Pave the Way to Salvation. Rehabilitation of injecting drug users, men and women, HIV positive or not, age 18-30 years old.

Pave the Way to Salvation. Rehabilitation of injecting drug users, men and women, HIV positive or not, age 18-30 years old.

Estonia
Organization type: 
nonprofit/ngo/citizen sector
Budget: 
$50,000 - $100,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Our task is to give hope to injecting drug users (IDU) and their relatives, to break stigma about useless of this work. We started with this work first in Estonia. Our main clients are opiate-users, from Russian speaking minority. Till now we are the only organization in Estonia, who does it in a complex from the first meeting with IDU on street work, needle exchange, later Methadone Treatment, rehabilitation in Day center and in a countryside house. We have different specialists who do this work: psychologists, psychiatrist, social workers, street workers, staff of the farm, needle exchange staff.

About Project

Solution: What is the proposed solution? Please be specific!

Our main innovative initiative is the complex approach to the problems of IDUs in our organization and project. We started with this work in 1997, first in the country. Today in our country we have several centers who deal with problems of IDUs, but as a rule all this centers deal only with one single problem and different centers work separately, without network connection. Other innovative approach is our cooperation with probation services. Probation officers send us IDUs for rehabilitation and after that probation system is working better. After rehabilitation (usually it continues 1-2 years) our social workers help IDUs to find work or study possibilities. Other projects and organizations usually do not do it. One more innovative approach is cooperation with a social system of children protection. We help women-IDUs to be ready to rise their children, because without rehabilitation it can not be successful. Other centers usually do not do it. One innovative approach was opening of a women rehabilitation farm in 2009. We hope that in future we can share our experience and try to spread our methods to other organizations working in the field. An organization in Narva, Rehabilitation Center for IDUs follows our experience and manages complex approach to rehabilitation of IDUs too.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

First step is to meet IDUs on the streets or in needle exchange point, inform them about safe injecting and safer sex, give clean needles for them, take dirty ones from them, tell about HIV and hepatitis B and C prevention, overdoses prevention, about possibilities of treatment and rehabilitation. Those who are motivated to get treatment are sent to Methadone treatment. Most of them go to maintenance treatment, some of them to detox. For those who finished Methadone treatment, we provide rehabilitation in Day Center or in the farm. It is very important to inform society about our activities because many people ignore the needs to help IDU-s and are pessimistic about results. One of the important activities of our project is the fighting against stigma and discrimination of IDUS e.g. HIV positive.
About You
Organization:
AIDS Information and Support Center (AIDS-i Tugikeskus)
About You
First Name

Nelli

Last Name

Kalikova

Twitter
About Your Organization
Organization Name

AIDS Information and Support Center (AIDS-i Tugikeskus)

Organization Phone

+372 5068156

Organization Address

Kopli street 32, Tallinn10412

Organization Country
Country where this project is creating social impact
How long has your organization been operating?

More than 5 years

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Innovation
What stage is your project in?

Operating for more than 5 years

Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.

Estonia is a small country, 1 360 000 inhabitants. Former Soviet republic now it is democratic independent country, member of the EU. Economic situation of people is still hard, prices are almost the same as in Western Europe, salaries 5-6 times less. The huge HIV epidemic in Estonia broke out in September 2000 from Russian border in the eastern part of the country (Narva). Most of HIV positives were IDU-s. Owing to the widespread needle exchange program, the intensity of the epidemic has diminished. If in 2001 1474 cases were discovered, then in 2010 the corresponding number was 372. Nevertheless, Estonia still holds the first place in Europe in the spread of the HIV infection. The most affected areas today are Tallinn and eastern part of the country. If in previous years the infection spread among IDU-s through sharing dirty needles, then today its transmission sexually is on the rise.
On September, 02 2011, 7949 HIV cases had been registered in Estonia, among them 342 cases of AIDS. Till now people aged 15-30 are dominated. The society was not ready to support such sensitive projects as HIV prevention of IDUs, sex-workers, gay people, support of HIV positive people. It took several years to change the attitudes of the society and policy makers, but till now stigma and discrimination of those groups still exist. Increasing of opiate using was new phenomena in middle 90-s in Estonia, and all our new activities (needle exchange, Methadone Maintenance, rehabilitation of IDU-s, HIV prevention in Prisons) met extraordinary resistance in the society and among politicians. In poor society help to marginalized groups of people was not popular. Last years new trends are in the field of drug using: more and more women are involved to opiate using. In whole country there were no places for rehabilitation of women-IDU-s. Our center started with women rehabilitation in the farm house in 2009 with help of the USA Embassy. Practically all our projects at the beginning were innovative and creative for our country, despite everything we continued the work and now our activities are acceptable among governmental and local politician and decision makers.

