 Hello, good afternoon. I'm Peter Shagashi and this is a drug reporter story from the stories from the Frontlines. It's a live video series. With these videos, we would like to show what is happening on the ground from the perspective of people working in harm reduction and how the COVID-19 epidemic affects the lives of people who use drugs and harm reduction services in different cities of Europe and the world. So today we will speak about the situation in the Netherlands. I have two guests here, Auke Polder and Cedric Chavey from the organisation AMOC, or the Harm Reduction Programme AMOC, which is operated by the Regenbouw Foundation. This is an Amsterdam-based harm reduction program. Hello guys, how are you? Hey, good morning. Thank you so much for accepting our invitation. Can you first speak a bit about AMOC and what kind of services do you provide? What is AMOC about? Yes, yeah. AMOC is a shelter for European homeless. So we support people that are legally in Holland but don't have the right to care. We're working with homeless and with people who use drugs mainly. In AMOC, we have a drop-in, somewhere people can have breakfast, take a shower, drink coffee, change their clothes, that kind of basic needs. Then we have a drug consumption room and night shelter and quite a big social work team with people from different European countries who can support our clients. How does this crisis affect the people you work with, your clients' lives? Well, when the lockdown started, in Amsterdam a lot of shelters closed. So there were a lot of homeless people who didn't have access to food and to shower and to a bed. So that's a few weeks ago the situation was quite difficult for homeless people. Also, the shelters who were still open like AMOC, they all had the maximum amount of clients who can enter. So a lot of people didn't have access to shelters. I think three weeks ago something the government started to realize that it is a problem and they supported our organization and also other organizations to be able to open more shelters. The Regenwald Foundation for example opened now three new day shelters and a big night shelter where hundreds of people can sleep. So actually in this sense the crisis has a positive effect on the homeless because there's more shelters organized. On the other hand it's also so that due to the crisis a lot of people don't have possibilities to make money. So the jobs, there's no jobs like no easy jobs. There's no people who donate money on the streets. The people who sell newspapers, yeah they don't sell them anymore. So this is an issue that the homeless people are dealing with. I suppose it's really strange now to walk on the streets of Amsterdam because it's usually very crowded with tourists and now I suppose it's quite like empty. So how does the lockdown affect the drug market? Do you see any changes in the drug market like prices of the drugs are going up or something like that? At the moment we don't see a change. What we ask in the drug consumption room to the client is do you notice a change in quality and price? For now there is no messages saying so. I think it will be interesting to ask this question within the next three months because I did ask to clients and professionals of our partners and there are conflictual messages but there is still a ruin and cocaine to be found in the street of Amsterdam. Just our clients are struggling so much to make money. We start to see that some of them would like to find more methadone in the street instead of relying on their let's say heroin street dealers and some new substance did appear but we don't know if it's temporary or if it's just a way to cope with the shortage of money. Your prime minister called the Dutch approach as the intelligent lockdown. So how does it work in reality? Like how strictly the police is enforcing it? Okay just I would like to say a couple of things about how the COVID-19 did affect our operating services because finally we are open but we have a limited amount of clients per day who can access a drop-in center. It's 20 in the morning, 20 in the afternoon. Everybody who come in has to wash their hands then they have to be very clear with the service they need. Once they have the service they need provided they have to leave the building and they have to come the next day. So this has a direct impact on the amount of service we can provide. Instead of 70-80 clients a day we have a maximum of 40. Inside the drug consumption room itself we also had to limit physical distance so from a user's room we used to be 18 to 20 clients at the same time using drugs. We accept four clients at a time one per table. Everybody has to wash his hands and once they are finished with using we ask them nicely to leave the building and let's leave the room for another user. In terms of intelligent lockdown what they mean is that in comparison to other countries we didn't put everybody indoor with no possibility of going outside. The advice of the government is to ask the people to be smart enough to take their own measures not gather together take enough distance when you go for a walk with your friends that means you can still go for a walk with your friends but you are asked to stay maybe two three meters distance from him and you can go in the park but other things have been closed like playground are closed football field are closed and the police have been patrolling at the beginning of the intelligent lockdown it's easy have been talking to the population and nowadays they are more asking the people what are you doing here in street what is your purpose you have nothing to do here just go back home please What about the coffee shops are they still open? Yes coffee shops are open like many of the service they call it hotel restaurant cafes yet to close as much as a coffee shop should close but finally those of the hotel cafe restaurant and coffee shop they can operate if it's takeaway or delivery so for the coffee shop it's one person at a time you go in you