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A CASE FOR DRUG AND SUBSTANCE ABUSE PREVENTION EDUCATION IN KENYA

By Dr. Bilhah O. N. Hagembe Medical Advisor¹, NACADA & Sosio Simiyu Programme Coordinator Public Awareness NACADA

INTRODUCTION

In Kenya, the drug abuse scourge has taken its toll on the society largely out of the fact that not many people treated the various substances as the source of the serious health afflictions.

Evident lack of awareness, fanned by unavailability of accurate information on the adverse consequences of indulgence habits left the problem of drugs and substance abuse to permeate communities throughout Kenya.

To a large extent, supply of drugs and demand complement each other, with the result being a vicious circle of drug abuse leading to compulsive use and tolerance. The various types of drugs and substances commonly abused in the country by the different communities have evolved in a cultural and social environment that tolerates and accepts consumption as a normal life style.

The government initiated action by enforcing measures to control supply reduction way back in 1983 with the formation of a specialised Anti Narcotic Unit under the police force.

NATIONAL AGENCY FOR THE CAMPAIGN AGAINST DRUG ABUSE

In a resolve to reign in on the problem of drug abuse, the government created the office of the National Coordinator for the Campaign Against Drug Abuse effective from March 27, 2001 headed by veteran administrator Mr. Joseph Kaguthi.

The office has a mission of coordinating and harmonising drug abuse prevention education activities to create awareness with an aim of achieving behavior and attitude change and eventually contribute to significant reduction on demand and abuse of chemical substances.

SPECIFIC ACTIVITIES OF FOCUS

The strategy encompasses;

  • Coordination of activities of individuals and organisations relevant to the campaign against drug abuse.
  • Initiation of public education campaign against drug abuse.
  • Development of action plans to curb drug abuse among the youth and general citizenry.
  • Development of action plans to curb drug abuse in schools and other institutions of learning.
  • Sensitize the parents on the abuse of drugs and the effects and their functions as role models.
  • Initiation of treatment and rehabilitation programmes to counter addiction.

LEGAL FRAMEWORK

The damage caused by both licit and illicit drugs and substances of abuse to the society, labour force and the entire economy has been of much concern to the Government. Government action on the problem is evidenced by promulgation of various Acts such as Traditional Liquor Licensing Act, and the recent Narcotic Drugs and Psychotropic Substances (Control) Act of 1994. The Government resolve to combat the menace is further seen in the formation of NACADA with a clear mandate that complements these Acts.

COLLABORATIVE INTERVENTIONS

NACADA has adopted an intervention line that encompasses comprehensive education for long-term empowerment of youth and general public to counter drug abuse. There is close collaboration in the fight against drug abuse with key actors including relevant government departments, the media, Non Governmental Organisations (NGOS) relevant professionals, spiritual leaders, parents associations and institutional leaderships. The agency thus advocates and multi-sector and disciplines approach.

While recognising the measures currently being instituted to combat drug abuse at the International scene, NACADA has chosen to lay more emphasis on homegrown solutions that are conscious of the societal, cultural and economic influences and environments.

The intervention measures underway or in the plan aim at achieving positive change of behavior and attitudes particularly among the youth and young adults in such situations.

CRITICAL ISSUES

In the one-year period the National Agency for the Campaign Against Drug Abuse has been in operation, it has identified the following:

The need for comprehensive drug abuse prevention and demand reduction policies.

Lack of reliable data on prevalence of drug abuse.

The need for intensification and co-ordination of anti-drug abuse activities.

  • Inadequate information materials on drugs and substances of abuse targeting the youth in particular.
  • Need to increase knowledge and awareness on harmful effects of drugs.
  • Need to tackle stigmatization of drug addicts.
  • Lack of adequate and appropriate treatment and rehabilitation services.
  • Denial of the existence of the problem by individuals and parts of society.
  • Needs for measures to enhance behavior change for abusers with adequate knowledge on harmful effects of drug abuse.

