Drug Use/Abuse: A More Humane Approach Needed…


There are no reliable statistics on the amount of persons engaging in the use of illegal drugs or those described as addicts. However, a Behavioural Surveillance Survey, done by the government in 2003 found that 11% of out of school youth use drugs, as do 8% of in school youth. Other users included 17% of GUYSUCO employees, 45% of female sex workers, 74% of male sex workers and 12% of members of the armed forces. Since then there has been a steady increase in the number of persons observed on the streets coupled with those who engage in the use of illegal drugs in social environment.

Furthermore the Guyana Secondary School Drug Prevalence Survey Project (2013) found that the first drug of choice for most students appears to be inhalants with an average age of first use of 10.8 years old. The average age of first time use for crack was 14.5 years, for ecstasy 14.7 years, for marijuana 12.8 years, for cocaine 12.1 years and for stimulants from 12.0 years to 11.7 years. These figures indicate that students are using these drugs at an increasingly younger age.

As well a 2016 Household Drug Survey in Guyana revealed that 66.5% of the respondents believe that drug use has increased in Guyana, while 40.9% believe that it is easy to access marijuana. In fact almost every survey and study done over the last two decades plus found that it is easy to access drugs in Guyana, especially given that drugs dealing has become an economic activity. In fact, empirical and anecdotal evidence gathered by The Caribbean Voice indicate that in almost every community there are well known drug pushers, and that every community has well known drug addicts, often benignly treated by the communities, who engage in odds and ends work to support their habits. Also, while there are no statistics available, it has been suggested that a significant percentage of deportees, especially from North America, have developed drug habits.

The illegal drugs of choice in Guyana today are marijuana, crack cocaine, hasish and to a limited extent ecstasy (MDMA, Molly). Marijuana is the most commonly used drugs among the student population according to the 2013 surbvy cited above. However, a 2009 study by the Inter-American Drug Abuse Control Commission found that the highest levels of cocaine used were in Guyana, Jamaica and Haiti.

Linkages and Costs

While reliable statistics are not available for Guyana, it is a fact that drugs have an overall socio-economic cost and take a toll on workplace productivity. The Guyana Human Development Report (1996) points out that “there appears to be an association between drug use and mental illness and the transmission of the HIV/AIDS virus,” that prostitution is linked to drug use and that many of the street children are into drug use. The Guyana Secondary School Drug Prevalence Survey Project (2013) showed links between drug use and absenteeism, poor academic performance, confrontations at school, difficulties at home, and thoughts of suicide. There was also a link between drug use and sexual abuse.

Furthermore, some of the studies referenced, indicate that drugs misuse and violence act as a catalyst for each other and that drug consumption is linked to drug abuse, delinquency, and anti-social behaviour in adulthood, as well as educational failure. Also they reveal that often times there is cross addiction as those who use/abuse alcohol, often gravitate to drugs after the alcohol lessens or eliminates their inhibitions.

As Minister Khemraj Ramjattan pointed out in 2015, “Not only does drug use affect physical and cognitive functions, but it also contributes to reduced physical control and the ability to recognise warning signs in potentially dangerous situations, which can make some drinkers (users) easy targets for perpetrators of criminal acts”.

Additionally, he noted that victims and children who experience and are subjected to drug related violence, strongly develop emotional and behavioural problems and are often known to seek the use of drugs as a coping mechanism. As such, he said the domino effect of drug abuse now becomes an economic burden to the State, since both the health and criminal justice sectors are directly affected.

Other substantial costs to society include property damage, job loss and health service costs. Actually, drug abuse has many potential consequences including accidental falls, burns, drowning, brain damage, impaired driving resulting in accidents, deaths and injuries, poor school performance, work productivity loss, sexual assault, truancy, violence, vandalism, homicides, suicides, lower inhibitions, increased impulsivity, risky sexual behavior, early initiation of sexual behavior, multiple sexual partners, pregnancy and STDs.

In fact, drug use/abuse results in a range of health related issues. Short-term effects can range from changes in appetite, wakefulness, heart rate, blood pressure, and/or mood to heart attack, stroke, psychosis, overdose, and even death. These health effects may occur after just one use. Longer-term effects can include heart or lung disease, cancer, mental illness, HIV/AIDS, hepatitis, and others. Long-term drug use can and often does also lead to addiction that not only affects the user but also families and loved ones, and can result in social trauma and family dysfunction.

Interesting to note also is that, the annual mortality rate per 100,000 people from drug use disorders in Guyana increased by 748.0% from 1990 to 2010, an average of 32.5% a year.

Government Approach?

Speaking in 2015, at the launch of the 2013 Guyana Secondary School Drug Prevalence Survey Project, Minister Khemraj Ramjattan, indicated that a final strategy (to tackle drug use/abuse) was yet to be worked out but he spoke about a “multi-pronged” approach to include a number of ministries and agencies that will focus on all levels of drug use– the demand, supply, treatment, and development of skilled workforce to deal with the issue. That NGOs, FBOs and CBOs were not included in this approach leaves one scratching one’s head, especially given that these are the entities that have their fingers on the pulse of communities throughout Guyana, are also best located to be first responders and cannot be left out in any approach that is wholistic and collaborative. Meanwhile for how long more should we continue to hold our breath while we await the transforming of words into action, especially given that we’re now in 2017, two years after that approach was touted?

