What we do
1. A. Harm Reduction Based Service Delivery through Drop-in-Centres/Outreach.
This covers 4 main activities:
(b) Community based Outreach
(c) Drop-in-center based medical interventions
(d) Counseling and psycho-social support
1.B. Referral-networks with Department of Health and other international organizations
1.A. a Drop-in-Centre
What we do?
A Drop-In Centre (DIC) is a safe and non-threatening space, where people injecting drugs (PWID) and people using drugs (PWUD) can have a ‘break’ and where AHRN services are available in a non-judgmental and users’ friendly manner.
Personal Hygiene and Recreation Facilities like bath rooms, TV/DVD, library, Guitar, Chess, Camron Board
Behaviour Change Activities like Health Education, culturally appropriate IEC
Dissemination of Risk Reduction Supplies like Needles/Syringes, Condoms
Facilitating Self-Support Groups of PWID/PWUD (MMT, PHA, TB, Female clients, BSPSG IG…
Monthly Client Dinner and competitions
1. A. b Community based Outreach
What we do?
Behavioral Change Activities like health education, culturally appropriate IEC
Needles and Syringe Exchange Program (NSEP):Based on in-country gained experiences and international best-practices, AHRN-Myanmar aims at the following NSEP activities: Photo: risk reduction supplies photo
Providing risk reduction supplies (needles, syringes, alcohol swabs, distilled water) & IEC materials for/and discussion on reducing injection risks for HIV and hepatitis infection;
Integrating safer sex practices and dissemination of condoms (upon request) in the NSEP programmes;
Exchanging used needles and syringes for sterile needle and syringes on a good practice basis (e.g. safe collection of used N/S) ;
Making the community as safe as possible through the collection of discarded and safe disposal of non-sterile, used injection equipment.
Switch campaign through Outreach:
AHRN provide aluminium foils for smoking, provide Health Education on Switch together with IEC (Photo: IEC on Swtich, folding method
Overdose Prevention and Management: AHRN Myanmar trained Outreach Workers and Peer Educators on Overdose Prevention and Management including signs & symptoms of OD, how to do put in recovery position, do’s and don’ts in treating OD clients etc. AHRN also use the life-saving drug Naloxone
Referrals to DIC: Outreach is an entry point for the clients for the access to the Treatment. Outreach workers refer the clients met in Outreach to DIC for further treatment, care and support services.
1.A.c Drop-in-Centre based medical interventions
What we do?
Medical interventions are an important and necessary part of comprehensive Harm Reduction programmes, providing an opportunity to PWID/PWUD to access health services (something they are often deprived of for a variety of reasons like discrimination, financially, fear of arrest…). At each DIC/OPO’s a team of doctor(s) and nurse(s) is available on weekdays (e.g. Monday to Friday at 09.00 AM to 12.00 PM and 1.00 PM to 4.30 PM) to offer free consultations. Activities include:
Health care services:
Free consultation for drug related health problems and general illnesses;
Primary Health Care;
Minor emergency arrangements (i.e. overdose…);
Free medication; (Photo: Abscess management)
Medical examination for establishing a diagnosis (including the recording of vital parameters);
Anti Tuberculosis Treatment;
Anti Malaria Treatment;
Symptomatic Drug Treatment (SDT);
OI prevention, screening and treatment;
Hep B screening and vaccination;
Screening and treatment of STIs, TB, Malaria;
Referrals to available specialized (TB, MMT) and general health services;
Care & Support:
Visiting clients at the place they reside by AHRN Treatment Facilitator or DOTs supervisor for treatment adherence support on ART, TB, MMT…
Buddy Care Systemand 24-hour Care Centre from Better Shade Peer Support Group BSPSG;
Linkages with AHRN Treatment Support Unit on psycho-social support including nutritional support to HIV, TB and malnutrition clients through World Food Program Food supplies, transportation for clients
Training of all AHRN staff on harm reduction, addiction, HIV, HBV, HCV, TB and other health issues related to drug use;
1. A .d Counseling and Psycho-social support
What we do?
Treatment adherence support
VCCT for (Injecting) Drug Users and the Bridge Populations.
Funeral support for deceased clients.
Considering the fact that harm reduction activities for PWID/PWUD are very sensitive and quite often misunderstood, AHRN encourages and does advocacy activities at each project site and Yangon office to generate support and establishing cooperation & collaboration with different stakeholders. Different advocacy strategies are used for different stakeholders.
Table: Stakeholders and Strategies for advocacies