Reducing the Risks

The Argentina Harm Reduction Movement

By Luis Gómez
Part II of a Series: Argentina at the Gates of Reform

August 15, 2003

History notes that in 1994, in Rosario (a city with a little more than 1.2 million inhabitants in central Argentina), the first act of “Harm Reduction” occurred. At the public hospital, professionals linked to the Center of Advanced Studies in Drug Addiction and Aids (CEADS, in its Spanish initials) of the National University of Rosario, began a series of workshops for drug users and worked with others in themes such as the disinfecting of injection devices and safe ways to inject drugs.

With concrete actions like this – like the distribution of Harm Reduction models to the 700 professionals who attended to the First Conference on Drug Addiction in the city of Buenos Aires in 1998 – a network was consolidated, a discussion and investigation was launched: In September 1999 the Argentina Harm Reduction Association (ARDA, in its Spanish initials) was born, with its first goal states as “foment public policies based on the principles of reducing the harms associated with drug use.”

Silvia Inchaurraga Photo D.R. 2003 Jeremy Bigwood

In an interview with Narco News, Silvia Inchaurraga, president of ARDA and director of the CEADS center at the National University, tells that the group grew out of “a group of people convinced that there were possibilities to develop more effective and fair – and more human – drug policies. We recognized that the public policy was a rotund failure.” Such policies, says Inchaurraga, “were – and they are still the official policy – sustained in the demonization of drugs and those who consume them, public health policies based on ‘abstinence,’ and laws based on repression and an iron fist.”

Dr. Gustavo Hurtado

“We who did not agree with official discourse of those who associate – and continue to do so – drug addiction with a plague or pestilence that infects the public from outside and who conclude that it must be combated by any means, including war, joined together,” recalls Dr. Gustavo Hurtado, the secretary of ARDA. “We brought together those, like us, who refused to degrade our work as health professionals by involving ourselves in repressive campaigns of social control.”

Today, ARDA is one of the key organizations in the Latin American Harm Reduction Network (RELARD, in its Spanish initials), which counts among its ranks doctors, attorneys, psychologists and psychiatrists. Also, the members of this association, in general, have wide reach in state agencies and health institutions (including a dozen hospitals) and in various universities in Argentina.

In this respect, Gustavo Hurtado stresses: “We joined with those members of Civil Society who felt it urgent and necessary to offer another kind of response, because we must not resign ourselves daily to inconsistent areas of State intervention – in the fields of health, education, justice, planning, etc. – and to reject our unconditional adhesion to the national government and the majority of state governments who offer nothing but a drug war that is administered by the United States.”

Silvia Inchaurraga, one of the founding members of RELARD, adds that ARDA “has a particular quality: its anti-prohibitionist stance.” That means that this group “understands that the damages associated with drug consumption are not only in the area of health but also in other public fields: social exclusion, discrimination, prison and criminalization… those are the first effects of the prohibition of drug possession in Argentina. And the damages caused by drugs under prohibition are worse than those caused by the drugs (police and judicial corruption, violence, easy crime, arbitrary detentions, and the stigma that criminal law places upon the private lives of citizens, as well as the unquestionable damages caused by prison).”

ARDA, as this series of articles reports, kind readers, is not only a public assistance organization, but, rather, a front for struggle against the entire policy. Have I mentioned, for example, that the honorary president of ARDA, Judge Martín Vázquez Acuña, of the First Criminal Court of the Capital City of Buenos Aires, is a determined reformer who, for years, has fought for decriminalization of drug possession for personal use in Argentina? No? Well, okay, let’s deepen our inquiry…

Reducing Harm with a “Fork”

In recent years, ARDA has participated in the creation of various Harm Reduction programs throughout the country, including the City of Rosario’s “Harm Reduction and HIV/AIDS Prevention Program.” This program has been directed by Silvia Inchaurraga since the year 2000.

According to a study conducted by Dr. Pablo Siri, in May 1999, approximately 71-percent of injected drug users shared their injection needles (more than 90 percent of them had no contact with public health systems), and 63 percent of those were HIV positive.

