Project Sanskar
 
 

“Sanskar”, a Targeted Intervention project on HIV/AIDS prevention amongst Injecting Drug Users at Guwahati, this project was initiated in April 2006. The project received funding from Assam State AIDS Control Society (ASACS) and National AIDS Control Organisation (NACO). Project Sanskar has been working to reduce transmission of HIV and STI among Injecting Drug Users (IDUs), and their sexual partners through a response of increased scale and coverage in the district.
Guwahati is the largest city in northeast India, with a population   of 22 million   The city   is also considered to be the "gateway" to the entire northeastern region. The project is located in an area of 216.79 sq km under Guwahati Metropolitan Development .The pattern of population is of cosmopolitan type.  The city has got innumerable problems like illiteracy, poverty and militancy with associated human insecurity. The region is also in close proximity with “Golden Triangle”, the high poppy growing area of Southeast Asia. Guwahati is also one of the important corridors in the world for drug peddling. There is easy availability drug in the region and substance abuse by the youth is very high in the city. There is high movement of people to this city from neighboring states for education and employment. This state of Manipur and Nagaland has dubious distinction of having   high prevalence of HIV/AIDS and movement of people from these states has made this city very vulnerable for HIV/AIDS epidemic.

Project Information:-
The project Staffs comprises of people who have been recruited by the organization for their experiences of being an ex- drug user   or due to previous work experience in AIDS related projects. Staff of the project comprises of    Project Manager – 1, Counselor – 1, Outreach Worker – 3, Accountant – 1, Doctor (part Time) – 1, Peer Educator – 15. The Project Manager and one of the ORWs of the project have past experience of injecting drugs and the peer educator’s entire are from the targeted community.  All peer educators are also current users. The project has a separate project office and a Drop -In -Centre (DIC), where regular training program for staff /peers/volunteers are conducted. There is also provision of counseling of family members and sex partners of IDUs.  Besides counseling, the project offer other harm reduction services such as needle/syringe exchange program, condom promotion, STI management, general health check up and abscess management. It also houses recreational materials for use of the IDU community. There is regular meeting at DIC for the IDUs and the problems they generally encounter are discussed in detail. Every effort is made to raise the self esteem of the IDU community. They are also involved in all decision making processes and implementation of the project activities. The DIC is located at the centre of the city and can be easily accessed by road by cheap mode of transport. The DIC is in close   proximity to some of the major hotspots,  The Project has thirteen hotspots which are serviced by the Peer Educators under supervision of the ORW .Two of the Peer Educators are given additional charge of working in two other sites as these sites have high load of  IDUs.   The project has six free condom distribution outlets and six outlets for needle syringe distribution. The project has till date registered  652 (six hundred and fifty two) injecting Drug Users, though according to the size estimation exercise conducted on march 2009,Guwahati,Assam, the Injecting Drug Users Community was estimated to be 807 (Eight hundred and seven).   

The project has already built a partnership with psychiatric department of Gauhati Medical College and law enforcement agencies of the state for implementation of the project activities.
The project is monitored both in project and organizational level. Every process of the project is documented for monitoring and evaluation. Any shortcoming found during monitoring is immediately dealt with. The project activities are also hugely complemented by the active participation from the IDUs   such as, formation of “Drop-in -Centre Committee” where the members frame the bye laws of the project   for the benefit of the targeted community.  During the DIC meeting the IDUs share their views and inputs for proper implementation of the project.  There is also a STI coordination committee   assisting to reach the community with STI services and ascertain necessary   follow up of individual cases.
The project offers training facilities to interns from different academic institutions on the issue substance abuse. Individuals from premier institutes like Tata Institute for Social Sciences , Martin Luther Christian University (MCLU),North East Academy etc   and  even from abroad are trained by the organization . It is also involved in conducting regular community events like indoor game competitions, celebrating world AIDS day, International Women’s Day   etc.   Each peer has been trained on crisis management including overdose and other medical emergencies.  Besides these, the project had developed innovative IEC tools like posters/ flipbook covering all aspect of drug abuse.
The project has also adopted innovative and practical means in managing biomedical waste management and disposal like conducting community drives where Project staffs along with community members collects used needle/syringes from injecting sites and dispose it at Drop in Centre for sterilization and final disposal. Puncture proof containers with bio-hazard logo    are used to collect used needle syringes. The organization   has developed a strong network with Mahendra Mohan Choudhury Hospital a government hospital for disposal of bio medical wastes of the project through the hospital incinerator.  The organization has already obtained the necessary permission from the hospital authority for the same. The project have close link with the Drug Detoxification Centre of Gauhati Medical College Hospital and ASHA Bhawan, where the community members are referred for detoxification and de-addiction. The Project is also linked with    DOTS   in which staffs from the project were trained for sputum collection from the high risk community. Necessary sputum containers and necessary documents are made available in the Drop in Centre so that community members can be tested for tuberculosis with ease. The organization has been made as a member of the district committee of Revised National Tuberculosis Program and District AIDS Control society.

Project objectives:- 
a) To enhance the capacity of the service providers to provide  quality   HARM  reduction  services  to  the Injecting Drugs Users of Assam.
b) Provide training and demonstration of ideal Harm reduction procedures to personnel working with IDUs.
c) Improve the functioning of all the harm reduction sites within the project area by direct supervision and offering necessary technical assistance. 
d) Ensure adherence to “Quality Assurance” protocol in all harm reduction sites in the project area.
(e) Availability of outreach services to the wives and sex partners of IDUs
(f) Facilitate rehabilitation services to the IDUS through the existing government welfare schemes.

Profile:

Target population: 600 IDUs
  • Number of districts: 1 district (Greater Guwahati, Assam, India)
  • Number of Hotspots: 13 numbers selected
  • Number of Drop in Centers :  1 number   
  • Number of project clinics:  1 (attached with the DIC)

Services provided to the Community:
  • Clean needles and syringes exchange program and safe disposal (NSEP).
  • Counseling and outreach services.
  • Abscess treatment and prevention materials.
  • STI diagnosis, counseling and treatment.
  • Free Condom distribution.
  • Referrals (ICTC, ART, DOTS).
  • Overdose management.
  • Capacity enhancement training of IDUs and PLWHA
Beside these services, the project is also involved in utilisings services of the following for the benefit of the Injecting Drug Users Community:
(a)Referral to ICTC’s for HIV/AIDS test. (b)Referral to ART centers. (c)Rehabilitation Centre’s for detoxification and rehabilitation (d) DOTS for management of tuberculosis.(e)Government hospitals for medical treatment.

Key Accomplishments:
    • Arrangement with Drug Detoxification Center (DDC), Psychiatry Ward, Guwahati. Medical College and Hospital, (GMCH).
    • Partnership with MMC Hospital for biomedical waste disposal.
    • Rapid scale-up of needle and syringe exchange program.
    • Early identification and treatment of abscesses.
    • Provision of abscess prevention materials.
    • Strong advocacy with local power structures.
    • Creation of demand for project services.
    • Safe disposal of used needle/syringe at incinerator of Mahendra Mohan Choudhury Hospital.
    • Training of persons involved in research on the subject.