Community programme in Pakistan aimed at preventing and reducing drug abuse
Author: K. A. MUFTI
Pages: 121 to 127
Creation Date: 1986/01/01
A voluntary organization called the Green December Movement was established in December 1983 to make better use of the resources available at the community level for the prevention and reduction of drug abuse in the North Western Frontier Province of Pakistan. As a result, two major treatment and rehabilitation centres have been set .up, one in Peshawar and another in Mardan, that provide free treatment for drug addicts, including those from other parts of the province. To cope with the recent increase in heroin abuse in the province , the Green December Movement has succeeded in involving both men and women in community efforts to reduce drug abuse. Emphasis has been placed on the involvement of religious leaders in drug abuse prevention activities, particularly in alerting the population to drug problems, as well as in providing spiritual and psychosocial support for detoxified addicts, which helps them to stay away from drugs. The Green December Movement has recently gained national status, and branch offices have been established in Karachi and Quetta.
In addition, the Green December Movement provides drug information adapted for various target groups and encourages students, teachers and out-of-school youth to participate in community activities aimed at preventing drug abuse. To this end, the Green December Movement closely co-operates with government agencies and nongovernmental organizations concerned with drug problems in the community and has undertaken research on various aspects of the nature and extent of drug abuse, as well as on its prevention and treatment. An evaluation of the Green December Movement activities carried out so far has revealed positive results.
The Government of Pakistan has recently undertaken strong measures against drug abuse and drug trafficking. These measures have substantially contributed to international efforts to cope with the increasing spread of drug abuse. In order to complement and strengthen such measures, broad-based community involvement in combating drug problems has been introduced.
* Founder of the Green December Movement.
To develop such an action-oriented community programme, a small team of social workers in a hospital unit in Peshawar initiated an organized community effort that resulted in the establishment in December 1983 of a voluntary organization called the Green December Movement. This organization has encouraged activities to prevent and reduce drug abuse by involving various segments of the community, including both the private sector and the official services and agencies concerned with drug problems.
The activities of the Green December Movement have been co-ordinated within the scope of the programme on utilization of community resources for the prevention and reduction of drug abuse, sponsored by the Division of Narcotic Drugs of the United Nations.
This article provides a summary of the achievements of the Green December Movement in its efforts to reduce the demand for illicit drugs in the North Western Frontier Province of Pakistan.
A small part-time detoxification clinic in Peshawar has been adapted and developed into a well-equipped treatment centre, which provides treatment facilities, research and the necessary administrative work. The part-time clinic has been converted into a full-time care centre that also serves as the central rehabilitation facility. Qualified social workers, a medical officer and other necessary staff members are employed at the centre on a full-time basis. The centre provides free counselling, treatment and rehabilitation services for drug-dependent persons. In addition to social workers, the treatment involves the client's close relatives and voluntary social workers from the clients area of residence. This strategy has helped to promote communication between the families and the centre, a factor which has proven to be of great therapeutical value.
Another major treatment centre has been established in Mardan, which is situated some 60 kilometres north of Peshawar. The local community has taken on the responsibility of managing this centre, which also provides free treatment and rehabilitation services. The services have been extended to include the adjacent semi-rural and rural areas. For this purpose, a mobile team consisting of a doctor and a social worker operate three days a week.
In March 1985 a three-day training course for general practitioners was conducted. It was attended by 90 family doctors from the North Western Frontier Province. An evaluation of that training showed that it was useful, acceptable and effective. Such training helped the doctors to improve their knowledge and skills in the treatment of drug addicts and, in so doing, overcome their reluctance to treat such persons. The training course was supported by the Pakistan Narcotics Control Board and by the Post-graduate Medical Institute, whose dean is a member of the Executive Board of the Green December Movement.
The Green December Movement has been trying to expand the community-based facilities to include other towns and rural areas of the North Western Frontier Province and, for this reason, has co-operated closely with two government hospitals.
By December 1985, the Green December Movement had provided free detoxification and rehabilitation services to approximately 5,000 drug-addicted persons. The majority of them were young male heroin addicts. Heroin abuse among men has been increasing lately. It has also been increasing among women, but to a lesser extent. There is some concern, however, that the prevalence of drug abuse among women may reach an unacceptable level in the near future. For this reason, emphasis has been placed on involving more female social workers in treatment programmes and on encouraging young women to take part in Green December Movement community activities. This has resulted in a well-organized women's section in the Green December Movement.
Speeches on drug abuse prevention have been given at various public places. In addition, posters that were designed with certain target groups in mind have been put up to promote a more positive attitude and a healthy approach to youth activities. Banners bearing attractive and carefully selected slogans have been posted, and publications on drug problems have been made available in public places. Efforts have been made to alert parents to drug problems and to motivate them to take partin activities aimed at preventing drug abuse.
The mass media has been actively involved in promoting the cause of the Green December Movement. Almost all the leading newspapers, as well as the radio and television network, have been helping the organization to attain its aims. The display of newspaper cuttings at a Karachi media conference in May 1983 is an example of such involvement.
Another example is the dramatized drug abuse preventive work that has been televised. The international press has also publicized the activities of the Green December Movement.
