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UN to scale up drug services

UN agencies plan to scale up investments in drug-treatment services in an effort to boost alternatives to the controversial “boot camps” that now serve as drug rehabilitation centres for hundreds of Cambodians each year, officials said Tuesday.

The plan comes in the wake of a scathing Human Rights Watch report that accused 11 government-run facilities of subjecting drug users to violence and forced confinement while delivering ineffective treatment.

In a press conference Tuesday, Gary Lewis, the regional representative for the UN Office on Drugs and Crime (UNODC), said the international community must work together with Cambodian authorities to replace the controversial centres.

“While we have to take stock of the observations of the report … we now have to figure out what to do about it,” Lewis said. “Pointing fingers is good to a point. But people responsible for managing a country … need to take decisions on how to improve the quality of services for the citizens.”

The UN’s role, he said, is to use its “limited resources” to point out more effective ways of treating people who are addicted to drugs.

To this end, UN officials are working on expanding a community-based treatment model to 350 communes in the Kingdom. Drug users, it is hoped, will be able to access treatment and rehabilitation services where they live, rather than face confinement in regional rehab centres.

Moek Dara, secretary general of the government’s anti-drugs bureau, the National Authority for Combating Drugs (NACD), said the UN effort would be vital in expanding treatment options.

“The UN’s support on community-based treatment is to push us to a battlefield of reducing the danger of drug use,” Moek Dara said.

‘Debatable’ treatment, counselling
The UN plan, which is still in development, builds on a previous pilot programme that was subject to false starts and lengthy delays.

The H83 project, run by the UNODC in Cambodia, was originally aimed at showing authorities “a viable alternative to the jailing of apprehended drug abusers”, according to project documents.

The results, however, have been mixed. The US$1.14 million project’s chief outcome has been to establish grassroots “commune counselling teams” in 10 communes.

An independent evaluator brought in to assess the project praised the teams for providing an “innovative” and “valuable” approach, effective in dissuading some young people from using drugs, according to a midterm evaluation of the H83 project obtained by the Post.

Other key goals aimed at establishing alternatives to what the report’s author calls “boot camps”, however, were not achieved.

“What is currently being delivered does not constitute treatment and rehabilitation,” the evaluation reads. “It is even debatable whether it is counselling.”

The evaluation notes that a series of delays saw the project not being implemented until February 2009 – almost four years after authorities first signed off on it and only one month before its original end date.

After extending the project for another year until March 2010, however, the pilot programme managed to reach 376 drug users out of 462 identified in the communes as of June 2009, according to the evaluation.

“The very engagement of drug users in this positive, non-penal way has provided the Cambodian state with an opportunity for exploring an entirely different set of policy options,” the report states.

“…In the immediate future, however, the basic challenge that was facing the country at the outset of the project remains. There are still no high-quality drug treatment facilities able to provide a service to the growing number of Cambodian drug users.”

Looming deadline
In the meantime, UN officials are faced with a deadline: 2015. The NACD has set a goal to close most of the existing centres and create the country’s first national drug treatment facility by that date.

Later this month, it is expected that 20 hectares of land will be cleared in Preah Sihanouk province’s Stung Hav district to make way for the facility’s eventual construction, said Neak Yuthea, the NACD’s director of legislation, education and rehabilitation.

“What the NACD and government is doing here is to help society, not to play politics with anybody,” said Neak Yuthea, who rejected allegations of abuse in the facilities. “Having drug centres is to help society.”

UN officials say the closure of most of the existing centres would be a positive development, but some questioned that treatment in the planned facility would be voluntary and evidence-based.

The Stung Hav location has a projected capacity of 2,000 people – more than the number of people now detained in all existing rehabilitation centres combined, according to recent statistics.

Effectively, the 2015 date leaves UN agencies with five years to help develop an alternative to the current model.

“We’re encouraged” by promises to close most centres, said the UNODC’s Lewis. “But at the same time we are sufficiently cognisant of reality to know that unless there are credible alternatives to the treatment centres that are currently in place, it may be difficult for that goal to be obtained.

For this reason, our job is to help support the establishment of those alternatives.”

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