Basic HTML Version
a gender hierarchy in drug-taking, with women’s injecting frequently initiated and
continued by men. Making harm reduction gender sensitive depended on involving
women who use drugs in the political decision-making process, he suggested, using
their expertise to design services and including them on the staff of harm reduction
programmes. On a day-to-day level, women should be encouraged to become more
independent, he said, through education, job-seeking, training and employment.
Claudia Stoicescu told delegates that the HRI report,
The global state of harm
reduction
, gave a comprehensive overview of the risks to women who used drugs,
including guidance on gender-sensitive services. ‘Services should be tailored to the
documented needs of women in different contexts,’ she said, pointing out that
small additions to services could be effective in changing such behaviour as
women’s dependence on their partners.
‘Women who use drugs should always be involved in the design of programmes
to make sure they’re respectful and appropriate,’ she added.
REACHING OUT TO CHILDREN
IN ROMANIA
STOPPING HARM REDUCTION FUNDING SPELLS DISASTER FOR MANY
ROMANIAN CHILDREN
The first harm reduction outreach projects in Romania had begun in 1999, Iona
Tomus told delegates in the
Children, young people and drug use
session. However,
as of June 2013, all funding for harm reduction services in Romania would stop.
The implications were dire, she warned. Figures from 2011 showed that there
were around 17,000 people injecting drugs in Bucharest, and far fewer syringes
than were necessary because of lack of funds. ‘Of course the consequences
appeared immediately,’ she said. ‘In 2010 the HIV rate among people who inject
drugs was 3 per cent. By 2012, it was 31 per cent.’
The problem was particularly acute among younger people, she said,
exacerbated by rising rates of ‘legal high’ use, particularly mephedrone. The age of
initiation could be as young as ten, and rates of equipment sharing were high. ‘In
order to have access to health and social services, however, you need the
permission of parents. It’s the opposite of “Nothing about us, without us” – it’s
“Everything about us, without us”.’
The children using drugs were mostly in Bucharest, she said, and typically had
low levels of education and literacy, as well as behavioural and health problems.
18 |
drinkanddrugsnews
| July 2013
Harm Reduction International |
Vilnius, 2013
www.drinkanddrugsnews.com
EMPOWER WOMEN THROUGH
‘RESPECTFUL’ SERVICES
INVOLVINGWOMEN IN THE DESIGN OF GENDER-SPECIFIC
SERVICES ENCOURAGES POSITIVE BEHAVIOUR CHANGE
‘We have to make sure women can get treatment – we’re empowering them to
fight,’ said Susan Masanja, in a session on developing harm reduction services for
women who use drugs.
The fight was against blood-borne viruses, poverty and stigma in Tanzania, where
injecting drug use was on the increase, more than a third of IDUs had HIV, andwomen
frequently reported violence and rape. The socio-economic condition of many women
who used drugs was poor, she said, with homelessness and lack of income making it
difficult to access harm reduction services. Médecins du Monde’s special focus on
women had been effective in extending outreach, peer educator training andwomen-
only initiatives, resulting in evidence of the first changes in behaviour.
‘We need to extend outreach services to more locations and days a week and
continue income-generating services,’ she said, alongside calling for additional
specialist training for medical personnel. ‘We need to keep spreading harm
reduction and strengthen advocacy.’
Visvanathan Arumugam shared experience from the Chanura Kol project in
Manipur, India. Around 60 per cent of registered female injecting drug users were
engaged in paid sex work, he said, and there were no government-funded targeted
interventions. The project, implemented in three districts in Manipur and funded by
the Elton John AIDS Foundation, provided comprehensive community-based harm
reduction services for women who used drugs, including positive living, education
and lifestyle advice, preventative measures, testing and follow-up services.
The outcomes were positive, with better education, more testing and an
increase in the number of women who had successfully completed detoxification
treatment. The project was ‘the way forward, showing the need for safe spaces for
female injecting drug users and access to harm reduction’, he said.
‘Drug use differs greatly between genders,’ said Vlatko Dekov from Macedonia,
who offered insights on integrating a gendered perspective into harm reduction
programmes. ‘One of the reasons for this is the gender roles in society,’ he said.
‘Men have the decision-making positions and women have more frequent roles in
the private sphere.’
Women tended to be invisible in treatment programmes in the Balkans, he said,
only becoming visible in life-threatening situations such as overdose. There was also
‘We have a lot good practice –
we just need to bring it together...
and fill the many urgent gaps.’
IONA TOMUS
‘Women who use drugs should
always be involved in the design
of programmes...’
CLAUDIA STOICESCU