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such, water-amps, swabs, filters, steri-cups and a range of needles (including
Exchange Supplies’ ‘NeverShare’ variety) and barrels can be provided, along with
harm reduction brief interventions. Each NSP pack given out also has an
adhesive label on it that promotes safer disposal with the peer-designed slogan,
‘If You Bang it, Bin It!’ – itself an illustration of dynamic, creative and innovative
outreach work that challenges many drug-related outreach projects’ reluctance to
walk the streets with injecting equipment for wider distribution.
Dotted around the city centre on many of the public litter bins are dedicated
advertising slots that have been provided by Dublin City Council at no cost to the
Ana Liffey Drug Project. Duffin explained that these prime advertising sites
provide the ideal opportunity to publicise and promote the project’s outreach
work, and its 1800-78-68-28 Freephone line gives callers information and
signposting to services.
Staff at Ana Liffey have combined the telephone service with the
outreach service to create a genuinely innovative and rapid
response NSP throughout the city centre. As Duffin says, ‘All our
staff are very client focused – we’re constantly seeking new ways to
reach marginalised clients, or to improve accessibility to existing
services.’ In the case of the NSP, individuals may call the 1800
number free of charge and be transferred to an outreach worker’s
mobile phone. The client and workers arrange a mutually
convenient time and location to meet, giving an opportunity to
discuss injecting paraphernalia and how the client can obtain new
equipment and return used paraphernalia. They are also offered
sharps boxes in an attempt to minimise drug-related littering. As
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Outreach
with conventional NSP, this meeting also provides opportunities to conduct some
form of limited intervention, such as checking an individual’s physical injecting
sites and inspecting any related injuries, and providing a referral to the blood
borne virus nurse at Ana Liffey’s medical surgery.
Provision of equipment takes place in a discrete manner and does not involve
the open distribution of injecting equipment for all to see. As with conventional
NSP, activity data is collected by the outreach team, including documenting the
interaction and what items may have been distributed and returned. In the first
five months of this year, 381 NSP interventions were done under this system of
outreach, including telephone referrals.
Further developments in this street-based project are to pilot the use of a
tablet, or other portable device, that can be linked to a centralised system for
recording similar data within static sites of NSP and have the ability to show
harm reduction videos relating to safer injecting. This would help to feed live data
to a master-monitoring system and provide immediate up-to-date information
regarding process, performance and outcome of all relevant activity. Ana Liffey
also intends to promote its Freephone number across the 12 counties of Ireland
where they currently provide direct client services through a telecommunications
hub, linking Freephone callers throughout Ireland to satellite Ana Liffey outreach
teams that can best respond to the caller’s needs.
This street-based form of NSP is innovative because, as far as I am aware, it
is the only service where the caller is directed by internal transfer within the
offices of a central location to an outreach team’s mobile phone. However, what
struck me most about Ana Liffey’s outreach project is the pioneering and
inventive application of old and new methods – combining peer-based outreach
with portable telecommunications that in turn are advertised by traditional
methods using street-based furnishings (litter bins). As the latter are positioned
in street settings they are more likely to be noticed by the target population of
this particular project – people who are homeless and/or those participating in
street-based injecting.
Simplicity and technology underpin the initiative to provide a method of actively
engaging with street-involved individuals who may not necessarily be in contact
with mainstream drug services. I am further impressed by how the project
genuinely reflects the original street-based ethos that defined harm reduction
throughout the UK during the 1980s.
In terms of drug-related outreach work, however, the project ticks all the
required boxes. In addition to engaging with hard-to-reach populations, it also
involves participation, intervention, advice and information, and creates
opportunities for referral to other services
while complying with the need for
confidentiality. In short, it is a project that
is consistent with the practice and
principles of harm reduction, and its
street-based focus provides culturally
relevant and environmentally significant
opportunities for interaction and
communication.
Indeed, this is a project that should be
given some consideration in other settings
and could very easily be emulated
throughout the UK and beyond, made
easier by Ana Liffey’s culture of sharing
their resources, knowledge and expertise
as much as possible.
DDN
Stephen Parkin is a research fellow at
the University of Huddersfield and is the
author of Habitus and drug using
environments (published by Ashgate
Sociology, 2013). Email:
s.parkin@hud.ac.uk
Tony Duffin is director of the Ana Liffey
Drug Project. Further details of the street
work described above are available from
tony.duffin@aldp.ie
ise