The Sunday Mail
Leroy Dzenga
Senior Reporter
“GUKAMUKAFELA, Dombo or Mutoriro,’ the beast has many names.
Crystal meth is perhaps the only substance that has competed with the Covid-19 pandemic in taking Zimbabwean lives over the past year or two. The highly addictive stimulant is hitting the country where it hurts the most, its youth.
Kutsomwa (hot pursuit), is the romanticised street reference describing a person under the clutches of the drug.
Sleep deprivation, paranoia, violence and hallucinations are among the behavioural manifestations believed to be a product of the drug.
So bad is Crystal Meth to those who consume it that they cannot drink borehole water as they claim doing so may put them at risk of death.
Although the number of people currently enslaved by the drug is unknown, the numbers are evidently far from low.
Last year, The Sunday Mail carried a story in which renowned psychiatrist Dr Sacrifice Chirisa said drug addiction accounts for 65 percent of admissions at mental health institutions.
Despite the growing numbers and the relatively complex drugs which are emerging, the country does not have specialised public drug rehabilitation centres.
Those who find themselves battling strong reliance on substances are admitted at the four tertiary psychiatric institutions namely Ingutsheni Central Hospital (Bulawayo), Harare Psychiatric Unit (Harare), Parirenyatwa Hospital Annex (Harare) and Ngomahuru Hospital (Masvingo).
Experts believe this approach may have worked for other kinds of drugs but the current fight against Crystal Meth may need a more specialised approach, where facilities are specifically designed to help those fighting vices.
Moreblessing Mlilo (name changed), who spent time at Ingutsheni on two occasions over drug abuse and depression, shared his experience.
“The nurses would not take time to understand your needs and concerns, what would happen is you would either get pills or an injection to stabilise you. The whole day you would be subdued, unable to perform a lot of tasks,” he said.
At one point he had a relapse trying to fool the authorities.
“If you are admitted, the medical personnel you speak to have answers they want to hear. So as time went on, I learnt to respond in ways that spoke to their biases and they discharged me. However, the first thing I did as I left the centre was to look for a supplier,” he said.
It took a hard relapse, which almost cost him his life, for him to take deliberate steps towards kicking the habit.
“Over time, I tried to explain to the doctors that I was not mad and I just needed help as I only did drugs to escape issues that were stressing me. They decided to enlist me for therapy sessions, which have been helping. Slowly I am working towards recovery. I feel like my issues are breaking my family apart. I wish they could accept me and try to solve issues with me, every time we disagree they threaten to send me back to Ingutsheni, like it is a prison. For many people there, it feels like one,” Mlilo said.
Founder of Zimbabwe Civil Liberties and Drug Network, Mr Wilson Box, said there is a need to establish specific drug centres to deal with the problem confronting the country.
“Unfortunately, Zimbabwe does not have public rehabilitation centres for people who use drugs. It has public mental health institutions like Annex at Parirenyatwa, Ingutsheni in Bulawayo, Ngomahuru and Mlondolozi,” he said.
Instead of getting help specific to their needs and challenges, people are at risk of getting generic help to complex problems.
“A person who uses drugs is not a mentally challenged person. He just needs treatment to wean him from drugs,” Mr Box said.
Due to the stigma associated with enrolling family members in a mental institution, some families are attempting the religious route, trying to pray away the cravings.
Mr Box told The Sunday Mail that in his years of experience, families are not able to help members fight off addiction single handedly.
“It depends on the person’s biological make-up but successfully fighting addiction, especially to drugs like Crystal Meth, can take up to a year,” he said.
Public mental institutions have limited capacity for drug addicts, as they also have to accommodate people dealing with varied mental health challenges including stress, anxiety, depression and bipolar disorders among others.
Ngomahuru in Masvingo accommodates 300 at full capacity, Ingutsheni in Bulawayo has a bed capacity of 708, Harare Psychiatric Unit accommodates 100 while Parirenyatwa Annexe Hospital has not more than 40 beds carrying capacity.
This brings the total capacity of tertiary psychiatric institutions to around 1 148.
Besides the tertiary psychiatric institutions, there are provincial mental health facilities which exist in Chinhoyi, Gweru, Marondera and Mutoko but they do not add much in terms of numerical capacity.
If figures carried in the Ministry of Health and Child Care’s National Drug Masterplan (2020-2025) are anything to go by, the available facilities appear to be inadequate.
The Masterplan says in Zimbabwe it has been estimated that approximately three percent of the adult population (450 000 people) had either a drug or alcohol use disorder.
According to the document, “alcohol and substance use related problems are one of the top three problems seen in mental health services in all 10 provinces.”
The shortage of specialised drug facilities as a public good has left families at the mercy of private players.
A weekly session at private facilities costs around US$400 per month, and if a person needs six months to kick out the habit, their family would have to part ways with US$9 600.
For an average employed person earning US$300, this translates to 32 months of their salary without spending a single cent on any other need.
This is holding other factors like relapses constant.
Besides the unavailability of drug-specific facilities, there is also a stark shortage of personnel in the general mental health sector, which is at this moment burdened.
The Ministry of Health and Child Care’s National Strategic Plan for Mental Health Services (2019-2023), says there are 917 registered mental health nurses in the country and 17 psychiatrists.
“There are six Clinical psychologists, 13 Clinical Social Workers and 10 Occupational Therapists working in the Government sector. There is a high patient to staff ratio across all disciplines, highlighting a need to recruit and retain mental health professionals and to increase numbers in all available training programmes,” the plan states.
Reports have shown that the drug problem is kicking in from an early age, adolescents and youths in their early teens are being introduced to substances.
In fact, according to the National Drug Masterplan, adolescents and young adults account for the largest share of those using drugs.
However, our facilities in their present form cannot accommodate part of the demographic, the adolescents as well as children.
The National Strategic Plan for Mental Health Services says; “There is a lack of admission facilities for children and adolescents, and lack of suitable services for effective occupational therapy.”
Executive Director of Youth against Alcoholism and Drug Dependency (YADD), Mr Tungamirai Zimondi, told The Sunday Mail that the Government is on the right path with the drug fight and what is left is the implementation of the laid strategies.
“Drug abuse and related harm is a major obstacle to sustainable development in all its dimensions. In line with its vision 2030, the Government must be applauded for timeously launching the five year National Drug Master plan in light of the surge in drug abuse around Zimbabwe. What is now required is to ensure that the strategies that have been laid down in this master plan can be expeditiously operationalised,” he said.
Mr Zimondi, who sits on boards of international anti-drug organisations like Movendi International and the African Tobacco Control Alliance (ATCA), said Zimbabwe should draw lessons from other countries in its drug fight.
“Other countries like Thailand and Indonesia have introduced alternative development to cash crops like coffee where opium used to be planted,” Mr Zimondi said.
On the legal side, authorities are taking the drug situation seriously as evidenced by Home Affairs and Cultural Heritage Minister Kazembe Kazembe who read the riot act to drug peddlers in a recent press statement.
In the past two weeks, 201 drug peddlers have been arrested and have had their drug bases destroyed.
As the country moves to clamp down on those who are introducing the youth to the substances, there is a need to also see to it that those already hooked are assisted.
In countries like South Africa, public health departments have established stand-alone drug centres where the challenges relating to substance abuse are dealt with in isolation.
Perhaps, it could be a path that Zimbabwe may pursue.
