Harm Reduction on the Kenyan Coast
Delivering evidence-based harm reduction through trust, not judgment
Context
People who inject drugs along the Kenyan coast face a double burden: the health risks of unsafe injecting practices and the social risk of criminalisation. Stigma drives many away from health facilities. Fear of arrest keeps them from carrying sterile equipment. The result is a cycle of abscesses, blood-borne infections, and overdose deaths that could be prevented.
Services are often far from where people use or live. In Kwale County, the distance between a person who injects drugs and a clinic that will treat them with dignity can be measured not just in kilometres, but in fear.
The Approach
Needle-Syringe Programme — TWC operates a fixed-site and outreach-based NSP that provides sterile injecting equipment, safe disposal of used needles, and health education at every contact point. Peers distribute kits and collect sharps in the community, ensuring coverage reaches people who cannot or will not attend the clinic.
Overdose Awareness & Naloxone — Overdose training is integrated into every peer encounter. Beneficiaries learn to recognise opioid overdose signs and administer naloxone. Take-home naloxone kits are distributed to people at highest risk, turning each peer into a potential first responder.
Medication-Assisted Treatment — Methadone maintenance therapy is available through TWC's clinic, providing a medically supervised pathway to stability. Peers play a critical role in supporting adherence, reducing the stigma of MAT, and linking clients to psychosocial support.