A PROJECT WORTHY OF EVERYBODY'S SUPPORT

For The Bohol Tribune

In This Our Journey

NESTOR MANIEBO PESTELOS

A project with the forbidding title, Community-Based Drug Demand Reduction Program & Recovery Support System (CB-DDRP&RSS) for the Municipality of Baclayon, may well be the answer to the riddle of how to address the messy situation of having hundreds of surrenderees without a comprehensive treatment and recovery program.

I have just been from a meeting between Miriam Peguit-Cue, a noted psychologist from the Professional Regulations Commission (PRC) and the New Day Resource Center (NDRC) in Davao City, and Karen Flood-Capapas and Karina Uy, both of Holy Name University and in less than an hour I was swept off my feet listening on what they planned to do to support the quest for a more humane and effective way to deal with 429 surrenderees in Baclayon.

They realized the surrenderees could not fit into the first and only drug rehabilitation center in the province, the FARM It Works Balay Kahayag (FITWBK) Chemical Dependency Treatment Center in barangay Laya which can only take in 30 clients at a time.

Getting the surrenderees out of the province to training centers in Cebu and other places would be too costly an option for both the Government and the affected families. Hence, the three psychologists agreed on the need for a community-based approach to the problem.

In a presentation made two weeks ago to the Technical Working Group responsible for the planning and implementation of Bohol’s drug rehabilitation program, Miriam Cue and Jay Valderrama, NDRC program director, cited the following as features of the often-cited community-based approach as opposed to the conventional center-based modality:

“any drug demand reduction effort or recovery support initiative for those with SUD [Substance Use Disorder], that exists within a community and generally operated by people from that very community;

“a cooperative endeavor that utilizes available community resources on a voluntary, self-sufficient and self-sustaining basis”

What they talked about within the hour were based on these precepts, aware that social preparation and community involvement could result in the use of local human and other resources for an affordable and sustainable treatment process for drug abuse victims.

On the matter of applying ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) to determine the addiction level of surrenderees, the HNU is willing that its 37 senior psychology students be intensively trained on the use of this tool designed, field-tested and validated in several countries by WHO and has been used worldwide since 2010.

NDRC Davao, which has been proposed as training institution for the Drug Advisory Program (DAP) of the Colombo Plan Secretariat based in Sri Lanka, will provide three trainors for this vital and pace-setting activity that will give a vigorous head start to the evolving community-based approach to drug rehabilitation efforts in the province.

With Baclayon aspiring to be the initial pilot area for this innovative approach, the training and eventual deployment of 37 trained psychology interns from HNU will be enough to cover the municipality’s 17 barangays with a two-member research team. As the NDRC presentation says:

“It is important that those responsible for intake, screening and assessment should be trained properly to ensure a systematic process of gathering personal and other pertinent information of the person as basis for determining the severity of the problem, and for identifying the most appropriate means of assistance.”

The NDRC consultants will join hands with the Psychology faculty of HNU to ensure that data collection per surrenderee will be professionally and properly done. This will be in consonance with Principle 2 as articulated by the United Nations Office for Drugs and Crimes (UNODC) in the document, Community-Based Treatment and Care for Drug Use and Dependence:

Principle 2: Screening, Assessment, Diagnosis and Treatment-Planning

Comprehensive assessments, diagnosis and treatment planning are the basis for individualized treatments that address the specific needs of each patient and that will also help to engage him/her into treatment.

It is then clear that the resulting database will be used as basis for planning appropriate interventions for each category of clients and thus ensure a more effective counselling and treatment process.

Through this database, high-risk clients can be identified and assigned to drug rehab centers outside the province while planned facilities by the Government and private sector are still being built. It is expected that clients in this category will not exceed 10% or even lower based on observed behavior of the surrenderees.

It has been observed that despite lack of systematic treatment and counselling, there has been no spate of violence and majority seem to refrain from resorting to the old habit by sheer force of will or they are simply restrained by fear of being neutralized (translation: arrested and or killed) by either the police or so-called vigilantes which have sprung up everywhere for the past two months. Others say this is just the calm before the storm.

