Nothing About Us Without Us

Various photographers

Robin Hammond and William Daniels worked with Médecins du Monde, looking at Peer Educators who are helping drug addicts, sex workers and homosexuals avoid infection with HIV and Hepatitis.~~Some groups either affected by or suffering from HIV/AIDS do not have access to proper care. These include injecting drug users, sex workers and homosexuals, many of whom are excluded because of what they are or what they do. They are more vulnerable and more at risk than others not because the virus is different or is transmitted differently in their case but because their social and legal status distances them from prevention and treatment programmes. As a result, they are more exposed and more at risk of infection with HIV/ AIDS and viral hepatitis. The most effective way to reduce HIV and hepatitis C transmission in such high-risk groups is a community approach based on the collaboration of individuals who are from within these groups. The French organisation Médecins du Monde (MDM) has decided to refocus its work

in combatting HIV/AIDS and viral hepatitis by implementing an original and new way of working. The organisation employs former and recovering drug users and former or active sex workers as peer educators. As they come from the high-risk groups themselves and have personal experience of their clients’ lives, the peer educators are able to manage harm reduction projects in a much more effective and appropriate way. As trusted intermediaries with the communities of drug users and sex workers, these people are vital in the process of educating in prevention, in building trust and raising awareness within the communities on a daily basis. Having experienced the issues and challenges facing people in high-risk groups, peer educators also advocate on behalf of these marginalised groups work to defend their rights.~~Photographers Robin Hammond and William Daniels were asked by Médecins du Monde to follow some peers educators on their daily rounds in several countries. Robin Hammond visited Afghanistan while William Daniels travelled to Georgia, Tanzania and Burma/Myanmar.~~In Tanzania, as in the rest of Africa, the HIV epidemic has started to stabilise in the general population. Amongst intravenous drug users, however, the prevalence is reaching alarming levels. For the past 15 years, the country has become a new staging post on the heroin smuggling route with a steep rise in intravenous drug use and transmission of HIV as a direct result. In Dar Es Salam, 30% of men and 67% of women who inject heroin are infected with HIV. Here, MDM runs a mobile unit consisting of peer educators and social workers which combs the streets of the city on a daily basis, raising awareness amongst drug users about the risks of intravenous drug use. It is the first programme to distribute sterile syringes in East Africa.~~In Myanmar, the AIDS epidemic affects the same groups in society that are often stigmatised and marginalised - sex workers, homosexuals and intravenous drug users. Many of them are unaware of their HIV status and only one in four people who need antiretrovirals are receiving them.~~Afghanistan faces a different set of problems, many related to over 30 years of conflict and instability. ~~The country produces 90% of the world’s opium and there are thought to be over 1.5 million drug users (2009 estimate), or 8% of the adult population. Drug users are harshly treated and severely discriminated against. Amongst other things, peer educators in Afghanistan are engaged in national and international advocacy work calling for the scaling up of the methadone programme across the country.~~Post-Soviet Georgia, on the other hand, is experiencing a new drug scourge in the form of krokodil, a drug which is made out of a mixture of codeine-based headache pills, gasoline, paint thinner, iodine, hydrochloric acid and red phosphorus – all items readily available over the counter in pharmacies. Penalties for drug use are severe and the police is known for its tough approach to drug users. More than 10,000 are serving long sentences in prison with little attempt at rehabilitation. It is estimated that 70% of injecting drug users are also carrying the hepatitis C virus.~~Robin and Williams work was made into multimedia pieces which are viewable on THIS website.