When workers at Bunbury’s Needle and Syringe Exchange Program (NSEP) heard about an East Coast idea for a postal order service, they knew it had great potential. After all, they’d been doing it successfully in Western Australia for years – mailing out injecting and other equipment to people with limited access.
Bunbury’s South West Fixed NSEP site, run by the Western Australian Substance Users Association (WASUA), not only operates a mobile service around Margaret River, Busselton and Manjimup, but also the postal-order system.
“The best way we can reach remote users is through mail order,” says Mr Kevin Winder, the South West NSEP’s coordinator.
“We are the only ones I know of nationally who do this.”
It is just one of the challenges faced by the service which, given the huge geographic area involved and the sparsity of the population, has a complex catchment quite different to those found in urban centres such as Sydney, Melbourne or Brisbane.
And Mr Winder says he has “the best job in the world”.
“The part that I get the most satisfaction from is working on the needle exchange, engaging with consumers, doing brief intervention work to improve the health outcomes for our consumers and reducing the harms associated with their drug use,” he says. “When a consumer returns and their health has benefited from the brief intervention work that we do, it is so rewarding and motivates me to support more consumers in the best way possible for them.”
Mr Winder came to the service as a volunteer when he emigrated from Britain two years ago.
“My background in the alcohol and other drugs (AOD) sector began in London while working in hostels for street-based heroin and crack cocaine users. I went on to work in rehab and then policy and service development. My work on the ground floor in hostels in London was the most rewarding part of my career.”
As a volunteer in Bunbury, he says he became passionate about the work that WASUA does to reduce the harms associated with drug use without judging or discriminating against consumers.
The south-west of WA has had a mobile service for about 10 years. The fixed site at Bunbury started five years ago – so now the mobile unit is less stressed, and can focus energy on meeting the needs of the areas outside the town and its immediate surroundings.
In the past year (July 2015 to June 2016), the Bunbury fixed site had 1723 client interactions, the mobile service 735 and the postal service 34.
Mr Winder coordinates both the Perth fixed site and the South West branch and says one of the great opportunities when dealing with clients is for positive interventions to help them make informed choices. The peer-based service is staffed by people with personal experience of illicit drug use: thus the workers at WASUA focus on being non-judgmental in their interactions.
“We have a unique opportunity,” Mr Winder says. “There is an implied trust when clients use our service that helps them feel comfortable to open up, whereas many don’t open up with mainstream health services.
“They’re usually very open about what drugs they are using – so we capitalise on that unique opportunity for targeted intervention work, to tackle what is the most important issue on that day for that person. So if someone comes in in emotional distress, then we are probably going to refer them for counselling.”
Likewise, if a client has abscesses or signs of bacterial infection on their arms, workers will discuss injecting practices, hygiene, how they are mixing up or how they swab to try and reduce the risk of further infection. They would also be referred to a GP for antibiotics.
Mr Winder, like many of his local and national colleagues in the field, draws encouragement from knowing that the work they are doing is also helping to dramatically reduce transmission rates of blood-borne viruses such as hepatitis C and HIV.
The service employs a hepatitis C community development worker to encourage local GPs to get onboard with prescribing hepatitis C treatments for more clients. The service is hoping, too, to establish an outreach clinic to maximise client uptake of hepatitis C treatments.