It has been proposed that the individualized database of the surrenderees can be aggregated and assessed for the purpose of programming the inputs relevant to the current needs and addiction status of the surrenderees.

The following key activities have been recommended once the database has been set up:

-Presentation/discussion of the ASSIST outputs to the Sandigang Bayan,

Mayor and the technical agencies indicating their implications

in terms of relevant interventions, policy support and assistance

to surrenderees in terms of their categorization (1 day)

-Presentation/discussion of findings and possible interventions to Barangay

Captains (1 day). BCs to orient their respective Councils.

-Initial organization and orientation of heads of families with

surrenderees to be done by Barangays under the

Councils with assistance from the Municipal Technical Working Group (TWG) and designated Community Facilitators.

These key activities will ensure broad-based participation of local communities and families , as well as the local governance structures. It is expected that through this participatory process, the healing and treatment process will be de-stigmatized and that a humane perspective on the drug addiction problem in the community will prevail.

Now to answer a question probably in everybody’s mind at this point – how much will be the cost of this community-based project?

Here is the estimated budget estimate as part of the proposal to be submitted to the Baclayon LGU:

SUMMARY OF FINANCIAL REQUIREMENTS

Support to establishing a Project Coordination Office

at MTO ………… Php 312,000 (35%)

Orientation of SB, Technical Agencies,

NGOs and CSOs …………………… 60,800 (7%)

Training on the use of ASSIST

for Screening/Assessment ………………… 91,500 (11%)

Encoding the data and storing

them in a central file ……………… …… 80,000 (9%)

Planning workshop to link ASSIST

data with interventions ……………… 47,000 (5%)

Hiring of external consultants to provide

technical assistance ………. 280,000 (33%)

==========

Total ……………………………………Php 871,300

Contingency (15% of Total) ………………………………………………………. 130.695

GRAND TOTAL …………………….PHP 1,001,995

We think that with resolute commitment and resourcefulness, the LGU will be able to producethis amount with the help of its partners: the Provincial Government, private sector, faith-based organizations, NGOs and civil society organizations.

Or they can do vigorous fund campaigns using all sorts of drvies and tapping the resources of the kababayans abroad. If they can do this to organize festivities, family and class reunions, beauty constests and all sorts of parties , they can surely do this “to save souls” and ensure the survival of our province and its people.

The three ladies I spent the afternoon with know that this crisis is also an opportunity to rediscover our unity around a project worthy of everybody’s support for Bohol and the country as a whole. Indeed may we not all fiddle while Rome burns. For comments, email: npesteslos@gmail.com #drugfreeboholcampaign

NMP/24 Sep 2016/5.20 a.m.

A COALITION OF THE WILLING FOR A DRUG-FREE BOHOL

For The Bohol Tribune

In This Our Journey

NESTOR MANIEBO PESTELOS

  

Events during the past two weeks have convinced me we must now vigorously move forward to form a coalition of the willing for a drug-free Bohol and that the first catalyst activity to give it momentum is to  produce a profile of each of the 31,000  drug users who have signified their intention to lead a new life without drugs.

In all our meetings which started Sunday evening, 21 August,  with consultants from the New Day Recovery Center (NDRC) from Davao City to today, Thursday, when we have continued to consult with friends from the drug addiction profession, and listened intently to discussions among social and health workers, I have become convinced that the task of profiling the surrenderees should be done first to ensure a systematic response to the needs of our target beneficiaries, the surrenderees.

If accomplished, this individual database will make it possible to provide interventions relevant to each category of drug-affected surrenderees to be classified as low risk, moderate risk and high risk. I am convinced that this task can be undertaken systematically starting at the municipal or city LGU level.

The provincial government, with its task force, can form a mobile team trained on the use of tools for determining the  extent of addiction of each surrenderee. The resulting database can be used to determine which surrenderees will be put on outpatient basis; those provided with comprehensive counselling and most likely livelihood , and others which can in-patient treatment services. This is part of the strategy proposed by the NDRC consultants as part of their

With this target-specific approach, the government need not worry about putting everybody in a drug rehabilitation center which will be costly and will take years to build taking into account the usual pace of infrastructure planning and implementation in our country.

