Combating drug abuse in the Maldives;Challenges -1

During the last campaign, every candidate, made deep and high impact statements on how they would make a difference to our existing drug problem. I am sure, they all intend to do so and I sincerely wish them best of luck as this is a problem which effect the soul of our beloved nation, we all want solutions. Every citizen who love our country would wish to solve this problem and it is all in good faith and honest determination, that our leaders are trying to come up with different strategies to deal with this problem.
But for me, a person who had worked in this area in the Maldives for five years, who watched the programs very closely, the future appears to be full of challenges. Some times I feel , it is better for me to be silent and keep my thoughts to myself. Because what I say now, may create a retort among those who would not like me to spell things out like this. But some where, I feel an urge, a national responsibility to let the public know.Therefore, I plan to write a series of articles on this topic.
To deal with the drug situation in the country two programs are conducted simultaneously. One is the program on supply reduction and the other involves the demand reduction programs. I have often felt that our public confuses the roles and responsibilities involved in the two different programs.
So let me clarify the difference , demand reduction primarily involves the process related to drug rehabilitation and drug prevention or awareness programs , while those involved in arrests of drug addicts and seizures of drugs are involved in the supply reduction side.
If we are to see a change in our substance abuse scenario, both supply reduction and demand reduction programs have to be strengthened simultaneously. I can definitely make out that the supply reduction side seems to be very active as several arrests and seizure reports have been publicized recently. However, we do not get much information on whats really going on with the demand reduction programs.
I left NNCB in September 2005, and have had no contact with the organisation since then, therefore I am not able to comment on whats going on now.However, my hope is that many things would have changed for the better. I am sure, the counsellors would never give up the hope of fulfilling their duties to the best of their ability and will be putting in all they have. But, while I hope for this...some thing inside me is in conflict. As if I have to make a confession, that I seriously do not believe, things can improve..atleast not yet.
It is not due the conflicts in the management , or lack of will on the government to handle this situation that is creating the many challenges that our demand reduction programs are facing. But I seriously think our entire drug rehabilitation program need to be re evaluated. This was actually done by myself and an Indian Psychiatrist, Dr.Rastogi and was submitted as a report to the then commissioner of NNCB and as far as I was told a copy of this was presented to the presidents office, in 2004. What I remember from this report is, that the existing program was perceived as very weak indeed and clients had reported dissatisfaction with various aspects of the treatment that was provided at DRC at that time. Unfortunately, this report was never published , so the public has no access to its detailed content. Definitely, its a big loss as a lot of work was put into the collection of data and preparation of this report.
I think it will be a waste of resources to just begin rehabilitation efforts in different parts of the country, without objectively evaluating the existing program , preferably by an independent group of people who have expertise in evaluating such treatment models. But, due to the way the drug problem escalated in our country, with the prisons bursting with prisoners primarily with sentences related to substance abuse or related offenses, we are faced with an urgency to implement what ever we could so that these people could be sent for some form of treatment, so that families and general public will feel the government is serious about really doing something to tackle this issue.
My question is , is this the solution? I read that a number of prisoners will soon be shifted to feydhoo finolhu, and they will go under NNCB. What is the program that will be conducted here for them? Is this going to be of any use??? Once upon a time, I remember, a previous boss of mine telling me in a state of utter dilemma and confusion, " rayyitthun beynunvani mi meehuntha male' yn huskoh , rashe hadhaafa alhaalan...dhen emeehun feydhoo finolha alhaaleema aharun hadhaani vaki kihinei??' And when I spoke to some of those who were to go to these islands most of them showed eagerness and enthusiasm to help. But , many of them , who were young people, with minimum training did collapse under the weight of the type of problems they had to deal with. I really am proud of this bunch who said to me,' But we will go, we will do what ever we can, even if it is sometimes difficult for us to listen to them ....."

Do you understand what all this mean? Well....lets change strategy now , close your eyes and visualise this scenario.

Imagine this situation. We need, surgeons to do surgery and for different specialisations we have different types of surgeons. But , in this hospital, we have a number of patients presenting with similar problems , but perhaps the underlying problems are different and need to be handled differently..by different surgeons. But here there are only nurses, with some training, so they step in to do surgery, simply because they just cannot afford to wait and watch as patients were collapsing around them and they felt the need to do something. Fortunately, some patients recovered, and then the hospital management declared that from now onwards , in this hospital and all other hospitals belonging to them, surgery will henceforth be carried out by their own team of successful nurse surgeons . Ahem. Open your eyes now.
Lets return to the previous discussion...and keep this example in mind....while you read!!!

My question now is, does our country have appropriate and adequate human resources to deal with this situation?? If we don't then what should we do? Is shifting drug addicts from a confinement of a prison to another island....with some colours of counselling going to rehabilitate, individuals with Chronic substance abuse disorder, possibily with co-occuring mental health problems..past history of offending ...etc..?? In the long run is this going to help? OR is it time for us all to think out of the matrix??? (to be continued)
Follow the following link to read up the RSA of substance abuse in Maldives published in 2003;http://www.mv.undp.org/Images/drug.pdf