HOPS

It was surprisingly difficult to find this next NGO. Apparently MK and Americans have different definitions of certain words upon giving directions. After 3 phone calls and 20 minutes we were finally able to meet. It made me VERY apprehensive for the meeting, as English was the main problem in the communication in the directions. However, the meeting went decent, not great, but still very good. The NGO is trying to be very active and is actually making a difference in Macedonia.

Association HOPS (Healthy Options Project Skopje) is an NGO that works for those that society often ignores. Most of their biographical information is from a handout as they just referred me to a printout. They began in 1997 as a needle exchange center (meaning that they give out free clean needles to drug users in exchange for dirty ones no questions asked to stop the spread of HIV/AIDS/STDs) as part of the Soros Foundation.  Their mission is to  promote, respect and protect human rights and liberties aiming to promote health and socioeconomic status of all people, especially drug users, sex workers and other marginalized communities based on the principles of harm reduction through equal access to services, empowerment of the community, capacity building, research, analysis and advocacy. They developed different programs to serve these communities. In 2001, they began to build the capacity of programs in Strumica, Bitola and Ohrid to offer the same programs as they had in Skopje. Then in 2004, they began working with the Ministry of Health to implement activities from the National Coordinated Response to HIV/AIDS. HOPS, along with the Global Fund to fight AIDS, TB, and Malaria, opened programs in Kumanovo, Kavadarci, Stip, Ohrid and Gostivar. This grew into the Macedonian Harm Reduction Network founded in 2005 with 20 members.

While HOPS originally began working with drug users, they turned to sex workers as well in 200. Mostly to help prevent HIV/AIDS in their population and families. They offer a daily center for sex workers to go to to relax and get condoms or health care.

Currently there are 13 NGOs that are working in harm reduction with 15 needle exchange centers. The main issue is quality/availability for the population they are trying to serve. Currently they serve about 9-1,000 unique people annually. Many people come back in everyday, but they receive a special identifying number to track them so that the numbers are not incorrect. They do not have to give any specific information (like names or the MK version of social security numbers) just enough information to use the same number every day. However, you can not provide services to those who are under 18 here without a parent’s permission. So if someone tells them that they are under 18, they can not give them condoms or clean needles. But, if they say they are 18, you are allowed to treat them (even if they look younger).

There are roughly 8-10,000 “problematic” drug users in the country and roughly 50% are reached through these exchange centers. HOPS is continuing to scale up these centers as well as focus on quality care.  HOPS only works with the non-stimulant drug users (such as with heroin, methadone, or cocaine).

These centers provide counseling for people who might want to get off drugs or out of the sex trade. They also can help them fill out official paperwork to receive state aid or whatever they are trying to do. (You need the state ID card in order to receive the state run health care services.)  There are state run addiction clinics to help people come off of drugs, but they are only for those who are getting out of prison and they aren’t accepting any other patients as of now. HOPS is in the process of trying to set up other clinics in Skopje but no municipality wants to have that clinic near them. They do also offer services to sex workers who want to escape that life style, but they then stated “They choose to be sex workers and we can’t help them.” (Further stating that in a 30% unemployment climate, who would hire them for legitimate jobs?)

HOPS is in the process of re-structuring their services. They want to provide education in the centers, complete research about the drug problems in MK, and provide advocacy (to lobby the government to provide the services needed to fulfill people’s needs). HOPS hopes through education they can convince drug users to not make as risky decisions. They are involved in building capacities in the local government/municipalities or other NGOs often through  trainings

Most of HOPS money comes from international sources, but there are some funds that are domestically based (not totally functioning). When HOPS applies internationally, they do so with the government who will then get the majority of the funds to re-distribute. There is good implementation of their services, but HOPS finds it difficult to work with the government. While HOPS is currently searching for new international donors, they will try to work more closely with the government for funding. The government provides the medication for HIV/AIDS but not for the needle exchanges. The City of Skopje, specifically center, does help with one of the exchange centers but it does cover their rent and helps to fund some creative workshops.According to HOPS, philanthropy in MK isn’t seen as intrinsically good, but even if people donate, they do not give to the marginalized. Also, neither government party  wants to help. (A benefit to this, is that HOPS is never accused of being part of the government or opposition.) The government does, however, utilize the resources of HOPS when it pleases them (such as when they need data for a report).