This section was informed by a workshop with the MELAA advisory group and discussions with people from these communities in 2023.
The term "MELAA" encompasses a broad range of cultures, languages, and backgrounds from the Middle East, Latin America, and Africa. Each subgroup has its own unique experiences and needs. The following considerations are essential for providing effective harm reduction support to individuals from these diverse communities.
Key considerations:
- Understand the experiences, cultural, and family context of the person you are supporting. Listen to them to hear what their needs are. Ask permission before sharing advice, this includes sharing information about the context in Aotearoa.
- Provide a space for people to feel comfortable talking openly about alcohol and other drugs. Some people come from countries or religions where talking openly about alcohol and drugs is considered taboo or could be responded to with harsh consequences. They may require a different approach or may take longer to build trust and feel comfortable speaking honestly. One person stated that, “We don’t often discuss this in our settings, people cope in silence.”
- Consider starting the conversation about alcohol, other drugs, and prescription medications early and without expectations or judgement. Be clear about confidentiality and whether you have any requirements to share information with other people – especially from the same community. This includes reassuring people that you will not share information about substance use with police or immigration. This can help people to see that it is ok to talk with you about alcohol and other drugs. You may need to revisit the conversation a few times to give people an opportunity to share more as they feel more comfortable.
“Many people who become dependent on tramadol are not aware it is an opioid and causes dependence.”
“The conversation needs to be started, it is difficult for people to come forward.”
- Consider whether translation services could help. If people feel they are not able to communicate clearly, their access to appropriate support services may be limited.
- Consider using a trauma-aware approach. Many people have left their country, family and support systems, and require a multi-faceted approach to addressing their needs.
“Cultural differences play a large role for refugee and migrant communities. When people move to a new country like New Zealand, where substances like alcohol, cannabis, and methamphetamine are openly used, they often start using these substances to cope with trauma and pain – their lens is different and so we must understand this.” – General Practitioner from a MELAA community