in preventing HIV transmission to IDUs by providing kitsfor IDUs and educate to treat abscesses, counseling.Some of the schools in Temeke district have been sensitized on drugs by TAYOHAGbut not all.IDUs get syringes from medical shops and or sometimes they reuse a syringe.TAYOHAG sometime conduct sensitization campaign in the community bycooperating with different NGOs. For example, they did sensitization campaign withUMATI at Sandale ward were also there was VCT services provided.Helping the community/parents: some parents bring their children who are drugaddicted at TAYOHAG center for more.No official partnership between MdM and TAYOHAG, but later MdM will see how andwhere they will help TAYOHAG.Presentation 7 ” The Community and Drug Abuse”, Mr Salum M.Mapande, POVERTY FIGHTER,Presentation was about

- Poverty Fighter history and Collaboration with other NGO within Temeke District onDrug Abuse,- Poverty Fighter Activities in the community and Challenges facing the Organization.Comments Small NGOs should have a system of preparing a report monthly or at leastquarterly in order municipal council could get actual data. Small NGOs don’t have a system of recording or keeping data of what they areworking on. So they should be helped on that.Presentation 8 “Introduction of MdM”, Dr Patrick Beauverie, MdMFrance.Presentation was about How MdM implements different programs around the world.A film was shown. Dr Beauverie also described how Harm Reduction program started inFrance, the challenges it faced and how drug users reacted during the initiation processes ofthe program.Thereafter, Dr. Patrick Beauverie carried on presenting about;- When MdM started until this year 2010.- Successes of MdM like needle exchange program (more organization started toimplement needle exchange program), how they initiated non and mobile servicesclinic to IDUs and forgotten people.According to Dr. Patrick Beauverie presentation, MdM;- Goes where others don’t go to provide health services.- Acts where there is nothing or not enough in regards to harm reduction or communityhealth.- Intervenes with and towards drug users as closely as responsible to production ortrafficking areas.- Testifies the importance of social and economical disruptions on the emergence ofnew practices.Presentation 9 “The Project in Serbia”, Celine Debaulieu, ProgramCoordinator, MdM Tanzania.Presentation was about- MdM project in Serbia since 2002 (until now 1600 beneficiaries came to the programfrom which 20% are women).- Staffs were mixed team like IDUs, active IDUs and nurses.- Outreach activities (Mobile Unit) and fixed place (Drop in Centre)- Provision of medical care, HIV and hepatitis testing, referrals to health care services.- 25% of the beneficiaries came were Roma people.

- Implementation of opiates substitution therapy was done.- At the end of the program, the program was handed over to a local NGO.Presentation 10 “MdM in Tanzania: 17 years in Kagera region”,Stéphanie Derozier, Desk Officer, MdM FrancePresentation was about programs MdM has been implementing for 17 years in TanzaniaPresentation 11 “MdM in Temeke District”, Dr Fatima Assouab,Responsible of Mission, MdM FrancePresentation was about- MdM wishes to focus on Most at Risks Population (MARPS) because the epidemic ofHIV/AIDS risks associated with injection drug use requires innovative HIV preventionprogram.- Objectives of the program are NSEP, condom distribution, IEC, VCT, Vaccination,and hepatitis services.- Activities which will be done by the program are HIV testing and counseling to IDUs,referral services to HIV treatment and care, training of personnel at referralinstitutions, and training IDUs to be peer educators.- Working with partners who are national authorities, MOHSW, drug controlcommission, TACAIDS, local authorities, local NGOs, TAYOHAG, POVERTYFIGHTERS, and UN agencies.QUESTIONS AFTER THE 3 PRESENTATIONSi. In Serbia and Afghanistan MdM worked on HR in reducing HIV infection among IDUsand succeeded, in Tanzania there is a critical law to drug users, how MdM will help tomoderate it in order to serve drug users?ii. In your program (MdM) we saw you integrated different partners, how did youcooperate with police and in Tanzania how will you work with police because they arefeared by drug users?iii. Why did MdM decide to implement its HR program in Temeke district and not otherparts of Tanzania?iv. What is the meaning of “Medecins Du Monde”?v. What plans does MdM have to employ local medical doctors because there areothers who know both Kiswahili and English languages?COMMENTS AND ANSWERS When there will be another workshop, MdM should not forget to invite court peoplebecause they are the ones who enforce laws and judge mistakes. MdM doesn’t have data on how many people use drugs in Tanzania, only has accessto published studies.

