Drug Rehabilitation in Mauritius

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Drug rehabilitation (often drug rehab or just rehab) is a term for the processes of medical and/or psychotherapeutic treatment, for dependency on psychoactive substances such as alcohol, prescription drugs, and so-called street drugs such as cocaine, heroin or amphetamines. The general intent is to enable the patient to cease substance abuse, in order to avoid the psychological, legal, financial, social, and physical consequences that can be caused, especially by extreme abuse.




Historical Background
In Mauritius, abuse of drugs is not new, although, in recent times drug abuse and illicit trafficking have become a matter of serious concern throughout the world. Drug use has been closely associated with our immigration history. Illicit rum production by slaves under the French colonisation (1715-1810) was a common feature.
After the abolition of slavery in 1834, the then British Administration brought Indian indentured labourers who came with their culture and traditions. They introduced cannabis, known as gandia, while the Chinese immigrants who came during the same period introduced opium to the colony.
However, these drugs, gandia and opium and illicit rum, were traditionally used in a controlled socio-cultural context in certain localised areas. They were mostly consumed by adults without much serious public concern. In the mid-sixties, the craze for drugs as highlighted by the popular music and the Hippy culture reached the shores of Mauritius. New drugs of abuse such as LSD, Mandrax and other hallucinogens hooked some young mauritians, including women. Fortunately, the problem was not alarming and the situation gradually regained its previous normal level of controlled socio-cultural use of drugs.
The Alarming Mauritian Drug Abuse Situation
The drug situation changed radically from its controlled socio-cultural use in the late seventies with the introduction of a crude form of heroin known as "Brown Sugar" from the Golden Triangle and the Golden Crescent through the Indian sub-continent. Brown Sugar was smuggled through the airport, harbour and through postal packets. The mauritian drug market became organised with its financers, smugglers, cultivators of gandia, dealers, distributors, retailers and "pushers". Opium dried up by 1984 and the traditional or the casual opium users were offered brown sugar instead. Mass drug proliferation developed a mauritian drug sub-culture with its own conventions and jargons. Mauritius was then facing a real "brown sugar" epidemic by mid 1980s.
Evolution of Drug Abuse in Mauritius
The nature and the extent of drug abuse was difficult to assess due to active police repression and the drug issue was still a taboo subject during the epidemic in 1985-86. No epidemiological survey could be undertaken which could have been used as a yardstick to measure the extent and pattern of drug abuse. In 1986, at the request of the Government, Mr. Gale Day, Evaluation Officer of the United Nations Drug Control Program (UNDCP) and Dr. Ariff of the World Health Organisation (WHO) estimated the number of heroin addicts only to vary between 5,000 and 20,000. Even if the lowest figure of 5,000 could have been accepted, the prevalence of heroin addiction was very high.
In the absence of epidemiological studies to indicate the extent and the gravity of the problem, the former Trust Fund for the Treatment and Rehabilitation of Drug Addicts gathered data from various Ministries, Departments and other agencies in order to monitor the trend and to understand the magnitude of the drug scourge as from 1980. These statistics, representing the tip of the iceberg, submitted by the Police, Prison Authorities and Treatment facilities, after analysis, confirmed that Mauritius faced a real heroin epidemic from 1985 to 1986.
After aggressive measures taken by government in 1985/86, a sudden downward trend was observed in 1987 and continued until 1990. Indicators revealed a slight increase in illicit trafficking and consumption.
Mauritian Response to the Drug Menace
In 1984, the Government set up a Select Committee of Parliamentarians on Drug Addiction chaired by Honourable M. Dulloo. He submitted his report just one week ahead of the notorious Amsterdam affair in December 1985. Subsequently, in 1986, a Commission of Enquiry on Drugs was set up. In the same year, two missions from UNFDAC and WHO were in Mauritius to evaluate the drug problem and to advise the Government on the course of action to be taken.
The anti-drug policy of the Mauritian Government rests on the findings and recommendations of the foreign missions, the Select Committee and Commission of Enquiry. The Select Committee Report, (known as Dulloo's Report) based on the United Nation guidelines and applied in the local context, has laid the philosophy, policy and strategies (Master Plan) to make Mauritius a drug free nation. A national strategy was developed to elicit a national response to the complex addiction problem in order to reduce both the supply and demand for drugs.
Measures taken
The National Advisory and Research Council on Drug Addiction (NARCODA) was set up under the Chairmanship of the Ministry of Health in 1986 with representatives of various Ministries, Departments and public and private agencies in order to coordinate the anti-drug activities, to carry out research, to assess the prevention and disseminate proper information, to formulate policies and to advise Government and other agencies on measures to deal with the drug problem. But it has not been able to deliver the goods and the setting up of the National Agency for the treatment and rehabilitation of substance abusers, in 1996 and all its objectives are now under the new Agency.
Law Enforcement
The Police and the Customs and Excise Departments are responsible for the enforcement of the legislations against drug abuse and trafficking. Special units have been set up namely the Anti-Drug Smuggling Unit (ADSU) by the Police Force and the Customs Investigation Unit (CIU) by the Customs Department. They are supported by the National Coast Guards in the Surveillance of land, water and air routes. However, Mauritius, with its easily accessible landing shores, makes it difficult to police these areas where pleasure boats and yatch cries-crossing the Indian Ocean can easily introduce drugs.
Demand Reduction
Prevention and Education
An important component in the fight against drug abuse and illicit trafficking is certainly drug education and proper use of information. Mauritius has embarked on a comprehensive national education and prevention campaign which involves the private and public sectors as well as the community at large:

