Community harm reduction in Colombia

This blog was written by Anyone's Child coordinator, Mary, to share some reflections from her PhD fieldwork at the Corporación Viviendo's harm reduction programme in Cali, Colombia.

Corporación Viviendo is a Colombian NGO with a community harm reduction programme for people who inject drugs in Sucre, a neighbourhood in the city of Cali, where I have been volunteering for over a year as part of my PhD fieldwork.

To prevent overdose deaths, reduce drug-related harms and improve the quality of life of the Programme’s users, Viviendo provides hygienic injection material, basic services, medical care, safer injection education and advice, and naloxone training. The community-focus is key here; Viviendo has also generated a network of allies, institutions and community leaders which respond to the needs of the people who use drugs and the neighbourhood’s residents, to improve inclusion and well-being across the whole of Sucre.

I cannot stress enough how challenging a context it is. In many parts of Colombia, the stigma around drug consumption is experienced so viscerally that people who use drugs have become targets of discrimination crimes, as threats and violence are deemed a valid and desirable way to deal with people considered ‘disposable’, ‘flawed’ or ‘dangerous’. This, coupled with inequality, extreme poverty, exclusion, and the lack of mental health support result in many people who use drugs in Colombia being severely marginalised and under-served.

Coming across the work of Corporación Viviendo filled me with hope. It was refreshing and inspiring to find a place where people who use drugs – many of whom have been victims of this stigma and violence – are treated with dignity and compassion, where they feel accepted and not judged, and where abstinence is not imposed as a goal. However, when someone in Sucre dies because of drugs, the whole community is affected as friends and family, first responders and professional workers simultaneously, and this takes a toll

In the last year, 513 people who inject drugs have accessed the services; an average of 120 people attend the point of care daily. Remarkably, regular naloxone training and the strong community response mean that there has been just one recorded death from heroin overdose among the Programme’s users since 2021. This marks a huge achievement and is hopefully testament to a change in attitude towards people who use drugs in Sucre.