Development of a Village Based Treatment Model for Afghanistan

Addiction treatment has posed several challenges for cities in developing countries all over the world. Limited addiction treatment facilities, lack of trained personnel, dearth of evidence-based practices and social stigma often function as barriers to treatment. Moreover, the quality of treatment has also been a cause for concern as many countries have been reporting high relapse rates. The selimitations are magnified further in rural communities where drug use is rising and access to treatment for substance use disorders is scarce. Additionally, practical barriers (e.g. distance from treatment centre, transportation) are often too great to overcome, necessitating a specialised approach where treatment travels from urban to rural setting. Afghanistan is the world’s largest producer of opium and heroin. Afghans particularly living in rural settings have no access to healthcare services, including treatment for drug dependence. The widespread dependency on opium poses serious debilitating social, economic and health consequences, not just for those who are addicted, but also for their families and communities. In a meeting between the Colombo Plan Drug Advisory Programme’s officials and the tribal leaders of Balkh Province, the tribal leaders shared that more than 50% of their villagers (including women and children) are addicted to drugs. In 2011, a drug use prevalence survey was commissioned by the Bureau for International Narcotics and Law Enforcement Affairs, U.S. Department of State, for two rural villages of Balkh province based on toxicology. The study concluded that 33.5% of villagers in Ana Gilday (total pop. 705) and 36.1% of villagers in KohnaKaldar (total pop. 753) tested positive for opiates. For comparison, the prevalence rate of drug use among the urban population of Mazar-e-Sharif, the provincial capital of Balkh province is substantially lower. In view of the above-mentioned situation, the Colombo Plan Drug Advisory 28 International Journal of Prevention and Treatment of Substance Use Disorders Programme initiated a Village Based Treatment Programme in four villages in Balkh province in Afghanistan. This paper will deliberate the genesis and adaptation of the South Indian widely-implemented Camp Approach to treat drug addicts, to pilot a village-based treatment in Afghanistan. The paper will also elaborate on the rationale, framework and initial treatment outcome of the village-based intervention. DOI: http://dx.doi.org/10.4038/ijptsud.v1i2.7689