New model of work in Zenica and Tuzla

Denis Dedajić, President of the Association Margina from Bosnia and Herzegovina sent us a short summary of the situation from March 1 to April 10.

Drawing on our life experiences we have had the opportunity to experience (the 4-year war, the floods of 2014), we can point out that we have very quickly adapted to the situation caused by the COVID 19 pandemic.

Our operations are compounded by the funding problems of our services that you are already aware of. Our organization is the only one that has survived the provision of harm reduction services in all of Bosnia and Herzegovina.

In accordance with the orders and recommendations of the Crisis Staff managing this health and social crisis, we had to close both Drop in centres (Zenica and Tuzla) and transferred all forces to the field.

A rapid mapping of the terrain was carried out and interviews with a large number of clients enabled a new methodology of work, all in line with the recommendations on the method of contacts between people. We currently cover all our clients in two regions, covering about 1 million people and about 1.800 of our clients, and with the great help of our clients we have identified in both regions 20 key points – persons to whom we deliver all the materials available to us.

The material is delivered on the basis of the stated needs of our clients. In the period from March 1st to April 10th we distributed in both regions 51.800 needles and syringes, 25.000 pieces of distilled water, alcohol wipes, containers for preparation of the mixture and 1.200 containers for disposal of infectious waste. It should be noted that during this period about 45.000 needles and syringes and other infectious material were collected and deposited in our drop in centres until this crisis passed.

We have established 4 sex workers supply lines and have distributed a lot of materials (over 500 hygiene packages) and unfortunately this is the only one they have received over the last three months.

The biggest win at the moment is the involvement and commitment of our clients throughout this work process.

In interviews with the inmates of the largest prison, we confirmed that they lack basic equipment such as mask gloves and disinfectants and the needs are quite high. The good situation is that all visits are suspended and there is very little opportunity for COVID to break into these facilities, although they need urgent help with these safeguards to improve the prevention system and reduce the possibility of infection.

 All of this work is done by 6 of our employees and we all do all the work and have very few resources at our disposal. The 6 of us have been volunteering for a long time and will work as long as we have materials to share with our clients.

If this model of work continues, our supplies are sufficient by the end of June. After that we will be forced to close after 18 years of conducting harm reduction services in Bosnia and Herzegovina because we will no longer be able to do so.

 

Duga active both locally and wider

Our member organisation Duga supports vulnerable populations in their municipality Šabac, but their outreach team is, as usual, active around Serbia.

During first days of the epidemic in Serbia, team of the Association Duga from Šabac, Serbia, visited suburbs with Roma populations and various vulnerable populations to inform them about preventive measures against coronavirus. They dedicated special attention to those who recently returned from the areas with high epidemics – Italy, Germany and Austria – who either came to visit their families back home or returned from seasonal work (especially sex workers).

This action was supported by the Regional Programme on Local Democracy in the West Balkans (ReLOaD), financed by the European Union and implemented by the UNDP Office in Serbia.

The extraordinary situation with coronavirus haven’t prevented Duga outreach team to continue HIV testing in cities around Serbia. On 9 April they have tested interested people in Kragujevac, Central Serbia, while the day after they went to Novi Sad in the Northern province of Vojvodina.

DPNSEE provided Duga with an amount of hygienic material, masks and food for vulnerable populations in their municipality. Duga also managed to get bread as donation from the organisation Human Heart of Šabac.

The Duga team, together with assistant of the Roma coordinator of the city of Šabac Sanja Petrović, distributed 122 humanitarian packages to 251 people in villages of Petlovača, Cerovac, MIšar, Letnjikovac, Pocerski Pričinović, Majur, Varna, Pocerski Metković, Bogosavac, Lipolist and the city of Šabac on 14 and 15 April.

DPNSEE Board discussed situation in the region

The meeting of the DPNSEE Board was held by Zoom on 13 April 2020. The meeting was scheduled to discuss the current situation related to outbreak of the coronavirus in South East Europe and plan future steps.

