Pretoria police arrested health department-sanctioned outreach workers on Tuesday. Their crime? Providing clean water to injecting drug users.
Two outreach workers from nonprofit organisation OUT and a University of Pretoria social work student were arrested in central Pretoria. OUT runs needle exchange programmes in Pretoria for the non-profit organisation TB/HIV Care Association. The association also runs similar programmes in Cape Town and Durban. All three sites are operated in partnership with the department of health.
People who inject drugs are at a high risk of HIV infection, in part because users may share needles. A five-city study conducted in South Africa found that the HIV prevalence rate among injecting drug users was about 40% higher than that of the general population, according to 2016 research published in the International Journal of Drug Policy.
To stem not only HIV infections but also the transmission of some forms of hepatitis, the OUT offers more than 2 000 drug users in greater Tshwane services such as clean needles and HIV testing and counselling.
The project also provides users with pharmacy grade sterile water, which is usually used by health workers to formulate injections and intravenous drips. Without it, drug users may use dirty water — including sewer water — to mix heroin before injecting. This can lead to infections and abscesses, says Shaun Shelly, TB/HIV Care Association's head of policy, advocacy and human rights for people who use drugs.
It was the water, and not the needles, that got the trio into trouble this week. The 1965 Medicines and Related Substances Act prohibits people from being in possession of more than 20ml of the liquid.
After more than six hours in custody, the three were charged with contravening this Act and distributing medical instruments to be used for illegal purposes, according to the South African Police Service’s (SAPS) communications officer, Captain Bonginkosi Msimango.
Shelly says charges were filed despite the police being provided with extensive project documentation, including memoranda of understanding with the City Of Tshwane and the health department as well as a letter of support from the SAPS’s national office.
Shelly and others allege that police officers were acting under advice from health department employee Shadrick Mopai.
Senior health department officials eventually intervened on behalf of the trio, and they were each released on R1 000 bail early on Wednesday morning.
The group was slated to appear before a magistrate on Wednesday, but the matter was taken off the court roll. The three are no longer facing charges, says StepUp Tshwane co-ordinator Nelson Medeiros.
He credits the health department’s swift response with helping resolve the case.
One hand giveth the other taketh awayHealth department spokesperson Popo Maja called the incident “unfortunate” and says it demonstrates the need to for better communication between departments.
Maja explained: “[There is a need] to ensure that all spheres of government and civil society are aware of the various programmes being implemented and are able to provide guidance and support.
“While the department prioritises prevention services, it is also obliged to mitigate risks associated with drug use. The department’s commitment to the programme is born out of the understanding that people who inject drugs are at [a high] risk of HIV infection.”
Shelly called the arrests ridiculous: “This is reminiscent of the old apartheid days when you’d see police trying to find something to nail someone with — it didn’t matter what. This is really one of the few areas where we continue to tolerate that kind of behaviour from law enforcement, when they’re dealing with drug users."
He said the arrests were a poignant reminder that for many in South Africa, harm reduction programmes that are proven to reduce HIV risk remain controversial. Shelly said clear policies and legislation have to be put in place to protect such programmes, adding that lobby groups managed to keep needle exchanges out of the latest national plan on drug abuse.
“It gives us an idea of how complex and emotional the concept of drug use is. People need to realise that without these services, people are going to die.”
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