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Needle exchanges help those most in need

090930_06
A recovering drug addict eats a meal at Korsang, a harm-reduction organisation based in Phnom Penh.

Dear Editor,

The Phnom Penh Post article “Locals say syringe handouts draw criminals” (September 28) is beyond irresponsible. Korsang, like other harm-reduction programmes globally, constantly struggles against the marginalisation and discrimination against people who use drugs.

Had the Post bothered to contact me, the founder of the organisation, then perhaps it would have avoided perpetuating the tired old stereotype of people who use drugs as “dangerous criminals”. You might also have understood the rationale behind the organisation. No one has requested to see our drop-in centre policy, so how can it then be referred to as irresponsible?

Korsang began in 2004 in order to provide crucial health services for people who use drugs. Injecting drug users in Phnom Penh are dying at an alarming rate. According to the National Centre for HIV/AIDS, Dermatology and STI Control, Cambodia has an overall HIV prevalence rate of 0.9 percent, although 24.4 percent of injection drug users are living with HIV. Korsang’s own statistics are even higher.

Programmes that furnish sterile syringes and other injection equipment to people who inject drugs are generally regarded as an essential part of preventing HIV/AIDS and other blood-borne diseases and are an important approach in reducing risks associated with injecting drugs. Sterile syringe programmes have been endorsed by a wide range of scientific and medical organisations, as well as by UNAIDS and the World Health Organisation (WHO).

Even the UN Office on Drugs and Crime says there is “evidence to suggest that the availability and regular use of clean injecting equipment can prevent, halt and perhaps even reverse HIV/AIDS epidemics among injecting drug users”. Korsang’s overall goal is a public-health approach to advocate for reduced harm and encourage medical care for the population we serve.

Korsang works in a part of Phnom Penh where drug use is common. We work here in order to be closer to the people we serve. The suggestion (made by some people quoted in the article) that Korsang is responsible for neighborhood drug use and crime is unsubstantiated.

A 2004 WHO review of sterile syringe programmes concluded that there is no evidence from the many rigorous studies of sterile syringe programmes that such schemes encourage initiation of drug use or in any way promote drug use.

All the available evidence suggests drug use existed in the area before Korsang began and would continue at the same rate if we left. If you get rid of a hospital, do people stop getting sick?

Needle exchange may also ultimately reduce drug-related crime. If needle-exchange programmes are able to link drug users with drug treatment, such as methadone therapy or drug detoxification, the number of individuals using drugs can decrease, thereby reducing demand for drugs.

Decreased demand for drugs can contribute to decreased drug-related crime and, therefore, increased public safety.

Cambodia is currently slated to begin a pilot methadone-therapy programme as early as December of this year. Harm reduction and needle-exchange programmes are at one end of the drug user service continuum of care; long-term drug treatment is at the other. We are holding our breath in order to begin referring our participants to the methadone programme,and they are holding theirs to get the treatment. We hope the community and the media can work with us, one step at a time, in the long road to HIV prevention with people who inject drugs in the Kingdom of Cambodia.

Korsang believes drug users, like everyone else, must be treated with dignity, compassion and respect.

Holly Bradford
Korsang founder/technical adviser

Editor’s note: A Korsang representative who addressed the public forum was quoted in the article.

Send letters to: newsroom@phnompenhpost.com or PO Box 146, Phnom Penh, Cambodia. The Post reserves the right to edit letters to a shorter length.
The views expressed above are solely the author’s and do not reflect any positions taken by The Phnom Penh Post.

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