Belarus case study: harm reduction

Published: 1 December 2010 13:00 CET

By Joe Lowry

Nikolay and Irina spend all their money on ‘semechki’, a homemade poppy-seed paste, the drug of choice in the drab town of Slutsk (pop. 70,000, levelled in the Second World War), two hours’ drive south of the Belarusian capital, Minsk. Their families have long since kicked them out. They work, they live, they use. Sober hours are spent wishing they had never started, till the rats start scratching in their brains and the only thing they can focus on is their next ‘hit’—their next ‘shot’. Release is immediate: the bliss, the love… until it wears off and the ‘hate-it-need-it-love-it’ cycle starts up all over again.

To the casual observer, Nikolay and Irina are just another couple of junkies, human refuse floating on the post- Soviet sea of despair. But they have a purpose. Nikolay and Irina are saving lives, needle by needle. Every day, they commute to a shabby apartment crouched under the shadow of two massive chimneystacks on the edge of town and begin their work. Each has 40 clients who inject several times a day. Nikolay and Irina bring them clean needles and take back the used needles (coated with a residue of narcotics, which, without a special agreement between the Red Cross and the police, could carry a jail term), package them for destruction and then head back out: back to the alleys and tower blocks where their fellow addicts are waiting. “No one I work with uses a dirty needle now, but we all used to,” says Nikolay. “We know what AIDS can do and we don’t want to catch it.”

In addition to running the needle and syringe exchanges, the couple handout needles, swabs, condoms, vitamins and specially fortified chocolate bars that help nourish those who are too ill, too poor and too drug-dependent to feed themselves properly. Nikolay and Irina know the streets, know the users, know the risks. They are trusted in a way no police, partner, parent or religious leader could ever be. That’s why they go to schools and tell children what it is like to be a user: how tough, ugly and dangerous it can be. We don’t say, “just say no”, we say, “this is how it is. You choose”.