Based on the information collected at conference calls with member organisations, the Board concluded that it is time to make some conclusions and decisions about what we can do in the forthcoming period to help member organisations and ensure their sustainability after the current crisis caused by the coronavirus.

The Board also concluded that member organisations and the did a good job reacting in time, providing information to the communities, organising the work of our services in accordance with the situation and protecting our staff and, wherever possible, communicating with state officials and inviting them to protect vulnerable populations. Most of our users behave responsibly, even taking initiative and helping our organisations. The drug market is stable. The problems include lack of opportunity to start the treatment during the epidemic and lack of income to buy essential needs, bit also drugs. In most of the countries, we have problem to ensure enough protective material for our staff. In some countries, state institutions, especially drug agencies/offices, should provide more help to users for methadone distribution, protection of their rights, etc.

The Board decided to call an on-line conference on protection of vulnerable populations in South East Europe for Thursday 23 April. Besides our members and other civil society organisations from the region and wider, we shall invite to the conference national drug agencies and health institutions, international organisations partners and donors.

 

Greek organisations started street work with vulnerable groups

The Positive Voice announces the suspension of the operation of the prevention and examination centres “Checkpoint” in Athens and Thessaloniki, from 16 March 2020.

In the context of our contribution to the suspension of the spread of the pandemic, but also to the protection of the health of their visitors, volunteers and employees, the Association took all appropriate measures and has already stopped the operation of Red Umbrella Athens in Omonia and the examinations at the “Syn Athena” Home of the Municipality of Athens.

But, the same day, in the framework of the emergency plan for the care of homeless and psychoactive substance users, the Municipality of Athens held a meeting with organizations active in the field of prevention and harm reduction of vulnerable groups. The Association of HIV-positive people of Greece “Positive Voice”, the Association of Liver Patients “Prometheus“, OKANA, KETHEA, Praksis, STEPS and Doctors of the World were invited and attended.

The agreements that were unanimously accepted are oriented to the following actions:

  • Minimize the transmission of the virus to the vulnerable population, through continuous information, wide distribution of sanitary and pure injectable material and access to personal hygiene, nutrition and hospitality services.
  • Adoption of measures aimed at reducing the consequences of the transmission of the virus

Since then, the street work of the associations “Positive Voice” and “Prometheus” has been carrying out actions to support vulnerable groups through the provision of food, safe use synergies and protective equipment (such as gloves and condoms).

In particular, to date they have reached 434 people and have distributed more than:

  • 200 kit of sanitary material for injectable use
  • 2,882 condoms
  • 110 servings of food
  • 464 snacks (toast / sandwich / croissant)
  • 208 juices and water

The Anti-Narcotics Agency (OKANA) has contributed to this effort by distributing sanitary material, safe use synergies and information leaflets.

On Tuesday, April 7, 2020, the Association of HIV-positive people of Greece “Positive Voice” and the Association of Patients of Liver of Greece “Prometheus” were hosted on the ANT1 show “Special Report”.

Journalists conducted extensive research discussing the people who live on the streets and the organizations that implement their support programs. Following the appearance of the first case of COVID-19 in a homeless day centre in Piraeus, the show is investigating the safety net of vulnerable groups from the spread of the virus.

As part of the emergency plan of the Municipality of Athens for the care of homeless and users of psychoactive substances, the two associations have undertaken an extraordinary initiative through street work, in order to support vulnerable groups. Users of psychoactive substances, homeless people, sex workers, immigrants and refugees are the target groups of the initiative and their support is provided through the provision of safe use and protective materials (such as gloves, injectable material and condoms).

In his interview, the President of the Association “Prometheus”, George Kalamitsis, among other things, noted that things have not changed enough today. “What has changed is that some of our fellow citizens are more afraid. There is fear either for the pandemic, or because there are too many police in central Athens at the moment. The reasons are obvious, but they are scary. As for the hospitality structures and the supervision of the people who live in them, we need services that can be adapted to the needs of the people.

