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T
he Sydney Medically Supervised Injecting Centre (MSIC) opened
in 2001 with strong support from both the local residential and
business communities – the result of a constructive dialogue
between relevant stakeholders in the Kings Cross community
more than a decade earlier. This support has continued to
strengthen ever since, despite the significant gentrification of
the area, which has in part occurred as a result of this important public
health initiative.
In October 2010 the New South Wales Parliament passed legislation to lift
the MSIC’s trial status, following several independent service evaluations
demonstrating that it was meeting its service objectives.
As with all successful prevention efforts, the future challenge is to
convince newcomers to the area that this initiative is still needed to maintain
the status quo.
The MSIC is, I believe, a textbook example of engaging vulnerable groups
and the broader communities in which they live to produce a strong public
health outcome while also addressing public order concerns at the local level.
To achieve ‘health for all’, health and social welfare services for vulnerable
populations need to be accessible, acceptable, affordable and equitable as
originally enshrined in the Alma-Ata Declaration of 1978 and now an integral
part of public policy in organisations such as the World Health Organization
(WHO).
A key lesson to be taken away from the MSIC experience was that such a
project needed to be sustainable over time, for the disease prevention and
health promotion efforts associated with it to be effective.
Implicit in any successful public health initiative of this kind is the
appreciation that the issues facing vulnerable populations are often complex.
Inequities in these communities are often entrenched; the chronic relapsing
nature of drug and or alcohol dependence is frequently associated with
instability, which can be compounded by mental health issues, transience and
high mobility, unstable accommodation, involvement in crime and risky sex
work, pending legal issues and time spent in custodial settings.
At the same time it is crucial to recognise the importance of an enduring
and successful coexistence of diverse groups based on the respect of cultural
differences – or better still, communities should be encouraged to embrace
such diversity as part of living in a rich and vibrant modern society.
However, the right to have a sense of community belonging, respect and
inclusiveness should go hand in hand with a sense of social responsibility
towards the community. Vulnerable populations should be considered equal
(full) members of their respective communities rather than just being tolerated,
or even accepted as an act of altruism/charity towards ‘the weak’.
There is also a need to ensure a balance between public health and public
order. While the broader community has to understand the need and support
efforts to achieve good public health, the right to live in a safe and secure
community should also be acknowledged – even if these do not seem pertinent
to certain individuals in that community.
It is also important to delineate real threats to public order from perceived
threats and it is here particularly that law and order authorities have a central
role to play. This is not to say that perceived threats should be ignored.
Instead they need to be addressed in different ways, and also monitored to
18 |
drinkanddrugsnews
| November 2013
Harm reduction |
Consumption rooms
www.drinkanddrugsnews.com
In our October issue,
Philippe Bonnet spoke
passionately about his
campaign for drug
consumption rooms in
the UK (page 17).
Here,
Ingrid van Beek
shares
her experience of overcoming
challenges to establish such
facilities in Australia
A fine