Minister Ramjattan further said that the approach will focus on reducing the demand for drugs by creating alternative opportunities. Particularly in terms of youth, he said that activities such as sports and music must be looked at to allow young people to meaningfully occupy their time. He added that community support and positive parenting will be necessities going forward. What the minister did not state and what has not, to date, been revealed, are the mechanisms and programs to ensure all of this happen. Of course The Caribbean Voice makes it clear that no previous government has ever addressed drug use/abuse in any concerted and substantial manner and the unchecked incremental increase in the drug culture has resulted in the distressing current situation.

One also has to wonder about the Guyana Drug Information Network (GUYANADIN), which seems to be a paper tiger.

Suggested Strategies

Various studies on Guyana have found the following reasons for drug use/abuse: seeking to be sociable, building confidence, helping to concentrate, enhancing excitement and energy at parties, improving sexual experiences, relieving stress and anxiety, wanting to fit in, family influence, curing ailments/self -medication, boredom due to the absence of gainful activity, experimentation and curiosity, peer pressure, seeking to enhance the thrill effect during recreational activities.

Recommendation to address this situation from the various studies and stakeholders include:

Ø regular sensitisation on the harmful effects of drug use and prevention messages via various media (including traditional and social media), and public access mechanisms (flyers, posters, booklets, billboards…) appropriate for different age ranges and inclusive of alternatives to drug use;

Ø developing an appropriate instrument to enable individuals to self-evaluate problematic drug use;

Ø giving greater priority to drug use/addiction in health promotion and disease prevention programmes such as what is currently being given to diseases such as HIV/AIDS;

Ø continued training of persons who have shown an interest in the field of treatment and prevention and the establishment of more treatment and rehab centers across the country (currently only two non-governmental and two governmental treatment centers exist);

Ø creation of more recreational centers and spaces so time can be meaningfully occupied;

Ø expansion in job training and economic insertion activities;

Ø creating/implementing mentorship programmes for youths from communities and households that display risk factors for illicit drug use;

Ø ongoing parental education relating to drug free lifestyles and strategies to help their children stay drug free;

  • integration of mental health care into the physical health care system to include substance abuse-related education, assessment, intervention, treatment and recovery services;
  • exploring new funding sources from donor communities for behavioral health programs, services, and providers and increasing gov’t funding for same.
  • partnering with NGOs, FBOs and CBOs to implément evidenced-based prevention programs focusing on personal responsibility for one’s health;
  • providing relevant, ongoing professional development and training for all health care providers;
  • leveraging technology/infrastructure by implementing an electronic health record (EHR) system to track treatment and ensure follow up, among other things;
  • establishing at least one Rehabilitation Treatment Center in each of Guyana’s ten regions;
  • strengthening the inter-institutional coordination or collaboration between Ministries of Health and other government agencies, (i.e. Drug Commissions or Councils and stake holder)
  • allocating adequate resources and finances to increase capacity building within the health and other relevant sectors to address drug use disorders;
  • encouraging international cooperation to share evidence-based practices;
  • strengthening the capacity to collect real time date and generate ongoing evidence’

While the government hopefully begins to take concrete action to address the increasing drug use/abuse situation, The Caribbean Voice and its partners echo the call by current activists and care providers for use of the ‘Humane Approach’ advocated at the launch of the United Nations 2009 World Drug Report by more than 40 international groups and experts worldwide. This more humane approach is based on harm reduction principles and respect for human rights and includes laws and policies that do not drive drug users underground, keep people away from life-saving HIV services and/or allow AIDS to spread. In this respect there is urgent need to re-examine laws pertaining to penalties for possession of small amount of marijuana for personal use as well as the need to develop policies to address stigma and discrimination associated with drug use and drug use disorders.

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Suicide Prevention in Guyana


Recently The Caribbean Voice received the following message from Dr. Leslie Ramsammy, former PPP/C Minister of Health, “When I was Minister of Health, I openly disagreed with them (WHO) on suicide…We have averaged between 140 and 170 deaths in my time as minister (2001 to 2011). The rate was between 18 and 25 per 100,000. I have argued that while Guyana has a troubling high rate, our rate is not nearly as high as what WHO used to say – 44 per 100,000. I used to challenge them to find the extra 100 to 150 deaths they were claiming. Their justification is that they made adjustments to cater for the underreporting, which they could not verify. It is interesting that when our actual deaths in the 1980 were over 250 they were actually reporting less than 150.”

So The Caribbean Voice did some digging and this is what emerged:

Year Rate – suicides per 100,000
2000 22.3
2003 27.2
2005 24.0
2006 26.4
2019 25.8
2012 44.2 – actual rate 32.15
2025 30.8

Clearly the 2012 figure is an anomaly, especially given that the only adjustment actually made by the WHO is from crude rate to age-standardized suicide rate, to eliminate the effect of differences in population age structures when comparing crude rates for different periods of time, different geographic areas and/or different population sub-groups. Thus the 2015 crude rate of 29.0 was adjusted to 30.6.

Whatever led to this apparent anomaly, it presents a skewed picture that makes the work of suicide prevention NGOs and activists that much more difficult, besides seeming to imply that with such a significant rate reduction, the government does not need to amp up resources to tackle suicide. That PAHO rep Dr. Adu was quoted a number of times in certain sections of the media as stating that the 2015 rate was 20.6 is even more puzzling and despite The Caribbean Voice’s suggestion that Dr. Adu, may have been misquoted, he has not, to date, provided any public clarifying statement.

 

Thus it is important to factor out the underreporting (estimated as 25% by WHO). That leaves an actual rate of 32.15 per 100,000, which would then mean that the reduction from 2012 to 2015 was 2.07 per 100,00 and not 11.4 per 100,000.