DRUG AND SUBSTANCE ABUSE COLLABORATIVE ROLES

Indeed the trend and magnitude is such that drug abuse has to be tackled from all fronts for NACADA to register perceivable success in its mission of preventing destruction of the health and productive life of individuals, families and communities in this country.

Kenyan youth face the greatest risk, being targets for recruitment into the abuse of drugs and substances by drug barons and firms engaged in the production of various brands of unsafe products.

It is increasingly clear that nearly 92% of the youth experiment with both licit and illicit alcohol, tobacco, bhang, miraa, inhalants (glue, petrol) and heroin among others during the growing up process.

Alcohol, tobacco and bhang are the most favoured in the trial process as well as the most abused by communities in Kenya.

Alcohol beverages are similarly readily available with powerful advertisements in the electronic and print media fueling the driving force.

NARCOTIC DRUGS AND PSYCHOTROPIC SUBSTANCES, THEIR EFFECTS ON HEALTH AND SOCIAL LIFE

Introduction

A drug is any chemical substance which when taken into the body can affect one or more of the body’s functions. For instance, when one feels pain and is given aspirin, the pain reduces or disappears. The aspirin modifies how the body works so that pain is tolerated or not felt at all. Similarly, when one smokes bhang, he experiences changes in the mind for example he may see or hear things that are not there.

The term drug therefore, includes those substances useful to the body and also those substances that harm the body. They may be legal or they may be illegal.

The abuse of narcotic drugs and psychotropic substances that harm or threaten the physical, mental or social and economic well being of the user, his or her family and society at large is a global phenomena.

In Kenya drug and substance abuse is a silent disaster that claims many lives ever year since there is a strong linkage between drugs/substance abuse and violence, criminality and currently the HIV/AIDS scourge.

Most commonly abused drugs and substances include:

  • Alcohol
  • Tobacco
  • Cannabis (bhang)
  • Khat (miraa)
  • Opiods
  • Sedative-hypnotics
  • Stimulants
  • Hallucinogens
  • Inhalants/Solvents, petrol, glue, paint thinners etc.
  • Prescription and non-prescription drugs

Effects of Drugs/Substances Abuse on health ad Social Life

People indulge in drug/substance abuse due to many factors. Some of these factors are personal while some are due to external forces. It should, however, be known that for whatever reason one puts himself in this situation, drugs of abuse do not solve a problem. You never win.

It may be important to point out here that the effects of drug abuse are vast. Many as they are, these effects also depend on other factors,. Some of these factors are listed below:-

  1. The physical and chemical properties of the substance of abuse
  2. The user’s personality
  3. The mode of the drug usage
  4. The environment or the area where the victim uses it
  5. The aim, goal or purpose for the use
  6. The cultural attitudes and feelings of the community where the user is based
  7. The law and the rules of the land
  8. The genetic factors
  9. The public control mechanisms

Going by the above, we find that the effects of drugs/substance abuse simply cover:-

  1. The individual
  2. The family
  3. The community and
  4. The Nationa as a whole
  5. Community of nations

Effects of Drugs/Substance abuse on the individual

When one indulges in drug abuse, let us see how he loses in the following three spheres.

Health
Different drugs of abuse affect different parts of the human body, when two or more of these drugs are taken together, they tend to have a combined effect (synergism). Ost drugs of abuse affect the main organs of the body like:-

  • The liver
  • The kidneys
  • The heart
  • The lungs
  • The central nervous system with the brain as the center
  • The reproductive organs

The effects can be gradual or sudden depending on the individual, the amount taken, the duration and the environment. All these generate poor health.

Social
Drugs of abuse are not accepted by society. One of the reasons is that users become anti-social. They behave differently fron non-users. The following may be detected: -

  • Being solitary
  • Irresponsible and erratic attitudes and behavior (sometimes moron-like, sometimes violent, suicidal tendencies, etc.)
  • Personality deterioration
  • Prone to accidents

Drug users therefore are detested by society and become social misfits.