The key questions in carrying out this important task are as follows: a) what are the tools to be used in profiling the surrenderees; b) who can be trained to administer them; c) how long will the training be conducted; d) how much will be the cost for the training of those who will administer the tools.

The tools used are as follows:

-ASSIST or Alcohol and Substance Screening Test

-ASI (Addiction Severity Index)

-Severity Index Form

-Psychology Tests

In a preliminary study conducted by a technical working group in Baclayon, the duration per training will be three days; two persons will be needed to be trained from each barangay; and that the expenses will be for training materials; meals and snacks; and transportation.

If participants will be trained on all four tools, the cost per participant will be Php 488 per day or a total Php 3,723 per participant per day.

It was the consensus of the group that ways must be found to reduce the costs of training the staff who will administer the tools, usually the health and social workers.

At this point, It is crucial to understand the difference between screening and assessment. I looked it up and I found this:

• Screening is a process for evaluating the possible presence of a particular problem. The outcome is normally a simple yes or no.
• Assessment is a process for defining the nature of that problem, determining a diagnosis, and developing specific treatment recommendations for addressing the problem or diagnosis.

Hence, in this light, since the surrenderees are identified as drug users, it may be asked whether we need still to use the ASSIST as a tool. I heard it in one of the meetings that the ASI may be the only appropriate tool to use.

The third tool may also be used but the psychological tests may be used later once the surrenderees have been categorized. If we use only two tools, ASI and the Severity Index Form, we will be able to reduce the costs of profiling the surrenderees.

During the meeting of the provincial Technical Working Group, I got the impression that the social workers and the health workers have been trained on the use of the screening tools. Hence, it is just a matter of mobilizing and training them as trainors this time by the consultants to be able to cascade the training at the municipal level.

As in practically all cases, how to fund activities is the key concern whether at provincial and municipal level. Hence, there must be a way to encourage LGUs to work closely with drug addiction professionals and find more cost-effective ways to do the profiling of surrenderees.

Yesterday, I was in Sierra Bullones in the company of former UN colleagues, Cecilio Adorna and Richard Prado,  as observer in the conduct of Focus Group Discussions (FGDs) as part of formulating the 2017-2022 Philippine National Nutrition Plan. It occurred me while listening to their quite intense discussions that the keen interest and leadership of the Local Chief Executives is key to mobilizing staff and resources to ensure that any national plan and projects formulated will get the support of the various sectors.

We have learned this lesson through forty years of working in projects implemented in partnership with local governments in various countries. Always there is the challenge to involve local political leaders so that they will help to mobilize resources for programs considered as top priority.

In Sierra Bullones, the Municipal Health Offricer and the Municipal Nutrition Officer have provided the leadership, with the support of the Municipal Mayor, to raise funds for its Municipal Nutrition Program. We hope the same tenacity of purpose will be shown in supporting the profiling of surrenderees so that the latter can eventually be provided with relevant interventions appropriate to their addiction severity status.

I learned from the MHO, Dr. Janice Belleza, that on the matter of profiling surrenderees, all ten nurses under her office have all been trained in the use of ASSIST. The next step is to decide whether they still have to be trained with the other three tools to be able to start this all-important work.

We need the drug addiction professionals to start a discussion on this vital issue. This is the time to review or evaluate the screening and assessment tools and decide which ones to use given the crucial task ahead of providing relevant services to the surrenderees.

Otherwise we may be going around in circles in planning interventions most appropriate at this time in managing the situation of having more than 31,000 surrenderees in our province. At this critical stage, we need a coalition of the willing for a drug-free Bohol but we cannot do organizing and social mobilization work if we do not know exactly the extent of the problems affecting the target beneficiaries.

For comments, email: npestelos@gmail.com ###

NMP/02 September 2016/4.11 p.m.