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Try out PMC Labs and tell us what you think. Learn More. For more than a decade, most parts of Somalia have not been under the control of any type of government. In contrast, the northern part of Somalia has had relatively stable control under regional administrations, which are, however, not internationally recognized.
The present study provides information about drug abuse among active security personnel and militia with an emphasis on regional differences in relation to the lack of central governmental control—to our knowledge the first on this topic. Trained local interviewers conducted a total of 8, interviews of armed personnel in seven convenience samples in different regions of Somalia; 6.
We assessed basic sociodemographic information, self-reported khat use, and how respondents perceived the use of khat, cannabis which includes both hashish and marijuana , psychoactive tablets e. In total, Self-reported khat use differed substantially from the perceived use in units. According to the perception of respondents, the most frequent form of drug use is khat chewing on average, Perceived use of khat differs little between northern and southern Somalia, but perceived use of other drugs reaches alarmingly high levels in some regions of the south, especially related to smoking cannabis and using psychoactive tablets.
Our data suggest that drug use has quantitatively and qualitatively changed over the course of conflicts in southern Somalia, as current patterns are in contrast to traditional use. Although future studies using random sampling methods need to confirm our , we hypothesize that drug-related problems of armed staff and other vulnerable groups in southern Somalia has reached proportions formerly unknown to the country, especially as we believe that any biases in our data would lead to an underestimation of actual drug use.
We recommend that future disarmament, demobilization, and reintegration DDR programs need to be prepared to deal with ificant drug-related problems in Somalia. Somalia—a country in eastern Africa—has been torn apart by civil war over the past few decades.
Fighting among clans and warlords has caused the near-complete breakdown of state control in the central and southern regions of the country including the capital, Mogadishu although independent administrations provide some governmental control in the northern regions of Somaliland and Puntland. Efforts to establish a transitional federal government have largely failed and, to date, it has been impossible to initiate a nationwide disarmament, demobilization, and reintegration DDR program in Somalia for ex-combatants, a key step in the transition from war to peace.
As in other war-torn countries, the social and economic reintegration of ex-combatants into civil society in Somalia is likely to be difficult. However, without effective reintegration, ex-combatants may take up arms again because they have no means of economic support or become disaffected and seek to destabilize the peace. One risk factor for poor adjustment to civilian life among ex-combatants is substance abuse. Many ex-combatants use drugs to help them deal with traumatic war-related memories, but unrecognized drug abuse can hinder reintegration, increase criminality, and threaten the peace-building process.
Most studies on substance abuse and treatment of drug-related problems of former combatants have been done in Western countries. Very little is known about how many ex-combatants abuse drugs and the types of drugs they abuse in postconflict regions in Africa. This information is needed if DDR programs are to be effective. Convenience samples are groups of people chosen to participate in a study because they were available rather than groups chosen randomly from the whole population.
Trained interviewers asked more than 8, military personnel about their own recent use of khat chewing khat leaves releases an amphetamine-like stimulant , a legally traded drug in Somalia, where its use has long been commonplace.
The interviewers also asked the respondents how much they thought others in their military personnel unit used khat and other drugs such as cannabis, psychoactive drugs tranquilizers and other drugs that change mood, behavior, and thinking , solvents, alcohol, and hemp seeds. Note that the researchers relied on perceived drug use; alcohol is illegal in Somalia, which is a Muslim country, and the use of drugs other than khat is not generally acknowledged.
Over the whole of Somalia, one-third of respondents said they had used khat recently. The use of convenience samples which may not be representative of the whole population and other aspects of this study mean that the numerical values of these findings may be inaccurate. For example, the levels of self-reported khat use may be underestimates because drug-using combatants may have been undersampled or not all combatants may have responded honestly. These changes in the traditional patterns of drug use in Somalia, if confirmed in studies that use random sampling methods, suggest that future DDR programs in Somalia will need to be prepared to deal with major drug-related problems and that drug use among the general population might have reached dimensions formerly unknown to the country.
