On March 5th and 6th, the in-person workshop series of the project “Connecting Parallels – Uniting Prevention and Treatment for Effective Drug Management in East Africa”, funded by the Swedish Institute and implemented by WFAD, Soberlife, SCAD, and United Voices for Africa, was finalised with a 2-day workshop in Nairobi, Kenya. Earlier in-person workshops were provided in Kisumu, Mombasa, and Nairobi in the last six months. The final workshop also welcomed members from the East African Network to discuss the essential topics related to Prevention and Treatment and how to fill the gap. The cumulative total number of participants for the two days was 69 from 6 countries, with over 20 Civil Society Organisations represented.

Day 1

On March 5th, the programme began with opening remarks from a government representative of NACADA, Ms Nyambura, highlighting the governments’ engagements in bridging prevention and treatment. She stated that to achieve the vision of a nation free from alcohol and drug abuse, the government has introduced public education and advocacy programmes and guidelines. The government is also involved in developing school curriculums to integrate matters concerning drug abuse, family engagements to educate parents on involvement in their children’s lives, and performance contracting with institutions.

Other speakers during the first day included

• Ms Sonali from the Addictions Prevention and Recovery Association of Kenya, which is a network of organisations involved in alcohol, drug, and other behavioural addiction prevention, rehabilitation, and care centres across Kenya.
• Cressida de Witte from the World Federation Against Drugs informed participants about the role of WFAD as a multisectoral membership organisation that networks with partners on prevention and treatment through innovative approaches, expressing the importance of the collaboration of prevention and treatment.
• Dr Pamela Kaithuru, Director of the International Society of Substance Use Professionals (ISSUP), which is an international society that brings together professionals in the sphere of substance use, prevention, treatment, and recovery and is formed by chapters on the country level.
• Ms Tove Karlsson from Healthy Thinking International expressed that even though many government services are free in Sweden, many young people are vulnerable to drug initiation knowing that they will get support easily from institutions. therefore, there is still a lot of work in prevention at the early stages left.

The presentations were followed by a brief panel discussion featuring experts from the treatment and prevention sectors, speaking on the challenges faced and opportunities. The panel discussion was presented by Lilian Gitau, a mental health practitioner who runs a rehabilitation centre in Kisumu and is also a community worker helping women with drug addictions. She shared that parallels are connected in several ways in Kisumu:

1. Community workgroups
2. Basic screening – including the SBIRT (Screening, Brief Intervention, and Referral to Treatment)
3. Prevention
4. Treatment
5. Harm reduction in the continuum of care

She also shared information on the Transtheoretical model of change, which includes 5 stages of change: precontemplation; Psychoeducation/contemplation; determination; action, and; maintenance. Challenged faced include:

1. Intellectual incapacity
2. Gaps in family therapy where everyone is struggling.
3. Lack of resources for prevention
4. Primitive approaches to prevention: for instance giving threatening messages on drug effects.

Some of the opportunities discussed were;

1. Public education and advocacy.
2. Family interventions
3. Early prevention and education have a positive effect on the future.

The participants discussed the challenges and opportunities and the divergent paths of prevention and treatment.

Day 2

On March 6th, the floor was given to civil society organisation representatives, reflecting on the current situation in their countries.

The first presentation was given by Dr Ruth Kikome, who provided an overview of the East African Network, its objectives, milestones, and challenges since it was formed 4 years ago. Some of the achievements include: the network being intact regardless of the prevailing social and economic conditions both at the local and regional (global) levels. She noted that the main challenges are a lack of consistent network meetings; as well as a lack of funding to actualize the action plans into practical projects. These include strong prevention and treatment manpower and facilities as well as social and economic empowerment projects.

The second presentation was provided by Emmanuel Kanyuri of the Democratic Republic of Congo, who shared the status of their country. The DRC is a country that is greatly affected by conflicts and a long period of war that has taken over 8 million lives. Being a resource-rich country, there are sections of people that try to use shortcuts to mine due to the long processes required to obtain legal documents, in turn, they engage the rebels so that they can cause chaos causing the people to run hence allowing them to mine peacefully.  These sects or rebels use intoxication to boost their system and suppress their conscience and sanity. The most commonly used drugs in the DRC are heroin, cocaine, and marijuana among others. Congo is home to thousands of internally displaced persons and refugees, from DRC, the Central African Republic (CAR), and Rwanda totalling over 6.4 million adults and 2 million children. Amid drugs, conflict, violence, and displacement, human smuggling is perceived to be a crucial means for vulnerable individuals to move within the country and beyond. This has resulted in homelessness with women also involved, early pregnancies and with no rehabilitation centres whatsoever in the 26 provinces. The resulting poverty makes young people vulnerable to rebel recruitment to gain an income, and hence the drug cycle keeps recurring. Communities have come together to try to help those individuals and help reduce which is proving difficult as there are no facilities to help those affected. Even with advocacy in Congo, there are no laws or government support set towards prevention, treatment or drug management.

The third presentation, given by the Uganda Alliance Policy Alliance, shared that while Tanzania has a government department focusing on drug issues, its main intervention is enforcement, arresting those in the business or consumption. It does not offer any alternatives such as recovery or aftercare services. Uganda has no State authority to tackle the drug issues, leaving those affected at the risk of the adverse impacts of the habit. Currently, there is a bill supported by the Uganda Alliance Policy Alliance (UAPA), a network of Civil societies formed in 2011 to advocate for policies for regulation to minimize alcohol (and drug harms) in Uganda.

After the presentations, the participants engaged in interactive and active discussions reviewing the current EAN action plan, proposing action points to be integrated, and recommendations to keep the network running, connect parallels, and scale up interventions.

Epilogue

The workshop series was wrapped on a general agreement that there are many opportunities to connect treatment and prevention, and this is the best approach to realising holistic behaviour change regarding alcohol and drug abuse. It reiterated the need to work together and know boundaries for effective support to those affected both at individual/ family and community levels. There is a need to focus on children to prevent risking to lose a generation. At the same time, it was agreed that the professionals should lead by example, and if any of them is affected by drugs, should seek help to maintain a moral and ethical impression.