There should be a seminar for all police commissioners on how MdM can cooperatewith them on HR program.In Morocco country, MdM outreach workers entered in the community, met with localleaders and discuss with them on how they will fight against drug use.Temeke district selected because, MdM planned to work with all Dar es Salaamregion but other districts are to be covered by other NGOs.B. DAY 2Film Presentation “Fix”, Céline Debaulieu, Program Coordinator,MdM Tanzania.- The film was about introduction to Harm Reduction in Canada, in Vancouver City. Themain objective of the film was to share experience and knowledge on advocating forHarm Reduction program.- The film ‘Fix’ is the story of an addicted city and how IDUs advocated for HarmReduction program. It also shared how they faced some obstacles during initiation ofthe program.Discussion and questionsi. Was Mr. Dean able to quit from drug use?ii. For Vancouver city most of people are literate, will it be possible for Temeke people tounderstand and accept about NSEP for safe injection program?iii. After safe injection center opened in Vancouver city, how much HIV infection wasreduced?iv. What measure did Vancouver government take for safe injection center?v. Would NSEP not be a way of motivating more people to use drugs?Comments and Answers If the community will be sensitized on safe injection program, Temeke people willunderstand the program because it is not a matter of literacy but education andinformation. HR program will be favorable for our country according to the laws and culture of thepeople. If drop in center will be opened at MdM office, not any drug will be given or providedto drug users who will come there for services. MdM Tanzania will not provide methadone at DIC but it will be provided in the hospitalidentified by trained and professional medical doctors as per other stakeholder’splans. There should be syringes provided to IDUs so that they don’t reuse syringes

Group Work Harm ReductionAfter the discussion, participants divided into four groups where by they did group work andanswered some question concerning Harm Reduction program and later each grouppresented its work.Group 1Questions:- What are the effects of syringe sharing?- What is the importance of providing education to IDUs?- What do you think will be the obstacles for Harm Reduction program, obstacles toinitiate HR and comments to overcome obstacles?Answers:- Q1 Infection of different diseases like HIV, Hepatitis and abscess- Q2 Increase knowledge for Drug users Will minimize the cost of caring for infected person to the government will increase manpower- Q3 Misconception of the drug Level of understanding Resistance to change to most of human-being Tanzania laws on drugs Stigmatization of drug users in the community. Resistance from drug users. Lack of professional staff to the program No policies to support harm reduction program No working tools.Comments from Q3: Enough education should be provided from the grass root people Engagement of all stakeholders in the community – e.g . Religious Leaders Drop in centre should be opened in all program sites.Group 2Questions:- What is methadone?- What are the obstacles might rise to initiate methadone?- Recommend on methadone.Answers:- Q1 Is a medicine- Q2 Lack of understanding among the community- Q3 Mobilization and sensitization on the importance of methadone Increase the number of professional with substance use knowledge.

Group 3Questions:- Who is peer educator?- Mention role of peer educator?- What topics that PE should be taught?Answers:- Q1- Q2- Q3Peer educator is a person who provides education to the people of his or her sameage whom they share culture, environment and level of education.To provide education in his/her communityTo sensitize/mobilize his peer in different issues e.g. health and environmentalissues, culture etc.Life skillsHIV/AIDS and STIsDrug AbuseReproductive healthGroup 4Questions:- Mention stakeholders and their responsibilities to IDUs.Answers: Hospitals, health centres and dispensarieso Make treatment available and accessible to IDUso HIV and hepatitis testingo Guidance and counseling to IDUs NGOs, FBOs and CBOso Community sensitization on drugs harm and effectso Guidance and counselingo Referral of IDUs to other serviceso Identification of IDUs Local Government Authorities and Central Governmento Identification of IDUs in their communityo Sensitization to the community on drug harmo Referral of IDUs to other services Communityo Guidance and care to their childreno Campaign against stigmatization to IDUso Referral of IDUs to other services.Recommendations1. Create networking with other NGOs that deal with drugs2. Stakeholders quarterly regular meetings in order to share experiences, knowledge ondrugs users and sometimes to avoid elapse services

3. Ward offices should get a report from each NGO within his/her ward,4. Information sharing among NGOs for updating each other in different issues arise.5. To have a same referral form for further servicesENDING WORKSHOPAt the end of workshop, MdM team thanked the participants of the workshop and advisedthem to send a message and share knowledge and experience on what they learnt from theworkshop to other people who were not able to attend the workshop.Also the chairman of the workshop. Dr. Mashombo Mkamba insisted that participants shallbe cooperative when the program starts, share experience with MdM on how they could workand help the community to understand about Harm Reduction program and its objective intheir community.It was stated that Needle exchange program could greatly help Tanzania because it is costefficient and would prevent new infection and thus decrease in ARV treatment budget.This workshop has been the first one on the list of the numerous next workshops to come inthe future of MdM’s program in Temeke. For any further information, you are welcome in:MDM OFFICE IN DAR ES SALAMMdM, opposite soko la maguruwe, Tandika, TemekePO box 105948LIST OF DOCUMENTS DISTRIBUTED- Definition on Harm Reduction- Substance Use and HIV/AIDS in Tanzania