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.

 

Advocacy for a cantonal institution for drug diseases

For this year Association Margina once again organised street action disseminating promotional materials, meeting people and spreading information about the campaign and work of the association.

By sharing an educational brochure (What to do when someone overdoes you, etc.) to several locations in the city by volunteers, Margina wanted to raise people’s awareness of a problem that doesn’t affect only individuals, but whole community. Passers-by had the opportunity to get acquainted with the organization’s work and campaign goals, and also to take pictures with campaign Logo in order to support those who need it the most. Organisers are very pleased with the community response to the messages that the campaign provides, as more and more people are aware that changes must be introduced to the entire system.

A special feature this year is the public debateDo We Need The Office of Addiction Diseases” with 40 representatives from institutions and civil society present, as well as active users of “suboxone” therapy and active users of harm reduction services provided by our organization.

The opposite views are expressed about how to fund a part of the health system, and insufficient systemic support for people using drugs. Also, for the first time data from the regional project “Budget advocacy and monitoring” were presented and representatives of the Ministry of Health and the Health Insurance Fund had mild panic outbursts, with the information provided and recommendations.

The conclusion of all the attendees is that this Department of Addiction Diseases, as urgently needed, will be one of our goals in the advocacy campaign that will follow in early September.

New accreditation for Margina

The Board of the Agency for Healthcare Quality and Accreditation in the Federation of Bosnia Herzegovina (AKAZ), at the meeting held on 29 April 2019, accredited the drop-in centres of the Association Margina in Tuzla and Zenica.

AKAZ performs a variety of services including standards for healthcare institutions, indicators for healthcare institutions, certification, accreditation, facilitation, clinical guidelines, education for healthcare professionals and support healthcare institutions in clinical revision. With Margina, they implemented a project Quality improvement for drop-in centres on back in 2014 whose objectives were:

  • Development of tailor-made training
  • Development of specialized standards
  • Development of risk-based indicators
  • Facilitation during accreditation preparation
  • External assessment of the centres
  • Granting accreditation status for 3 drop-in centres – in Tuzla, Zenica and Mostar

Margina benefited from the project gaining accreditation for the three drop-in centres in 2015 and became the first civil society organisation in South East Europe. The accreditation includes 13 standards and 89 criteria and 15 politics and procedures.

External assessment in the Association Margina

This accreditation status for NGO Margina expired on 23 November 2018 and they passed through the process of re-accreditation which was successfully completed. Margina is now accredited, now for the period of 4 years.

Congratulations!

Tuzla joined the Support. Don’t Punish campaign again

The Support. Don’t Punish campaign in Tuzla, Bosnia Herzegovina started on 11 June 2018 with showing film “I want to wake up” three times for the population of high school students and three times for the population of students. The goal was to point out the problem of education of this population and reduce stigma and discrimination against drug users. In this way, the message and the global goals of the campaign was promoted and shared among young people.

Association Margina had an ambitious plan to hold a public debate and press conference “CANTONAL INSTITUTION FOR DISEASES – Why do we not have it?” as introductory event to the entire day of action on 26th of June where Bosnia and Herzegovina National Drug Strategy 2018 – 2023, Policy to reduce drug use damage in the Federation of Bosnia Herzegovina, Decisions of the Government and the Tuzla Canton Assembly on the establishment of the “Institute for Addiction of the Tuzla Canton” should have been presented. Unfortunately, this activity was cancelled, because just before the start of the entire campaign, health workers started striking, both to fight for their rights, but also due to poor conditions for patients. The strike escalated in a way that 1.370 doctors and more than 4.000 medical technicians locked in their dismissals.

Regardless of the cancelled public debate, Margina have drawn good lessons from this process, as a model of pressure and struggle for the human rights of professionals and patients in whose interests they work. In the upcoming period they plan a meeting or a series of them with the Health Workers Union, in order to try to organize joint activities to improve the quality of services for drug users.

Still, a street action was organised in the city of Tuzla, including disseminating promotional materials, meeting people and spreading information about the campaign and work of the association.

Margina goes on!

As in previous years, Association Margina from Bosnia Herzegovina organized several activities within the campaign “Support. Don’t Punish”, this year on two locations: Tuzla and Zenica. During this year’s campaign, their goal was to focus on young people as target population through two aspects: scientific -through public debates at two universities in Tuzla and Zenica, as well as support for contemporary music events for young people – Sound of Nature Festival.

Activities had solid media coverage and the main goal was achieved. The messages were transferred and taken very seriously. Margina’s management was invited and held two meetings with the creators and decision-makers in these two regions, as well as the extraordinary hosting of the two most visited TV companies upon campaign completion. What they are most pleased with are the 50 new volunteers of the organization, with whom the coordinator has already begun preparations for new activities.

Support. Don’t Punish publlic debate

Chronologically the activities happened in this sequence:

25 June – Support to the Sound of Nature festival – 1300 participants, 800 leaflets and 4000 condoms distributed

26 June – The press release, with all details of the campaign, goals, history and data for Bosnia and Herzegovina on drug use, human rights violations and evidence base approach in creating a public health approach to drug users and their families

27 June – Public debate at the Faculty of Medicine of the University of Zenica, with participation of 90 participants

30 June – A public debate at the Faculty of Education and Rehabilitation, University of Tuzla, where a press conference was held, followed by a debate with students with a total of 60 participants

01 July – Margina President participated in the thematic show for half an hour

Generally, Margina is satisfied with these activities, especially with participation of the young ones, under the advice and support of the senior staff of our organization. They are especially pleased to have new members joining their volunteer team, which is preparing for the new activities and new challenges set by the organization.

Support. Don’t Punish 3D graffiti