Apart from holding multiple public meetings in communities, two meetings were of major professional interest. Taking part in one meeting, which was held in December 1984, were scholars from all over Pakistan, including educationists, psychologists, medical doctors, religious scholars, artists and students. The United Nations Fund for Drug Abuse Control, the World Health Organization, the Pakistan Narcotics Control Board and the Department of Health made important contributions to that meeting. The meeting was opened by the Governor of the North Western Frontier Province , who presented a grant to the Green December Movement. At the other meeting of major professional interest, which was held in June 1985, individuals who had done commendable work in the control of heroin abuse were awarded Green December Movement prizes and certificates. The meeting was presided over by the Honourable Chief Minister of the North Western Frontier Province, who also presented a grant to the Green December Movement. It was stated that the active support of the Government of the North Western Frontier Province was of particular importance in achieving such favourable results in the fight against drug problems in that province. For example, the annual production of 800 tonnes of opium in 1979 was reduced to 44 tonnes in 1984. This was accomplished with the financial assistance of the United Nations Fund for Drug Abuse Control, which supported the crop substitution programme in the North Western Frontier Province.
Meetings have been held on a regular basis with Muslim religious leaders who have been helping by informing congregations in the mosques about drug abuse. The Green December Movement currently plans to hold a national seminar on the topic "Islam against drug abuse''. The Muslim religious leaders in the Green December Movement programme have been alerting the population to drug problems and providing spiritual and psychosocial support for drug-addicted persons after they have been detoxified, thus helping them to avoid turning to drugs again. During a 40-day period following detoxification, the detoxified persons generally join a team of religious leaders and assist them in their efforts to reduce drug abuse. During this period the detoxified addicts do not stay in their places of residence. These efforts have resulted in a treatment success rate of 42 per cent, with success being defined as a treated individual's having abstained from drugs for at least six months after detoxification.
College and university students and their instructors have been encouraged to take part in action committees aimed at dealing with drug abuse. These activities have yielded very positive results. During the International Youth Year, 1985, emphasis was placed on involving rural youth in efforts to deal with social problems, and to that end, the Green December Movement co-operated closely with various youth organizations.
The Green December Movement strongly supports the view that youth should be provided with ample opportunities to spend their leisure time participating in healthy activities such as sports. With this in mind, the Green December Movement has organized cricket matches, Association football competitions and badminton tournaments. In order to promote the participation of youth in sports, the Green December Movement has established close co-operation with the Pakistan Sports Board. For example, the Green December Movement organized an Association football championship for youth under the age of 18 in Peshawar in October 1985 that was attended by more than 5,000 people, and it plans to organize more sports and other healthy activities for youth in the months to come.
The Green December Movement has also established close co-operation with the various government agencies and services concerned with drug problems, such as the police, the Customs, local authorities and the Regional Pakistan Narcotics Control Board Office, in order to help mobilize the community against drug problems. For example, to suppress the trade in and availability of illicit drugs, members of the Green December Movement have helped the law enforcement agencies to disclose drug traffickers.
The community liaison programme has been extended to involve tribal populations of Pakistan at the Afghan border. This programme has enabled the local people to achieve a better understanding of the hazards of drug abuse and, as a result, they have become more willing to participate in efforts to stop the flow of illicit drugs across the Afghan border into Pakistan.
The Green December Movement plans to co-operate closely with other non-governmental organizations concerned with drug problems in Pakistan with a view to increasing their participation in the efforts to prevent and reduce drug abuse in the whole country. To this end , a national conference of non-governmental organizations , which was opened by the First Lady of Pakistan , established a national federation of non-governmental organizations in which the Green December Movement has played an important role.
The Green December Movement intends to contribute actively to international efforts to prevent and reduce drug abuse. The Green December Movement was represented by its president at the regional workshop for Asia and the Pacific on national projects for the utilization of community resources for the prevention and reduction of drug abuse, which was organized by the Division of Narcotic Drugs of the United Nations and held at Bangkok from 11 to 15 June 1984.
Many visitors from abroad have shown interest in Green December Movement activities. For example , during a recent visit , the co-founder of Parents Resource Institute for Drug Education of the United States of America examined the activities of the Green December Movement in Peshawar.
The research programme , which is supervised by outstanding scholars in social work, psychiatry and clinical psychology , includes the following activities :
Research on sensitivity group meetings attended by social workers , medical doctors and members of the Green December Movement ;
Research contributions to the Green December Movement from post-graduate students of social work from Peshawar University ;
Research on the effectiveness of treatment and new treatment modalities ;
Trends in drug abuse ;
Risk factors in the occurrence of drug abuse among youth ;
The re-integration of addicts into society after treatment ;
Psychiatric illness associated with drug abuse ;
Heroin addiction in Peshawar : new strategy for prevention and rehabilitation ;
A population survey (to be carried out if funds become available).
The following three components of the Green December Movement activities have been evaluated : direct campaigns; activities carried out in connection with the International Youth Year ; and community mobilization with a view to preventing and reducing drug abuse. The evaluation has been carried out using interviews , surveys and observations by trained personnel and random cross-checking by specialists. The results of the evaluation have been very favourable in all the areas of activity mentioned above. There has been a notable increase in the number of addicts who applied for treatment. Approximately 25 per cent of the total population of Peshawar and Mardan are directly or indirectly involved in the Green December Movement programme , helping to promote drug education , identify early drug abuse and promote treatment and rehabilitation , particularly with a view to providing the necessary after-care for addicts who have undergone drug detoxification.