Share the story of the founder and what inspired the founder to start this project

Our organization started to work in 1994. All our activities were occasioned by the situation in society. In the beginning of the 90-s prostitution started to be a problem in Estonia and we started with our first and till now sole project "HIV and STD testing, counseling and STD treatment of Commercial Sex-Workers. February, 1994" In the middle of the 90-s epidemic of injecting drug using and in 2000 huge epidemic of HIV started in Estonia . It was urgent need to start with several projects helping IDUs. We were the first who started the following projects in Estonia:
• Needle exchange and counseling of injecting drug users. May, 1997
• Methadone treatment. September, 1997
• Rehabilitation farm house for men-drug users „Pave the Way to Salvation”. Desember,1998
• HIV prevention in Prison, 2000.a.
• Rehabilitation Day Center for men drug users, 2001
• Day Center for sex-workers, January, 2003
• Case management for drug users, 2007
• HIV prevention among newborns (the treatment of pregnant opiate-dependent women with Buprenorfin), 2008
• Rehabilitation of drug users from Probation System, 2008
• Rehabilitation farm house for women-drug users „Pave the Way to Salvation”. January,2009

Social Impact
Please describe how your project has been successful and how that success is measured

1.Our needle exchange project have 900 visits per month, 10800 per year. This project is resource for our treatment and rehabilitation activities, staff of the project motivate clients to move to treatment.
2.Our methadone treatment has 200 patients on the list. More than half of them (65%) started to work after starting treatment. Criminal activity of Methadone patients has decreased dramatically, from almost 100% to 5-6 %.
3.In rehabilitation Day Center we have approximately 150-200 visitors per month. In Day Center visitors have counseling of social workers, psychologists, group of art-therapy, support group for co-dependent relatives. The quality of life of visitors of Day Center has improved.
4.In the countryside house we have two houses, one for men with 10 places, other for women with 10 places too. Clients stay in the farm for 12 months. Life skills education, work therapy, art therapy, 1 time a week counseling of psychologist, peer educator for program "12 steps", agricultural work, all this measures are offered for clients of the farm. After rehabilitation at the farm clients continue to visit Day Center. Our social workers help them to find work and successfully integrate into society.
Our center has good image among IDUs and they prefer our methadone center and farm to another similar centers.

How many people have been impacted by your project?

101-1,000

How many people could be impacted by your project in the next three years?

101- 1,000

Winning entries present a strong plan for how they will achieve growth. Identify your six-month milestone for growing your impact

We will include to our rehabilitation system activities for turning to the better the health of our clients in Day Center and in the farm, e.g. mental health and mental outlook.

Task 1

Organize computer courses for clients of Day Center and the farm for preparing clients for the future labour market

Task 2

Organize a sport-room with sport equipment in the farm for health improving.

Task 3

Organize Estonian language courses in the farm to prepare clients for the labour market

Identify your 12-month impact milestone

To continue task 1 and task 3, to repeat both courses for next group of clients of Day Center and farm. To include the course of cultural education (Estonian culture, sight-seeing, etc.)

Task 1

Continue computer courses for clients of Day Center and the farm for preparing clients for the future labour market

Task 2

Organize cultural course for clients of Day Center and farm to improve mental outlook.

Task 3

Continue Estonian language courses in the farm to prepare clients for the future labour market.

How will your project evolve over the next three years?