buy your marijuana and you leave the building What about like opiate substitution programs do the clients have access to the medications for a longer time? So this has been one of our fight from the day one I understood right away from the lifestyle that our clients are experimenting that it would be very complicated for them to access money and drugs so we requested from the day one to the health authority to make sure that anybody with no criteria whatsoever could access substitution program whatever it's heroin, methadone or what existed in the Netherlands it took about a month and a half for the authority to accept and to put in place some measures to facilitate the access to methadone substitution but it has not been as easy as other countries like UK or France So then we can see that sometimes the Dutch authorities are not as progressive as their reputation right? Okay yeah you can say that this is like said it is difficult to get access to the methadone project yes. So you said that the dark consumption rooms are open with some restrictions like you have to wash your hand and things like that do you also try to test people who have symptoms for COVID or what do you say when someone is coming who is coughing or you don't even let him in or how is it working? Yes yeah we let people in and if we see signs of people coughing a lot that normally they don't cough or they have a fever we call we call a nurse from the health service and a nurse comes to check the person if the nurse also thinks that it could be coughed then the nurse takes the client to quarantine place there are three quarantine places for homeless people in Amsterdam and now there are I think 20 people inside there. So in many cities the problem was that you know the people who use drugs and who are homeless they just they just can't use the quarantine shelters because because they have to go out to buy the drugs so how do you solve the situation in Amsterdam? Yeah they can access these quarantine places and they get a lot of medicines like methadone inside places yeah to use. Yes the client of the user's room we suspected to have corona they went in the quarantine hotel from the first seconds they have the maximum dose of methadone to make sure they stay in the hotel. Okay and if they use other drugs such as stimulants how they will not be able so much to live in and out the hotel that's why we provide with the highest amount of methadone and probably some banzoles or some other mood regulators to make sure that the person is feeling safe and stressed less as possible and hopefully we increase by giving a high dose of methadone the possibility of the client to stay on site and not want it to go back in the street. The street have nothing to offer it's like a ghost town there is no tourist there is no money people are afraid of each other so for the people who sell the homeless newspaper it's also a problem for them even without any corona symptom just having an usual homeless less life is complicated so for drug users even more. How do you see the the reaction from the general society like does it make them feel more solidarity to people or they just think about themselves? No solidarity I was expecting more solidarity towards the homeless for example selling the street newspaper and what I heard from the street sellers is that people are very distant and give less. Now maybe Alcure can say something about the general city of Amsterdam in terms of solidarity because there are some positive impact of this. Yes go ahead. Yes I want to add something on this because indeed it's true that we hear stories that on the streets people donate and don't buy the newspaper but on the other hand here in Amok I also we experience a lot of solidarity there's a lot of people who knock at the door and ask us if we need help there's new volunteers coming there's people from the neighborhood every day will bring us cakes and bring us food and and this kind of support is more than it normally is so yeah that's a positive sign of solidarity here. We have a lot of reports for example in Hungary about that there is more domestic violence after the lockdown than before do you also experience that? I would like to say something because finally here we do not notice in our target group a raise of domestic violence because people have no house and even if there was violence towards client we are somehow first responder we have to we have to to be careful if we notice violence toward client that we will report it to the correct authorities. Now about domestic violence in the general public my wife worked for an organization in charge of kids at school who are already struggling with family problematic and yes there is an increase of request for help. It doesn't mean yet that there is an increase of domestic violence or child abuse but the message are that parents are seeking for more help because the lockdown is getting long and we know that with the time the longer it lasts the more there will be probably an increase of domestic violence or child neglect. So is there any like specific risk for for migrant people now like who maybe you have a lot of clients who are not citizens of the Netherlands so do they face any problems specific problems? So strange enough when the lockdown started we were thinking that we would make no intake whatsoever because the border are closed so one practical aspect is if people want to return to their country of origin they might not be able to do so. We have a client at the moment who was looking to waiting to go back to the Czech Republic the border is closed so we have to stay here on standby. What we see is that there are intakes of people who have been under the radar for many years in Amsterdam people who have been working black buying illegal methadone in the street for 10 years 15 years 20 years and now there is no more job so then they start to appear and we do intakes of this this particular target group now. On the other hand also now the the facilities that that