solvent-abuse-pakistan

Recommendations

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RECOMMENDATIONS Section four Recommendations Based on results of this study, it is suggested that Modified Social Stress Model (MSSM) be applied to have an ABC analysis (Antecedent, Behaviour, Consequences) of solvent abuse among street children. A dichotomous strategy should be designed to achieve such an analysis, which aims to minimize (if not eradicate) and to prevent the probability of occurrence with a short and long term perspective. There is an urgent need for the development of a comprehensive national strategy, for the control and prevention of solvent abuse. The strategy should concentrate on bringing together government entities (both national and provincial), international agencies (UNODC, UNICEF, UNAIDS et al) key stakeholders, community based organizations (CBO's), nongovernmental organizations (NGOs), empowering the target community itself to enable holistic programming and excellence in prevention, care and support. The overall national strategy developed should encompass the following: Owing to the lack of awareness of the issue among the general public and drug abuse service providers, an extensive population based awareness campaign is suggested, which aims on raising the general public awareness about this emerging problem in terms of national development, stability and integrity. Various communication channels including mass media, print media and local communication channels need to be mobilized for an effective impact of the activities. Components of the campaign should address the street children as well, providing them information on drug abuse especially Solvents, the untoward consequences, motivation for treatment, and awareness regarding HIV risk behaviours and safe practices. Secondary prevention activities should take the form of providing drug treatment & rehabilitation services to the children involved with solvents or other drugs. While designing such programmes, the issue of solvent abuse need to be addressed in a broader perspective as opposed to merely a mental health problem. Special importance should be given to the dynamics of this population that is very different from other high-risk populations. The differences between solvent abuse and other forms of addiction should be kept in mind, when treatment plans are devised. Thus if existing drug treatment facilities need to be utilized, up-gradation of the material resources and training of the staff on issues of solvent abuse and especially the needs of street children needs be considered. Training modules should be designed and on going training packages for capacity building should be provided to GO's, NGO's, CBO's and people dealing or in contact with these children. Special emphasis should be laid on the rehabilitation of these children. The rehabilitation programme should have components on education, social skills, skill development in the form of vocational trainings, and placement of these children in their families In addition to the formal treatment and rehabilitation activities, various outlets (in the shape of shelter homes or drop in centres) need to be established in areas that are accessible to street children, possible regular contact with the service providers and motivational sessions could be conducted. These shelter homes or DIC's would encompass : The task of educating street children in basic interpersonal and social skills. Empowering children with civic sense Enhancing their capability to communicate and comprehend messages effectively like simple arithmetic and vocabulary. Training in self defence to avoid risky behaviour and practices Knowledge about rights and duties Moreover, these centres can act as sources of information dissemination and contact points for these children. The centres need to be linked to the chain of drug treament and rehabilitation services and proper referral can be made when and where required. Outreach services need to be provided in the form of mobile units linked with a network of health and legal facilities. In an ideal scenario, the outreach services need to be connected with the DIC's and shelter homes for maximum effectiveness. 38 39
REFRENCES Section four Formative ongoing research to thoroughly understand population dynamics, behaviour and practices as well as underlying beliefs which lead to the behaviours, aetiology of solvent abuse etc., are issues which need be studied further. There is a need to involve women in these research studies, and ascertain baseline situation in smaller cities. An important avenue for epidemiological and behavioural research is the risk assessment of this population for HIV prevention and control. REFERENCES 1. A One-Way Street? Report on Phase I of the Street Children Project. World Health Organization. July 1993 (WHO/PSA/93.7) 2. Feldman J, Middleman AB. Homeless adolescents: common clinical concerns. Semi Pediatric Infect Dis. 2003 Jan; 14(1): 6-11. 3. Children at Risk: UNICEF. United Nations, New York 1998. 4. Phyllis Kilburn. Street children. MARC publications,1997. 5. United Nations Development Program, Human Development Report .New York. Oxford University Press, 1996. 6. http:// www.casa-alianza.org/EN/streetchildren/drugs/overview.phtml date: 18Mar2004 7. United Nations Development Programme (UNDP), Human Development Report, 1993 (New York: Oxford University Press, 1993), p. 24. 8. (ILO-IPEC, Sri Lanka Country Report, October 1998, citing Plan of Action for Children in Sri Lanka) www.globalmarch.org 9. Street Children in Karachi: A Situational Analysis. Azad Foundation. June, 2001. 10. Children at Risk: UNICEF. United Nations, NewYork 1998. 11. Phyllis Kilburn. Street children. MARC publications,1997. 12. United Nations Development Program, Human Development Report .New York . oxford University Press, 1996. ADB study 13. World Bank report-reference 14. Reference India 15. Reference, Nepal etc 16. Reference UN shortlising street children as issue 17. CSRD reference 18. Street Children in Karachi: A Situational Analysis. Azad Foundation. June, 2001. 19. Kozel N, Sloboda Z, and De La Rosa M. (eds.), Epidemiology of Inhalant Abuse: An International Perspective. 1995. National Institute on Drug Abuse Research Monograph 148. Dh18.HS Publication No. NIH 95-3831. Washington, DC: U.S. 40 41
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