DrugScope a UK charity provides information about khat. Little is currently known about the prevalence of drug consumption by former combatants in states or countries that can no longer perform basic security and development functions, and that have lost effective control over their territory. Based on interviews of large s of combatants, we report on khat and other drug use among active armed forces and militia personnel in Somalia, where decades of civil war have produced a vacuum of state power [ 1 ] and where in some regions law is not enforced.
In order to understand the current political situation in Somalia, it is essential to realize that its society is clan-based, with six major clan-families and some minority groups. In early , the autocratic rule of the former president Siad Barre, which had increasingly relied on his closely related subclans, was overthrown by several other clan-based armed groups, which split off later in rivalry over power and resources and produced the disordered situation that continues today [ 3 ].
Early on, the two northern regions, which roughly correspond to the former British protectorate Somaliland in the northwest, and some years later Puntland in the northeast, built up independent administrations and largely managed to restore stability with state-like governmental control.
In , at the time of our interviews, in the centre and south of the country the situation was much more complex and numerous factions had maintained the armed conflict for more than a decade, rejecting the authority of the Transitional National Government in Mogadishu.
Our assessment was initiated by these peace talks and was meant to prepare the disarmament, demobilization, and reintegration DDR program in Somalia. However, after our interviews took place, the political division within the TFG made it impossible to start a DDR program, and in a completely new situation emerged: the United Islamic Courts UIC seized the capital, driving away the warlords who held positions as ministers and threatened the whole TFG.
As a consequence, Ethiopia started a military intervention with the backing of Western governments to enable the TFG to gain control over Mogadishu. Since then, however, the country has not been stable for a more detailed report of the current political situation in Somalia see [ 4 , 5 ]. Thus, the current political situation offers little hope for the effective re-establishment of a central government and an end to the armed conflict.
After the end of armed conflict, former refugees, internally displaced people, and ex-combatants must be socially and economically reintegrated. During this process in many countries, ex-combatants were frequently found to have severe adjustment difficulties, e. Substance abuse and dependence have been identified as risk factors for different aspects of their readjustment to civilian life [ 9 — 12 ]. In particular, ex-combatants who had been exposed to ongoing traumatic stress, which may have resulted in post-traumatic stress disorder PTSD , were frequently found to have high levels of alcohol consumption as well as the use of other substances [ 13 — 16 ].
Current knowledge supports the self-medication hypothesis, i. Thus, in recent years psychiatric services for ex-combatants developed more integrated models of care, including the treatment of substance abuse [ 21 , 22 ]. However, most studies on substance use, readjustment, and treatment of drug-related problems of former combatants have been conducted in Western countries. Information from African postconflict regions are sparse, especially related to the prevalence of abuse, the type of drugs consumed, and the relation of drug use to other psychiatric conditions and readjustment measures.
This lack of information hinders the efforts made by reintegration programs in many resource-poor postconflict countries, as unrecognized drug abuse might lead to failure of reintegration in a substantial of cases, which, in turn, could lead to social problems e. Widespread drug abuse might even affect the peace-building process as a whole [ 24 ], e. The main drug abused in Somalia is khat [ 26 ]. The leaves of the khat shrub are traditionally consumed in parts of Africa and in Arab countries for their stimulating properties [ 27 , 28 ].
Recently, as khat is used by immigrant groups, its use has spread to Western countries [ 29 , 30 ]. The chemically unstable alkaloid cathinone, S - alpha-aminopropiophenone, present in the fresh plant material, is the main psychoactive agent [ 31 ].
Numerous laboratory studies confirmed that cathinone resembles amphetamine in chemical structure and affects the central and peripheral nervous system [ 32 ] and behavior [ 33 , 34 ] similarly for a review see [ 35 , 36 ]. Khat use has been related to numerous somatic and psychiatric health sequelae [ 37 — 39 ]. The information currently available concerning drug intake in Somalia is sparse. More recent data from the neighboring countries indicate that khat chewing is frequently comorbid with alcohol consumption, smoking cannabis which includes both hashish and marijuana , and intake of benzodiazepines [ 41 — 43 ].
