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Asian Directors visit Caribbean Drug Treatment services in the Caribbean

Following on from the very successful visits made by the Directors of Caribbean drug treatment services to Malaysia, Thailand and Pakistan in November 2002, DOH International, with financial assistance from the European Union (EU), is coordinating a reciprocal visit of Asian directors to the Caribbean this November.

Directors of treatment programmes in Afghanistan, Pakistan, India, Malaysia and Cambodia will visit outreach and residential programmes in Port of Spain, Trinidad & Tobago; Santo Domingo, Dominican Republic and Kingston Jamaica. Support will also be given in Nassau, the Bahamas. The programme will conclude with a workshop in Port Antonio, Jamaica at which The Caribbean directors and Asian directors will be joined by representatives of UNESCO and Caritas.

During the last workshop in Chiang Mai November 2002, the Director of DOH International, Mr. Ulrich Kohler described succinctly the rationale of such visits

“The hallmark of the 21st century is that isolation is no longer an option. Whatever trends are being set in one part of the globe is likely to spread to other areas. This is absolutely true in connection with drug use. The trends in drug use can now be anticipated in many regions because of the influence of practices which have already taken hold elsewhere. It is for this reason that drug treatment services cannot remain isolated from one another. It is essential that the tenor of work – skills, techniques, strategies and competencies – is echoed throughout the network. Wherever there are individual gains in terms of expertise, approaches and intervention, these will be most effective if made available to all.

The commonality evident among drug treatment service providers releases resources and underpins joint efforts. This will become a key element in future strategies. The differences among service providers will become a matrix of a concerted response rather than a source of division. In order for this approach to become effective it will be essential to cut the line of dependency on outside resources. This workshop will examine the capacity evident in each of the service providers present and seek ways and opportunities for releasing these resources to other members within the network. From this perspective all represented organisations become donors”

In this context both regions have much to learn from one another. The Caribbean region has in the last two years, through EU finance and DOH International direction, developed street based services and drop in centres in all the islands. Outreach programmes have been developed in Asia for many years and have now become sentinel points which provide accurate and essential public health information about the hidden population of drug users. This is key to an effective response to the threat of diffusion of HIV, Hepatitis C and other blood borne and sexually transmitted infections.
The Caribbean region is second only to Africa in the extent of the diffusion of HIV among its population. Worldwide, drug use is replacing sexual transmission as the main route of diffusion of HIV. Caribbean services are at a point where they will benefit greatly from the up scaling of their programmes so that they become essential and pivotal to the public health policies and strategies of each of their island states. Two consultants with extensive experience in this area of work, Mr. Tariq Zafar, Nai Zindagi, Pakistan and Mr. Luke Samson, SHARAN, India have been contracted by DOH International to provide support to local NGOs in the Caribbean region.

The Asian delegates will benefit from exposure to the effects of crack cocaine on the street life of drug users. The behaviour and effects of cocaine based and opiate based drugs differ markedly. It is now an established fact that heroin is being trafficked through traditional cocaine routes i.e. from Latin America to the US and Europe and Cocaine is steadily developing a market in regions which traditionally have opiate consumers. Visiting services designed for crack users and absorbing lessons learned from practitioners in the Caribbean region will enable Asian delegates to respond effectively to this growing threat.