At the same time, Nikos Fitsialos, head of the street work team, added that “general attention needs to be paid to the people who are outside, especially now that citizens who are in solidarity are not circulating and will share a portion of food or a conversation. People lack communication. We notice that people want to talk to us, they ask us and they need it. Not necessarily to learn information about the coronary artery, but to have a human contact.

In the interview, the Municipality of Athens highlighted the need to minimize the transmission of the pandemic to vulnerable populations, through continuous information, wide distribution of medical supplies and access to personal hygiene, nutrition and hospitality services. In addition, Nikitas Kanakis from Doctors of the World added that “the homeless today are under the radar of epidemiological surveillance and are people who do not have the ability, not only to protect themselves but also do not have the right to individual responsibility.

The action of the street work team takes place three times a week, every Wednesday, Thursday and Friday and is implemented mainly in Omonia, Exarchia, Syggrou Avenue in Metaxourgeio and on Panepistimiou (Nomiki), Kavala, Iasonos, and Patision (ASOE) streets. . After careful consideration of the growing needs, it is necessary to expand working hours and days, something that will happen very soon.

Positive Voice also published advice for Greek citizens that have been stranded abroad and those that are not a Greek citizen and have been stranded in Greece on the procedure for accessing antiretroviral treatment.

For more information about activities in Greece, you can contact Positive Voice.

Services in Slovenia well organised

Drop-in centres in Slovenia have been closed by the decision of the Ministry of Labour, Family and Social Affairs since the beginning of the COVID-19 epidemic.

In Ljubljana, the Association for Harm Reduction Stigma continues to distribute sterile injecting equipment. The mobile outreach service (a van) continues to operate in the central part of Slovenia.

Injecting drug users have access to sterile injecting equipment but security measures are introduced: clients and staff have to keep 1.5 m distance from each other. All other information and counselling are available via telephone or online.

Drug testing, performed by Association Drogart, is open, but in smaller scale as before and with more safety measures.

OST is working, users get their take home medicine for a week, some even for two or three weeks. OST delivery was organised in a very good way since the first indications that the epidemic can hit Europe appeared.

One of the problems is closure of public transportation, which means that some persons cannot reach the OST clinics. For some of them, Association for harm reduction Stigma can deliver their methadone.

The greatest challenge is to support homeless people because they have nowhere to go (all daily care programs are closed, as well as public toilettes, due to safety reasons). There are negotiations with local authorities and ministries on how to deal with this situation.

Night shelters and safe houses for women are still open. However, it is very problematic because staff and clients have no safety masks. The use of disinfectants is mandatory.

The shelter in Ljubljana, run by the organisation Krali ulice, received new furniture. A special shelter for homeless people who may be infected with coronavirus is ready if this happens.

New COVID-19 documents translated into Serbian

Timok Youth Centre from Serbia and DPNSEE continue translating and publishing UNODC documents in Serbian. Now this includes three infographics on COVID-19 – HIV prevention, treatment, care and support for people who use drugs:

Philanthropy is opening an urgent shelter

Our newest member organisation Philanthropy, in collaboration with the City of Kragujevac, Serbia and the local Centre for Social Work, is opening the urgent shelter for socially vulnerable homeless people in Kragujevac. This service will enable protection of beneficiaries’ health well-being and prevent COVID-19 spreading. Urgent shelter will be provided based on the referrals submitted by the Centre for Social Welfare, according to the Law on Social Protection.

The project for opening the shelter for homeless people was developed for some time and completed just now, at the outbreak of the coronavirus. That helped the local community to offer home to some of those who were in jeopardy now when elderly people, especially those who are in pensioners homes, are in a high risk category.

DPNSEE managed to provide Philanthropy with an amount of hygienic material, masks and clothes for users of their centre.

 

Terra Association Programs in the Age of Coronavirus Outbreak

Our member organisation Terra sent us information about their work in the new circumstances caused by the coronavirus outbreak through the words of two of their staff.

Marko Mušković, Program assistant on the program to increase social inclusion of the users of the City of Rijeka Emergency Accommodation

As of 1 June 2018, the Terra Association has been implementing a program to increase the social inclusion of beneficiaries of City of Rijeka emergency accommodation, which, as far as field work is concerned, has been paused at the request of the National Civil Protection Headquarters, due to the need to protect our users and the association staff.