Economic and Security

The issue of drug abuse is not cheap to sustain. Because the drugs are illegal and difficult to obtain, they are costly. One therefore has to look for extra ways of getting money. This promotes theft and other criminal activities, which lead to insecurity.

Effects of the family, community and the nation

Similarly, we shall look at the effects of drug/substance abuse in the same three spheres they affect the family, community and the nation as a whole.

Health

With one member of the family or community getting sick gradually or constantly, other members have to care for their kin. Sometimes diseases are passed from one member to another due to drug/substance abuse. Examples of such infections include:- Human immunodeficiency virus (HIV), Hepatitis B.

Sustained stress will lead to mental problems. A sick family or community will mean reduced nutritional status, increased mortality and reduced life expectancy. The family of the abuser becomes the victim.

Social
There is neglect of the family. This is followed by disintegration of the family or social set-up. Institutions like schools get disrupted. Those dropping out of school will increase. Violence or crime in general will equally increase. Since the social fabric is affected, social norms will also be affected. Hence, an increase in incest, homosexuality, etc. will be noticed. There will be moral and spiritual erosion.

Economy and Security

The general economy of the family or community will suffer due to the inevitable:-

  • Reduced family earnings
  • Decline in economic production
  • Increased cost of running and maintaining health care
  • Increased cost of running and maintaining schools and other institutions
  • Crime increases and general insecurity increases rapidly
  • Rebels are led by substance of abuse
  • Political equation changes

A few individuals have ill-gotten money from trafficking become arrogant and have great influence on political decisions

ONGOING INTERVENTIONS TO PREVENT AND REDUCE DRUG AND SUBSTANCE ABUSE

Given the harmful effects of drugs and substances in the destruction of lives, families and communities, there is a felt need to find a common ground in the mission towards making Kenya a drug/substances of abuse free country. Tackling the problem, therefore, demands effective networking of all interested parties, from a multi-sectoral and multi-disciplinary approach.

The youth
The group that is at greater risk is the youth who have often indulged in drug/substance abuse activities whose consequences they least understand. The problem of drub/substance abuse has pervaded the education and training system, hence the need to institute viable prevention measures and also encourage stoppage of experimentation. The measures undertaken should empower the youth to say NO to drugs and substances of abuse, by choice, as a consequence of acquiring the necessary knowledge and life skills. This then will have enabled them to change their perceptions, expectations, beliefs and intentions pertaining to the use and abuse of rugs and other substances. The custodians of the youth, who include the parents, the institutions, management, and religious bodies, must be key players in the interventions undertaken to prevent durg/substance abuse for the problem to be tackled successfully.

Education Sector
The Education sector is critical in the fight against drug/substance abuse and therefore effective linkages have already been established between the Ministry of Education, Science and Technology, and NACADA

Plans are underway to collaborate with Kenya Institute of Education to develop life skills packages for the youth including training manuals. A comprehensive information booklet which is youth friendly will also be developed to disseminate information on drugs and substances abuse. The target groups include the youth, per educators, teacher counselors, parents and relevant NGOs

The Kenya Education Staff Institute will also incorporate drug/substance abuse preventive education in the education managers training curriculum and will train a core team of trainers.

A major expected outcome of these activities is an educated and empowered youth, with changed attitudes and perceptions on drug abuse. The education managers as custodians of the youth will be sensitised and helped to acquire knowledge that enables them to prevent and control drug/substance abuse in their respective institutions.

The Kenya Music festival organised by the Ministry of Education Science and Technology will introduce new classes on drug/substance abuse preventive educaiton, starting 2002. This is aimed to create awareness among the youth in and out of school, teachers and even the general public who are attracted to this festival. At the same time, the national Drama Festival for schools and colleges will also incorporate drug/substance abuse preventive education in their competitions.

