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Miriam Saarde

I'm giving you a gift! Immunizing for hepatitis.

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I work in Roskilde in a substance abuse clinic. We see all kinds of patients, aged 18 and over, who have problems with drugs or alcohol. My job is to give them medicine and to arrange for blood tests and to vaccinate them for hepatitis.

Immunizing for hepatitis is a big part of my job. This client group uses needles, which they share, meaning they end up infecting each other with all kinds of diseases. Even though we give them free needles, they still share because when people are taking drugs they don’t think about risk in the same way.

This is an extremely vulnerable group of people. A lot of them are homeless, they’re the people you see on the streets, many of them are prostitutes and criminals. We use different pedagogical approaches depending on the person.

For hepatitis I try to ‘sell’ the good idea of being vaccinated - everyone understands that theory. Young people feel they will be freer in their ‘party life’ if they can’t get hepatitis, so then I have another job to tell them about other diseases. I have to talk to the person in front of me in such a way that they will understand it. Sometimes I draw a picture to show them how the infection spreads. I tell the patient: “I am giving you a gift so you don’t get sick from the life you are living.”

Some of my patients don’t get the idea of being immunized but it’s not a trust problem. It can be really hard work making them understand the importance of it and even harder work to get them to turn up for the appointment. When we send patients for blood tests we can order the tests electronically rather than giving people pieces of paper. Where possible we actually walk with them to the place where they get the blood test. The most frustrating thing is when patients don’t show up. It’s unfortunately rare to get to finish all three doses of the vaccine.

In an ideal world we would vaccinate at the same time as giving methadone so the patients are at the clinic anyway, using every contact with a patient to vaccinate is a very good strategy and I hope we may soon be able to do that here. A trickier aspect of my ideal world would be a wonder vaccine for hepatitis that would only require one dose. Could you do that for me? I am very patient…..

 

 

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