Author: Md. Mamun-Ur-Rashid; Technical Coordinator-M&E
Source- PWID Project, CARE Bangladesh
There are 33,067 injecting drug users in Bangladesh who are known as PWID (People who Inject Drugs) and among them approximately 6,500 PWID live in Dhaka city (Mapping and Size Estimation of Key Populations in Bangladesh 2015-2016). HIV prevalence rate is high among the PWID in Dhaka city and now its 6.4% (Integrated Biological and Behavioral Survey (IBBS) 2020). PWID project of CARE Bangladesh is a comprehensive prevention program to prevent HIV in Bangladesh among the people who inject drugs (PWID). CARE Bangladesh runs 35 drop-in centers (DIC) in 13 districts. Through the DIC, CARE Bangladesh implements Needle-Syringe exchange program at outreach, essential clinical services for PWID, provide Opioid Substitution Therapy (OST), conduct HIV test among PWID, Provide Anti-Retroviral Therapy (ART) to HIV positive PWID, conduct advocacy for enabling environment for the participation In HIV Program etc. PWID project does not provide only services to the PWID, but also integrate them to the project by giving opportunity to work as a project staff who are competent for the different positions.
Md Jahir is a 40-year-old Peer Outreach Worker (POW), currently working at Hazaribag outlet. While asked him about his journey to become a staff of CARE Bangladesh, his quick retort was, “It was only possible because of the people work in the CARE Bangladesh. They taught me how change my life and live with hope”. However, the journey was not a simple one.
There were 6 siblings who were living with his parents when he was young and he was fifth. He was introduced to Marijuana at the age of 20 as he lived in a neighborhood where it could be easily accessed. Jahir spent almost all his day smoking marijuana with his buddies, but he never imagined that this would become an addiction. As time went by, his usage increased. His family decided to marry him off in hopes to bring him back to a normal life. But it was an effort in vain and failure to cope in family life diverted him to more serious drugs, heroine. When his family tried to help him by forcibly taking him to a rehabilitation center, he got furious and decided to continue taking heroine after being released from rehabilitation center. He said, “my family tried their level best to take back me normal life and admitted several times for rehabilitation. But it was very short time to relapse after coming back from the rehabilitation center.”
Soon after his release, Jahir went back to his old practices; however, it was getting difficult for Jahir to afford heroine pills. In this situation, other users suggested him to switch to injectable heroine as it was cheaper and would elevate his euphoria further. While switching to injectable heroine, he also moved to being a drug peddler as it brought him some income and he found this quite lucrative too. In response he riposted “I also started peddling injecting drugs to other fellows, which was too much profitable and by this profit I managed drugs for me 2/3 times in a day.”
Jahir came across CARE Bangladesh’s PWID project in one his daily routes when one outreach worker discussed Opioid Substitution Therapy (OST) and its importance in creating a drug free life to Jahir. He got curious and later he was referred to Chankharpul Comprehensive DIC to consult with the doctor and counselor. After a few successful sessions, the counselor finally persuaded Jahir to try OST. He realized that it was a good decision which may eventually turn his life around. He became a regular OST client and received regular counselling sessions. Subsequently, he expressed his desire to work for the DIC and proved himself worthy of that job. The DIC management assessed his skills and recruited him as an outreach worker of Hazaribag DIC. As a POW he is responsible to distribute needle-syringe among PWID, educate PWID regarding HIV related risks, refer PWID to DIC for different services, influence PWID to get admission under OST treatment etc. He dedicated himself for helping his fellow injecting drug users for better life and safe injecting practice. Overall, he is contributing to prevent HIV among PWID nationally through the PWID project of CARE Bangladesh. Currently he is working in Hazaribag outlet as a POW and reintegrated into a family life. He aspires to live a life of prosperity and also serve the people who inject drugs. He tells his tale to his fellow injecting drug users in a hope to transform their life as well. He says “today I am living a good life with respect in my family and society. PWID project helped me to change my life. My life has gone in the dark and now I live in the light.”