The Maleku Indigenous Territory is located in the canton of Guatuso, province of Alajuela, in northern Costa Rica. Covering an area of approximately 2,994 hectares, this territory is inhabited by around 1,000 people spread across three communities. The Maleku people are one of the eight officially recognised Indigenous peoples in the country and maintain their own political organisation through their local Indigenous government.
As facilitators accompanying a process, and members of a non-indigenous civil society organisation, we aim to share our experience of a process still in development with young indigenous users. The project is supported by a consultation carried out in 2019 by the National Council for Young People of Costa Rica with young indigenous people, which identifies drug use as one of the most significant problems in their communities.
That said, we start from the premise that thinking about an indigenous perspective on harm reduction means prioritising a framework for action that values Maleku culture throughout the project. This implies starting from an approach based on international conventions that recognise the rights of indigenous peoples, emphasising cultural respect and rejecting punitive or stigmatising practices. The primary objective is for the Maleku community itself to lead the identification of its needs and the creation of effective and culturally appropriate solutions for harm reduction.
The process has been coordinated by drug users from the Costa Rican Association for the Study and Intervention in Drugs (ACEID), in dialogue with local organisations in the Maleku Indigenous Territory and with the support of the Ditsö Association of Popular Initiatives, in response to community concerns about the stigma and exclusion faced by young people who use drugs. In a context marked by the recovery of territory and the strengthening of the identity of the Maleku indigenous people, it was proposed to open spaces for dialogue and collective action to understand drug use from a non-punitive, intercultural and rights-based approach.
A participatory and decolonial practice
The project has been running from June 2024 to the present. The first experience was organised thanks to the global campaign Support, Don’t Punish. At that time, four collective activities were carried out, involving 46 people from the Maleku community, including young drug users, community leaders, older adults and Maleku territorial political representatives.
The activities included participatory community workshops, a meeting with indigenous organisations, and a meeting organised by young people who use drugs. This process gave rise to the project initiative ‘Strengthening sociocultural management: Youth and Collective Health in the Maleku Indigenous Territory’, which was funded by the Costa Rican Ministry of Culture and Youth. The main objective is to generate sociocultural management processes aimed at raising awareness, integration, and empowerment among young indigenous people who use drugs.
We start from a broad-spectrum harm reduction approach from a global south perspective, understanding it as an ethical and pragmatic stance focused on the well-being and rights of people who use drugs. Our approach to support is decolonial, through intercultural dialogue, participatory action research, Latin American liberation theologies, popular education, and an ethic of care. And while we are not indigenous people, we are drug users who, like the young Maleku people participating in the project, are directly affected (albeit in different ways) by prohibitionist drug policies, stigma, and criminalisation.
The fundamental concepts of harm reduction are adapted by integrating cultural elements and considering the specific social fabric of the community, which translates into support free of judgement and stigma. The aim is to strengthen community actions with the active participation of drug users, in order to influence the social fabric and internal cohesion, valuing their relevance and importance in the community. In these spaces, horizontal methodologies, collective analysis tools and critical pedagogical approaches were used to identify problems and propose community action plans around drug use, mental health and sexual and reproductive health.
In practice, this perspective is manifested through the implementation of participatory meetings as safe spaces for indigenous people who use drugs to share their experiences, express their perceptions, and articulate their needs. It also means coordinating with community networks, such as local political organisations and community leaders, who, thanks to their deep knowledge of local history and context, facilitate reflection and collective care, promoting awareness-raising processes for the entire community and society in general.
During this process, young Maleku people who use drugs shared their experiences of stigma and discrimination in the community. They pointed out that they are often judged or excluded by other sectors of the community, which limits their participation in cultural, educational, training and decision-making spaces. They expressed feeling observed with mistrust or treated as a ‘problem’, which directly affects their self-esteem, mental health and sense of belonging. They also recounted how these forms of exclusion reinforce barriers to accessing health services or support, deepening their isolation and marginalisation. Despite this, they expressed a strong desire to be heard, to share their perspectives without being stigmatised, and to actively contribute to the collective well-being. These voices underscore the urgency of building community dialogue spaces that embrace diversity of experiences and recognise the dignity and value of all people, regardless of their relationship with drugs.
We particularly appreciate some of the testimonies from participants, such as that of a Maleku mother who shared how harm reduction transformed her relationship with her son. Before, her relationship with him was tense and difficult; she did not know how to approach him or how to support him. However, by understanding the principles of care and non-judgement, her perspective changed completely: she began to talk to him more, to accept him as he is, and to look for ways to be present with respect and support. Today, she describes her relationship as ‘more beautiful’ and points out that what she has learned has not only improved her bond with her son, but has also been useful for other mothers in the community who are going through similar situations.
Practical tools
For Arturo, a young Maleku drug user whose identity we are protecting, harm reduction has provided him with practical tools. He tells us that this approach has helped him manage his substance use more consciously. Now, for example, he knows that combining certain substances is dangerous, which allows him to take better care of his health. In addition, the project has helped him interact better with other people, get along better with them, and feel more integrated into his community.
Among the main findings is the profound impact that stigma and discrimination have on young people who use drugs, both on their mental health and on the cohesion of the community fabric. Limited access to health services, evidence-based information, and safe spaces for recreation and dialogue was also evident, as was the systematic exclusion of young people from decision-making processes within the community. At the same time, the fundamental role of Maleku women leaders as bridges between generations and promoters of an ethic of care was recognised, reaffirming the need to incorporate a gender and intercultural perspective in future actions. These findings reaffirm the validity and relevance of harm reduction principles from the global south as an ethical and methodological basis for continuing to build community-based, inclusive, and sustainable responses.
The proposals that emerged from the participatory process include: reducing stigma through community participation processes; facilitating access to drug use care services and psychological support; managing recreational, artistic and sports spaces led by young people; promoting peer support; and disseminating evidence-based information on drugs and human rights. Coordination with local Maleku authorities helped to legitimise the harm reduction approach as a care approach and a culturally relevant course of collective action.
The value of dialogue
This process highlights the value of community dialogue as a basis for advancing the implementation of harm reduction strategies. It recognises that indigenous communities have the capacity to develop their own culturally sensitive and sustainable responses to drug use, moving away from punishment and focusing on well-being, autonomy and dignity. However, the support process struggles with global cuts in international cooperation, lack of local funding, and resistance inherent in a process of changing perspectives on drug users. Even so, the Maleku Indigenous Territory clearly states: “Young people who use drugs are not the problem, but rather key actors in the transformation and strengthening of the community fabric.”