Now regardless whether the 2012 anomaly had a political motive as implied in some quarters, TCV can testify to the fact that politics and ethnicity have been interwoven into officialdom’s response or lack thereof to our suicide prevention and anti-abuse campaign. Just after the National Stakeholders Conference on Suicide & Related Issues, in August 2015, a cabinet minister told us that President Granger was happy about our work in Guyana and that the Prime Minister and himself were tasked with providing TCV with all necessary support for our campaign. Almost three years later we are still waiting for that support to kick in. However a rationale of sorts for that not happening emerged when we learnt through a number of very reliable sources that suicide was allegedly identified as a problem specific to one ethnic group and TCV as an NGO reflective of that same ethnic group. While both of these assertions are inaccurate, is the implication that there exists a policy of different treatment for different ethnic groups?

In 2015 the army approached us to help with suicide, which they indicated was a significant issue within its ranks. Subsequent efforts to set up a planning meeting elicited no response. Then we learnt that another NGO, with political connections, had been contracted to provide assistance. Also, in 2015 Minister Ramjattan set up a meeting between TCV and the Police Commissioner to explore collaboration. Subsequently, the meeting was postponed by the Commissioner’s Office and to date requests to reschedule that meeting have met with silence.

As well, we had a meeting with the General Manager (GM) of the Guyana Chronicle to discuss non-publication of our letters. The upshot was a promise made to ensure publication of our letters, as well as a weekly column by TCV. Subsequent efforts to realize these promises were unsuccessful in spite of numerous emails sent to the GM and the Editor. More recently, our request to use the government guesthouse during a two-day outreach in one of the regions was rejected by that region’s Chief Executive Officer who incorrectly claimed that TCV ‘is PPP’. So is it only pro-government organizations and personnel that are entitled to access to such state resources?

There are many more examples like these. Yet, the reality is that TCV is neither politically affiliated nor ethnocentric. Our 70 plus volunteers and support specialists, with a range of skills and expertise, including psychologists, clinical counselors, researchers, pollsters, sociologists, medical personnel and social and community activists, reflect the ethno and political gamut of Guyana. And those who take our training, attend our workshops and outreaches, appeal for help or are proactively provided assistance, are not screened for ethnicity, political affiliation or anything else. In short no one has ever been, is ever or ever will be turned away by TCV, on the basis of age, ethnicity, political affiliation, gender, sexual orientation, status or any other indicator.

Furthermore, over the past three years, The Caribbean Voice has invested about five and half million dollars in suicide prevention and anti-abuse in Guyana. During this time we have engaged in over 300 successful counseling cases; held over 20 workshops that trained about 2,000 persons, including hundreds of students, and engaged in another 20 outreaches that networked with a few thousand persons. As well we held more than 50 meetings; attended over 25 different fora, widely disseminated information (articles, letters, interviews) across numerous media platforms, traditional (including international media such as New York City’s Daily News newspaper, the BBC, Vice News, ITV and Al Jazeera), and online posts (Facebook, Twitter, Instagram, Google, Linkedin, Pintserest, Tumblr, Youtube) reaching millions; engaged with other stakeholders, in lobbying for a range of measures, with the suicide helpline coming into being (promises to place counselors in schools and to develop a model to tackle pesticide suicide were made but not delivered); commissioned two surveys and held four press conferences. Also, we held the first and only truly National Stakeholders’ Conference on Suicide and Related Issues that was attended by over 70 stakeholders from across the nation, with transportation assistance provided where requested.

Additionally, TCV launched the Annual El Dorado Awards, which has, so far, honored 34 social activists and change agents – individuals and organizations – with another 18 to be honored this year. Among the 2017 honorees is an NGO working with children in the Amerindian community, an Amerindian artist who engages in tremendous social work, a few businesses that give back to the tune of millions of dollars, two community based organizations that do tremendous work within their communities, one youth activist and one youth organization that focuses on youth activism, a disability rights activist who is visually impaired, a women’s empowerment activist, an organization that works with autistic children, and an organization that provides relief supplies to families who face disasters such as fire and flood. The names will be publicized closer to the awards.

Also, TCV partners in Voices Against Violence, which organizes the Annual Anti-Violence Candlelight Vigil that, in two, years saw 500 plus candle light vigils held across Guyana. This year 59 partners organized vigils from Corriverton to Mabaruma and Charity. Partners were drawn from all ten administrative regions and included NGOs, Faith Based Organizations, Community Based Organizations, special interests groups (including youth and women’s groups), Regional Democratic Councils, Neighborhood Democratic Councils, businesses, media, religious institutions and political parties. Thousands of person participated and many cultural programs were held. Collaboration underpinned almost all the vigils, community togetherness was reinforced and social activism given a boost.

This year, like last year, letters were sent out to various cabinet ministers as well as the President, the Prime Minister and the First Lady, seeking meetings to discuss collaboration with and support for the vigil, but none of the communication was even acknowledged. Both the PNC and the AFC were invited to partner in the vigil but neither responded. However the PPP and the URP did. Hopefully, next year would be different since not only is the vigil here to stay; it keeps gaining more momentum, participation and support. In fact an event like this should be supported, promoted and fostered by the Ministries of Social Cohesion, Communities and Indigenous Affairs as it fits into their respective agendas.

In effect, our work has a national reach and TCV have established regional sub groups in seven regions with the remaining three to be set up next year. In recognition of our work we were invited to make a presentation at a special session of Guyana’s parliament. Interestingly, the invitation came from the local UN office in Guyana rather than parliament itself or the government. As well our work has been featured in the newsletter of the International Association for Suicide Prevention.