But these almost two years of work in three locations covering the necessary accommodation have proven useful now when we are able to provide help not to all, but probably the most vulnerable citizens, in their elementary need – nutrition. Namely, the drastic reduction of the public transport lines necessary for the beneficiaries to go to one of the four points of public kitchen prevented them from exercising their right to use the food service, which for many is the only opportunity to consume freshly prepared food.

Therefore, since 26 March 2020, in cooperation with the Department of Health and Social Welfare of the City of Rijeka, the head of emergency accommodation Mrs. Nevenka Kovačević and the City of Rijeka Red Cross Society, whose staff prepare the food, a hot meal is provided at all three locations. The number of beneficiaries (and thus the meals) is almost every day increasing, and some of them are using this service for the first time.

As a rule, meals are distributed outside, in front of the necessary accommodation. Exceptionally, due to the poor health of individual beneficiaries, meals are delivered to their doorstep. A record is kept of each user: whether or not he has taken over his meal, with the possible note that, if done, the food has been handed over to a neighbour or friend.

On this occasion, we thank our dear beneficiaries for their patience, adherence to social distancing, respect for order in distributing meals process, and readiness to use protective masks and gloves. Also, we have to mention the important role of the Centre for Social Welfare, especially social workers, who through their tireless work have promptly enabled their beneficiaries to exercise this right.

Without diminishing the importance of meeting the basic necessities of life, for our part, we try to additionally “spice up” every bite – with a warm word.

Ilijana Grgić, Harm reduction program assistant

Terra Association Drop-in centre is closed to visitors from March 16 and the injection equipment (needles, syringes, ampoules of distilled water, alcoholic wipes, condoms and lubricants) is distributed through a so-called ”window”. We notice that our clients take more equipment than usual, which indicates the creation of supplies. Thanks to the donation of Neosalon, since Monday we have been sharing reusable masks to the clients of our programme.

Since last week, needle exchange programme has been operating from 11 am to 2 PM. Some of our clients are working, so they cannot come during the specified hours. For them and some others, there is a telephone line available, which they can call and arrange another time of picking up the injection material.

Psychological support is still being provided, but over the telephone. Our colleagues are in regular contact with numerous clients and their family members.

Users still have the opportunity of using the telephone; this is very important for them, to contact their doctor and loved ones. Of course, the telephone and the space around the Drop-in centre are regularly disinfected.

Considering that currently there is no option of using the kitchen, food is being provided for the clients of poorer economic status.

Except the information about the working hours, clients have been introduced to the recommendations of the National civil protection headquarters and Basic measures of protection against the new corona virus for drug users, provided by DPNSEE.

At the Gea Counselling Centre, we are in ongoing online communication with all our beneficiaries through social networks (Facebook and Instagram) and different application platforms like Viber, Whats App, Skype and Zoom. Counselling centre staff members’ phone numbers and e-mails are published and visible on all of our social platforms.

 

Juventas keeps providing services

We got a comprehensive information about activities of our member organisation Juventas from Montenegro about their activities on coronavirus outbreak. Here it is:

The services we deliver to persons using/injecting drugs, persons providing sexual services and ex-prisoners, although under different circumstances, are still functioning, along with new Corona preventive measures to protect staff and clients introduced:

These are:

  1. Distribution and exchange of safe injection equipment (syringes, needles, cookers, medical alcohol, elastic tourniquets, …) in Drop in centres and during outreach
  2. Distribution of free condoms and lubricants in Drop in centres and during outreach
  3. Service of washing and drying of laundry and garments (on a regular basis, but now even more so as a part of measures preventing the spread of Corona virus)
  4. Online and phone counselling with outreach and expert workers (doctor, psychologist, social worker)
  5. Delivering food packages for the ones most economically challenged (once per week, quantity for 7 days)

 According to measures issued by the Government, all external partners/associates are forbidden to provide additional services in prison. On the other hand, we are supporting the work of this institution by providing materials for in prison tailoring of protective masks throughout the framework of a project we have.