In recent years, there is growing evidence that khat-related business is one source of income for civil war factions in southern Somalia [ 45 ] and that the cultivation and trafficking of cannabis and other illicit drugs constitutes an increasing problem, but available data have remained limited [ 46 ]. In all of Somalia, drug control and rehabilitation efforts are not exceeding primary levels: khat is legally traded and little is done to raise public awareness of its potential dangers. Alcohol is illegal because of religious beliefs; other drugs are not officially acknowledged as a problem.
This lack of acknowledgment must be understood in context: the former, Siad Barre regime had tried to ban khat, and its trade and import tax are main sources of income for civil war factions in the south as well as for the regional administrations in the north. In the area of DDR, the international agencies have only just started to address the drug problem of ex-combatants in Somalia [ 48 ], but so far no systematic approach has been worked out.
Based on seven large convenience samples from different regions of Somalia, we present data based on self-reported khat use among active security personnel and militia in Somalia, some problematic use patterns e. The exact of armed staff and militia personnel in Somalia is not known. In , international organizations estimated that the total lies between 70, and 80, men under arms [ 49 ]. Of them 17, were in Somaliland, 6, in Puntland [ 50 ], and approximately 17, in Mogadishu [ 49 ]. In addition, we used the proposed s of demobilization camps to estimate militia s in other regions see Table 1.
Given that the country remains in armed conflict and sampling of armed staff of opposing factions was based on vague political arrangements, it was not possible to apply random sampling methods as we initially intended, because necessary information about group size, location, and so forth was, understandably, not revealed. Thus, we drew seven large convenience samples in seven parts of the country. The use of convenience samples does not allow for the estimation of biases, and thus must be interpreted with caution.
However, under certain conditions the use of convenience samples in studies determining prevalence of drug use is justified [ 51 ], and especially in clinical research, studies with large convenience samples actually have produced estimates that come very close to those of studies using more rigorous sampling strategies [ 52 — 54 ]. Bay and Bakol are two regions dominated by the Rahaweyne clan.
Kismayo included parts of the Lower and Middle Juba regions; at the time of the interviews, this region was dominated by the Juba Valley Alliance, which tried to establish an independent administration as in the northern regions. In central and southern Somalia, the territory was divided between a large of smaller and bigger factions, who, at that time, did not allow a central government to exert power [ 3 ].
Interviews were conducted with all collaborating groups, asking for a minimum of one unit within the overall structure to be completely assessed. We had no access to basic information concerning the units e. In Somaliland and Puntland, due to the establishment of regional administrations, regional armed forces had been established by incorporating the former clan-based factions.
In Somaliland, the project made use of the ongoing DDR activities, which included registering armed staff on the government payroll. The study used all data available until the project had ended. In Puntland, we interviewed military units under the regional administration in three major population centers and one other armed group. In every region, we aimed to assess a minimum of respondents, including as many factions and armed groups as possible.
Interviews were conducted between August and December The interviewers went directly into a compound used by the respective militia or units to conduct the individual interviews in a place that provided as much privacy as possible, e. But before asking for informed consent in the individual interview setting, all participants were assured that a refusal to participate would not be reported to superiors. According to the observation of interviewers, the motivation of the individual unit members to participate in the assessment was very high. Despite the fact that they were accurately informed about the study, and that their participation would not have any effect on the participation in a future program, they still hoped that they might increase their chances of being selected by participating in the assessment.
In total, 8, militiamen and security staff were interviewed; of them were excluded from the analysis because they denied their consent after being informed about the purpose of the study empty sheet returned or during the interview 6. Of them, 4, belonged to regional authorities and 2, to warlord factions, 1, were members of freelance and clan-based militia, of sharia court militias, and 78 members of business militias.
Prior to data collection, a d training was conducted that contained clinical concepts and research de, role playing, and field exercises. Contact with interviewers was maintained throughout the assessment phase by cell phone, radio, and field visits by a team member of Somali origin and international staff. Close contact with the forces' and militias' command and a large-scale awareness campaign by local press, radio, and TV prepared the ground.
There were no security incidents reported during the assessment. After the assessment, local NGOs handed in the questionnaires and assisted data entry.Drugs in somalia
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The Consumption of Khat and Other Drugs in Somali Combatants: A Cross-Sectional Study