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Community mobilisation | self-organising

In this video, Mat Southwell from EurNPUD speaks about community mobilisation and self-organising of people who use drugs
Drug users across the world face many risks and challenges in many countries we are criminalized, stigmatized and generally denied our human rights. The harm reduction movement aims to address these problems. This is best achieved when people who use drugs are partners in designing and delivering these harm reduction services. This requires harm reduction services to build meaningful partnerships with people who use drugs and ourorganizations. This requires the development of trusting and respectful relationships with people who use drugs. A key way to do this is through community mobilization.
It’s important to understand that there are two different forms of community mobilisation, self organization and peer work in harm reduction.
this often results in a community led organization, which means the majority of the people leading and delivering the organization are themselves community members or peers.
Peer work teams are particularly effective at connecting services with the active drug users through outreach and the delivery of community based services. Community mobilization is most effective when it is backed up by a strong partnership between the drug using community and traditional drugs services. Drug user groups often work in close collaboration with harm reduction services. Sometimes drug user groups distribute harm reduction equipment provided by the harm reduction service, or they sit within a network of NGOs, each responding to different needs of the local drug using community. Peer work teams are often most effective at lowering the threshold or entry point to drug services. They achieve this by going out and engaging community members in their chosen locations.
However, being able to refer peers for medical or nursing services ensures that the team is able to respond to the needs of the local drug users, building the credibility of the wider service, bringing together the lived experience of peer workers and the learned experience of professional partners results in a combined service that meets the client’s needs. Research into the New York HIV response in the 1980s highlighted the critical role played by professional workers who also had lived experience.
Community mobilization builds on the natural instinct of community members to provide mutual aid. In every friendship group of drug users, You will find individuals who selflessly go out of their way to help others. They’ll look out for other peers and do acts of kindness for members of their own community. In some cases, these mutual aid initiatives turn into formal peer led harm reduction responses, such as secondary needle and syringe programmes and peer to peer naloxone distribution schemes. The members of a drug user group come together due to their shared lived experience and their desire to contribute positively to their community.
This allows peer workers to reach their peers with life saving equipment and advice. The peer workers used their shared community experience to try and achieve change for the better, for individual members and for the community as a whole.
In Bath, my home city in the west of England, I was told about a local stock out of needles and syringes at the local pharmacy, needle and syringe program, I negotiated an agreement between our local drug user group called West Country Respect and our local drug service. I collect the needles, syringes and other drug using paraphernalia and distribute these through secondary needle and syringe program outlets run by community members. The value of this scheme was further recognized as we responded to the covid-19 pandemic. This led to a scare up of the scheme with an increasing range of equipment being distributed and more and more outlets opening.
Both peer and professional workers receive specialist capacity building to help develop their skills and knowledge, what makes peer workers unique is their ability to judge what information to share with their peers and at what moment. Peer workers are often present at the moment drugs are being purchased, prepared for use and then taken. Providing their workers with specialist knowledge and skills empowers them to engage their peers with advice and equipment just at the moment when they are most needed. Community mobilisation needs to evolve and develop alongside often rapidly changing patterns of drug use and risk behavior on active drugs scenes.
This requires an active process of assessing the community’s needs and developing tailored responses to meet these needs. It is important to invest in the development of peer work teams, ensuring that peer workers have the chance to grow and develop in their roles. The more peer workers have the chance to build their skills and develop their careers, the more the partnership will feel truly meaningful and truly empowering.
In 2014 I started providing technical support to Bridge Hope and Health Organization Bridge was formed by people who use drugs in Kabul and now represents all the key populations affected by HIV in Afghanistan. Building on his experience as an MDM peer worker, the program director of Bridge, Abdur Raheem Rejaey, formed a new health based NGO led by key populations. We started our work together with a community consultation in 2015, helping local peers develop their expertise in community research in order to consult nearly 500 people who use drugs and other key populations affected by HIV in Afghanistan.
Building the project on a community consultation was key as it helped identify the community’s needs and also secured the community’s Buy-In to this community led project. Raheem and his peer workers journey from being MdM peer workers to being an independent community led organization took several years. It takes time to build the credibility of a community led organization and even longer to attract enough resources. It’s taken more than 15 years, but Kabul’s drug users went from service users to the Afghan drug user group. Then they became an independent healthcare not for profit NGO, And now, finally, they are an independent organization of drug users and other key populations that attracts global fund moneys.
However, over time community approaches is build up momentum as the critical mass of community members involvement grows, there will inevitably be debates and discussions about the best models for delivering and developing harm reduction, and particularly for employing community mobilization. However, it is through such a dynamic and reflective discussions that good practice can be developed and defended. Community mobilization is a key part of the harm reduction movement because it empowers community members to be part of the solution rather than only being framed as the problem.

You might have noticed throughout this course, that people often mention that harm reduction programs are working WITH people who use drugs, rather than FOR people who use drugs. Looking back at Judy’s and Mat’s previous videos, I’m sure you see why people chose to use this language. In this video, Mat dives us deeper into the second component of community mobilisation; self-organising of people who use drugs.

In week 1, we already heard from Louise Vincent, in the frontline to fight the overdose epidemic. This project is a beautiful example of an entirely community-led initiative. Mat is an expert in providing technical support in setting up and fostering self-organisation of communities of people who use drugs. He explains that.. “Self-organisation is when community members come together to form their own initiatives to respond to community needs.”

We will hear from examples in his home-town, as well as from his work with Raheem in Afghanistan (we met Raheem in week 1). At the end of this second week, you will hear from another fantastic community-led initiative in San Francisco.

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Drug Use and Harm Reduction

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