Omari Project
Context
Since the mid 1980s heroin has been readily available in the towns on the Kenyan Coast. A growing number of mainly young people, particularly those working in the tourist industry, have become addicted to the drug with dramatic consequences for a concerned community alarmed by the death, imprisonment and destroyed lives of young people in their midst.
Since 1986 BDP has delivered a wide range of services in order to prevent substance related harm and to promote positive change within communities, and for carers and individuals, by working with individuals to control and end their drug use and by encouraging other organisations and communities to achieve this.
BDP has been working in partnership with The Omari Project (TOP) in Kenya to tackle the escalation of heroin use there since the mid 1980s. TOP is managed by a committee of elected local volunteers. It aims to test and adapt approaches to the rehabilitation of heroin users, which have met with success elsewhere. In coastal Kenya it is the only established counselling and rehabilitation service available.
In 1995, 1996, 1997 and 1998 the British Council in Nairobi supported the development of the project's activities with an intensive counselling and training programme, which was carried out by BDP. By 1998, 54 volunteers, drawn from the local community in Watamu and Malindi, had completed training. Active volunteers continued counselling, rehabilitation and prevention work. They are Muslim and Christian, women and men, and include school teachers, health workers, shopkeepers and tourist boat operators. BDP worked closely with TOP on their plans to develop a residential rehabilitation centre, involving volunteers, families of heroin users and, most importantly, heroin users themselves.
Development of a residential rehabilitation programme
In June 2000 the Omari Project realised its dream and opened a residential rehabilitation centre at a time when it couldn't be needed more. Brown smokeable heroin supplies have been replaced largely by ‘white crest’, which cannot be smoked. As a consequence, an estimated 50% of all heroin users in Malindi are now injecting the drug.
Field research in May and October 2000 indicated alarmingly poor injecting practices and a high level of sharing of needles and syringes. In October 2000, Malindi District Hospital estimated levels of HIV infection among the population of Malindi District at 20%. Clearly, shared injecting equipment adds another transmission route and the likelihood of soaring levels of HIV infection amongst heroin users.
This residential rehabilitation centre is the only resource offering free treatment in sub-Saharan Africa.
BDP secured £73,841 running costs, over three years, from the National Lottery Charities Board’s International Grants Programme. The British High Commission in Nairobi, under the DFID Small Grants Scheme, awarded the Omari Project £20,000 for the construction of the residential centre. The residential centre comprises two blocks of rooms, toilets, showers, kitchen and dining/meeting area. The centre’s buildings are designed to accommodate 20 men and women in a simple style that is in keeping with the local surroundings. A coordinator and five residential support workers provide 24-hour staff cover throughout the six-month programme. Residents participate in a programme, which includes support in withdrawal from heroin, group and individual counselling, exercise, and volunteer work and rehabilitation through job placement. Senior residents who have completed at least three months of the programme take much of the responsibility for the day-to-day running of the centre.
There has been a strong demand for places in the centre, all 20 places are occupied, and a waiting list grows by the day.
A second grant was secured by BDP from the NLCB (now known as The Big Lottery Fund) to secure TOP's future until 2006.
Funding for the 20-bed rehabilitation programme continued and additional funding enabled the focus to fall on harm reduction work with active injectors. Drop-in centres were opened in Malindi and Watamu and plans to set up a needle exchange — certainly the first in East Africa and most likely far beyond — became a possibility. However, international developments have constrained the pace of development of harm reduction work in many countries and Kenya is no exception. Despite enthusiastic community support and a hard-won lack of opposition from religious leaders, no real progress has been made towards making needle exchange a reality.
However, much has happened on other fronts with a strengthened Aftercare programme funded by Global Fund monies through Futures Group Europe and a Three Cities Programme where TOP is sharing its experience with other areas of a growing heroin problem with other areas and similar cultures in Lamu, Zanzibar and Dar es Salaam.
This is a unique project — one of only two centres in sub-Saharan Africa offering free treatment and rehabilitation to drug users. The struggle to open the centre which could offer heroin users a way out of addiction has been long, hard and impressive. Now in its sixth year, TOP has made a unique contribution to tackling heroin use in Kenya and beyond.