C+ |Be+| Be your rights... an example of community mobilisation in a neighborhood with an open scene of drug consumption in Porto.

Background:

During the 90’s Portugal had an estimated number of 100.000 high risk drug users, mostly of injected heroin. Data from EMCDDA from 2014/2015 shows that the prevalence of Hepatitis C (HCV) among people who inject drugs is still over 80%. So, we ask ourselves where are all this people? Are we reaching the most vulnerable and excluded drug users?

Experts suggest the need of a specific and inclusive approach, to reach people who use drugs, particularly those in a vulnerable situation, sometimes in a framework of micro-elimination, but until now there are still no concrete measures or specific strategies to include vulnerable groups in their own health promotion.

Description of intervention:

The project followed an action-research principle - promoting and reporting the involvement and mobilization of the community through outreach and immersive fieldwork activities in the identified territories – collaborative work with existing services and networks allowed us to more freely be focused on relationship building with the people that use in a logic of human relation first, local first, more vulnerable first, namely homeless and sex workers, reaching the harder to reach...

So, our organization, to contribute to the elimination of HCV by 2030; recognizing and validating the potential of Peer Work (particularly reaching the most vulnerable). With the objectives of: Involving the community and develop synergies with outreach teams and other services seeking integrated answers; Empowering people who use drugs and know well the Porto open scene neighborhoods of consumption, to design and implement their own micro-interventions in the field, with supervision, and internal and external monitoring and evaluation. The projects focused on being the bridge to the most “hard to reach”, developing a non-judgmental relationship, and then knowing about health status and support the re-connection with public services.

So, we designed a capacity-building action for users that knew the open scene in February 2018. Between March and July, 2 small projects were implemented in 2 neighborhoods with an open scene of consumption. Every week there were 3 paid days, one of which, for supervision and monitoring.

Effectiveness:

- More than 150 people contacted.

- Articulated moments with different services:

- Outreach teams particularly the local team from ARRIMO but also Médecins du Monde, APDES.

- Public Health Center for integrated answers to Addiction from Eastern Porto

- Testing and referral with Médecins du Monde

- Cleaner spaces and foil and syringe distribution 24h

- Deeper knowledge on the different layers of hidden realities that these spaces have.

- A film Director and Producer is doing a documentary film on one of these “city Islands”

- Thoughts and needs: more continued monitoring and registering, more training opportunities, protection of Peer Workers, more time and a more detailed budget.

Conclusion and next steps:

Partially the project is still happening because some people in fact didn’t stop work even without funds to pay for their work. So, in some way, one conclusion is that it didn't ended there.

The results will help advocacy for the meaningful involvement of people who use drugs in the strategy and elimination of HCV.