At Intercambios Puerto Rico, Inc., we never stop our search to improve the quality and offer of services available to our participants. We are finally able to share with you that our long-held dream to open a harm reduction health clinic is finally become a reality. The health and medical services are being provided at our movil unit “La Movil”, by one of the newest members of our team, Dr. Elisa Pujals. Dr. Pujals is a family doctor that now joins our team of psychologists, a nurse, a clinical social worker and a case manager. These amazing team provides primary health services, along with vein care and psychosocial services, and will soon be able to provide drug substitution treatment in a harm reduction caring environment to participants who needed and wanted. In the near future, these services will be available, both at our movil unit and at our fixed site. We already have a location for our new clinic/office space in the town of Fajardo. This will be the first harm reduction clinic in the island offering primary health and full psychosocial services to our participants from a harm reduction model where they are they comprehensive needs are listening to and meet without judgment, prejudice, discrimination, or shaming. We share below some pictures with you of how this is coming along. This is perhaps the most ambitious project we have undertaking with the support of our partners at Direct Relief. This clinic specifically aims to cover the medical and mental health needs of drug users, homeless individuals, sex workers, but will also be available to the community in general. We aspire for it to be a safe space for our participants and inspiration for other services providers who may want to incorporate harm reduction principals into their practice and workspaces but have a hard time imagining what that might look like.
We also started a project that focuses on providing education and prevention services to youth, immigrants and the LGBTTQI+ community in the island. As part of this effort, Intercambios’ team will be offering workshops and talks about safe sex, sexually transmitted diseases, and drug use to share scientific evidence-based information to these communities, so they make informed decisions about their practices.
We thank you for your continued support and ask that you help us spread the word about these exciting news! In order to sustain these efforts, we need the help of people like you! It takes a village!
These last few months, we have been concentrating our efforts in raising awareness about the harsh reality of rising numbers of deaths due to overdose in Puerto Rico, just as in the United States. Previously we did not have numbers to back up what our staff was reporting and experiencing on the ground: the fact that Fentanyl hit the markets in Puerto Rico and that heroin and cocaine where being mixed with this potent substance. Our staff have been warning the Department of Health that our participants where reporting higher number of overdose fatalities and non fatal overdoses. Our concerns where no paid much attention to. Only recently did the government began to pay attention to our warning and in the last couple of month we have seen some numbers and reports by the department of health supporting the sad reality we were witnessing. That is, overdose numbers were on the rise and rapidly growing. Between 2017 and 2020, at least 1,060 people have died in Puerto Rico of a drug overdose. We believe this is still an underestimate. It was only in the last couple of years that the Forensic Insitute included fentanyl in their testing panel for drug overdose. We have been working non-stop to distribute Naloxone kits to community members as well as drug users, have trained hundreds of first respondents and clinical staff all accross the island and began a media and social networks campaign to make visible this reality.
With your support we are hoping to increase drug users chances to survive and leave healthy and dignified lives. Thank you for bieng our partners in these efforts.
At Intercambios Puerto Rico, we are committed to bringing health and harm reduction services to marginalized communities and to make visible the need to change punitive public policies that hinder access to care for those who need it the most. In the last months, as part of our efforts to deal with the COVID-19 pandemia, we began to engage vaccination campaigns for homeless individuals and other community members. Our first vaccination efforts were a success, and we were able to vaccinate at least 40 homeless individuals who are also participants in our harm reduction services in Humacao. We anticipated continuing vaccination efforts to our participants.
We are also providing psychological services, nursing care and case management at public housing complexes at Humacao, Fajardo and Luquillo. With La Movil (mobile unit), we can bring mental and physical health services to where people are most in need especially to those who don’t have private transportation (these towns lack public transportation services) are most affected by the past hurricanes, the earthquake and now the pandemia. As part of our new advocacy program, we participated in a vigil organized to commemorate and honor the lives of people who have died due to overdose. This event was a collaboration effort with other organizations that work with people who use drugs and groups of family members who have had an overdose related death in their families to bring attention and create awareness about the need to bring about strategies that prevent and attend to this public health problem that is costing so many preventable deaths day by day.