Religious organisations

Programmed meetings with religious leaders representing key religious organisations have been held, with the aim of establishing networks with NACADA, and help intensify the awareness campaign amongst their captive audience. Consequently a meeting with the Imams in Nairobi in October, 2001 came up with tangible strategies of raising awareness of drug/substance abuse among the Muslims. Another meeting held with the Catholic Secretariat mapped out strategies of collaboration to disseminate drug/substance abuse preventive education and raise awareness in the Catholic Church. The role of the spiritual leaders is considered vital in the fight against drug/substance abuse hence the need to enhance networking.

Media Sector
In collaboration with the media Sector, public awareness programs have been launched in print and electronic media. The print-media has already come up with informative and educative articles on drugs and substances of abuse which have excited interest. Similarly, discussions on drugs/substances have taken place on Television and radio between officers of the media, NACADA and medical professionals.

In addition, development of radio programmes on prevention and control of drug/substance abuse, in local dialects is underway.

The office of the National Coordinator has already reached a working programme and memorandum of understanding with the Kenya Union of Journalists. Key features of the memorandum are identification and awards for the best journalists addressing the issue of drugs, role model identification and expressions by students on the issue.

Non-governmental Organisations
Various NGOs have taken keen interest on drug/substances of abuse issues and even initiated activities towards reduction of drug/substance abuse. Development of strong networks with these NGOs has commenced following a meeting with the NGO Council. Plans are therefore underway to meet and establish areas of collaboration.

Through the NGOs and religious organisations, Community based organisations will be reached targeting particularly the parents. The communities have a pivotal role given their resources, material and human, that can be utilised and enable them to be focal points in tackling drug/substance abuse.

Treatment and Rehabilitation
There will be need to expand the treatment and rehabilitation facilities, so as to make them accessible and affordable to the general public. Consultations with the Ministry of health in this respect are in the process. An area of priority is to hold a seminar for the staff in the public health sector, on drugs and substance abuse, and thus empower them with adequate knowledge required to handle drug issues.

International collaboration
In line with the demands of the international conventions and Declarations, the country maintains close liaison with other regional and international organisations concerned with drug/substances issues such as UNDCP and WO. The office of the National Coordinator plans to play its role in strengthening the existing networks through active interaction and sharing of information and ideas with the relevant organisations.

THE CHALLENGE TO THE MEDICAL PROFESSIONALS
In a nutshell, individual medics and medical organisations in particular face a challenging role where they have to respond to the public concern through taking over high profile preventive education and information provision to empower Kenyans.

Simply put, drug abuse in Kenya as it is elsewhere is a health problem.

Experts in the medical profession face the challenge of demystifying drug/substance abuse problems by providing scientifically supported evidence on the relationship between drug/substance abuse and various ill health risks.

The public concern cannot be wild misgivings when the uniformed children of this country are entitled to protection from an environment likely to encourage indulgence into non-medical use of drugs and substances that cause serious injury to them. Neither is it misplaced when women in Murang’a demand to know the reproductive health effects suffered by their husbands after regular consumption of some of the local brews, spirits wines from Naivasha.

It is a professional and social responsibility that firms and medical professionals in the country adequately enlighten the public on the hazards of glue sniffing which may no longer be a practice of the street children in the major urban centers along.

The intention of NACADA lies with implementing measures intend to increase knowledge levels of the harm to the health and social welfare of drug abusers, as well as sensitizes and mobilises the parents to undertake their lifelong parental responsibilities. It is in the process of harnessing efforts of families, community and the society to come up with intervention and prevention programmes beneficial to the young Kenyans.

Individuals and organisations involved in the campaign against drug abuse require an environment where information is quickly and easily accessed and clear delineation of roles and responsibilities undertaken in an all out war to combat the menace effectively.

¹ Dr Bilha Hagembe is currently back at Minsitry of Health after serving as the first Medical Advisor to NACADA

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