• The Ministry of Education and Human Resources Development has set up The Health and Anti-Drug Education Unit since 1987 to provide drug education to students at all levels and to train teachers in the Health and Anti-Drug Education Curriculum.
• The Ministry of Health has set up a Non-Communicable Disease Unit which is actively engaged in drug education through radio and television programmes.
• The Ministry of Women's Rights and Family Welfare is actively engaged in providing drug education to adults (male and female) in social welfare centres.
• The Ministry of Youth and Sports is providing education on drugs to the youth as well as ensuring that alternative activities to drug abuse are available to the students and youth (15-25 years old).

TREATMENT AND REHABILITATION

The Brown Sequard Hospital was until 1986, responsible for the treatment of drug addicts. The National Centre for Rehabilitation of Drug Addicts, Vacoas (NCRA) took over the Treatment aspect following one of the recommendations of the Dulloo's Report. The NDRA with a 14-bed capacity supported by medical and paramedical staff, under the Ministry of Health, operates a medical detoxification hospital for drug/alcohol addicts, who are then followed up for rehabilitation by community-based non-governmental organisations assisted partially or totally by the Trust Fund for the Treatment and Rehabilitation of Drug Addicts.
Because of the increasing number of drug/alcohol addicts seeking treatment, the Brown Sequard Hospital was obliged to cater for these cases as seven (7), out of ten (10) patients admitted to Brown Sequard Hospital were alcoholics. Recently, the Ministry of Health was obliged to decentralised treatment of psychiatric cases (including drug/alcohol addiction) to regional hospitals.

Note: Over the last ten (10) years, according to data obtained from Ministry of Health (Brown Sequard Hospital), the Brown Sugar epidemic was confirmed in 2985/86, followed by a downward trend. However, after the aggressive measures taken by the Government, it appears that alcohol abuse has increased tremendously as compared to the pre-epidemic years (3-4 times more).

TREATMENT AND REHABILITATION
(NGOs projects funded by National Agency)

Pilot Project/Drug-Free - Residential Therapeutic Community Model
The National Agency, with the technical assistance from the Italian Solidarity Centre (CeIS), and financial help from UNDCP, entrusted the Roman Catholic Diocese of Port Louis to implement the five-year pilot project based on drug free Italian Therapeutic Community Model, which includes a Day Care Centre (Centre D'Acceuil), and a Residential Therapeutic Community and a Rehabilitation Home, at Rose Hill.
Dr. Idrice Goomany Treatment Centre
The Dr. Idrice Goomany centre for the Treatment and Rehabilitation of Alcoholism and Drug Addiction provided evening out-patient services until 1990. The National Agency has put up a building worth Rs2.5 million for the Centre and it is also financing its recurrent budget each year. The recurrent budget is being increased annually for the project covers thirty (30) years. The Centre has embraced multi-disciplinary approach in the treatment of drug and alcohol addicts. It is functioning as a Day-Care Centre since January, 1992. It has also implemented the Teen Hope Project which is being financed by the International Council on Alcohol and Addictions (ICAA) and the United States Information Agency (USIS).
The Mauritius Sanathan Dharma Temples Federation - A Multi-disciplinary Model
The Mauritius Sanathan Dharma Temples Federation, is now running a Treatment and Rehabilitation centre at the seat of the Federation. The National Agency has injected Rs200,000 in capital and Rs350,000 in recurrent budget, while the Federation will meet the additional expenses of Rs1.6 million as capital and Rs350,000 as recurrent expenditure. An evaluation of the one year project was carried by an independent evaluator.
Treatment and Rehabilitation of Drug Offenders within the Carceral System
The prison system is under stress for 50% of the prison population are incarcerated with drug or related offences. The National Agency, in collaboration with the Ministry of Reform Institutions and the Prison Authorities has launched a Treatment and Rehabilitation Programme for drug offenders within the prison system in September, 1993.
Rose Belle Action Group
The NGO started its operation in September, 1992. The Rose Belle Action Group is exploring the traditional acupuncture model on an experimental basis.
Centre d'Accueil de Terre Rouge
The Centre d'Accueil de Terre Rouge (CATR) runs a short-term drug free residential programme based on the french model since 1986. The Centre is funded by the "Bread for the World" and "Misereor" while the land and building have been put at its disposal by the Roman Catholic Church. National Agency has assisted the centre partially in providing equipment, etc.