where our clients normally don't have access to because they don't have the rights for us for social care now during the crisis they do have the right also for night shelter and that kind kind of services so that is yeah also a positive thing the clients cannot move so they are stuck here but at least now they can access to yeah harm reduction services yeah and then also count for undocumented people we have a quite a big group in Amsterdam as well maybe not if you compare it with other cities but there's still still a big group who was sleeping in yeah in in garages and that kind of unsafe places and now also in the last week so there's organized two extra day shelters and one night shelters specifically for this group who yeah to keep them inside. You mentioned you both of you mentioned that a lot of people lost their incomes because there is no tourism no possibilities so what is the government doing something to support people to substitute their income during the crisis yeah yeah of course only the the people who have legal jobs and yeah but they are supporting people with social benefits yeah and if someone is like a sex worker what can she do or he do yeah they can apply for the same social benefits as any other any other worker if it's a yeah if it's legal and that is like the those people who work in the sex industry in Amsterdam do they left now did they go back to do to Eastern Europe or they're still there in the city? They're not working because the contact work is not allowed most of them are not working and no I mean a lot of people are still here also because it's not so easy to travel. So and how do you see the the future like how long you think this lockdown can be maintained and and how what will happen in the future? It's very hard to tell it's very hard to tell the government is very careful to not make projection on a long term it's months after months so we know now that we will continue the operating service as it is today until first of June and after they will give advice probably for the months of June at the end of June for the months of July and so on. There are different ideas behind making this lockdown a bit more supple but still it has been very clear that there will be no return to normal activity at least until September October that means for hotel restaurant cafe clubs nightclub sex work etc the season is dead for us we go on months by months I don't expect that we will come back to normal before let's say October because we also expect eventually a second wave the government said there might be a second lockdown after the summer let's continue working like this and not project too long because we don't know ourselves so many people in the working in our reduction say that this crisis can also be used as an opportunity to you know change some outdated rules for example you mentioned OST rules do you think that these kind of more flexible progressive rules can stay after the crisis? Yes yeah well what what what we see now is that with this with these extra shelters and this extra support I would really like them to stay we experience way less aggression in our mall since people can just sleep at night and have some food and a shower it's actually it's so easy and it's a big big change in our clients so so what I hope for the future these extra shelters will stay and I also would advise to invest more in social work so so the shelter is not the end station but social workers can work on an individual level with people to improve improve their lives for a long term but this can be a good start I would say I would really yeah I would really like to continue with these extra shelters and then and then work from there of course yeah and about the OST the substitution programs it has been twice in the history of drug policies in the Netherlands that they facilitated the access to methadone the first time was at the beginning of the heroin epidemic in the 90s second time was at the end of the 90s with sex workers and now this is the new opportunity that means many of our clients visitors of the users room will end up at the end of the COVID-19 crisis with a substitution which probably will have to build down or stop but once you start substitution program it's complicated to stop it or to reduce it so we might see people who will finally this this crisis is their opportunity to enter a substitution program for a longer period than just the crisis and that is my hope finally any lessons learned you you would like to share with with other countries with other harm reduction workers in other cities um well I think what I just said you you prefer is a question that I think we learned in this crisis that it's worth to invest in shelters for the homeless people and yeah for the rest yeah probably there's a lot of lessons to be learned globally and I think the next time a crisis like this will come we know better what to do because we all really experienced it once so all the yeah I think and for me I've been writing a lot uh in in regard to the drug consumption room I really recommend as lesson learned that we can continue to operate but differently we don't have to stop the services it's very important to keep the continuity of the service because we are somehow uh dropping center drug consumption room one of the only place they have left somehow this homeless population so we are some somehow very important in their daily routine of surviving the street but we also can learn a lot from other countries when I see that in England they facilitated metadone substitution very quick that in other cities they they took over all the hotels to let the homeless not being in the street we could also inspire uh let's say the Netherlands could get also inspired from other countries okay okay Cedric thank you very much for being with us today and thank you for those who are watching us please follow us on Facebook and on Twitter we will continue our stories from the Frontline series stay informed and stay safe good bye stay safe bye bye