A pilot project between the Cape Town Central City Improvement District (CCID) and partner NGO TB HIV Care is working to reduce the harms associated with substance use among people who live on the street.
The pilot project, which has been running since March 2018, was the result of TB HIV Care’s Step Up Project teaming up with the CCID. The Step Up Project provides people who inject drugs (PWID) with harm reduction, HIV prevention and wellness services, based on the World Health Organisation’s recommendations. This includes the provision of sterile injecting equipment and the safe collection and disposal of used equipment, as well as the offering of HIV testing and other medical services, including opioid substitution therapy (OST).
Says Rudolph Basson, key populations project coordinator at TB HIV Care: “The project is progressing better than expected. Its main aim was to support positive change in the lives and actions of people living on the streets of the Cape Town CBD who use drugs, and it has been remarkably effective in doing so.
“We have managed to retain a consistent cohort of participants who regularly take part in project activities and they have made significant positive changes in their lives. In addition, some of the project participants have also made use of the opportunity to access other CCID and TB HIV Care services, which has helped some of them get off the streets. And we have retained in our care all project participants who joined our OST programme.”
OST provides people who are dependent on opioid-type drugs with medication that replaces the illicit drug as part of a structured treatment programme. This, in turn, allows the individual to work on improving their life circumstances with assistance from TB HIV Care.
Rudolph further notes: “As a partner, the CCID has given us the flexibility to be responsive to participant needs and realities and that has enabled the project to continuously evolve to provide support in ways that we hadn’t thought of initially.
“One often hears that street people aren’t interested in services that aim to support them, and I think this project has shown that they are very interested. What’s important is that the services must be appropriate and adapted to their needs.”
Part of the pilot project also involves participants in in an initiative that enables the careful clean up and removal of needles from public spaces.
In support of this initiative, Rudolph adds: “What’s also important to note is that while improving their lives, participants have done a great service to our city through their clean-up patrols and this has resulted in the removal of almost 3 000 injecting needles from public spaces.”
Pat Eddy, the CCID’s Social Development manager, shares Rudolph’s sentiments on how the pilot project is exceeding expectations: “It is heartening for my team to see the positive impact this partnership is having on our clients. And what is most significant for us, which we’re also observing with another one of our NGO partners, namely Khulisa Social Solutions, is that - contrary to popular belief - streetpeople are motivated to move off the streets and are interested in services aimed at improving their circumstances.”
Funding for the pilot project will carry on until the end of July 2018 which also coincides with the Step Up Project, currently run from the TB HIV Care’s offices in the Central City, moving to new premises which could be outside the CBD. Both organisations are in agreement that whether the collaboration continues in its current form will depend on logistical matters as well as the availability of funding, both of which will be discussed in the next few weeks when the project is evaluated in its entirety.
“In terms of the next steps,” explains Rudolph, “some of our participants are at the point where they are ready to graduate from the project and we are hoping to identify options for them to continue their journeys beyond what this project is able to provide. They have regained dignity and increased control over their lives, but for lasting positive change, they need to find longer-term accommodation than what is available at most shelters, as well as opportunities for employment and the development of marketable skills. And this next level in support will help them to become independent and socially reintegrated.
“Overall, regardless of whether the project continues in its current form, it has strengthened the relationship between the CCID and TB HIV Care and has resulted in other collaborations which will continue to benefit members of the public in the CBD, particularly our city’s most vulnerable.”
Image by TB HIV Care