Training at Karisma Foundation Indonesia

Early September, Mainline trained the outreach team at Karisma Foundation in Jakarta. Since 2016, Karisma pioneers outreach work for people who use crystal meth, referred to as shabu in street-slang. 

Harm reduction for stimulant users is in many ways different than harm reduction for injecting opioid users. The training focused on specific elements to take the outreach work to a next level. Trainer Ferry was assisted by Victor – who takes part in Mainlines trainer-of-trainers programme.

Part of the training focused on motivational interviewing. This is a method that an outreach worker can use to see when a person is open for change, for example to take more control over their drug use or to be safe with sexual partners. One participant mentions:

“Motivational interviewing will help people to change their behaviour when they want to. If people are ambivalent towards a particular behaviour, they are more open to change. By asking open questions and listening carefully, you can help people to look forward rather than to think in circles.”

Another participant said:

“I learned the difference between attitudes that sustain behaviour, stages that prepare a person for change and wording that can mobilise change.”

The training also addressed different attributes of shabu and the risks of poly drug use. As many local shabu users don’t see their use as problematic, this was a topic of lively debate. One participant reflected after the training:

“it was useful to learn about the difference between experimental, instrumental, recreational, binge and regular use.” 

In a third part, the training addressed stimulant intoxication, (long-term) effects on mental health and first response to overdose. Mental health turned out to be an interesting topic, as there are cultural differences in how people explain and deal with depression, anxiety and psychosis. After a day of field observations and coaching on the job, the training ended on Friday with a feedback session.

After an interesting week, Mainline again concluded that outreach work that targets shabu users is – although new – useful and effective. This claim is supported by a recent operational research report conducted by Atma Jaya Catholic University.

This type of outreach and intervention requires a lot of creativity. Although meth users are at greater risk to contract infectious diseases such as HIV and HCV – as shown in the behavioural survey conducted by Atma Jaya – the angle for outreach interventions is more effective when focused on problems in the family setting, with work, with being ‘unproductive’, with paranoia (mental health) or with self-control.

Get an impression of Mainlines week in Indonesia:

Video: Mainline in Jakarta

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