KUALA LUMPUR, June 16 — Sexual transmission has been identified as the main cause of new HIV infections in the country.

This is a known fact and has been the trend for the past few years.

Yet, non-governmental organisations that specialise in helping what used to be the main cause — drug use — continue to exist to help keep those numbers in check.

How they figure in current times remains crucial if the country hopes to reach its lofty goal of ending AIDS by 2030.

Malaysian AIDS Foundation honorary secretary Bakhtiar Talhah said keeping HIV transmission to zero is a continuous effort and the efforts by these bodies will remain relevant in coming times.

He added that stakeholders including law enforcement, health professionals as well as the local community needed to be active in implementing harm reduction programmes such as needle syringe exchange programme and methadone maintenance therapy.

"Malaysia is a role model in the region for harm reduction, and as a country, we must continue to implement scientific and evidence-based methods on the ground as drug use remains a social and public health issue here and elsewhere,” Bakhtiar told Malay Mail.

According to Bakhtiar, non-governmental organisations that focus on drug use are part of an ecosystem in addressing not only HIV and other communicable diseases, but function also as a network of grassroot and community-led individuals and groups.

These groups can act as the bridge between the marginalised communities to the formal public health and other essential governmental systems.

"Whilst HIV catalysed these NGOs some 20 years ago, other health and social issues are now emerging, and these NGOs are best placed to leverage their experience and presence to also play an effective role,” he said.

Health ministry statistics show that there have been a total of 125,878 cases of HIV from 1986 to 2020 with over 3,000 new reported cases in 2020 alone.

The stats also show that there were 2,970 cases reported in 2020 because of sexual transmission while there were 122 HIV cases involving people who inject drugs (PWID).

This translates to 94 per cent of HIV cases being sexually transmitted while only 4 per cent transmitted because of injecting drug use.

The downward trend to transmission among PWID is largely attributed to the introduction of harm reduction programmes in the early 2000s.

Still serving the community after 20 years

Among the NGOs that are still serving the PWID community is Komited Malaysia.

Founded in 1998 by seven friends, who were on their own path to recovery, Komited now has five rehabilitation shelters as well as two drop-in centres in Pahang and Selangor.

There are around 180 clients living across all their shelters while they also get around 70 to 120 clients visiting and using their facilities daily at their drop-in centres in Kuantan.

They also have about 2,000 street clients around Pahang who are under their needle syringe exchange programme.

Komited which is an acronym for Komuniti Intervensi Dadah Malaysia is also run by former and recovering PWID following its model of being Malaysia’s one-stop drugs intervention model which offers a holistic approach on rehabilitation and treatment.

Their "womb to tomb” approach includes rehabilitation shelters for key affected populations including a shelter for women and kids affected by drug use called Casa Harapan as well as shelter for elderly PWID called Casa La Obe 60.

The group’s daily drop-in centres, which provide basic facilities such as beds, bathroom, kitchen, washing machine and a TV room for free, also has a drug information centre to assist recovering PWID.

Aside from that, they also produce some of their own poultry and kelulut honey at their farm at their palliative care rehabilitation shelter known as Casa Paliativo.

Turning Over a New Leaf

Banu (not her real name) had been using drugs for 30 years and served time in prison.

After getting released from the Simpang Renggam prison, she went to Kuantan.

This was where she was introduced to the drop-in centre run by Komited. Fast forward 10 years later, she is now staying at one of Komited’s shelters and is also working as a full-time staff with the NGO at their women and children shelter home, Casa Harapan, where she helps to carry out chores like cooking and washing up.

"Previously when I decided to change, it was a struggle. I doubted myself but I tried really hard to convince myself that I can change for the better. After staying with Komited, I’ve been clean for 10 years now. And as a staff member, I can finally buy my own things. I can buy my own daily essential items, a handphone and I’m also able to hold my own money.

"I’m grateful for Komited and I prefer to stay here. Not that I’m afraid of relapsing but it’s the children. I love them and I love it here, and they are nice to me,” Banu said.

For 30-year-old transwoman Anja (not her real name), she too has been a regular patron at Komited’s drop-in centre for the past six years.

Anja is from a poor family and at the age of 19, she was living on the streets and was using methamphetamine.

She has been clean for five years and said that the drop-in centre meant a lot to people like her.

She added that it was not just a shelter but a safe space where they could get advice, support and motivation to continue their journey to recovery.

