HIV Australia | Vol. 12 No. 2 | July 2014
By Ele Morrison
This article presents some case studies of successful partnerships between the Australian Injecting and Illicit Drug Users League (AIVL) and networks of people who use drugs in Asia, reflecting on some challenges experienced by these networks, both in Australia and across the region.
Case study one
I first met the Coordinating Committee of the Vietnamese Network of People who Use Drugs (VNPUD) in March, 2010.
This group of five people had been introduced to me through a Vietnamese non-government organisation (NGO) which provides support for the group.
They had only formed a few months before and already had over twenty member groups at local levels around Vietnam, despite very few of them ever having had any funding or support.
I wanted to meet with them and was going to Vietnam anyway, so organised through the NGO to have a meeting with the President.
A few days before I arrived I was asked to provide a workshop. It sounds crazy now, but as probably the first peer-based organisation of people who use drugs (PUD) to ever receive funding to work with other PUD organisations in developing countries, it was an opportunity we didn’t want to miss.
I delivered VNPUD’s first organisational development workshop on developing a mission statement, designing a constitution, basic strategic planning and some very basic ideas for communication within the network.
The idea was that these things could help them start to develop the structure and governance of their organisation and start advocating for support from other organisations within Vietnam.
The workshop was like no other I had delivered during the course of my international career. At no time in the four day period were all five people in the room, and at no time was I told who I could expect to be there.
One woman missed two-and-a-half days because she was worried about her chickens, and spent most of the time she was there on the phone.
Another person left a day early and others missed periods of time to attend meetings with other organisations.
They were eager to start early, but forgot to tell me and after the first day, most of them were late. They weren’t so eager to stay late. But when they were there, they were some of the most enthusiastic and motivated people I’ve worked with.
They obviously liked each other, enjoyed each other’s company, and really wanted me to be happy. And the President was a tiny woman who had more charisma than most of us have in our left elbow.
At the time we thought AIVL was at the end of its work in Asia. The program was supposed to end a few months later and we didn’t believe there would be any more funding.
A couple of months later, against the odds, we were asked to submit a proposal for another two years of funding and we decided to include supporting the development of VNPUD in our proposal.
It was only then that I found out the results of our hastily developed and slightly chaotic workshop.
VNPUD had taken everything we had talked about and developed a brilliant Mission Statement and Constitution that reflected their objectives perfectly.
They were using it to show other organisations what they wanted to achieve, and were already receiving other support from stakeholders in Vietnam.
Since then, we have worked with VNPUD in several different ways. We have provided workshops, support for their launch, shared resources, brought them to international and regional events, and worked with them to develop relationships with other stakeholders.
Their membership has more than doubled. Their Coordinating Committee has changed.
The President, the petite woman from my first meeting, is still fearlessly leading them all.
They still face serious barriers to their ability to legally register the organisation, and they still don’t have much core funding.
They have received funding for some activities and training over the years, all of which they use to help them navigate their next steps and develop the capacity of their members. The many organisations and relevant government departments in Vietnam know who they are.
They stand up and advocate for change whenever they can. They are extremely passionate about issues like compulsory drug detention centres and the human rights of people who use drugs.
Case study two
Recently I worked with the Coordinating Committee and a few key leaders from their member groups in another workshop.
This time, I was co-facilitating with someone from one of the most successful and established PUD networks in Asia, the Indonesian Drug Users Network, PKNI.
The workshop focused on training the participants to provide training on blood borne viruses, particularly HIV and hepatitis C, to their peers in the network.
Over three days they learnt the basics, as well as more in-depth knowledge about HIV and hepatitis C.
The Indonesian facilitator and I were surprised to find out the extent to which a person’s right to health has been ignored in Vietnam.
Many of the participants in the workshop were HIV-positive, but none knew the results of their viral load or CD4 tests.
They had never been told why they had been started on antiretroviral treatment (ART) when they were, and nor were they educated about the Vietnamese standards for antiretroviral medication.
Some thought they were positive for hepatitis C as well, but few had voluntarily accessed a hepatitis C test, they just knew they had been given a hepatitis C test at some point.
It was most likely an antibody test, which would only have told them if they’d been exposed to the virus, not whether they had developed chronic hepatitis C. And they weren’t told the results of those tests either, they just made assumptions based on the way they were treated afterwards.
They learnt a lot from hearing the experience of the Indonesian facilitator, and everyone agreed people have the right to know their own health status.
Our similarities and differences: some reflections
The workshop was also revealing in other ways. My experience in countries around Asia is that there are many things we share with our peers in other countries. We tend to quickly develop trusting relationships over cigarettes and stories about drugs.
We talk to each other about things we can’t easily talk about with people who don’t share our experiences. This workshop, attended by people from three different countries, including two lower income countries, revealed the ease with which those similar experiences can bring out and translate into useful information across cultures.
The Australian experience is relevant in many ways, but there are ways where it isn’t as relevant, or isn’t perceived to be as relevant.
In particular, Australians who inject drugs don’t have a shared history of high rates of hepatitis C and HIV co-infection.
In the middle was the Indonesian experience, where harm reduction and the capacity of PUD networks have come a long way in comparison to Vietnam.
PUD networks and organisations in Asia are all fighting a lot of personal, social and political battles, similar to many of the battles we continue to face in Australia.
Over the three years or so I’ve known them, VNPUD have stayed the same in many important ways such as their commitment and their passion. They have also significantly changed.
The amount they have grown and learnt in this relatively short period of time is incredible, and they have achieved this with very little resourcing.
The partnerships we have developed with these different networks reveals something to us in Australia about where we have come from, and where our peers in other countries could be heading.
At the same time, our different experiences show that we all have things to learn from each other.
Ele Morrison is International Program Manager at AIVL