The National Monitoring Centre for Drugs and Addiction (Národní monitorovací středisko pro drogy a závislosti - NMS), the Czech partner of the Joint Action on HIV and Co-infection Prevention and Harm Reduction (HA-REACT), is participating in and adopting cross-sectional activities on harm reduction in the Czech Republic.
Viktor Mravcik, the head of NMS, and his colleagues, Tereza Cernikova and Eliska Plavcova, talked about their work in this Joint Action and how the activities were carried out in the Czech Republic on the national and local level. Furthermore, NMS has implemented a local pilot project of installation and usage of four condom vending machines in the Czech prison Pankrác, located in Prague.
Question (Q): What is your task in the HA-REACT Joint Action?
Viktor: NMS is the Czech partner of HA-REACT. We are involved in several work packages. We work on integrated care for people who use drugs in the context of infectious diseases. This Joint Action is aimed to improve harm reduction services in the Czech Republic. We get people together, who work in different settings of harm reduction, like harm reduction professionals, medical doctors, prison staff and others. Furthermore, we organise workshops on integrated care and study visits to introduce work aspects in other countries.
Q: How did this Joint Action influence your work so far?
Viktor: We learned to use this HA-REACT as a platform to exchange expertise and share professional experience with other partners who work on harm reduction services within Czech Republic and in other countries. It is a useful resource and we can implement its assistance and support into our work to develop and improve services. The pilot project on condom distribution in prison settings in Prague was possible due to this exchange. The Joint Action is a platform for inspiration.
Tereza: We had study visits in other prisons and learned about their implementation of harm reduction services. It is a good opportunity to discuss profession-related topics and see evidence. We learned about work on the international level and how important it is. On our study visit in Berlin, we were introduced to a needle exchange program in prison. The condom distribution, needle syringe exchange and opioid substitution treatment in Berlin prison showed us results and data of running projects. Effective harm reduction services are needed in the prison structure as well as in the community. The prison setting is special and has its special needs. We learned about other programmes, which can cover these needs and prevent harm.
Viktor: Connecting policy makers and people who work on the ground is essential. We facilitate and link institutions. The different institutions and experts allow us to start new projects and to network. Joint Actions like this provide us with opportunities and initiatives.
Q: Did you face problems in the implementation of activities?
Tereza: Sometimes things happened differently than we have expected in the beginning, but we have learned from that and we use gained knowledge for implementing next activities. I would not call it problems itself. When we are working with professionals from different settings, their focus and mind setting is also very different. Thus, it might be complicated to define common goal and to reach it.
Viktor: Exactly. Different perspectives are quite challenging. Communication is a key here. Joint action provides also additional resources to help all stakeholders to communicate, cooperate, to find solutions.
“Connecting policy makers and people who work on the ground is essential. We are linking institutions. Bringing together different institutions and harm reduction experts allows us to start new projects and to network. Joint Actions like this give us opportunities for new initiatives.“ - Viktor Mravcik, the head of the National Monitoring Centre for Drugs and Addiction (Národní monitorovací středisko pro drogy a závislosti – NMS), Czech Republic
Q: NMS runs a pilot project on condom vending machines in the Czech prison Pankrác. How was the cooperation with the prison representatives?
Viktor: Prison settings are closed and organized hierarchically and usually have their conservative structure. It was not easy to implement this project. We are starting new services, adopting them is difficult and takes time to come through the structure of the law enforcement. However, we see positive changes: the attitude of prison service and guards is slightly changing. The trainings and workshops are good tools to open discussion about sex and other certain topics related to harm reduction in prison settings. The condom vending machines in Pankrác prison are now running. Question is whether they will stay there in the future, but it is the next step of our work. NMS will support this service and take this opportunity to form a new thinking of harm reduction. This project contributed to open new perspectives.
Tereza: We already launched four machines. When talking about the biggest outcome of HA-REACT, I would say, it is the pilot project itself. We work on evaluation of the pilot project and moving it onto a sustainable level.
Q: What do you want to reach further by this project? And how does the public react?
Viktor: It was launched unexpectedly before the planned date. It made us more problems than expected. The big publicity was not needed, prison service is very sensitive. We have learned from it.
Eliska: Sometimes it is better to run pilot projects quietly. Involving the public can even harm the project. We plan to present this project results to the public and see how to work further with them.
Q: What is the work benefit you got by HA-REACT?
Viktor: Improved prison harm reduction services is one thing. The other achievement is the improved integrated care in community; improved cooperation between different services, between drug services and clinical care services, it is not that common. People can gain real benefit out of it. Initiatives and cooperation at a national and local level is a big achievement.
Tereza: Study visits are important, it is always better to see than read or listen. We need to share experience with more experienced professionals. The access to different expertise of countries and institutions helped us to create new connections and to trigger new activities. We are now an international partner and we will further cooperate, even after the project. Also on the national level.
Viktor: At the very end, people who are involved might not know about the HA-REACT objectives and its background, but they know about the condom vending machines, about the integrated care workshops and initiatives, needle distribution service in Berlin, they met experts in other countries and they already exchange their work experience. We have linked experience and contacts. Even after this Joint Action, they will further meet and learn from each other.