Meanwhile, regardless of what kinds of labels are thrown at TCV will continue to educate, enlighten, advocate, lobby, train, counsel, network, engage in outreach, foster collaboration while debunking myths and misinformation, providing coping skills, developing self esteem, arming Guyanese with the wherewithal to face and overcome challenges/stress and to identify suicide and abuse warning signs and take action proactively, ensuring that all, who so request or are identified, do have access to counseling.

Meanwhile, we will continue to reach out to government at all levels with the hope that, among other things:

  • The promise made by Ministry of Education officials to ensure that our Youth & Student Workshops are offered to public schools, will be kept;
  • Our National Youth & Student Essay Contest will be facilitated in schools throughout the nation, having already been endorsed by the Ministry of Education;
  • We will be allowed access to schools for our workshops and outreaches and access to state guest houses especially in the hinterland where we plan to soon extend our activism starting with Region One later this year;
  • Both the Annual Anti-Violence Candlelight Vigil and El Dorado Awards will be endorsed and supported;
  • Chronicle will keep its promise to publish our letters and the weekly column that was agreed on.

Suicide and abuse are national scourges affecting all segments of our population. Thus, suicide prevention and anti-abuse should be everybody’s business and government at any level should not display ethnic, political or any other bias towards those who give selflessly of their time, efforts and resources to save lives and empower people.

 

 

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Suicide prevention continues to operate at the level of rhetoric


While The Caribbean Voice awaits suicide figures for 2017 we must point out that even though such figures may well indicate a decline over the previous year because of the work of all stakeholders, they would invariably be rather conservative. This is because as the World Health Organization has pointed out, 25% or more of suicides are generally unreported and because, in the case of Guyana, reportage is also affected by the still strongly held taboo (family dishonor) and attempts that ensure that many suicides are reported as otherwise.

That being said The Caribbean Voice notes the Ministry of Health’s ‘suicide deterrent measures’ with a certain degree of skepticism. For one, efforts to ensure that existing laws and regulations regarding pesticide sale, use and storage, are being enforced, will have no impact unless these attempts are part of a concerted pesticide suicide prevention strategy, such as the Shri Lankan Hazard Reduction Model, which has been lobbied for by The Caribbean Voice since 2015, and which is, by far, the most successful pesticide suicide reduction plan ever. We strongly believe that should Guyana approach the World Health Organization, a similar level of assistance may be offered as was available to Shri Lanka.

With respect to moves to be made to train at least 50 percent of Primary Health Care doctors in the WHO recommended mhGAP-Intervention Guide, we have pointed out that the WHO also recommends that the best way of approaching mental health care for small economies like Guyana is to integrate mental health care into the current physical health care system, an approach that would ensure that mental health care (including suicide pevention) is cost-effectively accessed nationally in the same manner as physical health care.

While we applaud plans to increase the number of beds added to the inpatient service offered at the Georgetown Public Hospital Corporation’s psychiatry ward, may we point out that Georgetown is not Guyana and such a service must be offered at every public hospital in Guyana at the minimum to have any kind of impact, especially since the much touted plan to rebuild the National Psychiatric Hospital in Berbice, seems to have fallen off the radar screen.

Meanwhile we commend plans to incorporate important mental health topics into the Health and Family Life Education syllabus in secondary schools, a call that was mooted by The Caribbean Voice almost two years ago. However, we hope this plan will not follow the fate of counselors in schools, which was top priority when the government got into power, only to be subsequently relegated to ‘a few years down the road’. The fact is that The Caribbean Voice and other non-governmental stakeholders have been continually working with schools and students and everywhere the appeal is the same – ‘our students need so much help, please come back as often as possible’. In fact one school we visited recently asked us to go back weekly as well as to devise and implement training for teachers.

In effect, at the government level, suicide prevention continues to operate at the level of rhetoric with intermittent, isolated, one off, piecemeal action, here and there, and all the talk about stakeholders collaboration is just that, as most of the stakeholders – entity and individuals – that actually are doing consistent, collaborative work are being ignored or sidelined.

For example, over the past three years, The Caribbean Voice, a totally voluntary NGO, funded by members and supporters, has undertaken more than 300 successful and free counseling interventions in Guyana, most of them based either on direct appeals or referrals. Our information dissemination campaign has probably been more extensive that that of the government with respect to all media – print, broadcast and social media. Our community outreach and youth and student workshops are gaining traction to the extent that we receive more requests that we can handle. And in February we will be launching our Train the Trainer Program to get gatekeepers into every community as quickly as possible since promises to bring back this program have ended the way of all other promises. Yet, The Caribbean Voice continues to be blanked by the Ministry of Education (among other government entities) in our attempts to obtain permission to visit schools as requests are made, to launch a national essay contest for youth and students and to train teachers in classroom management without corporal punishment.

Meanwhile the government’s suicide hotline seems to have been relegated to the back burner and to date, no official statistics indicating its extensive and successful use have been released; most public hospitals are still to be serviced by psychologists or clinical counselors; the National Suicide Plan is still awaiting daylight, the Gatekeepers Program seems a lost cause and while Trinidad & Tobago recently took the lead in raising the age of consent to 18, Guyana continues to be mired in the past. What about a registry of sex offenders? Peer counselors in schools? A national parenting program to instill empathetic communication and parenting skills to combat the high level of dysfunction that contributes to suicide and violence on the whole? Trained domestic violence/suicide prevention personnel, or personnel with basic training in mental health or social work, at every police station? And so on….?