Among other exciting news, Intercambios Puerto Rico is finally ready to launch its first and new integrated health services clinic with a harm reduction approach focused on serving primarily who use drugs and who may be homeless in the municipality of Fajardo. In addition to health services, the clinic will provide biopsychosocial services and treatment to our community. We are extremely happy to be able to continue expanding the scopes of services we bring to our communities, so they may have opportunities to fully exercise their right to health and dignity, as well as contribute to create a more just society for all. We thank you for your continued support and invite you to share our news with family and friends who might want to help support our efforts!
We are really excited to share with you that our new mobile harm reduction and health services unit is a reality and is out and about in our communities in the eastern side of the island. What was once a dream, it is now a reality. "La Movil,' as we call it, now offers bio-psycho-social services to individuals who use drugs, homeless individuals and community members at large. At 'La Movil', we will be offereing psychological and mental health services, social work and case managements, as well as tending to basic physical health with a nurse. We are working to incorporate a medical doctor as well in the near future. As part our team in la 'La Movill', we also have a community outreach worker who is a peer worker as well. At Intercambios Puerto Rico we believe in the importances of empowering peer workers to assume an outreach role as peer harm reduction educators, because they have valuable knowledge that comes from being part of the community and sharing the experiences of the community they are working with. This mobile unit works parallel to our harm reduction mobile syringe exchange program which is now the largest in Puerto RIco. We are redefining what health and social services look like in the island.
Our aim is to bring 'Health to the Street', from a harm reduction perspective that serves marginalized community in the municipalities we served. Health is not a luxury, it is a human rigtht for all, special those most disadvantaged and marginalized! Your support has gotten us this far, help us take it even further!
We are extremely proud to share with you, that despite the new reality and challenges that COVID-19 pandemic represents, at Intercambios Puerto Rico we have maintained all of our services running non-stop even in the midst of stay-at-home executive orders by the governor of Puerto Rico. Even while most government operations, including the department of health came to a stop and everyone was mandated to stay at home, our stuff venture to the streets with protective gear and keeping safe distance to deliver not only safe injection kits and counseling, but providing much needed COVID19 safety equipment and information to a marginalized population who would not have received any information on how to protect themselves and be safe from COVID19 otherwise.
Even when methadone state clinics closed their doors to its participants in the days of the curfew, Intercambios Puerto Rico lead the way by keeping its mobile services up and running with all necessary precautions despite risking being subject to arrests and towing of its vehicles. Our staff understood that our participants were ever most vulnerable to this pandemic than others giving their living conditions (a large number lack proper access to housing and cleaning/hygiene facilities), have multiple health conditions and as visible drug users are bound to receive poor health care or be deemed less worthy of health care if resources are scarce. Our organization pushed the administration to name syringe exchange and HIV health/housing services as essential services and advocated with other syringe exchanges that they could/should continue provision of services despite the vagueness of the executive order on this respect. Our team did not stop providing services even for a week. We have been on streets providing services and advocating for those who most needed since day one of this epidemic.
We are saddened that our partners in health, Doctors Without Borders have finished their work in Puerto Rico for the time being. We are extremely thankful for all the knowledge and helped they so generously shared with our organization. Our staff received much need professional training in dealing with pandemic protocols and understanding how to integrate such protocols to accommodate service provision in our new COVID19 pandemic context. As part of this partnership, we were able to implement access to a medical doctor with a harm reduction perspective via telemedicine through our mobile units and when possible in person. We are working to be able to maintain that service and create even more access to medical services in person through our mobile comprehensive health services unit. We have also been busy developing relationship and memorandums of collaboration with government agencies and other services providers to be able to offer Naloxone access and overdose prevention to our participants. Overdose deaths in the island are high and have not been a priority, but we are working to make visible this reality and bring much needed prevention resources to our participants.
These are extremely challenging times. As the pandemic continues, we know that consequences of business closings and increasing unemployment will exacerbate the already thin support systems in place for those without means. Your help and that of our partners will be even more important as the emerging social consequences of the COVID-19 pandemic become more visible. We count on you to be able to be there for our participants every day, pandemic, or no pandemic.
A heartfelt Thank you and hoping that you are well. Stay safe and protect yourself and others.
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