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SANKALP Rehabilitation Trust
(‘a firm resolve’)
Mumbai Central, Mumbai India

Background
Sankalp Rehabilitation Trust is a non-governmental organisation that began with a commitment to respond to the needs arising from the community of drug users. Since its inception in January 1995, Sankalp has been involved in HIV/AIDS prevention initiatives among the increasing number of Injecting Drug Users in the city.

A not for profit organisation, Sankalp Rehabilitation Trust strives to improve the health and quality of life of drug users. It also strives to identify skills and channelise their energy towards appropriate employment. Working at the grass roots helps the Sankalp team understand the changing needs of the drug users. Among its main activities Sankalp carries out Awareness Programmes, Harm Reduction Programmes, Counselling and Referral Services as well as a Sober Hostel for drug users and Home Care visits to PLWHAs.

What does Sankalp do?
Through its Preliminary Assessment, Sankalp Rehabilitation Trust became aware of the large majority of street drug users who had no access to any service in the city due to paucity of beds. This paved the way for a Harm Reduction programme focussing on prevention of HIV/AIDS among the injecting population. This in turn brought to focus the risks of Hepatitis B and C and the need to educate the community about the same. Sankalp is also involved in Training and Research besides the fieldwork.

First Counselling Centre In Navi Mumbai Exclusively For Drug Users.
On noticing that drug users had to travel long distances to find out about treatment options, and some of which had lengthy intake procedures, Sankalp Rehabilitation Trust opened a counselling centre in Navi Mumbai in 1997. This centre was initially started to help local families get access to Family Association meetings and raise the awareness of treatment modalities. Regular attendance encouraged the need for a full-fledged counselling centre, which is now situated at Koper Khairne near Vashi. There has been a good response with referrals from this centre going in for long term indoor treatment as well as substitution programmes. Programmes from this centre include regular Awareness generation with focus on the alcohol problem in the Industrial belt.

Harm Reduction.
Harm reduction means the employment of any measures likely to reduce an adverse health consequence of illicit drug use. Harm reduction policies and programmes span prevention and treatment. Although Harm Reduction approaches are not intended primarily to reduce consumption of drugs, this is often a long-term result. Sankalp Rehabilitation Trust is involved in a Harm Reduction programme among IDUs in the city of Mumbai. The sublingual buprenorphine substitution programme prevents the efficient transmission of HIV from one injector to the other and therefore to their spouses. (Figures in high prevalence areas like Manipur have shown 75% HIV positively among IDUs and 45% among their spouses.) It also prevents the transmission of Hepatitis B & C, decreases the rate of Overdose deaths and abscess formation.

Drug related crime is reduced through such programmes and social functioning of drug users improves. The daily wage earners now contribute to the needs of their families, which in turn improves their health.

Rehabilitation Before Detoxification.
Substitution programmes are considered effective for heroin addiction because even though they do not ‘cure’ the addiction, the remove the injecting drug user from the criminal world of illegal drugs and bring them into the socially acceptable world of the Drop in centre. The key of the programme success is retention of the drug users in the programme. Even though the drug user is given a daily dose of sublingual buprenorphine he receives counselling on personal hygiene, accessing health care and employment possibilities. At Sankalp Rehabilitation Trust we have seen clients who were involved in various antisocial activities, forfeit a meal if they do not have honest means of earning it. The client is thus being rehabilitated even before his detoxification and all this happens in the same environment where illicit drug use took place.

Counselling and Referral.
The managing Trustee of Sankalp Rehabilitation Trust Mr. Eldred Tellis has been actively involved in counselling people with HIV/AIDS. He has been conducting training programmes for counsellors in the North East as well as in metros like New Delhi, Mumbai and Chennai. Having been exposed to the field of HIV/AIDS since 1989 there is a vast experience in dealing with the various issues related to HIV/AIDS. Sankalp Rehabilitation Trust does pre-test counselling for clients wishing to be tested even before referring them to the voluntary testing centres or municipal hospitals. Follow up counselling is also being done along with monitoring the health status of the individual. Referrals are made to specialised hospitals where necessary like the TB hospital at Sewri.

Care for HIV infected IDUs.
As the number of IDUs with HIV infection and AIDS is continually growing, and as many of these people are social outcasts even without the HIV infection, there is a major challenge in providing for their medical and social needs. Drug treatment is available only to a small percentage of Drug Users, and effective with only a percentage of those!! Sankalp Rehabilitation Trust is at the fore front in creating a healthy environment for IDUs, especially those infected with HIV, involves confronting issues of human rights and discrimination, often within the medical profession. Specific care for HIV infected IDUs, tailored to their particular needs and provided in a non-judgmental, caring and accessible environment is what Sankalp is constantly striving for.

Networking and Collaboration.
Sankalp Rehabilitation Trust believes in working actively with other NGOs in the field. In developing countries like ours, it is not possible for an NGO to have a wide range of specialised services. It is therefore essential to refer clients to other programmes that may be more suitable to their expressed needs. Sankalp Rehabilitation Trust collaborates actively with organisations like the Lawyers collective in dealing with issues related to Human Rights and discrimination. Partnerships with agencies like SHARAN New Delhi has also played a vital role in accessing funding through donors like the European Commission and Deutscher Orden.