The excruciating pain Sameera (name changed) experienced in her abdomen came out of the blue. Unable to afford the doctor’s fee to treat the ailment, she resorted to home remedies. She finally told her husband, Raymond (name changed), when her condition worsened, but she knew he wouldn’t be of much help. Sameera had recently realized, after three years into their marriage, that Raymond was dependent on drugs and had been injecting drugs for a number of years.
She learned that Raymond had started with brown sugar (an opium derivative), but had later switched to injecting pharmaceutical combinations. That explained why he never stuck to any job, and had, at times, even resorted to petty crimes. To make ends meet, Sameera had started to do odd jobs, such as washing dishes or doing household chores. She tried dissuading her husband from taking drugs, but his habit was a hard one to break. Feelings of desolation, anguish and stress increased the discord between the couple and, now, with her paralyzing pain, Sameera felt even more helpless and hopeless.
What Sameera didn’t know was that Raymond had been approached by a local NGO that provided free needles, syringes, condoms, and advice on safer injecting practices and safe sex to injecting drug users like himself. The NGO was implementing the Hridaya Project, which aims to strengthen the HIV response amongst people who inject drugs (PWID) in three states in India including Sameera and Raymond’s home state of Uttarakhand. The programme builds the capacity of service providers and makes harm reduction programmes more gender-responsive. Hridaya also serves to improve access to health services, and advocates for the rights of injecting drug users.
A female outreach worker from the Hridaya Project had kept in touch with Raymond. Fortunately, it didn’t take long for Raymond to trust her since he recognised that the outreach worker was trained and possessed essential skills and knowledge about his condition. She also seemed sensitive towards his drug use and for his concern for Sameera’s health. Raymond learned that the Hridaya Project had an exclusive service component for the spouses or partners of drug users, which provides outreach services to them, empowers them through peer support groups, and increases their access to sexual and reproductive health and legal rights.
Though a bit hesitant at first, Raymond invited the outreach worker to his home where she talked to Sameera about issues related to her husband’s addiction. She also addressed Sameera’s sexual and reproductive health concerns, which included her recent abdominal pain, and informed Sameera about how to avail of medical treatment from the nearest district hospital. To help Sameera overcome her inhibitions about seeing a doctor, the outreach worker accompanied Sameera on each of her visits to the doctor regarding her gynecological concerns.
Sameera was very grateful to the outreach worker and the Hridaya Project for helping her get treated and empowering her with more knowledge. She is now aware of her sexual and reproductive health needs, knows how to protect herself from HIV, and is also much more informed about harm reduction and her husband’s health needs. Drug use is a compelling psychological disorder and it is with love, care and compassion that Sameera can help Raymond get out of it, a fact that she now understands. With her newfound knowledge and support, Sameera is optimistic that her relationship with Raymond and their life together will continue to change for the better.
The author of this post, Francis Joseph, is Programme Officer for the Drug Use & Harm Reduction programmes of India HIV/AIDS Alliance, New Delhi.
Spanning five countries (China, India, Indonesia, Kenya, and Malaysia), Community Action on Harm Reduction (CAHR) expands harm reduction services to more than 180,000 injecting drug users (IDUs), their partners and children. The programme protects and promotes the rights of these groups by fostering an enabling environment for HIV and harm reduction programming in these five countries. CAHR is supported by the Ministry of Foreign Affairs, Government of Netherlands.
In India, CAHR is called Hridaya and is implemented by Alliance India in partnership with SASO, Sharan, and a number of community-based harm reduction organisations and networks. This project helps build the capacity of service providers, makes harm reduction programmes more gender-responsive, improves access to services and advocates for the rights of PWIDs. In addition to providing services, Hridaya has a strong capacity building component to support advocacy, knowledge management and improved services for PWIDs.