Saturday, October 20, 2012

Preventing HIV and harmful consequences associated with drug use among young people

Vibol (name changed) points at the whiteboard as he mentors another Korsang client.
© UNICEF Cambodia/2012/Robens
“Korsang is the main reason why I stopped using drugs. The staff motivated, counselled and educated me,” said 21-year-old, former drug user, Vibol* from Meanchey district, Phnom Penh. “They gave me hope when I thought my life was finished.”

After battling with drugs since he was 13 years-old, to cope with years of domestic violence committed by his late alcohol dependent father, Vibol was on a road to recovery after meeting the Korsang outreach team.

Since 2006 UNICEF, with contributions from the German Committee for UNICEF and the French Committee for UNICEF, has been working in a long term partnership with Korsang, a non- governmental organisation, to offer harm reduction services to marginalised young people and women who use drugs in Phnom Penh. According to Korsang, during this collaboration from 2006 – 2012, the lives and living conditions of young people aged 24 and under, who use drugs and make up 33 per cent of all Korsang clients, (of which 22 per cent are female), have been significantly improved and new HIV infections reduced.

Battling drugs

In 2001, when Vibol was 10 years-old, he lived with his mother, father, two sisters and two brothers including, his twin brother, in Meanchey district. His parents earned a meagre income through farming and fishing and sold their goods at the local market, earning 10 – 15,000 riel (US$2.5 – US$3.75) per day. Whilst his parents worked to provide the basic needs for the family, Vibol was able to attend primary school.

However, throughout his teens, Vibol grew up in an unhappy environment marred by domestic violence and alcohol abuse. On a regular basis, after being beaten by his father, Vibol would run away from home, often seeking refuge at his neighbours or aunt’s home for one day, or even up to a week at a time. And on such occasions, he was absent from school. In 2004, when Vibol was 13 years-old, he was introduced to Yamma (an amphetamine mix of speed and ecstasy) for the first time by his classmates. Vibol and his friends would often share the tablets, costing 10,000 riel (US$2.50) per tablet, during and outside classes.

“When I was taking Yamma, I felt powerful and brave enough to fight anyone who stood in my way,” recalls Vibol. “But during class, I wasn’t able to retain information, nothing would sink in.”

After three months of taking Yamma, Vibol would feed his twice per week drug addiction using his daily allowance (3,000 riel / US$0.75), and to meet any shortfall, he sometimes stole from his mother, siblings and neighbour.

However in 2006, Vibol’s drug taking increased dramatically following the death of his father, who died suddenly from a serious illness and Vibol began using ‘Ice’- (a pure form of methamphetamine) every day, paying between US$30- 35 per gram. Whilst addicted to ‘Ice’, Vibol’s health deteriorated, he suffered from sleep deprivation and acquired skin lesions. To finance his addiction, he broke into homes and stole anything of value.

Road to recovery

It was only in late 2006 when the Korsang outreach team visited Vibol’s district informing residents about the dangers of drugs, and in conjunction with a number of his friends being imprisoned for burglary, did Vibol seriously contemplate seeking help for his addiction.

“I was petrified of going to jail, many of my friends were serving long sentences. My mother kept on persuading me to stop taking drugs and my neighbour was ignoring me,” said Vibol emotionally. “I knew I needed help, but I couldn’t do it alone.”
Korsang Drop –In Centre, Phnom Penh.
© UNICEF Cambodia/2012/Robens
On his road to recovery, Vibol engaged with the Korsang outreach team who educated residents on the harmful effects of drugs and the risks of contracting HIV. Korsang arranged transportation to pick Vibol up from his home and take him to Korsang’s Drop-in centre, two kilometres away, two - three times per week, to ensure he regularly attended the sessions. At the drop-in centre, as part of the programme, Vibol participated jointly with other young people who battled with drug addiction, in group discussions, awareness raising sessions on HIV and AIDS, drug use and health promotion. When Vibol was not at the drop-in centre, he received regular counselling sessions from Korsang outreach staff, a team of trained peer educators at his home.

As Vibol’s continuous drug use had suppressed his appetite, Vibol was not eating properly and was experiencing the consequences of malnutrition and lack of sleep. He was more susceptible to becoming ill because of his poor health.  To address his health concerns, Korsang provided Vibol with a nutritious meal every time he visited the drop-in centre, and medical staff would treat his skin lesions - which developed as a result of prolonged drug use - and provided him with medical treatment for his overall health.

With continued support from Korsang, Vibol attended Khmer and English lessons and eventually completed his high school education at grade 10, aged seventeen. Over the years his drug use reduced significantly and Vibol became committed to helping others with similar drug issues. Through Korsang, he volunteered as a Peer Facilitator at a local market in his community, providing risk reduction information related to HIV prevention, overdose prevention, drug and health education to young people.  He also provided people with hygiene kits including; condoms, soap, a toothbrush and toothpaste.  While carrying out this role he received encouragement from his neighbour, mother and siblings.

“Working in the community I felt valued knowing I was helping others,” explained Vibol.

Aiming for a better future

Committed and determined to remove drugs completely from his life, Vibol ended his drug use in January 2011 and was selected by Korsang to undertake a four year vocational training course, with a French non-governmental organisation, Pour un Sourire d’Enfant (PSE). At PSE, he would gain experience and obtain general knowledge on cooking.
Vibol (name changed) entering the Korsang Drop –In Centre’s kitchen.
© UNICEF Cambodia/2012/Robens
This year, 2012, Vibol is in his second year of training at PSE and volunteers as a Peer Facilitator at Korsang’s drop-in centre.

“I want to complete my training with PSE and make a living as a chef”, says Vibol. “I want to earn more money to provide for my mother and siblings and eventually marry my girlfriend.”

Through this partnership, Korsang targets people who are engaged in using and injecting drugs, and are at serious risk of contracting HIV and other health related hazards that accompany drug use and high-risk sexual behaviour. Korsang implements drug and HIV prevention activities including, health education and medical services on site at the drop-in centre, and through outreach, using peer education based approaches to harm reduction, and skills building efforts to develop life skills. Importantly, Korsang refers for voluntary HIV testing and enables access to antiretroviral treatment if needed. Effective collaboration with the national methadone maintenance programme is in place as well. Through the drop-in centre, Korsang provides a safe space on the basis of emergency shelter for some of the most marginalised populations, young people and women who use drugs and their children, free from violence, harassment and discrimination.

* Name changed to protect young persons’ identity

By Angelique Reid

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