Anja is now working as a housekeeper at a local hotel and has rented a place of her own but still occasionally visits the centre to get her blood checked.

"My hope is that I can continue to stay this way. I hope not to return to my previous state no matter how bad the day is, I won’t look back.

"My motivation to stay sober now comes from my family; I have a sister, she’s all grown up now. She’s taking her SPM exam this year and she’s been living with my grandmother since my mother passed away and I’ve been providing for them since.

"I can’t stand seeing my sister being on her own, I feel sorry for her, my decision to stay clean is for her,” Anja said.

Along (not her real name), a former occupant of Casa Harapan and single mother of three, Along, said she came to the shelter when she was 30 after she left her husband.

Both of them were drug users and in 2008, Along who just had their third child finally had had enough of the life.

She decided to separate from her husband, who did not want to change.

"I took the kids and went back to my hometown in Maran but when we got there, we were faced with stigma from my fellow villagers.

"They called me a sick person while I was under stress, and I had lost weight. But it’s okay, I made up my mind to come here (Casa Harapan) even though some people told me that it is a trap set by the government to apprehend drug users.

"My decision was firm, so we came here and we’re ready for a fresh start,” the 44-year-old said.

She has since gone through the rehabilitation programme at Casa Harapan and is ready to live independently with her kids.

"At first, I did think of leaving Komited but I thought about my kids and plus I was offered a job at the drop-in centre. I also don’t have the heart to see people go through what I’ve gone through.

"So I feel like helping. I cannot stand seeing my friends being in a distressed state. We don’t want them to be like who we were before and that really opened my eyes.”

She added that Komited had sent her for training in KL and she had sharing sessions with the various target groups when she returned.

Along is now renting a house of her own and living with her three children.

The eldest child has just received his vocational diploma in electrical engineering while her second child just finished secondary school and her third child is 14 years old and is currently at a boarding school.

Lending a helping hand

It is not easy to run an NGO no matter how much one wants to help people.

Among the first in the list of challenges is getting funding or financial aid.

In this aspect, Komited recently received RM2.5 million in funding, courtesy of Sime Darby Foundation (YSD).

Komited founder and former PWID Khalid Hashim said their NGO used to receive funding from women, family and community development Ministry until 2014.

Funding was then taken over by the health ministry, which was RM400,000 to RM500,000 yearly until June 2021.

Their funding was then cut due to the Covid-19 pandemic.

"At that time, we were on the brink of shutting down. However, we’re grateful to Allah SWT when YSD came in with the RM2.5 million sponsorship.

"It is the biggest funding we’ve ever received.”

The funding from YSD will be used to pay for the rent of all their shelters and drop-in centres for the next three years.

The funds will also be used to pay the salaries of 40 former PWID who are working under Komited.

YSD chief executive officer Yatela Zainal Abidin said they were glad to help Komited in their time of need.

Komited spends RM853,800 yearly to cover the cost of food and drinks.

This includes the three daily meals for clients at their drop-in centres and four daily meals at their shelters.

They need approximately RM3 million yearly to cover the overall expenses of their NGO,

Yatela also said that the reason YSD has chosen to support Komited was also because of its One-Stop Drugs Intervention Centre model or also known as the "womb to tomb” approach.

The model is a holistic approach for continuum care and services that emphasises the need of PWID clients and other key affected populations including women and children living with HIV.

"Doing only one stage is not enough, we need to be with them till the end. Training them to go out and get a job, training them to be able to be one with the community is very difficult because they’ve been out of the community for most of their lives.

"So, they have to build resilience to get the community to trust them. In order for them to have that resilience, they have to have the support, that is what Komited is doing.

"And then ultimately it is a sustainable livelihood that they will get, to help not only themselves but their families as well,” Yatela said.

YSD is also lending their expertise to assist Komited in improving their operational standards, transparency, and governance.

Amongst the five rehabilitation shelters operating under Komited includes the shelter home for job placement called Casa Vista where they will help train recovering PWID to get a job and build a sustainable clean life.

They also recently just opened another shelter home in Jeram, Selangor called Casa La Obe 60 where they’re focusing solely on taking care of recovering elderly PWID’s with nowhere else to go.

They also introduced a 24-7 tele-counselling helpline in 2020 to assist those in need.

"I’m so grateful to still be alive and my life is a message of hope. God didn’t save my life for no reason, he saved me so that I can help others not to go through what I’ve been through,” Khalid said.