We also deliver services to the LGBTIQ community in cooperation and synergy with activities of community led organizations NGO Queer Montenegro, LBTQ Women’s Association “Stana, and Trans/Gender Variant persons’ Association “Spectra”.

All the services that we deliver to the LGBTIQ community are the following: 

  1. Distribution of free condoms and lubricants – NGO Juventas
  2. Online and phone counselling with outreach and expert workers (doctor, psychologist, social worker) – NGO Juventas
  3. Service of washing and drying of laundry and garments (on a regular basis, but now even more so as a part of measures preventing the spread of Corona virus) – NGO Juventas
  4. Delivering food packages for the ones most economically challenged (once per week, quantity for 7 days) – NGO Juventas and NGO Queer Montenegro
  5. Peer online and phone individual and group counselling and support – NGO Queer Montenegro
  6. Free legal aid – NGO Queer Montenegro
  7. Peer online and phone individual and group counselling and support for LBTQ women – LBTQ Women’s Association “Stana”
  8. Online self – support group for trans and gender variant persons- Association “Spectra”
  9. Individual online and phone consultations for trans and gender variant persons – Association “Spectra”

All communication (online/phone/in person with all preventive measures in place) is being instigated by our outreach and expert workers and completely needs focused.

Online communication with all our communities is being done via social networks (Facebook, Instagram and Twitter) and different other social application platforms like Viber, Whats App, Skype and a new app called Houseparty that provides different social games next to persons involved being able to converse. 

It is important to mention that staff members’ phone numbers are published and visible on all these platforms. Also, we have prepared detailed specific guidelines for our team and our clients. Together with partners, we have been advocating for protection and human rights of all communities we are working with from the beginning of the epidemics.

Read more at their website following this link>>>

 

HOPS – Options for healthy living Skopje and services during COVID-19

Taken from the HOPS website

After the announcement of the corona virus pandemic, harm reduction services were modified but all clients were covered.

Drop-in centres for harm reduction of HOPS are closed, but each service has a special phone number and contact person that meets the needs of users. They can also contact the services through all social media (Facebook , Twitter , Instagram , Website) where all the news related to harm reduction from the coronavirus and all the new recommendations for protection of the population from and the World Health Organisation the Government are continuously published.

Mobile field teams operate every day, where users with pre-made contact are visited in front of their homes. The team is formed in dependence on the need of the clients (therapeutic and social worker, therapeutic and medical worker, therapeutic and lawyer). In accordance with the recommendation of the Government, there may be a maximum of two people in one vehicle. Field teams distribute sterile utensils (needles, syringes, distilled water, condoms and lubricants) daily and inform customers about all news related to the coronavirus and instructions and advice on protecting public health (such as the recommendations from INPUD).

HOPS team at work even in surprisingly bad weather conditions

HOPS, in cooperation with other humanitarian organizations, is also planning humanitarian actions in order to provide food and hygiene packages for the most vulnerable populations. Once a week, the medical person (doctor) must be part of the field team in order to assess the general health of the population and to react in a timely manner if necessary.

Substitution therapy centres carry out their activities smoothly and clients regularly receive their therapy. The staff employed at the methadone centres has increased the level of protective measures. They don’t allow more patients to be gathered (therapy is raised one by one) and fully follow the recommendations for protective equipment from the government of Northern Macedonia and the WHO.

For now, our team is working bravely, without obstacles and is dedicated to support all those in need. We thank them for their empathy and sacrifice during these strange times.

 

Edit (6 April)

The Foundation for Open Society Macedonia, in cooperation with the Macedonian Red Cross, donated 100.000 USD for humanitarian support including food and hygienic packages for Roma population. It will be distributed to 2.000 families with around 10.000 people in 9 cities and villages across the country. Our member organisation HOPS will be among 6 civil society organisations that will organise the delivery.
More (in Macedonian) is available following this link>>>.