March - April 2000
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WHO World Health Organization |
A
workshop for trainers within the framework of the global initiative on primary prevention
of drug abuse in Russia and Belarus took place in Moscow on March 29-31 as a collective
effort of WHO and UNDCP. About 20 health care and education experts from different regions
of Russia such as Ekaterinburg, Kaliningrad, Moscow and St.Petersburg and from Belarus
(Gomel, Minsk) representing the health and educational sectors and nongovernmental
organizations were introduced to the techniques of developing projects to overcome this
serious problem. The meeting was conducted in collaboration with the World Health
Organization (WHO Geneva Headquarters and Copenhagen Regional Office for Europe) and the
United Nations International Drug Control Program (UNDCP Vienna Headquarters). The
Norwegian government donated the necessary funds, and the Moscow offices of WHO and UNDCP
made practical arrangements.
Vladimir Egorov, the Chief Narcologist of the Ministry of Health, and Andrei Gerish, Chief Specialist on Drug Dependence among Children of the Ministry of Education, painted the overall picture in front of our eyes. They said that according to official statistics there are about 200,000 drug addicts in Russia. The real figure is estimated to be close to one million. About 2.4 million Russians are estimated to have been exposed to narcotics at least once. To put all this into perspective, the problem with drug abuse alone is immense and is feared to be growing. Out of one hundred Russians, one or two are personally experiencing it. Considering the involvement and suffering of family members of addicted persons, we are talking about a very common phenomenon indeed. The young are in a special danger zone.
Although the use of drugs may be the most dangerous form of addiction, we should also remember that today the biggest killers of people in Russia and elsewhere are actually alcohol and tobacco. The prevention of abuse of these "legalized" addiction-causing substances is also of great importance, especially helping young people not to start the use against their own will or informed choice. Most abuse and addiction starts from strong peer-group pressure and the inability of say no, even if one really would want to do so.
Presently the environment in Russia and Belarus is far from being safe and supportive to prevent substance abuse. Aggressive alcohol and tobacco promotion is targeted at young people. Social deregulation has made drugs easily available. The economic crisis with mass unemployment has forced people to want to earn money by whatever means including illegal trafficking and selling of drugs.
Giovanna Campello from UNDCP, Vienna, and Dr. Vladimir Pozniak and Dr. Nina Kerimi from WHO navigated the participants during three days through updated information about psychoactive substances and the forms of abuse existing among young people in particular. Practical methods were provided on how to prevent their use and how to create local projects to harness all available resources in the community to minimize this problem. A considerable amount of time was dedicated to the training exercises of participants themselves so that they would be fully prepared to spread the information and organize training workshops for trainers in their own regions. All materials were provided in the Russian language and the recommendations of participants were carefully taken into account for the finalization of the training package, which eventually will be spread throughout the country.
Larissa Chapurina, teacher and psychologist of the Vozvrashchenie Foundation ("Return") in St. Petersburg, summarized her views, why she thinks young people in Russia are so susceptible to start experimenting with drugs. She said that there is a tradition among adults in the country to cope with problems with the help of psychoactive substances such as alcohol and tobacco. Another reason is that we are used to blaming society, the government or parents for our own problems. There is also lack of responsibility to control individual behavior leading easily to experiments with drugs. Add to this equation easy access to drugs, and the problem is there! At its best the Russian family can be very supportive, but there are too many exceptions to this rule. Underdeveloped social infrastructure is unable to compensate for weak parental influence.
When asked whether the workshop was useful, Dr. Grigori Latishev, Director of the Drug Prevention Center in St. Petersburg, said that the information received during the course was invaluable.
The specialists in Russia have no clear understanding about the complexity of preventive work. Most of them think that it is enough just to provide information. Despite the fact that there are a lot of health professionals involved, prevention has not been successful and many are disappointed: "We had a wrong method. We can overcome the epidemic only if we mobilize the whole society to implement the new approach. I feel that now I have got the right instrument to start my work anew," he said.
Dr. Mikko Vienonen Special Representative of WHO, Russia
Representatives from 20 countries most burdened by tuberculosis marked World Tuberculosis Day on March 24 in Amsterdam, agreeing on a framework for action aimed at "consigning to the history books" a disease that currently claims two million lives per year. The Amsterdam Declaration was signed at a conference by the World Health Organization (WHO) and the World Bank (WB), partners in the Stop Tuberculosis initiative aiming to increase coverage of the highly effective directly observed treatment, short course (DOTS) program from 25% of patients with tuberculosis to 70% in five years.
The Amsterdam Declaration calls upon countries and international organizations to:
develop and strengthen national plans that incorporate tuberculosis control as an essential component in them;
ensure universal access to tuberculosis drugs;
accelerate research on diagnostics, drugs, and vaccines; and
establish a global fund to mobilize, invest, and support activities against tuberculosis.
The Amsterdam Conference was attended by a strong delegation from the Russian Federation representing the Ministry of Health, Ministry of Justice, Russian research institutes leading the work against tuberculosis, and WHO tuberculosis project in the Russian Federation. Reports from different countries, including Russia, revealed that drug resistance is increasing. It was emphasized that reducing the burden of tuberculosis is not a humanitarian and medical issue alone. Three-quarters of cases occur in the most economically productive age group of 15–54 years of age. Neglecting tuberculosis results in economic losses. Therefore, the explanation that tuberculosis cannot be treated due to the lack of funds is "bad business".
Dr. Gro Harlem Brundtland, Director General of the World Health Organization, said at the conference: «For the first time, we have evidence that the drug-resistant tuberculosis bacilli that have shaken New York City and Russia are increasing elsewhere. If countries do not act quickly to strengthen their control of tuberculosis, the tuberculosis strains resistant to the normally used anti-tuberculosis drugs costing New York City and Russia hundreds of lives and more than one billion dollars each year, will continue to emerge in other parts of the world".
Dr. Wieslaw Jakubowiak WHO Tuberculosis Coordinator in Russia
According to the new UN appeal for the North Caucasus for humanitarian assistance launched March 15 in Geneva and the Memorandum of Understanding covering operations in the North Caucasus signed between the Russian authorities and UN, WHO continued its help in the region.
In March, WHO delivered six surgical kits to the following hospitals in Ingushetia: the Republican hospital, Sunzhinskaya central district hospital, Nazranovskaya municipal hospital and Malgobekskaya central district hospital. Similar kits were delivered to the Daghestan Republic that has also suffered from the military activities from the territory of Chechnya.
In mid-March, WHO transported 13 disabled IDPs from Ingushetia to the WHO prosthesis workshop in Vladikavkaz for measurements for limb prosthesis.
The total number of amputees in need of assistance is still unknown but the estimate is that it may be as high as 3,000 people.