Outreach work, detoxification and rehabilitation, HIV care and support, income generation and vocational training for street-based people who use drugs. These are the four components of the continuum of care that the organisation Nai Zindagi (‘New Life’) embraces to improve the health and lives of people who use drugs in Rawalpindi, Pakistan. Recently, the Chargé d’Affaires of the Netherlands Embassy, Mr. Sander Janssen, visited the organisation’s location. The meeting acquainted the government representative with on-the-ground achievements of Bridging the Gaps.

Nai Zindagi is Pakistan’s largest non-governmental organisation that focuses on HIV prevention and harm reduction for people who use drugs. It implements activities in the framework of Bridging the Gaps. For eight years, Mainline, the Amsterdam based organisation that focuses on improving drug users’ health and quality of life, has been supporting Nai Zindagi’s continuum of care programme in the city Rawalpindi.

HIV prevention

One of the activities of Nai Zindagi is the outreach work for street based people who use drugs. Paid outreach workers, who usually are (former) drug users themselves, visit spots where people using drugs gather. They provide information materials on HIV prevention, distribute condoms, exchange needles, and tell about places with health services. Moreover, the outreach workers are trained to provide basic health care services on the spot. For people that need support in quitting drugs, Nai Zindagi has a detoxification and rehabilitation programme of three to six weeks. The programme also offers voluntary confidential counselling and testing to people who use drugs, their spouses and relatives.

In the same building, Nai Zindagi offers HIV care and support, including HIV counselling and treatment adherence sessions. Since 2012, the unit is equipped with a CD4 count machine. This allows HIV positive people to monitor their CD4, so that patients do not always need to go to the hospital. Whenever the level goes below 350, the patients are referred to the national hospital, where they can start antiretroviral treatment for free.

Learn a skill

Those who are interested can participate in a vocational training programme. Nai Zindagi has different ways to support people to learn a skill and earn money. Options include farm work, leather production, carpentry, mechanics, and dog breeding. Besides, people can choose to be in the Butterfly project, which makes wooden butterflies and coffins for a firm in The Netherlands (see www.grafkist.nl). After three months, the trainees leave the project to find employment and go back to their families. Some of them will be employed by Nai Zindagi as outreach workers, farm managers, and training coordinators.

During the visit to Nai Zindagi, the Dutch diplomat Mr. Sander Janssen expressed his admiration:

While I realise the problem of drug use will never be solved, it remains important to create an alternative for drug users. Something to strive for, to hope for, even if you are down and out in Rawalpindi, where a dose of heroin costs less than 80 eurocents. Nai Zindagi provides that perspective. I wish them all the best.

Nai Zindagi plans to scale up its HIV prevention activities throughout Pakistan.