Breaking Barriers

Written by Ruth Birgin.

My name is Ruth and, like Tam, I started my engagement in drug user activism and harm reduction in 1989, as a community development worker with ACTIV, the new and first drug user service organisation in the capital of Australia, Canberra. Unlike Tam, I was working in a context where needle and syringe programmes were endorsed and available across the cities and - soon - in major rural areas.

Methadone programmes were also expanding during this period, so our work focused on engaging people who inject drugs to have a meaningful stake in what was going on around them, working collectively to reduce the strictures applied to pharmacotherapy, supporting nascent drug user organisations, creating connectivity through newsletters and gatherings, lobbying for places at the policy making tables etc.

In the early 1990s I moved to the Northern Territory (NT) capital, Darwin. Here the scene was much more deprived and serious challenges for people who use drugs abounded. The NT was the only part of Australia without methadone and instead, opiate dependent people were offered a one way ticket to another State to seek treatment! The population was small and transient, with confidentiality being a relative luxury. The focus had to be on outreach and finding discrete ways to provide Needle and Syringe Programmes ( NSP ) to people in remote areas.

Despite significant barriers, a group of us managed to band together to create and sustain a drug user organisation. We established direct lines of communication to the Minister for Health and the Attorney General, which enabled our early achievements including production of bi-monthly newsletters filled with contributions and brilliant art work from members; collection and use of evidence to liaise with police to stop them attending overdose calls with ambulances; lobbying for methadone availability; creation of linkages with people who used drugs in Alice Springs, Tenant Creek and Katherine to provide low key services and prevention commodities for their networks; participation in a May Day march with a banner and a giant colourfully painted syringe; and a lead on other public events with music and theatre to raise awareness of NSP services. Although the work was obviously important, it was also exciting to be in at the ground level and starting something new, working with a small, but hugely dedicated bunch of committed activists.

I then moved to Indonesia in 1993 trying to take harm reduction responses forward in various alternating private and professional ways. In 2002 I had the privilege to be involved in the early stages of rethinking approaches to drugs in Indonesia as secretariat for the National Harm Reduction Committee which oversaw the introduction of NSPs and peer outreach programmes in Indonesia. I've since worked in a number of countries in the Asia region and in East Africa.

My main interest areas are probably too many! But they include a focus on women who use drugs; ending capital punishment; drug policy reform; peer engagement; overdose prevention and management; harm reduction programme design, implementation and evaluation; working with law enforcement; and expansion of pharmacotherapy.

Being a part of Coact means being in a working space with people who share professional and personal experience, and driving interest in drug user engagement and policy reform in a collective and supportive environment. I believe our combined interest areas and capacities, together with the personal characteristics of the Coact Team, form an authentic unit, ideally suited to engagement on the range of issues affecting people who use drugs.

Ruth BirginRuth Birgin

Based in Brisbane, Australia. Ruth Birgin has worked as a harm reduction specialist for over twenty years throughout Australia, Asia and, more recently, Eastern Africa. She has a working knowledge of the relevant UN organisations and INGOs involved in HIV/AIDS and harm reduction activity, as well as the issues faced by injecting drug users at community level in different parts of Asia and Eastern Africa. She is proficient in Bahasa Indonesia.

Ruth's full profile


  • "Coact facilitated a drug user workshop for the Public Health Agency. The event went extremely well, with Coact doing an excellent job of ensuring the aims of the day were met."

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@RichardREngnath people who use drugs face a range of public health issues. Drugs and HIV are key themes in internatioinal development

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