In follow up of earlier exchange visits this year, Bridging the Gaps partner organisations Mainline and Nai Zindagi jointly organised a training for their colleagues in Kenya on ‘Comprehensive outreach-based harm reduction services to prevent HIV infection’. The aim of the training was to increase knowledge and skills on harm reduction services for people who use drugs (PUD), particularly focussing on people who inject drugs. Participants of the training included outreach workers, social mobilisers, field workers,  programme managers, directors and data entry officers of our partner organisations OMARI, MEWA and REACHOUT. The participants were actively involved during the training, more particularly during exercises and when bringing in issues based upon their own experience in the field.

The training was helpful to understand that providing harm reduction services means a different approach and role for the outreach worker.

Harm reduction

Harm Reduction services focus on improving the health and conditions of people who use drugs (PUD). The training included various aspects of harm reduction, namely:

Stigma and discrimination:

Participants learned how poverty, drug use and HIV infection lead to more stigma and discrimination by the community, health workers, police and judiciary. Another topic was self stigmatisation, and was covered by using examples that the participants brought forward themselves.

Outreach work:

Participants learned how to make contact and relate to drug users in a professional way in order to be able to promote harm reduction.

Safer injection:

Participants gained knowledge on what are the necessary commodities, steps and actions to take to guide a drug user to inject more safely. The pictures on how to use a needle one or more times affects the quality of the needle (and hence the harm it causes on the veins) evoked astonishment among the participants.

Data recording and entry:

Participants learned to correctly register the drugs users they work with; the services the drugs users need; which services they were able to provide; and follow-up activities. The data entry officer learned how to enter this data so that at the end of the day staff of all levels had the relevant information needed to improve their work.

From TukTuks to motorbikesFrom tuk tuks to moter bikes

After three days of training the participants went out to apply their new knowledge on the ground.  As the outreach workers need to travel large distances to go to the different areas where they work, Mainline provided funds to purchase five motor bikes. This immediately proved to be much faster than travelling by ‘tuk tuks’ and will allow the outreach workers to reach more drug users with their services.

Challenges

A problem remains access to treatment for people who use drugs because of discrimination by healthcare  providers and because they cannot pay for the costs. Another challenge is police harassing drug users, with harassment and violence taking place on a weekly basis. To be able to provide harm reduction services, drug users and outreach workers need a safe environment. This is one of the priorities Mainline will work on together with our Kenyan partners in the coming two years. Participants further expressed their interest to get more training on human rights issues, recording rights violations and on the specific needs of women using drugs. At the closure of the workshop, the participants were able to raise these issues with a representative of the Health Department at Mombasa County, who closed the meeting and handed out certificates.