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Rebuilding a Safe Haven for Future Crises

by Intercambios Puerto Rico Inc
Rebuilding a Safe Haven for Future Crises

At Intercambios Puerto Rico, we are happy to share with you our progress over the last three months as continue to provide support to the homelessindividuals and problematic substance users in the northeast of Puerto Rico. Our syringe exchange project has impacted the community by collecting and delivering clean syringes as well as other safe injection and personal hygiene items. We are currently providing these services in the 9 municipalities of the Northeast and we have recently added the town of Yabucoa. Between the months of August and October, 50,209 syringes were collected and 65,408 syringes were delivered to program participants. These data demonstrate the number of participants who have benefited from work focused on harm reduction and that has an impact on the well-being of the overall population. The syringe exchange project allows the reduction of transmission of HIV, hepatitis C and other bacteria that can be contracted due to not having safe injection equipment to use intravenous drugs. Also, we have managed to link participants to other social and medical programs such as medication-assisted treatment and primary health care.

In addition to the syringe exchange team is also accompanied by a nurse and a case manager provided individual case managing services to a total of 50 participants between the months of August to October 2019. This project has offered preventive services and liaison to other social organizations and primary medical care. A total of 50 rapid HIV tests have been performed on participants from the northeast area of Puerto Rico including the town of Yabucoa. It should be noted that our staff also participated in a health fair in the town of Loíza aimed at people with problematic substance use and the community in general. We specially want to highlight the addition to our organization of a crisis/emergency coordinator with a social work background who has undertaken the development of an emergency protocol in the face of atmospheric phenomena such as hurricanes and floods and coordination with municipal emergency offices to ensure addecuate attention to the population we serve.  This is project was made possible thanks to the contribution of and is allowed us to better prepare in the event of future natural disasters as an organization and to help our community navigate its aftermath.

Finally, our GBHI team funded by SAMHSA is working in the community and offering psychosocial services to homeless individuals with problematic substance use and mental health disorders. Several communities in the municipality of San Juan have been impacted and we have begun to provide services in the town of Humacao. The team consisting of a mental health counselor, a substance counselor, a community outreach worker and a case manager have directly supported a total of 30 participants from August to October 2019. These services are based on providing counseling once a week, support with peers and link to different services according to the needs identified until obtaining permanent housing for this population. It should be noted that participants have been linked to medication-assisted treatment, primary medical care and mental health treatment.

Our entire team appreciates the support you provided us to continue the projects in the communities affected by the lack of access to services related to human rights.  This work would not be possible without the support of people like you and we hope you continue to be our partners in bringing about social change and justice for our communities! Thank you!

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In the past three months, our team at Intercambios Puerto Rico has continued its mission to provide life saving harm reduction services to vulnerable populations in the eastern side of the island of Puerto Rico. Life in the island has slowly recovered a sense of normalcy after two years of post-recovery work, however life continues to be a struggle for those who live in the streets and who have problematic use of illegal substances. Puerto Rico has in the last two year witness the implementation of a myriad of austerity measures imposed by a fiscal oversight board, whose priorities have been to recoup monies for the island’s creditors and has continuously disregarded the consequences such measures are having on the island essential services such as health and social welfare among others. These have simply created a greater vacuum of services for those most disenfranchised groups, including homeless and drug users. Most recently the island has been the object of much press coverage as evidence of rampant corruption and disregard for the wealth being of its citizens was revealed in a series of social media scandals. This evidence prompted a level of local outraged and protest never seen before in Puerto Rico. The island and its people are ready to see a new way of doing things and are tired of the same old political and social discourses.

This is a time where exciting ideas are gaining momentum and local citizens are wanting to seek social justice in many areas. Intercambios’ work and vision for social justice for marginalized communities has the potential to gain track in this new and exciting context where every week people are getting together in different municipalities across the island to map out their vision of a future for Puerto Rico that is steered by the people and for the people. At this historic moment, Intercambios is gearing to become a stronger voice and advocate for a harm reduction approach to mental and physical health for marginalized communities and offered up an agenda for how to attend to homeless and drug user community not only in times of crisis but in regular times. In order to do so, our team is working hard to hire a social worker with experience in dealing with crisis and disaster preparation that will advocate and work closely with municipal governments to ensure their crisis preparedness protocols include measures that specifically attend to homeless and drug using individuals’ needs in times of crisis and natural disasters. This new team member will also be working with our clients to help navigate obstacles that they may still have related to Hurricane Maria and Irma aftermath. It is our understanding that no other organization in the island serving these populations is working to develop crisis preparedness protocols, capacity and kits for its participants, as we are. We are not satisfied with simply covering immediate needs and always work to develop individuals’ capacity as well as expand services and infrastructure as our resources allow, in order to provide a wholistic harm reduction approach to improving our participants’ and their communities’ lives.

We also continue to provide sterile injecting equipment, rapid HIV testing, nursing assessments and referrals to permanent housing for homeless individuals, motivational interviewing and referrals to treatment for problematic drug use for individuals who request it. Among the projects down our pipeline are to be able to set up a mobile clinic with access to a medical doctor, Hepatitis C testing and treatment, and ambulatory drug treatment assisted with Buprenorphine/Suboxone for opioid users.

Our team is excited about what the future holds for us, and we hope you are too and continue to be our partners. Our work would not be possible, were it not for social justice minded individuals like yourselves who believe a better and more just world is possible. Everyday we invest ourselves in the belief that every single effort helps make someone’s life more meaningful and has a ripple effect onto the communities we live in. Help us continue to demonstrate that it is possible to approach drug use and homelessness in a different way that is cost-effective, humane and socially just.