 

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Building Stakeholders’ Collaboration


It has been repeated ad infinitum by various government ministers and other officials: stakeholders’ collaboration is critical… However, when it comes to tackling social issues, the gap between words and deeds remains unbreachable. And, to be one of the few who are embraced as ‘collaborators’, you have to be a celebrity, have political affiliations, belong to particular groups, know ‘connected’ ones…be seen as one of ‘us’ and not one of ‘them’.

In fact, many of the government’s actions negate its mantra of stakeholders’ collaboration. For example, at a recent parliamentary sitting on suicide (at which The Caribbean Voice made a presentation), a cabinet minister was quoted in the local media as referring to a 2016 National Stakeholders’ Conference on Suicide. How can a conference be national when its attendees were less than 25% of all stakeholders and many of the major stakeholders were not invited? Contrast this with a 2015 National Stakeholders’ Conference on Suicide and Related Issues organized and fully funded by The Caribbean Voice (TCV) and its partners, at which there were over 60 stakeholders and another 15 plus activists, as well as media, members of the Diplomatic Corp and Cabinet Ministers.

On the other hand most stakeholders continue to strive for real and meaningful collaboration. One significant example of stakeholders’ collaboration is the National Anti-Violence Candle Light Vigil launched last year by Voices Against Violence, a loose umbrella of over 50 organizations, to mark World Suicide Prevention Day on September 10. This event saw about 300 vigils held across Guyana.

2017 is year two for this vigil. This year’s vigil is being held under the theme for World Suicide Prevention Day: ‘Take A Minute, Save A Life’. Vigils are inexpensive and easy to organize and Voices Against Violence is urging all organizations to join hands and ensure that their communities come together to focus on suicide, all forms of abuse and other types of violence. Additionally individuals should reach out to any organization of which they are members or that exists in their communities, and urge them to organize vigils.

This vigil is an attempt to get communities across Guyana involved in anti-violence activism, while fostering the concept of communal action for community well being. It is hoped that this vigil will catalyze a process of genuine togetherness and enhance the process of communities taking ownership for their safety. That process is also expected to create the environment for NGOs to collaborate with community leaders and organizations to hold community empowerment sessions and help implement anti-violence training.

For the purposes of this vigil all of the following are considered acts of violence either against self or others: trafficking in persons, suicide, drug and alcohol abuse/addiction, domestic and child abuse, rape, incest, teenage pregnancy, road carnage, dysfunctional relationships, neglect of the elderly, abuse of the mentally and physically challenged. Besides, relationship violence and its dysfunctional socialization spawn, which are more and more looming as issues of critical urgency, can and do shape personalities that easily gravitate towards crime and attending violence.

Thus, violence should be addressed holistically and when communities come together they begin to communicate, connect and care as they build togetherness while getting their feet wet in the practice of mindfulness. This process is also hoped to enhance NGO/NGO/CBO/FBO collaboration, thereby enabling more impactful work, more extensively and more cost effectively within communities. In this way the help will reach where its most needed and hopefully positive changes will emerge sooner than later. Such help starts with each person taking a few minutes each day to ask someone ‘How are you?’ and then listening without judging. As this year’s vigil theme emphasizes, those few minutes can save lives.

Each organizing group has total control over its vigil. In addition to candles, cell phones can also be used. We urge that vigils start around 6PM so that they can finish for residents to get back home early enough. We also urge that all vigil organizers get in touch with either TCV (caribvoice@aol.com) or Save Abee Foundation (info@saveabee.com) or via their Facebook pages. As well, contact Annan Boodram, Sham Tilak or Nazim S. Hussain via FB…so we can log your vigil, help to provide publicity and promotion and/or provide additional info and any specific support. Or touch base with any member of any of the organizations mentioned in this article.

Last year Pastor John Joseph and the Seven Day Adventist Church organized almost 100 vigils last year and they were one of the first entity FBO to come on board this year. The Guyana Hindu Dharmic Sabbha and the Anna Catherina Islamic Complex were also vigil participants last year and we anticipate that both will partner this year too. As well, the United Republican Party is partnering this year. Last year we wrote all the major political parties and many cabinet ministers but only got a response from Minister Khemraj Ramjattan, whose ministry publicly endorsed the vigil. This year we are inviting all other religious entities, including umbrella bodies, to become involved. Please feel free to contact TCV, Save Abee Foundation, Pastor John Joseph or anyone else associated with vigil. Incidentally as this article was being written an estimated 105 vigils were already in the works. As well vigils are being organized in Trinidad & Tobago, the US and Canada.

Meanwhile, Save Abee Foundation, in collaboration with other stakeholders, started their Annual Medical Outreaches at Black Bush Polder on July 15th and are at Imbaimadai, today, July 17th. These outreaches provide eye care, dental services, general checkups, tests for hypertension and diabetes. In addition, medications, eyeglasses and medical equipment are provided free of cost. Clothing is also distributed. The Blood Bank was at the Black Bush Polder outreach to collect donations of blood while TCV provided mental health awareness services. Shoes, food items, and personal hygiene items are being distributed at Imbaimadai

Another mechanism through which social activists are brought together is the Annual El Dorado Awards. This very successful event was launched three years ago to:

  • build connections between the business and professional community on the one hand and activists and advocates on the social landscape on the other hand with the hope that ongoing partnerships can be established to harness social responsibility and enhance social activism.
  • help foster unity across various divides and emphasize the concept of Guyanese first and foremost.
  • recognize and honor those who give of their time and efforts and go beyond the scope of their jobs and professions to lend a helping hand and/or work to make society better.

This year the El Dorado Awards will be on November 18th at a venue to be announced. For additional info and lists of previous honorees please log on to http://caribvoice.org/el-dorado-awards.html. We take this opportunity to sincerely apologize to this year’s honorees, who were not informed in a timely manner about the date change, as the awards were initially set for this month – July.