Over the next 3 years we plan to develop rehabilitation in Day Center (organize support groups for IDUs on Methadone Treatment, to enlarge support group for co-dependent relatives, art-therapy for clients and for staff of center as "burning out" prophylaxis, organize support group for HIV positive people). In the farm we plan to continue current measures and plan to organize work-shops for men (woodwork)and women (fancy-work).

Sustainability
What barriers might hinder the success of your project and how do you plan to overcome them?

1. Stigma and discrimination toward IDUs in society. We have popular website on Estonian and Russian languages and through that make influence to young people –the Internet users. 5-6 times a year we do interviews in TV, Radio and newspapers, explaining how important is treatment and rehabilitation of IDUs for society, how it decreases drug-related illnesses, how it decreases criminal activity of IDUs, how many of them come back to society.
2.Project based financing of the projects. Usually all our projects have one year financing and it continues many years. We cannot plan our activities for 3-5 years, because we are not sure about next year financing. We work with our officials and policy-makers about possibility for longer financing period, at least 3-5 years.

Tell us about your partnerships

AIDS Tugikeskus has developed international relations with several other ASO-s (AIDS Service Organizations): Finnish AIDS Council in Helsinki, Finland; GENDERS, Latvia, HIV-positive groups in the Baltic countries, Finland, Sweden; STAKES, Finland, Kvinnoforum, Sweden.
We are the members of EuroCASO, EATG, ILGA, TAMPEP, AIDS & Mobility
Our partner, Medical Center „Elulootus” registered in 1997, is responsible for all medical procedures of our project (methadone, HIV and STD testing and treatment, they are located at the same address.

Explain your selections

1.Families support feeding of rehabilitation farm clients 85 USD per month per capita.
2.European Structural Found support our rehabilitation project approximately in amount 50%.
3.Regional and National Governments support our project equally approximately 25%.

How do you plan to strengthen your project in the next three years?

1.European Structural Founds finish our support in November 2012. We plan to do new application for next 3 years.
2.Regional and National Governments probably will support our project next three years too.
3. We plan to do application for 2012 year to our National Gambling Foundation.

Challenges
Which barriers to health and well-being does your innovation address?
Please select up to three in order of relevancy to your project.

PRIMARY

SECONDARY

Lack of physical access to care/lack of facilities

TERTIARY

Health behavior change

Please describe how your innovation specifically tackles the barriers listed above.

1.Lack of affordable care. 90% of our clients-IDUs have not medical insurance and they have not access to services. Our project offers them free Methadone treatment rehabilitation in Day Center. Most of our clients are Russian speaking young people. We offer them linguistically and culturally appropriated services.
2.Lack of physical access to care/lack of facilities. In Tallinn we have 50% of needle exchange services in town. In Methadone Treatment our center offer help for 200 clients. Two other Methadone facilities from other organizations cover equally 50 clients. In whole country only our center has a rehabilitation farm for women (10 places).
3. Health behavior change. All IDUs who came through rehabilitation, have changed their behavior to healthy life direction.

How are you growing the impact of your organization or initiative?
Please select up to three potential pathways in order of relevancy to you.

PRIMARY

Influenced other organizations and institutions through the spread of best practices

SECONDARY

Enhanced existing impact through addition of complementary services

TERTIARY

Repurposed your model for other sectors/development needs

Please describe which of your growth activities are current or planned for the immediate future.

In our opinion our best practice is a complex approach to the problem of drug using. We are planning to share our experience with other organizations in our country, who deal with several aspects of drug using problems too. The goal of this activity is to create real network with plan to create complex approach involving other organizations of same profile.

Do you collaborate with any of the following: (Check all that apply)

Government, NGOs/Nonprofits, Academia/universities.

If yes, how have these collaborations helped your innovation to succeed?

1. Government structures help us with finances of our project.
2. NGOs and nonprofit organizations in Estonia and abroad share with us experiences of work with IDUs, give us new methods and ideas. Many of them are interested in our experience.
3. Academic and university investigators did several scientific investigations in field of behavior of IDUs, needs of them e.g. HIV positive people. Most of investigations were conducted by Tartu University, one by USA scientists and one by investigators from England. Those investigations helps us deeper understand our tasks and to analyse results of our work.