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Unfortunately, more than a year after the hurricane’s aftermath, social and health services for drug users continue to be limited. There continue to be many barriers to access medication-assisted treatment (i.e. Methadone and Buprenorphine) for people with problematic opioid use. In addition, there still limited availability and accessibility of syringe exchange services around the island. The declaration of an opioid crisis in the USA allowed for the distribution of the drug naloxone at a large scale in order to prevent opiate’s overdoses, however it is extremely difficult for people in the island to access this antagonist. The government of Puerto Rico has not yet established micro and macro-structural strategies to allow access to Naloxone. The lack of sensitive public health policies has perpetuated the disastrous health and life consequences of problematic use of substances (heroin).

In response to this reality, Intercambios Puerto Rico continues its mission to strive for social justice and provide social and health services for people who are homeless and people who use drugs by meeting them where they are and in their own communities. The syringe exchange program continues to work from a harm reduction perspective in 12 communities in the northeast side of the island. Our regular outreach team includes a service coordinator, two community outreach workers, a case manager and a nurse who attend to the social and health services needs of our participants. Our participants lack access to primary care centers. However, through our mobile street outreach, they are able to access life-saving services for free on a regular basis such as: HIV tests, health evaluation by a certified nurse, linkage to medication-assisted treatment for problematic substance use and other essential services.

In addition, we recently added a new team to our staff that includes a professional mental health counselor, a professional substance-related disorders counselor, a community outreach worker, a case manager and a service coordinator. This new team will carry out mental health interventions from a harm reduction model with the purpose of supporting individuals who are homeless and had problematic substance use in their recovery process. We are excited to inform you that this new project will be working not only in the communities we serve in the northeast of the island but also in the metropolitan area. This guarantees a greater number of marginalized people will be able to access much need health and social services. And more importantly, we will be able to link homeless inviduals with/without problematic substance use to permanent housing programs. According to the Homeless Count of Puerto Rico (2017), it is estimated that there are over 3,501 homeless individuals in the island. This number is bound to increase due to the devastation caused by Maria and Irma’s Hurricanes. At least 30.6% of individuals identified as homeless reported the main reason for being on the street was problematic substance use.

We are extremely grateful to all those who have donated and supported our work in the past and hope to have your continue support as we engaged in Post-Hurricane Recovery Work in our communities. This work is more challenging for Puerto Rico given that is government finds itself in the midst of a bankruptcy and has implemented harsh austerity measures that undermine the provision of essential services, such as health and education, to its population. Thank you for keeping up with the hard work carried out by our team at Intercambios Puerto RIco. We are committed to promoting public policies and direct service that may positively impact our vulnerable populations and ensure that we are better prepared to face similar natural disasters in the coming future.

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Here at Intercambios Puerto RIco, we continue our efforts to aid in the reconstruction of Puerto Rico in the aftermath of Maria and Irma through our committment to serving our participants.  We are happy  to report that the provision of our clinical and harm reduction services to participants in the eastern side of the island have not only continued without being negatively affected by cuts in local government funding to the department of health, but actually have increased thanks to the support of private foundations and our individual donors.  In addition to harm reduction and life saving services, we now have a nurse and a social worker that are able to provide first aid care to participants and connect them to social and health programs that they so desperately need.  Connecting to social and medical services is more challenging in the aftermath of the Irma and Maria due to the shrinking availability of doctors in the island who have migrated and the ever-increasing budget cuts resulting from the island's bankruptcy.  Finding housing and connecting to medical services requires that many participants travel everyday long distances to other municipalities because they are not available where they live.  

However, we still very much need your help in raising the funds to create storm survival kits (that contain water filters, solar portable lights, toilettres, and first aid iterms) that can be distributed to our participants  especially as we geared towards a new water rationing season (due to lack of rain in certain areas of the island) and the upcoming hurricane season.  Although our modest  main office is back in shape and is better prepared to weather a hurricane, we still need to make upgrades that will make it self-sufficient in the event of a major weather disaster and outfitted, so it can serve as a refuge to participants who do not have a safe place to weather the storm.  We need your help to continue our efforts to be resilient and effective in the event of a new disaster.  


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It has now been exactly one year since the devastation of Hurricanes Maria and Irma. Thanks to our supporters, Intercambios was able to quickly rebuild and be more prepared for future storms. We have been able to repair the damage to our office and resume our lifesaving services. Our clients have been able to attain greater stability, as they are no longer faced with ongoing power outages and lack of access to communications. The support from our generous donors and foundation partners made it possible to purchase a generator, cistern and water filter. These items will greatly help our clients stay safe in the event of future storms!

Although we have recovered from the immediate damage wrought by the hurricanes, we now look to the future to achieve full disaster preparedness. In the coming months, Intercambios will seek to create an emergency supply of essential items such as batteries, a convertor, and a power generator. In addition, we are raising resources to conduct an organizational needs assessment and establish written policies and procedures to implement in future storms, which will ensure a systematic and highly coordinated response that will save the lives of our constituents. We are also seeking support to purchase client survival kits, which would be equipped with canned food, bottled water, detergent, hygiene items and LED lamps.

Last but not least, we are excited to report that we are in the process of ramping up our clinical operations to address any barriers to treatment our clients face. Intercambios is deeply grateful for our individual and foundation donors, whose support in these difficult times has allowed us to rebuild to be stronger than ever!

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Organization Information

Intercambios Puerto Rico Inc

Location: Fajardo - Puerto Rico
Facebook: Facebook Page
Twitter: @Descrimina
Project Leader:
Debora Upegui
Fajardo, PR Puerto Rico
$4,272 raised of $50,000 goal
63 donations
$45,728 to go
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