Could you please tell us about your interest in women and harm reduction?
“It was 15 years ago, I was sick and in pain, I just heard my family cries and thought I was going to die. But I was being saved – because our village head treated me with “the magic drug – opium” from his back-yard opium plantation. Since then, I consumed it for the sake of my health every day, I can’t live without it. Now the opium became very rare, expensive and my grandson d brought me white heroine from his jade-mining work, as it is cheaper. I am addicted to it. I wanted to get-off this, I need help and help me please…” I met this 70-year-old, a healthy looking, grandma from Seng Taung, Kachin state during an outreach visit to a drug consuming site with our outreach workers. She had walked for miles from her villages to score drugs with the pocket money her son gave her. She was treated with respect by her fellow male-drug users. She might be discriminated against by her village fellows, but in this peer- environment, she is safe, secure and respected as a senior.
Since then, my interest in women and harm reduction grew. The calls for help women with health care, drug treatment and harm reduction services are lost to the male dominated responses. There are many un-heard and un-told stories by WUD that need the attention of donors and service providers. Since
How does Best Shelter Myanmar engage with women who use drugs?
Women who use drugs feels respected by women peers, so we engage with them by employing peers and empowering them with regular training and coaching. In addition, they live within the community as grandmothers, mothers, sisters, wives etc, so we also recruit women community prevention workers, working for the community by the community. It is our experience that the work is more successful with community-based engagement by involving peers in reaching WUD.
How has Best Shelter Myanmar designed services to be relevant to WUD?
Drug issues in Myanmar is not only an urban issue, but widely a rural issue. Drug use is found in all villages on drug trafficking routes, as well as those in contact with economic and conflict migration. Every village household in Kachin has faced challenges with drug dependency. Being a community-based organization, we involve women peers/CPWs from the villages who are interested in helping. They are being trained on different drug use related topics including drugs, dependency, overdose, HIV/ TB and drug use, COVID-19 etc and they then provide health education to their fellow peers, offer them choices of drug treatment, HIV testing, TB screening and other services. After trust has been established, WUD who want to seek further services are referred to the Best Shelter mobile teams or nearby harm reduction service providers. It is the client’s choice to seek the required service, ranging from a sterile needles and syringes, condoms, HIV testing and counseling, psycho-social support, or drug treatment. When women choose so, we assist, mostly with accompanied referral along with full transport and meal support so that they do not feel alone – a sort of buddy system. The community peers follow up with the women for support with treatment adherence on MMT, ART and TB if there are issues to resolve, by consulting with Best Shelter or harm reduction teams. In summary, the peers are the bridge between the hidden women who use drugs who are looking for support and the harm reduction service providers.
Which would you choose as the most exciting part of your work (and why)?
“Despite of my HIV status, I get pregnant but I couldn’t stop my drug use. I want to deliver a healthy baby. My friend introduced me to a free harm reduction clinic where I receive free medical consultations and drug treatment (methadone), and a hospital referral for delivery which covers all my expenses. I could deliver a healthy kid and thanks!” “Both my husband and I tested HIV positive. We felt like shit. After the counseling session, we came to know that there are options and not to lose hope. Now we both are on ART.”
Based on this experience, what would be your advice to other organizations around the world wishing to improve services for women who use drugs?
Many donors, politicians, head of the organizations, harm reduction program implementers –regardless of their gender, “unintentionally” forgot to include women who use drugs and to provide relevant services. Just look at my example! I came to know of this gap only after I heard the voice of grandma.
- First WUD themselves should be assisted to be aware of their health rights and needs
- Listen to their voices
- Involve them in service delivery
- Even if you have funding limitations, try to integrate basic harm reduction services tailored to WUD (as part of general harm reduction activity) such as NSP, condoms and health education, having women outreach workers, a relevant referral system etc..
- Be aware of womens specific needs including GBV, family planning, SRHR, perinatal harm reduction services, and expand services accordingly.
Profile: Thinzar Tun, Program Director, Best Shelter With almost two decades of Harm Reduction experiences in Myanmar with Asian Harm Reduction Network (AHRN-Myanmar), a local founder of the organization since 2003. Currently working as a Program Director at Best Shelter, a local NGO dedicated
to the community-based Harm Reduction activities, including WUDs interventions. A woman leader for bringing in the capacity building of local staff, peers on WUD related knowledge and expertise as well as expanding community-based WUDs interventions through the international networks of WUDs expertise organization like APHR, NHRC, WHRIN etc.
Contact details are:
E mail – bs.pd@bestsheltermyanmar.org
Listening to client feedback on our work is the most exciting part of my work. Though they are not always success stories, WUD felt they are being respected and included, being heard and listened to – that matters for me since most are otherwise being ignored, neglected and discriminated against.
Is there anything you plan to work on more on WUDs in future?
Yes – specifically for the pregnant mothers who use drugs in Myanmar. If the WUD are facing “double stigma” for being a woman as well as using drugs, they face “triple stigma” for being a mother who still can’t get “off drugs”. They worry for the baby and consequence of their drug use with very little information or help available. They are challenged by huge stigma as well as very few services linking with women’s maternal health, drug dependency and post-natal care for both the child and the mother. There is no attention paid by service providers in Myanmar. Best Shelter is currently working with Academy of Perinatal Harm Reduction (APHR) and the National Harm Reduction Coalition (NHRC) to revise and and translate the Pregnancy and Substance Use toolkits developed by APHR and NHRC, to transform them into digital information and edutainment (education/entertainment) for clients on a range of specific topics, for training harm reduction staff who are working with WUD and for advocating with donors for potential funding for WUD including the pregnant women who use drugs. The digital health education is a collaborative effort of BSM and APHR and will be seen at https://www.perinatalharmreduction.org/videos.
In addition, Best Shelter has created a dedicated page for WUD under Best Shelters-Myanmar website called “Best Shelter for Her” where Best Shelter and its sister organization Asian Harm Reduction Network (AHRN Myanmar) services for WUD are being launched. https://bestsheltermyanmar.org/best-shelter-for-her/. In future it will be linked with social media platforms to reach a wider audience in-country and promote awareness for WUD through entertainment activities, widely using the resources for pregnant women who use drugs.