Harm Reduction Drug Project Uzbekistan - Contact Netz

The Uzbek partner outlined developments related to the drug problem and the new
challenges arising from these. For the Uzbek participants the participation in the
conference of all the relevant groups from institutions and NGOs was a new
experience. Doctors, as well as representatives of the NGOs, the police, and the
government, commented on various aspects of the problem from their own points
of view. While the discussions did not always lead to consensus about harm
reduction and substitution therapy, most participants agreed that the debate must
continue and that new ways to overcome the problems must be found. From the
doctors’ point of view, the fact that anonymity is not guaranteed in their dealings
with drug addicts is a very serious problem. Here the reality seems to fall well short
of the project’s objective. 4
One objective of the conference was to work with the Uzbek participants to develop
ways of carrying out the work in a way that fits in with their own work environment.
This proved difficult. In a number of cases the discussions were unable to move
beyond questions about Swiss-style implementation. It proved extremely difficult to
develop ideas of how the Swiss approach could be adapted. In the unanimous
opinion of the participants there is an urgent need for discussion in this area at the
political and expert levels.
6.2 Phase Two - August 2003 – October 2004
6.2.1 Opening the Contact Centres in Tashkent and Samarkand
At this point Contact Centres were opened in Tashkent and Samarkand. These are
meeting places for addicts, and it is here that syringes are exchanged and
information provided. The Contact Centres also serve as meeting places for other
interested parties including parents and self-help groups.
The search for suitable locations ran into difficulties, particularly in the Tashkent
region. Although there are many empty apartments and houses in Tashkent, it
proved impossible to find one for the project. As soon as the landlord discovered
how we intended to use the property, it was withdrawn from the market. In the end
a house had to be bought so that the centre could be opened.
6.2.2 The project teams in Tashkent and Samarkand
Each of the four paid employees supervises between 100 and 140 volunteers who
distribute syringes. The volunteers are not paid for their services. As incentives,
however, they are offered additional training as well as items such as T-shirts and
food. The counselling provided by staff and volunteers is more or less limited to
concrete questions about heroin use – the transmission of diseases such as
HIV/Hepatitis, overdoses, etc. Psychosocial counselling is rare, partly because staff
lack the necessary basic training, and partly because there are no therapeutic
support services accessible to all. 5
A pilot project for the supply of methadone was due to start in August 2003, in
collaboration with the Soros Foundation. It has still not been launched however,
and is unlikely to start up in the near future, since the Soros Foundation was forced
to curtail its activities in Uzbekistan for political reasons.
4
See the report “Drug Policy and Practices Uzbekistan - Switzerland, Harm Reduction Drug
Conference July 2003”.
5
The few therapeutic services available are in general too expensive for those involved in
the project.
20
Challenge of
new drug
problems and
drug policy
Developing
scenarios
Need to buy a
house for the
Tashkent
Centre
Help from
volunteers
Methadone pilot
project
postponed
indefinitely