    The delegates who are part of the visit are as follows
Eldred Tellis from Mumbai India is the Executive Director of SANKALP (http://www.sankalp.org.in) rehabilitation trust. SANKALP have developed key outreach services to drug users in central Mumbai, providing needle exchange, buprenorphine substitution, nutritional advice, basic health care, night shelter and supported referrals to public health institutions. Eldred is a key member of the network and provided a weeks training in Port of Spain, Trinidad in February 2001. This training programme kick-started the move to develop outreach programmes in the Caribbean which seeks to reduce the harm caused by dysfunctional drug use among street drug users.
Sujata Ganega has developed comprehensive services to street children in Mumbai as Executive Director of SUPPORT. The organisation provides basic health care, nutrition, counselling and access to drug rehabilitation to young street drug users in Mumbai. In addition the residential component provides full accommodation and preparatory education leading to introduction into generic schooling. During the programme Sujata will also visit the CARE organisation in St Lucia to observe the impact of the SERVOL programme which has been pioneered in the Caribbean region.
Qasim Zamani is executive director of NEJAT an Afghan NGO. Qasim founded NEJAT in 1991 and throughout the last difficult years in Afghanistan’s troubled history has provided services to Afghan refugees needing drug treatment services in Peshawar Pakistan. NEJAT also provided health and detoxification services in the Badakshan province of Afghanistan during the Taliban years. NEJAT began providing treatment services in Kabul from February 2003. The reciprocal value of NEJAT to the international of NGOs is extensive. NEJAT continues to provide services in the most difficult of circumstances and this is both an inspiration and encouragement to other NGOs within the network.
Shanti Ranganathan is Honorary Chairperson of TTK Hospital Chennai, India. For over 20 years Shanti has provided in patient and latterly out reach services to men and women who have drug and alcohol problems. In 2001, Shanti was awarded United Nations award by Kofi Annan for her pioneering services to villages in Tamil Nadu India. Many villages have become alcohol free after many years of violence and abuse as a result of chronic alcoholism. During this programme Shanti will visit CARE St Lucia as the precursor for a visit from the Directors of CARE to Chennai in 2004.
Rainer Rotthoff is executive Director of Pelangi Community Foundation
(http://www.pelangifoundation.org), Kuala Lumpur, Malaysia, which is committed to providing hospice care to homeless drug users who are HIV+ and have contracted AIDS. Visits were made by Caribbean delegates to the Pelangi programme in Kuala Lumpur in 2002. Rainer’s experience of equipping health authorities with the skills necessary to provide in and out patient support to homeless drug users who have contracted AIDS has been remarkable. In the growing epidemic of HIV AIDS sweeping the Caribbean region Rainer understanding of a compassionate response will be invaluable to other colleagues in the network.
Sebastien Marot has developed comprehensive services to street children in Phnom Penh Cambodia. Sebastien is the Executive Director of Mith Samlanh (http://www.streetfriends.org). Mith Samlanh’s services range from daily outreach to young people living in Phnom Penh’s streets, night and day shelters, residential accommodation, high quality schooling and early education, vocational training and stand alone businesses which train and equip young people for employment. During the exchange programme Sebastien will visit the Servol programme in Trinidad and hope to compare notes with fellow practitioners.
Luke Samson is Executive Director of SHARAN (http://www.sharan.net) in New Delhi. SHARAN pioneered street based services to drug users in India, introducing needle exchange programmes, primary health care and drug substitution therapy. Having developed a comprehensive and analytical approach to their work, SHARAN have highlighted innovative and necessary strategies necessary to combat the diffusion of blood borne viruses. This is a key health issue for all countries health policies. During the visit local NGO’s will introduce Luke to major policy figures in Health and Social care in the island states.
Tariq Zafar is the Executive Director of Nai Zindagi Pakistan (http://www.naizindagi.com). Tariq is also the Chair of the Asian Harm Reduction network. He has introduced business initiatives which employ former and functioning drug users to the predominantly health and social care NGOs in the network. The concept of small business development is timely. It has long been understood that drug use is a vicious cycle. On rehabilitation ex users find it very difficult to find employment because of fostered prejudices among the community. Stand alone training businesses have broken that cycle and provide the additional bonus of becoming a part donor to the treatment programmes run by NGO’s. Tariq will support local NGOs as they develop business initiatives.
Patrick O'Gorman works in development in Asia and the Caribbean. He is Irish by birth and nature. Over the years he has developed and supported into development many small businesses which employ drug users, street children, and disabled people in different parts of the world. Patrick will coordinate the exchange programme and Final Workshop in Port Antonio.
Ulrich Kohler is the Director of DOH International and is directing the Inter Regional Programme to support the development of a common response to drug use in Asia and the Caribbean. Ulrich has worked for many years in both Asia and the Caribbean where is has pioneered the contractual relationship between local NGOs in both regions and the European Commission. The outcome of this work has been the development of distinctive approach in services for drug users.