The Harm Reduction program

The harm reduction program is the primary program of the NGO HOPS. Actually, this is the program with which HOPS started its operations in 1997. The program is directed towards reduction of drug related harm, and above all towards reducing the risk from:

HIV/AIDS
Hepatitis B, C and other blood born and sexually transmitted diseases
Overdose
Other health consequences
Social consequences

It is based on services and assistance according to the s.c. low threshold and several services under one roof, and strives towards improving the health and social condition of users, via:

- Outreach
- Exchange of injecting equipment and condoms
- Education and information
- Basic medical help
- Social services
- Legal help

These activities are performed in our 3 drop in centres in Bit Pazar, Kapistec and Suto Orizari, as well as during outreach.

Drop in

A typical example for one-stop services where in a friendly atmosphere customers may also receive all needed services:

-Exchange of sterile injecting equipment
- Free of charge condoms
- Services and counseling from a medical professional
- Services, informing and counseling from social workers
-Services and counseling from a legal professional
- Education for HIV/AIDS, hepatitis and other blood born and sexually transmitted infections
- Voluntary and confidential counseling and testing for HIV
- Education for safe injecting and safe sex
- Education regarding overdosing and prevention
- Information regarding types of treatments
- Information about the types of drugs and consequences of their usage

All services are free of charge and anonymous

Working time
Monday - Friday, 14:00 - 18:00.

Contact:

Old Bazzar, Drvarska 1, Skopje ; R. Macedonia
Tel: +389 (0) 2 3 130 058
e-mail: hristijanj [at] hops.org.mk

Shuto Orizari: Ul. Shuto Orizari br. 54, Skopje , R. Macedonia
Теl: +389 (0) 75 528 260
e-mail: knuskov [at] yahoo.com

Kapishtec: Kiro Gavrilovski br.3, Skopje, R. Macedonia
Тел: +389 (0) 2 3 176 428
e-mail: asitnikoski [at] yahoo.com

MAP for DC Kapishtec



Outreach program

Тел: 02 3 130 058
е-mail: hops [at] hops.org.mk

The primary aim of our outreach program is to reach specific user populations that do not use or use drop in centers very rarely: Roma, commercial sexual workers using drugs as well as hard-to-reach clients. At the moment, the outreach program is focus in the following regions of the town: Shutka, Chair, Topaana, Madzari, Hipodrom, Aerodrom, Karposh, Kisela Voda and Novo Lisice. All services that are offered in drop-in centers are also offered in our outreach program. The outreach program is performed with one terrain vehicle.

Outreach

Year
Needles given out
Needles returned
Syringes given out
Syringes returned
Condoms given out
Total contacts
1997/98
/
/
/
/
/
/
1999
6080
3590
4310
1950
120
208
2000
15880
8718
9972
5960
133
263
2001
/
/
/
/
/
/
2002
17216
3810
9352
2203
0
270
2003
14810
1625
7220
780
5
273
2004
11005
550
6739
530
472
250
2005
37509
25349
18818
12260
9943
1596
2006
79648
28325
38032
16985
12130
5508
Total
182148
71994
94443
40668
22803
8368

Exchange of injecting equipment and condom distribution

The use of sterile injecting equipment is the best way of preventing the spread of HIV/AIDS among intravenous drug users.
Since 1997, and conclusive with 2005, HOPS has distributed 989.289 needles and 557,448 injections for 1918 drug users.

Year
Needles given out
Needles returned
Syringes given out
Syringes returned
Condoms given out
New clients
1997/1998
178015
87315
89852
44694
31474
861
1999
179105
116481
83535
69055
27225
350
2000
203687
115548
116356
74951
25722
186
2001
86820
58833
48469
38770
/
81
2002
99696
54315
45860
28065
/
71
2003
70622
32406
29565
15594
1690
68
2004
71217
36376
36492
20629
1892
78
2005
100127
56174
49513
30993
17763
223
2006
206192
92404
107769
56859
25556
834
Total
1195481
649852
607411
379610
131322
2752

 

Year
Total contacts
Unique clients
New clients
1997/1998
n.a
n.a
861
1999
3925
n.a
350
2000
4110
n.a
186
2001
2158
n.a
81
2002
2110
n.a
71
2003
1540
294
68
2004
1899
303
78
2005
3706
n/a
223
2006
13912
1610
843
Total
33360*
2107**
2752

* Total number of contacts excluding 1997/98
** Number of separate customers for 2003 and 2004. 100 clients appear in both years


Education and information

Within the Harm reduction program, the HOPS team offers education and information about: Drug types and consequences of their usage, HIV/AIDS, hepatitis B, C and other Blood & Sexual Transmitted Disease, safe injecting, safe sex, help in case of overdosing etc. To that aim, educational material, brochures and leaflets are printed and distributed free of charge.

