Blue Point’s syringe-exchange program in District VIII will close for good on 31 August. The program has been subjected to various criticisms by the district council and residents. Blue Point, however, believes that there is a great HIV threat, which will manifest itself within a year of the centre’s demise.
Pink decoration, flowers on the table and an all-girl staff – these are the first things to grab our attention when entering the place. It is Monday, which means one thing: Girls’ Day, as is highlighted by the “Entrance only for girls!” note on the door. What makes the place special is that it is not the venue of a beauty salon or a women’s conference but of the syringe-exchange program of the Blue Point Drug Counselling and Outpatient Centre.
As Blue Point employee Orsolya Kovács explains, women of all ages visit on Mondays to benefit from its services in a very special atmosphere. While all these girls are drug abusers, a great majority are also sex workers. Apart from receiving syringes and condoms, they can take away free clothes, make-up and kids toys, and talk with the staff. However, along with all Blue Point’s other services, Girls’ Day will terminate on 31 August.
“Harm reduction, not the promotion of drug abuse,” answers Ferenc Dávid, Blue Point biopolitical workshop coordinator, when asked about the significance of the syringe-exchange program.
The organisation, which has been treating substance abuse in Hungary for almost 20 years, has been operating the exchange program since 2006. As Dávid explains, Blue Point has programs in the fields of harm reduction, prevention and rehabilitation, and is based on four great pillars: the ambulances of Békásmegyer and Ferencváros, the Biopolitical Workshop (which specialises in prevention programs) and the syringe-exchange program.
The latter, says Dávid, is of major significance in reducing substance use-associated risk factors for diseases such as HIV and Hepatitis C. Clients who visit the centre can obtain sterile needles in exchange for returning used syringes, to decrease the number of unsterile or contaminated injector users.
Clients can also benefit from other free services, including harm-reducing products such as herbal tea, vitamins and condoms; personal counselling on drugs, risks and legal issues; HIV and hepatitis testing; and internet use.
Nevertheless, not everyone agrees with the vision of Blue Point and the implementation of the needle-exchange program. Residents of District VIII have been repeatedly voicing their concern over needles in the streets, doorways and stairways. “There are needles everywhere,” a resident says. “These junkies inject themselves wherever they please and then throw away the used needles. There are children living here. What if my 4-year old daughter steps on a needle? I am not surprised that the program is being shut down.”
The district council voiced similar concerns when it decided to end the cooperation with Blue Point in September 2013. Councillors said the program facilitates drug abuse rather than hinders it. Blue Point was also criticised for carrying out needle distribution as well as needle exchange and for serving drug users from other districts.
District mayor Máté Kocsis said Blue Point should be collecting thrown-away needles itself but wasn’t, and thus civilians faced a constant threat. He criticised the organisation’s office for not having authorisation from the National Public Health and Medical Officer Service (ÁNTSZ) to carry out health services.
The Budapest Times asked ÁNTSZ. “Blue Point has been authorised for the provision of health services at its District III and District IX locations in Budapest,” capital city and county chief medical officer Dr. Zsuzsanna Homor said. “The licences pertain to several professions.”
Blue Point said it organises the voluntary collection of thrown-away needles in places such as stairways each Monday. Nevertheless, it was the role of the district council to manage public health and social issues and improve the residents’ life quality. As such, the cleaning of streets would be the council’s duty, as well.
Dávid said cooperation would be needed to solve the issues, instead of looking for scapegoats for already existing problems. “At this point there exists no more cooperation between the council and Blue Point,” he said. “After the council terminated the bargaining agreement, Blue Point got excluded from District VIII’s Drugs Consultative Forum (KEF) and our rental fee was increased as well. Under such conditions we can do nothing but to close the Blue Point syringe-exchange program in District VIII.”
He said the program cannot continue without council support, not because of financial reasons but due to the lack of a supporting medium. The area’s drug problem could only be overcome if the council started to treat it as a socio-political issue rather than a moral one.
On the ÁNTSZ authorisation, Dávid said: “The council has been under the belief that we have been providing health services. The syringe-exchange program is a social service, not a health service – and for the former, we did obtain the necessary authorisation. Also, we provide health services at our ambulances in District III and District IX, and at those locations we do have the authorisation to do so.”
Blue Point says District VIII has the greatest semi-open drug user community in Hungary. Blue Point has about 3,000 registered clients, 50% from District VIII. “According to our statistics 80% of the clients visiting the centre daily are from the area, which calls attention to the alarming number of drug users here and shows that drug users and thrown-away needles will remain even after the closure.”
Closure would mean there would be no means to monitor epidemiological and public safety implications, and drug users would have no institutional form in which to seek help or information.
Dávid said the main characteristic of drug abuse in the district is new psychoactive substances, namely designer drugs. “Here, people are injecting themselves every half an hour-hour. This means around 10 injections a day, 70 injections a week and around 300 injections a month. At that speed, wounds and diseases are likely to appear, and the first epidemiological risk is the Hepatitis C virus. The incidence rate of this C virus among Blue Point’s registered clients is 80%. This high infection rate is likely to increase in the near future.”
László V., a patient of the centre, said: “I don’t think people will bother to go to the pharmacy to buy sterile needles, it will not be convenient for most of them. I think people will be more likely to just use one another’s needles.”
Blue Point warns of a great HIV threat. “If the syringe-exchange program closes, the first infected people will appear in the district within a year, just the way they appeared in Greece and Romania after the closure of similar centres.”
It seems that the underlying issue hindering tackling the drug problem is the social perception of users. According to studies on xenophobia, drug abusers stand as the most marginalised group. It is apparent the issue needs cooperation between the district council, police and medical professionals.