Rebuilding a Safe Haven for Future Crises

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

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!

Our Movil Team
Our Movil Team
Health on the road
Health on the road
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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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The last three months have been extremely challenging for everyone around the globe. In Puerto Rico, as, in much of Latin America and the United States, the reality of a COVID-19 pandemic hit us in march 2020 as we heard about the first reported cases, and by March 15th the governor of Puerto Rico had issued an executive order instituting a mandatory curfew from 7pm thru 5am, which stayed in effect until just a week ago. That is almost three months, where all government operations came to a stop and everyone was mandated to stay at home with very few exceptions for essential services. The process for defining essential services in Puerto Rico was fraud with errors and lack of careful understanding of the social/health dimensions of this crisis. For example, the Department of Health failed to name Syringe Exchange, Homelessness and HIV services as essential services. The executive orders were vague in their definitions, and the department of Health was not proactive in ensuring service provision to most vulnerable communities. Most syringe exchange programs interrupted their services in the first days of the curfew, however Intercambios Puerto Rico led 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 excited and want to thank our new partners in health, Doctors Without Borders. The internationally renowned health organization, Doctor Without Borders, decided to begin working in Puerto Rico because of the new COVID-19 pandemic. They felt their expertise could be of use in the island. Intercambios PR was selected as one of its partners in the island and feel honored to have access to their expertise and partnership. In the last two months, Doctors Without Borders already trained all our staff in COVID-19 PPE measures and protocols, helped designed our COVID-19 intervention and personal safety protocols, and trained our staff as Teacher of Trainers. Intercambios PR is now able to multiply this COVID-19 safety knowledge by providing “Teach the Trainers” workshops for community-based organizations, besides proving accurate COVID-19 safety information to our participants. In addition to the sharing of safety and hygiene knowledge, Doctors Without Borders is helping us upgrade our mobile units with hygiene stations that include access to hand washing and showers for our participants, many of whom are homeless individuals or don’t have adequate access to clean water and soap. Furthermore, this partnership is working to implement access to medical doctors (in partnership with Doctors Without Borders) via telemedicine through our mobile units and when possible in person.

Other news we wanted to share with you, our donors and partners, is that we recently recruited an additional staff member that is going to provide services’ participant navigation in order to reduce the high threshold for access to services that faces our population.   Our participants face discrimination and poverty everyday which makes accessing adequate health and social services more difficult. The island privatized and bureaucratic health system places a high threshold for accessing services to individual who most needed. Our staff member, a social worker, will be able to help our participants navigate these hurdles and increase their chances of meeting their immediate health and social needs.

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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In the last three months, we at Intercambios Puerto Rico have continued our work by supporting participants through harm reduction strategies and defending the dignity and rights of individuals who have problematic drug use and individuals who are homeless.  Our syringe exchange program continues to impact communities in the eastern side of the island by removing from circulation used syringes and providing new syringes to those who need them.  By doing thin s exchange, we reduce the risk of HIV and Hepatitis C via injection among drug users and to the community at large.  Between November and January, our program collected 60,561 used syringes and distributed at least 93,822 sterile syringes.  Our services now extend to a new community, Yabucoa.  We are also excited to share our success in implementing opioid  overdose prevention interventions among our partiicpants.  In the last three months we have distributed at least 164 dosis of Naloxone, a prescription medicine that helps revert an overdose and has saved many lives. 

We continue to work as well with our project "Grant for the Benefit of Homeless Individuals" (GBHI) that targets 12 municipalities, mostly in the eastern side of the island and also San Juan.  This project's goal is to provide psycho-social services to individuals who are homeless and may or may not have problematic drug use or severe mental health disorders.    This work is carried out by a mental health counselor, a substance use counselor, a social worker and a case manager that are providing direct services to at least 40 partiicipants on a regurlar basis.  Through this project participants have been referred to and enrolled in Medication Assisted Treatment with Buprenorphine or Metadones, have received primary medical care, mental health attention and have been connected to permanent housing/or in the process of.

Recently we hired a social worker who is has been working in developing natural disaster emergency protocols for attention to homeless individuals and persons who have problematic drug use.  Giving the recent earthquakes experienced in the south of the island it is evident the need to have these protocols in place and share them widely with elected officials and government institutions in charge of responding to emergency situation and natural disasters.  Although the earthquakes did not occur in the eastern side of the island, it is a reminder that emergency response protocols and prevention plans are a priority in the evolving context that Puerto Rico finds itself. 

A new mobile unit equiped with physical examination rooms was recently outfitted and put into the road in Humacao, Puerto Rico.  We are very excited for these new stage of our organization.  Our goal is to be able to provide mobile primary medical service, mental health services including buprenorphine treatment for compulsive drug use, HIV rapid testing to the most vulnerable populations, compulsive drug users, homeless individuals and sex workers.  You support is ever as important in order to help us reach our goals of providing high quality medical and harm reduction services, improving the quality of life of our partiicpants and champioining their rights to education, health and housing.  Thank you for accompanying us in this journey and for your continued support.

           

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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 Globalgiving.com 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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Organization Information

Intercambios Puerto Rico Inc

Location: Fajardo - Puerto Rico
Website:
Facebook: Facebook Page
Twitter: @Descrimina
Project Leader:
Debora Upegui
Fajardo, PR Puerto Rico
$4,982 raised of $50,000 goal
 
95 donations
$45,018 to go
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