Meanwhile TCV and other stakeholders would like to point out that a recent statement in parliament that the reduction in suicide is due to the work of the Mental Health Unit (MHU) of the Ministry of Health is untrue. The reality is that this reduction is much more significantly due to the collaborative efforts of NGOs, FBOs and CBOs working, mostly voluntarily, on the social landscape, than to the MHU or any component of the government.

We must also point out that mention made about reaching out to families of suicide victims leaves us scratching our heads as TCV and other stakeholders, including Crossroad Suicide & Mental Health Awareness Services, and Monique’s Helping Hands, do this regularly, and we are yet to hear from such families that they were visited by reps of the MHU. But it indeed would be fabulous if the MHU can make such visit across the nation, and not selectively, as these families do urgently need counseling.

However, we are happy that the myth about East Indians being 80% of al suicides has been finally debunked. We have been saying all along that this figure is closer to 50% as the Minister pointed out. Yet we are also disappointed that governmental spokespersons at that parliamentary session on suicide made no mention of counselors in schools (promised but not yet implemented), strategies to tackle pesticide suicide, bringing back the Gatekeepers’ Program (also promised but not yet implemented); an integrated approach to health care as advocated by the World Health Organization; establishing a mechanism to support suicide survivors and families of suicide victims and sensitivity training for all health care workers, police officers and media personnel.

Meanwhile in exploring collaborative efforts TCV is always reaching out. Collaboration takes place with the five workshops that are being offered: Youth & Students, Teachers, Community Outreach, Train the Trainer and Employees Mental Health. In fact businesses have been very supportive of the work of TCV and other stakeholders. These include Imam Bacchus & Sons (Essequibo), A. Ally & Sons (Berbice), Gafoor & Sons, Galaxy Communications, Team MMR, Cara Hotel, Marriot Hotel, Prashad’s Medical & Pharmacy, Guyenterprize and Metro Office Supplies, among others.

In addition to linking with various businesses, NGOs, CBOs and FBOs, TCV has held meetings with a number of ministers and/or their reps, the University of Guyana, business organizations, various government agencies including the Childcare Protection Agency, a number of diplomats and/or their reps and many of the media houses and international organizatiosn such as the Global Mental Health Program at Columbia University (New York City) and Seva International, headquartered in Indian. Some have yielded results; some have not and some are a work in progress. We will continue this approach because we truly feel that suicide prevention and anti-abuse are everybody’s business and thus greater positive impact can only result, as more and more stakeholders join hands and hearts to tackle suicide, child abuse, sexual abuse, gender based violence alcoholism, drug use and other social ills. And so we appeal to all of you to join this fulfilling journey as we seek to save lives and empower people. Our hearts walk with each one of you.

Finally TCV suggests to the chair of the parliamentary committee on social services to convene a meeting of all activists on the social landscape to be informed about their work, get a sense of the realities on the ground and foster collaborative efforts already under way.

 

 

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Counseling is absolutely necessary for individuals who exhibit suicide warning-signs or express suicide ideation.


The Caribbean Voice joins with others in expressing our angst that a young man had to take his life because of the stigma attached to his sexuality. Amidst the many issues arising out of this tragedy we would like to emphasize the necessity of counseling.

News reports indicate that the young cop was out partying with friends, some of whom knew of his intentions to take his own life and thought they had convinced him otherwise. The reality is that with respect to suicide ideation and/or warning signs, a layperson, no matter how well meaning, can end up pushing the individual faster towards suicide. And, as TCV and so many others have constantly been advocating, once suicide ideation is expressed or warning signs noted, it is critical to get someone with necessary counseling credentials and experience to deal with situation.

In addition to the Suicide Helpline, counseling can be accessed through the National Psychiatric Institution at New Amsterdam, the Psych Ward at the Georgetown Public Hospital, the counseling center at Corriverton (started by ex-magistrate Krishnadat Persaud), Help and Shelter, Guyana Foundation, SASOD, Monique’s Helping Hands, Crossroads Suicide & Mental Health Awareness Services and The Caribbean Voice, among other NGOs and entities providing such services, mostly for free. As well every region has sociologists and/or welfare officers who do have some amount of counseling training as do a number of government agencies such as the Ministry of Health, Mental Health Unit, Childcare & Protection Agency, Various Regional Health Authorities, and so on. We urge all media to get hold of all contact information through which counseling can be accessed and publish them even if once a month as a public service. As well we urge the Ministry of Health to compile all the available counseling services, private and public sector, and make them widely available via various avenues, including traditional and social media and flyers and posters

The fact is that counselors possess requisite training and experience to help patients improve their mood, cope with their diagnosis and change harmful behaviors. Counseling often focuses on stress management, coping skills and therapeutic education. The medium of communication is emphatic, geared towards being non-judgmental, non-threatening, and building comfort and trust, thereby making it easy for patients to verbalize their feelings and enabling them to work towards positive goals. Counseling also helps people to be able to dissect their problems then figure out how to solve them.

In Guyana there is a stigma attached to counseling as many feel that only ‘mad people’ need counseling. It is important for this stigma to be eliminated so that seeking counseling becomes a normal, everyday desire as long as the need for such counseling becomes necessary. And, again, The Caribbean Voice believes that the media can play a significant role in eliminating this stigma.

Incidentally we repeat our appeal for media to stop using the term ‘commit suicide’ and instead use ‘died by suicide’ or is/was a suicide victim. ‘Commit’ has connotations that criminalize suicide but suicide is most certainly not a criminal act.

