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1. Type of organization
The organisation X is a non governmental organization working since 2000 in Burgas, Bulgaria. The organization is the first one running harm reduction programs among drug users and prostitutes in Burgas town. These policies are quite new in the country and the society is still skeptical about them. However the organization exists in almost a decade and its experience is much appreciated among other organizations and colleagues.
The accent of the organization’s activity is put on the health, social and legal statute on the target groups with risky behavior. Some changes were made on the managing council and the Statute on the organization in 2004 because of the changeable external environment and the legal frame. The necessities and structure of the target groups are also different than before and the organization strives to adapt and develop.
2. Mission and goals
The mission of The organisation X is to participate in developing local and national strategies concerning the target group. One of the goals of The organisation X is to prevent HIV/AIDS and other blood transmitted infections (BTI) among people with risky behavior. Groups with risky behavior are injecting drug users (IDU), commercial sex workers, men who have sex with men (MSM) etc. Very important to the organization is the creation of contemporary network for social, health and legal help for the drug users in the town. As it was mention above the drug users in Burgas can be considered as rejected by the most of the society and it can be hard for them even to buy injecting tools. Some pharmacies do not sell syringes and needles to IDU with the hope that this can prevent or even stop the drug use.
Other goals of The organisation X are to establish a new approach to the drug users and to ensure a qualitative help adequate to their needs. Of course it is important even to increase the living standard of the drug users. Many of them have other, secondary problems caused by the drug use as criminal behavior, health and social problems. The organization is not only interested in helping drug user but even interested in preventing drug habits in general.
3. Resources
The resources The organisation X dispose are mainly coming from the Ministry of Health in Bulgaria and from the Global fond. Donations are also welcomed in the organization representing mostly services and materials than a financial help. The Burgas Municipality helped for instanceThe organisation X by contracting its current office.
4. Target group
The main target group the organization works with is IDU. Not mentioned below is the other target group – commercial sex workers men and women.
The injecting drug users in Burgas are approximately 1200. The data is taken from the latest research ordered by the National Addiction Center. It is important to mention that the target group is nowadays more sporadic, the community between the drug users does not exist as it was couple years ago and the drug use nowadays is more hidden and individual. That means that the target group is harder to reach.
5. Main programs of
Two of the main programs The organisation X works with are 1) HIV\AIDS and BTI prevention among IDU and 2) HIV\AIDS and sexual transmitted infections (STI) prevention among commercial sex workers men and women.
Concerning prevention of HIV\AIDS and blood transmitted infections (BTI) among IDU the work consists in exchange of sterile needles and syringes, giving information for safety injecting, alcohol swabs, sterile water, aluminum "cookers", distribution of condoms, lemon acid. The organisation X provides even anonymous and free HIV/AIDS, Hepatitis B and C and Syphilis testing and before and after test consulting, psycho-social consulting, motivate the client for a entire change of life and coordinates the efforts of professionals in the field.
Regarding prevention of HIV\AIDS and STI’s among sex workers men and women the concrete activities are distribution of condoms, pregnancy tests, lubricants, sterile injecting sets, information for safety injecting, snuffing, testing for STI and other infections, before and after test consulting if needed, and directing for treatment.
6. Main methods of reaching the target group
The good practices The organisation X uses are approved on the territory of Burgas town. Those approaches explain the way how the organization reaches the target group. Not mentioned in detail are the education of peers (equal learns equal), the Burgas Prison, the surveys The organisation X participated in and the publication Methodology of work.
Outreach - The organisation X works with outreach activities among both IDU, among prostitute’s men and woman, and among MSM. The organization is still the only one in Burgas working with those current target groups and offers them services in a proved adequate and effective approach. The outreach method addressed to IDU has a very wide spectrum of activities. The outreach can be different depending on the target group. There is for example a home outreach (when the worker visits an apartment used by a group of users) and there is a mobile outreach (when the IDU calls if injecting tools are needed). The most popular outreach is however the classic one – when the worker visits a public spot in a certain time and make contact with the target group. In Burgas one for the moment key spot is the Post office. The place due its importance to the phone cabins used to call a drug dealer.
Drop-in Center for drug users – The organization continues to support the activity in the center which is the only one of its nature in the town. It is important to mention that the use of any narcotic substances or alcohol in the center is not allowed. The center is open seven hours per day, five days per week. Once in a week there is a nurse that does blood tests and gives health information. The clients are also offered sterile injecting sets. They are welcome to have a cup of coffee with the worker and discuss important issues. The subjects the clients can take up can be various, but the workers always try to discuss with the client how for instance to react in case of over dose, how to prevent and deal with health and social problems and motivate clients to some convenient treatment. These conversations are not characteristically only for the Drop-in center but in the most of the contacts with the IDU.
Mobile Cabinet – At the moment the mobile cabinet is the only one in the town. The organisation X realize consultations, small manipulations and takes blood for testing directly in the target groups. This method of reaching the target group is efficient because it predispose the individuals to make contact and not to feel ashamed for eventually having an infection. The organisation X respects their way of life while there is a belief that public servants can be more critical and judging to prostitutes or IDU.
“Gate-keepers” – key collaborators from a drug users community. The organisation X educates and consults gate-keepers from the target group and the approach is effective in a qualitative and quantitative way. The group members trust the chosen gate-keeper and are highly predisposed to listen to the health information coming from him or her. Another benefit using this method is the fact that the most of those community members should stay out of reach otherwise.
7. Demography
According to a survey made by The organisation X the public opinion regarding the IDU is changing. The society is now more open for the IDUs’ problems while this issue was provoking aggression and fear before. Now the society understands better the philosophy of the Harm reduction programs which was kind of taboo until 2004. Characteristically for Burgas is that the IDU in the town are more socially active and not as marginalized compared to Sofia, the capital of Bulgaria.
8. Shortcomings
Unstable financing and EU membership is a couple of the biggest challenges the organization is facing. The relatively new EU membership gives Bulgarians non government organizations (NGO) many opportunities. However it is a fact that big amounts of money are coming into the country but they are not straight addressed to NGOs, they are directed to, in our case, the Ministry of Health (MH). Additional conditions are also laid from the MH and the opportunities are in practice more appropriate for bigger organizations.
Other shortcomings can be the difficulty to keep the coworkers because of the insecure and low financial status of the organization. Difficulties according to the target group IDU is that they are nowadays hard to reach. The situation is similar according to sex workers – they are also more hidden than before, because they mainly work on telephone.
9. Shortenings
AIDS – Acquired Immune Deficiency Syndrome
BTI – Blood Transmitted Infections
HIV – Human Immunodeficiency Virus
IDU – Injecting Drug Users
MH – Ministry of Health
MSM – Men who have Sex with Men
STI – Sexual Transmitted Infections