Training professional staff
The HOPS team has organized a huge number of trainings for Harm reduction and principles of work with drug users for social workers, medical personnel in the primary health institution and for members of the Ministry of internal affairs.
Harm reduction training for 3 teams from the Red Cross, and for 7 teams from Kavadarci, Stip, Kumanovo, Ohrid, Gostivar, Strumica and Bitola was organized and implemented.
Also, the HOPS trained teams of Medicine Du Monde – Belgrade, Initiative for Health – Sofia and CAZAS – Podgorica.
Every year HOPS hold education of students from Institute for Social work and policy at the University “St. Kiril and Metodi” in Skopje.

Medical support

The medical team offers basic medical help for reducing the consequences of long term and inappropriate injecting:
- Cleaning wounds, treating abscesses
- Counselling for raising health conduct awareness
- Counseling for HIV/AIDS, hepatitis B, C and other Blood & Sexual Transmitted Disease
- Voluntary and confidential counselling and testing for HIV/AIDS
- Informing about the types of treatments existing in the country

Year
Number of provided services
1997 - 2000
5872
2001
510 (11 months)
2002
247 (8 moths)
2003
771
2004
1190
2005 excl. january
3862
2006
/
Total
12452

Voluntery and Confidential Counceling and Testing

As of 2004, HOPS is providing a VCCT and in that respect it is the only NGO in Macedonia that does that. Conclusive with 31.12.2006 and with a 6 month break, up to now we have made 205 testings among injecting drug users and commercial sex workers.

Social services

The team of 4 social workers provides the following services on the outreach and in the drop in centres:

- Services and support for fulfilment of social rights (right to social welfare, health insurance etc.)
- Assistance in issuing necessary documents
- Linking with health and social institutions and accommodation there
- Providing employment related information
- Contacts with clients’ families etc.

Year
*a)
*b)
*c)
*d)
*e)
*f)
*g)
*h)
*i)
1999
14
10
14
2
11
2
2
1
/
2000
n.a
/
/
/
/
/
/
/
/
2001
2
10
21
41
0
2
2
1
/
2002
37
34
40
121
2
8
5
2
/
2003
48
22
41
86
2
20
1
4
/
2004
65
47
66
139
9
24
2
1
/
2005
183
66
193
228
27
63
15
0
3
2006
/
/
/
/
/
/
/
/
/
Total
368
189
624
42
128
3
27
9
3

*a) ИInformative counsel for receiving health insurance
*b) Informative counsel for receiving social welfare
*c) Informative counsel for issuing ID documents
*d) Reference to another appropriate institution or organization
*e) Informative legal counsel
*f) Counseling and other type of socioterapeutic individual intervention
*g) Informative council for accommodation or shelter
*h) Informative council regarding employment or employment training
*i) Counceling and other type of socioterpeutic group intervention

Year
*j)
*k)
*l)
*m)
*n)
*o)
*p)
*r)
*s)
1999
/
/
/
/
/
808
/
3
/
2000
/
/
/
/
/
380
/
/
/
2001
4
9
2
0
13
/
2
6
1
2002
5
21
34
1
32
/
3
15
1
2003
8
23
48
1
62
/
2
25
9
2004
3
27
71
2
88
/
4
39
4
2005
22
29
338
2
764
0
11
895
28
2006
/
/
/
/
/
/
/
/
/
Total
42
109
499
6
947
1188
22
983
43

*j) Accompanying clients to different institutions and organisations
*k) Contacts with institutions on behalf of the client
*l) Visiting a client in his/her home
*m) Visiting the client in a health institution
*n) Administrative costs for issuing documents
*o) Free meal
*p) Other type of material support (clothes, blankets, vitamins)
*r) Informal conversations
*s) Contacts via phone

Provided social services

Year
Number of provided services
1999
66+808 (Meals) = 874
2000
263+380 (Meals) = 643
2001
135
2002
367
2003
402
2004
591
2005
2874
2006
/
Total
4698 (6215)