The Caribbean Voice can be reached via email to caribvoice@aol.com or via Check out our website at www.caribvoice.org or our Facebook group page at facebook.com/caribvoice.

 

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Mechanisms must be in place to prevent abuse


The Caribbean Voice supports CPIC Monique’s call for civil society to get involved in the campaign against child abuse. We also agree that tackling child abuse in all its forms – physical, sexual, emotional and psychological – needs “outreach, family-based prevention and home visiting, and school-based models to meet families where they are and to help them build their new lives and hopeful futures”. Indeed, mechanisms must be put n place to foster the involvement of civil society.

One such mechanism is our Youth & Student Workshop, which has been endorsed by the Ministry of Education and already been taken to a number of private schools, but for which we are awaiting permission to take to public schools across Guyana. This workshop focuses on arming young people with alertness and awareness with respect to abuse and violence (domestic, gender based, sexual, physical, substance related, online and Internet) and equip them with knowledge, self-esteem, self-confidence and coping skills to face challenges and stress.

Within this context too we expect to soon launch a National Youth and Students Essay Contest, also endorsed by the Ministry of Education that would become annual. This year’s focus in on suicide, with aim of getting young people to engage in primary research and information eliciting within their communities and in developing models for redress thereby becoming change agents on the social landscape.

Meanwhile, the media – traditional and social – recently publicized a case of corporal punishment that left a student bleeding and in pain. There have been many similar cases over the years and this begs the following questions: Are doctors required to report such cases of child abuse to the authorities for investigation, or is it simply a question of parents seeking redress without assistance? Why is the cane still used in Guyana, when the country that exports it has banned its use in the classroom? Did this teacher teach his students homework/study skills, or he just expects his students to know how to do homework and study? Did this teacher have or considered having a conference with the parents? Did this teacher have or considered having a discussion with other teachers of this child so as to find out whether any perceived behavior is across the board or only unique to his/her instructional time/subject? Can the administration in a private school immediately relieve a pedagogue of his/her duties or agree to a psychiatric evaluation/mental status evaluation when these kinds of mental aberrations occur? The bottom line is that there should be a clearly defined process of disciplinary action by the Ministry of Education to address corporal punishment that must also include possible psychological help for any teacher who displays the tendencies inherent in the actions of this particular teacher.

TCV needs to point out that a training workshop on ‘Classroom Management Without Corporal Punishment’ was offered free of charge to the Ministry of Education in the pervious government and also to the current government. The previous government pulled the plug at the last moment after TCV and the VSO (which has since pulled out of Guyana) had put measures in place for the workshop. The current government has not acknowledged our offer to date.

As well, it is in this context of the need to protect children and the vulnerable that we launched out petition for a registry of sex offenders in 2015, and thus support the recent announcement by Ann Green, head of the Child Care and Protection Agency for the establishment of such a registry in 2018. Consequently we must respond to criticism of such a registry by a recent letter writer in the local media.

To begin with, there is the straw man argument that the registry is not a solution to sexual abuse, a claim never made. The fact is that there is no single mechanism that can eliminate sexual (or any other) abuse but the registry can be one item in a basket of measures that would include other items such as education (National Youth and Students Essay Contest), sensitization and training (Youth & Student Workshop), active oversight and monitoring, increased parental empowerment and harnessing (such as through Parent Teachers’ Associations and religious institutions), providing teeth to all impacting laws and unrelenting applying them, police training so they can handle cases with sensitivity and empathy as well as display an understanding of the factors that militate and so on.

Also the citing of selective data and stats to argue that a registry is ineffective is a disingenuous ‘seeing a tree and shouting that the forest has been found’ technique that ignores registries globally. The fact is that the registry enables citizens to know which of their neighbors are registered offenders. This knowledge not only helps to develop a greater level of awareness and alertness leading to proactive preventive steps as well as a reservoir of community activists and advocates but also ensures that perpetrators are reminded that they should not again indulge in such actions and if necessary seek help to prevent themselves from doing so.

It must be noted too that the vast majority of the sexual assaults are perpetrated by family, friends and acquaintances, and thus it is better to be as proactive about sex offenses as possible and take advantage of the tools available in the community so that no one is enabled to perpetrate such acts. Besides, keeping close tabs on registered sex offenders doesn’t necessarily make us safe but it makes us safer. This element of safety is reinforced by police officers or trained community aides deployed to knock on the doors of registered sex offenders, making sure they are abiding by the conditions of their release and living where they are registered. This ensures that offenders know that a police officer is going to come knocking but they just don’t know when. The knowledge that someone is keeping track of them, and making sure they are not around children or are living where they are registered, helps keep offenders from reoffending. Secondly, if the sex offender is not at the residence, police can be alerted and the offender can be arrested. Thirdly, sex offenders without a permanent residence should be mandated to report in person weekly/monthly at the closest police station, with a list of their whereabouts in the intervening period. The police can then verify the list.

Finally a network of non-governmental, community based and faith-based organizations can be a critical element in the fight against abuse. And Voices Against Violence, the loose umbrella of some sixty plus such entities, that organizes the annual Anti-Violence Candlelight Vigil, already provides such a vehicle for networking and collaborating. To be a part of the Voices Against Violence network, please contact The Caribbean Voice via email to caribvoice@aol.com or via our Facebook group page at facebook.com/caribvoice. Check out our website at www.caribvoice.org. In Guyana call Chandanie at 697-9968 or Ibima at 694-7433/610-8451.