The “Harm Reduction Bus” in Rosario

“This reality in Rosario, more than a decade ago, and since the foundation of ARDA, caused us to think and develop new responses,” Ichaurraga tells Narco News. “Responses that can only be understood from a different logic: one that respects the differences and human rights of all citizens, whether they consume drugs or not. This defines ARDA’s policy and what we are pushing in this country: A health policy that is inclusive, not exclusive, and that solves or at least reduces the problems and damages associated with drug use, and, fundamentally, at least does not worsen them.”

From this perspective, Inchaurrage and her colleages at the CEADS began to develop a program that included new strategies of contacting drug users, such as a “Harm Reduction Bus” that travels Rosaria by night to, according to Inchaurraga, “crisscross the urban areas where drugs are used and sold, including poor neighborhoods, as well as parks and nocturnal entertainment zones, distributing pragmatic information about drugs, pamphlets with condoms, and explanations about the services and materials that we offer.”

Supported with government financing (from AIDS prevention programs and the national Health Ministry), the Harm Reducers of CEADS also provide “workshops in Harm Reduction, training for drug users themselves to become community educators, and street work to distribute information, pamphlets, condoms and clean injection materials.”

ARDA’s “little box”

The group has also created a kit called “La Cajita” (“the little box”), a packet of material about injected drugs with which each user receives two clean syringes, needles, a sterile container to prepare the drug, two condoms, and also an Injection Manual, elaborated by CEADS and ARDA with the collaboration of some injected drug users, with the message: “If you are going to shoot-up, take less risks.”

This was the first manual of its kind created in Latin America in Spanish. Silvia Inchaurraga comments that the manual “advises, in specific and clear language, about the precautions to take in preparing the drug and where to inject it, how to avoid abscesses and overdose, not to share needles, syringes, the water used or the container in which the drug is prepared.” Also, “it provides specific information related to the risks of cocaine consumption by injection, how to verify the quality and quantity and the amount of time between shots, how to take one’s pulse or use a filter, as well as the use of condoms and the prevention of HIV/AIDS.”

“Fork-head” on the street

For three years, the Harm Reducers of Rosario have worked constantly… accompanied by one personality in particular, baptized as “Fork-head,” which is the “spokesman” of the campaign and also present in the cajita, the pamphlets and all the material produced by CEADS. And the success of Fork-head and his companions is very encouraging…

The Rosario Harm Reduction program, says Silvia Inchaurraga, “is now in a season of expansion into the most marginal neighborhoods of the city, with an important presence in the squatted areas (known as ‘Villa Miseria’), where the black market of drugs, particularly cocaine, base paste, and pills, dominate everything.” And it’s that, according to Inchaurraga, “an indicator of the impact is the results that show that of each ten injected drug users contacted through the street workers with the injection kits, five then enter the health system.” What remains clear is: “Here, we don’t look at the health system as ‘treatment,’ and even less as ‘treatment to stop using drugs.’ We run the gamut from counseling, HIV/AIDS tests, Harm Reduction workshops, interviews with professional psychologists, doctors, social workers, legal advice, etc.”

The program, of course supported by ARDA, has had such an impact in its first phases that the panorama has not only improved in Rosario, but also throughout the State of Santa Fe: “The state AIDS program and the Health Ministry of the state have promised to continue this program throughout the entire territory,” says Inchaurraga.

Beyond the support of the United Nations, as Gustavo Hurtado points out, the program, “has been a key element in the first organization of drug users here, the Argentina Network in Defense of the Rights of Drug Users (RADDUD, in its Spanish initials).” Have patience, kind readers, our tour through Argentina is just begining and, as you can see, ARDA’s labor is nothing to shake a stick at… Its work, long and hard against the poorly-named “War on Drugs” has much more to say to the Latin American movement that fights for real reform, at the roots, and from below, against prohibitionist policies.

In the upcoming chapters of this series we will detail for you more facts and statements about this important group in Argentina that, for years, has been reducing risks, reducing harms… stay tuned with us for more….

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