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6 –
Daily Update
– DAY TWO – Tuesday 21 April 2009
Monday’s
Policing, treatment and rights
session heard about human
rights abuses across the globe. Founder of the Korsang harm
reduction programme in Cambodia, Holly Bradford, described mass
round ups of drug users, sex workers and homeless children in
Phnom Penh last June, which led to 40 of her programme’s clients
being detained at a former Khmer Rouge execution centre.
There were high rates of HIV and hepatitis C among injecting
drug users in Cambodia, and arrests were seriously undermining
harm reduction work, she said. ‘There is little or no healthcare in
detention centres – no medical treatment for HIV, TB or opiate
withdrawal.’ Detainees had also reported beatings and other abuses,
and two clients had died in escape attempts.
There were signs that the Cambodian government was trying to
address the issues, although funding was almost non-existent, she
said. Many detainees had been released, although up to 85 were still
detained – in marginally better conditions – and the centre had had
no access to them despite writing to the government and the UN.
‘Our main concern is that we’ll be raided,’ she said. ‘The police could
come in and round everyone up if they wanted to.’
The project had now set up the Kamp Korsang initiative to offer
drug users a range of services including 24-hour protection,
counselling and overdose treatment. ‘We’ll continue to operate
Kamp Korsang for as long as it takes, for as long as we can raise the
funding and until drug users in Cambodia are treated as human
beings,’ she said.
Meanwhile Robin Pollini of the University of California described
human rights violations against drug users in Tijuana, Mexico, a city on
a major drug trafficking route to the US. Although sterile syringes could
be bought without prescription, people were still arrested for carrying
a syringe, a syringe wrapper or having track marks. ‘These types of
arrests are associated with higher levels of syringe sharing,’ she said.
Research participants reported police demanding money to
avoid jail, as well as beatings, sexual assaults, the burning of
possessions and even shootings. Tijuana was in the grip of a major
feud between drug cartels for control of the city, she said, which had
seen law enforcement officials targeted as well as high levels of
police corruption. ‘This is not to say that all police are corrupt. But
with the targeting of the police by the cartels, and involvement with
the police by the cartels, it’s difficult to get them to engage with
issues of the human rights of drug users.’
‘When the first IHRA conference took place 20 years ago, harm
reduction was seen as the lunatic fringe,’
executive director of IHRA,
Professor Gerry Stimson, told delegates. ‘Now it’s at the centre of drug policy
and it’s those opposed to harm reduction who are at the fringe. Harm reduction
is based in public health and strong evidence for effectiveness, and the
scientific argument has been won.’
There had been significant progress since last year’s conference in Barce-
lona, he said, not least the fact that the US government had at long last
rescinded its opposition to needle exchange. ‘In total, 84 countries now
support – or at least tolerate – harm reduction in policy. But that’s not enough.’
In more than 70 countries drug injectors had no human rights at all, he
stressed, and in other countries programmes were under threat.
Drug users jailed, beaten and shot
Harm reduction comes of age
‘Just as individuals deny their alcohol problems, so
do communities,’
said Ian Newman of the Community
Alcohol Policy Project (CAPP). And when these were
finally acknowledged because of a crisis, the response
was frequently not thought through, he said. Often the
reaction was applying policies used elsewhere,
irrespective of how effective or appropriate.
Alcohol use was increasing in China, but while
western strategies were based on taxes, opening hours,
advertising and age limits, Chinese values focused more
on self-respect, moderation and family. Raising taxes in
China, for example, could lead to more non-commercial
alcohol production, he warned – the challenge was to
avoid denial, reflect local cultural values and maintain
engagement. ‘We’re looking to communities to develop
policies based on their local situation,’ he said.
Andrea Fischer of the Burnet Institute’s Centre for
International Health, described a project looking at non-
commercial alcohol and HIV risk in Papua New Guinea,
which aimed to reduce levels of intoxication and risky
behaviour, such as unsafe and unwanted sex – 40 per
cent of females had reported being forced to have sex in
the last six months. It was important to base
interventions on facts, not beliefs, and focus on
empowerment, she said. ‘Simple and low cost
interventions work.’
Don’t just copy
western solutions
Gerry Stimson: ‘it’s those opposed to harm reduction who are at the fringe.’