You can also contact other members of Voices Against Violence, including CPIC Monique’s, Samantha Sheoprashad, and the Enterprise Youth Development Group, Pandit Deodat Persaud and the Golden Om Dharmic Youth, Pastor John Joseph of the Seventh Days Adventist Church, Raheema Rahaman of the Sadr Islamic Anjuman, SASOD, Theresa Arifa and Crossroads Suicide and Mental Health Awareness Services, Zorg Women’s Group, the Amerindian People’s Association and the Guyana Responsible Parenthood Association.

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Employee Mental Health Critical


The Caribbean Voice (TCV) absolutely agrees with the Director of Mental Health, Dr. Util Richmond Thomas, that smart employers do foster their employees’ positive mental wellbeing. Such employers develop policies that support employees by ‘normalizing’ mental illnesses as health conditions that carry no shame; facilitate access to care and adopt effective work re-entry programs for individuals with mental health problems. Employers who want to maximize work productivity need to know that they will have greater success when they spend some time and resources on addressing mental health at the office.

The fact is that six in 10 people say poor mental health has impacted their concentration at work – meaning that they are physically present but seriously underperforming. And then there are millions of workdays that turn into sick days each year due to mental health problems – 70 million in the UK, 32 million in France, 18 million in Germany. One in ten employees have taken time off work for depression. One in five employees will have a mental health condition over the course of their careers that impacts performance and requires time away from work. And workers have partners, parents and children who also may have mental health conditions requiring extra attention at some point. Addressing employee mental health needs comes with a cost – but ignoring mental health in the workplace is not an option; the costs triple and quadruple when we turn a blind eye – which doesn’t make any cents. The fact is that just $1 of investment in treatment for depression and anxiety leads to a return of $4 in better health and ability to work. 

Stats are not available for Guyana but each year in the U.S., mental illness accounts for the loss of 217 million workdays and costs $193.2 billion in lost earnings.  And the World Economic Forum estimates that the cumulative global impact of mental disorders in terms of lost economic output will amount to $16.3 trillion between 2011 and 2030.

A 2008 World Health Organization report on Guyana stated that, “75,000 to 112,500 Guyanese suffer from mental disorders and require some level of mental health care services. Of these, approximately 22,500 to 37,500 would be expected to suffer from severe mental illness. One can easily estimate the massive losses to employers and the economy because of this reality, especially since today, those figures would be significantly higher.

It is in recognition of these realities that TCV launched our Employees Mental Health Workshops last year, which like all out other workshops is offered for free to businesses. Among the issues addressed in the workshop are depression and anxiety, self-esteem, coping strategies to handle stress and challenges, self/wellness care, abuse in all forms and suicide. The workshop is interactive and uses the facilitative delivery method and the KISS approach, that includes ice breakers; diagnostic and self knowledge questionnaires; use of fact sheets, posters and other ancillary materials; role play, simulations and games; Q&A; case studies and anecdotes; use of enabling technology such as power point slides, videos, virtual charts and graphs.

While we urge businesses to take advantage of our workshop we also once again call on the government to heed the WHO’s call for mental health care to be decentralized and integrated into primary health via a coherent and concerted national process. According to the WHO, “By making (all) health care workers sensitive to the presence of mental health problems and by equipping them with skills to deal with those problems, much wastage of efforts in general health care can be avoided and health care can be made more effective”.

In fact this approach has been highly successful in Zimbabwe and Uganda in particular, among many other nations. In Zimbabwe lay health workers screen for common mental disorders, including depression and anxiety. For those who screen positive, a lay health worker delivers problem-solving therapy with education and support. Those who receive the intervention improve and look better six months later, compared to usual outcomes. As well, local community members without formal mental health education can be trained to deliver basic psychotherapy services as is happening in Uganda. One of the first randomized controlled trials for mental health in low and middle income countries was a landmark study of group interpersonal therapy in war-affected Uganda. The intervention led to large and significant reductions in depression for participants.

Also an innovative study in Chile demonstrated that stepped-care for depression in primary care works better than treatment as usual. The Chilean government translated the research into policy and depression is now a priority health condition, with depression treatment included in Chile’s national insurance plan. In Guyana, depression and anxiety treatment should also be covered by the National Insurance Scheme.

As well, we urge the Ministry of Health to make sure that mental health professionals are available 24/7 at public hospitals, and where there are psych wards, mechanisms, including signage providing directions, must be put in place to make access to such wards easy and quick for anyone seeking help, given that delays and consequential frustration/anger can lead to loss of lives.

Also, the media recently reported the case of an individual with mental health issues sentenced to imprisonment in the court. This begs the question as to whether magistrates and judges should not first mandate psychiatric evaluation and treatment for such persons, if deemed necessary. Perhaps government should ensure such a mandate is in place.

Meanwhile TCV is thrilled that the Public Health Ministry has decided to offer counseling to family members of teenaged rape/murder victim Leonard Archibald. We also hope that this marks the beginning of a policy that would embrace all families of abuse – sexual, gender based, child, alcohol and drugs – as well as suicide survivors and that the offer of counseling would not be selectively offered. We also urge that all regions follow the example of Region Two, which, in collaboration with The Caribbean Voice, recently set up a committee to visit families of suicide and abuse victims in order to ensure that any necessary counseling be offered as needed. Towards this end the region also recently acquired the services of a psychologist.

Finally, we believe that Guyana should join other nations such as the US and UK and mandate counseling in all cases where mental health issues are identified especially at workplaces, schools and homes. This would ensure that employers, in both the private and public sectors, become responsible for the mental well being of their employees and consequently become the smart employers that Dr. Util Thomas referred to and that is desirable.

 

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