The National Drug Agency (NDA) has defended the accuracy of a recent national survey into the scale of narcotics abuse and addiction in the Maldives, claiming the prevalence model used by researchers was the most efficient method presently available.
Some sources who participated in the survey process have expressed serious concerns about the “flawed methodology” of the data collection process, which they claim produced a final report that was inaccurate and had grossly underestimated the extent of drug use in the Maldives. The NDA has previously refuted criticisms over the drug report’s methodology in a letter sent to Minivan News.
NDA Chairperson and State Health Minister Lubna Mohamed Zahir Hussain has since claimed that on the back of a reduced state budget for its prevention and treatment programs in 2013, the findings would play a key role in helping authorities devise its future strategic action plan.
Lubna’s comments followed the publication by the NDA and the United Nations Office on Drugs and Crime (UNODC) last month of a prevalence survey based partly on primary data obtained from atolls capitals and almost two dozen randomly selected islands across the country. The survey concluded there were a total of 7,496 drug users in the Maldives, with the highest proportion among those aged between 15 and 19 years old.
To gather the findings, the team behind the study said they had used a scientific methodology combining secondary data from the state, such as police and prison services, with survey information gathered from 35 of the country’s inhabited islands.
Representatives from the team involved in compiling the study added that the data provided risked being “skewed” if its researchers had focused specifically on islands with known drug problems, rather than random parts of the country.
The NDA was among one of three key agencies working on the report that also included the (UNODC) and Inova Pvt Ltd – a national research organisation.
Sources who had worked on the report have alleged that the number of drug users identified in the survey was extremely low compared to the number of actual users, claiming that previous studies had estimated that the number of local users ranged between 20,000 and 30,000 people.
The report’s authors contend that there had been little scientific study to confirm such figures beyond anecdotal evidence in the past, with the latest figures better reflecting the scale of the problem in the country.
“Significant drug problem”
Criticisms were also raised by sources involved in the survey process over the scope of testing, which was alleged to have excluded women and the country’s prison population.
The charges were denied by the state organisations and civil society groups behind the report, who added that the latest figures indicated a significant drug problem in the country, with the study providing the first such data of its kind on drug use in the Maldives at a national level.
As part of the methodology used for the report, the survey team told Minivan News that respondents aged between 15 to 64 years of age were questioned across 35 of the country’s inhabited islands.
According to the report’s producers, two islands per atoll were focused on in the study. These included the capital of every atoll and another randomly selected island.
Asked whether such a system could provide an accurate reflection of the number of drug users around the country, the survey team claimed that prevalence studies were favoured by some experts as they allowed for greater control of perceived error limits that might affect the outcome of findings.
A similar methodology used to in the report’s calculations had also used to compile national data for the World Drug Report, according to the research team.
“The methodology [used in the national drug report] is in line with information gathered in the World Drug report. The is the first such information of its kind [for the Maldives],” a member of the team who compiled the report claimed.
“Skewed” figures
A source who has worked in the Maldives NGO sector for the last two years also accused the NDA, UNODC and other stakeholders behind the report of using a methodology that was not relevant to assessing the true scale of drug addiction across the country’s often isolated island communities.
However, a civil society representative involved with the study told Minivan News that the formula used in the report would have been “skewed” if researchers had singled out islands suspected of having more severe levels of drug use and addiction.
Under the same rationing, the survey team claimed that directly including the country’s prison population, 80 percent of whom are claimed to have been imprisoned on suspected drug offences, would again have adversely impacted the formula used to compile its most recent findings.
Rather than omit prison populations entirely, the report’s authors said they had turned to secondary information such as prison data and arrest figures from the police to help “indirectly estimate” the number of drug users using a specially devised methodology.
Researchers behind the survey added that the only other alternative to this model would have been to conduct a census-style test. They claimed such a model would have been too costly for the nation considering the economic challenges facing the country in recent years amidst heightened calls for reduced state spending.
The NDA also added that the study had been independently monitored by the EU and UNODC during the survey period that was conducted across various atolls for a period of two to three months, starting in October 2011. The study period was said to have run for slightly longer in the capital of Male’, according to the research team.
Experimentation
With the findings now released, Afiya Ali, a clinical psychologist working on the study said that the findings had shed new light on the reasons why people were turning to drugs in the country, with young people between 15 to 19 years of age being particularly susceptible.
Afiya said that the findings had indicated that a large number of people turning to drugs in the country found to come from regular backgrounds as opposed to common perceptions of drug takers coming from criminal or troubled backgrounds.
Experimentation was highlighted as a major driver to encouraging young people experiment with alcohol and drugs.
“It is only recently that life skills have been introduced to schools as their has been reluctance from parents and senior figures in the schools to accept these topics,” Afiya explained.
However, she added that that work was being undertaken within the national curriculum, even with young children to indirectly teach them about peer pressure that could lead to such experimentation.
Limitations
The team behind the report told Minivan News that a high level of social stigma among Maldivian females of being associated with drugs had limited the overall effectiveness of understanding narcotics use among women and girls – despite maintaining that users in the country remained predominantly male.
Further study specifically around the amount of females using or addicted to drugs in the Maldives was highlighted by Lubna and the survey team as an area potentially requiring a greater focus in the next few years.
“There will always be limitations to such studies, this include the difficulties in capturing data on females using drugs,” the report authors claimed, adding that similar challenges faced researchers around the world, with drugs widely accepted to be a male-orientated problem.
“There is a social perception that for a guy to be labelled a drug user is less taboo than for a woman. We need to conduct targeted research on women only [concerning drug use].”
Also highlighted among limitations that would impact the final report by the team was the prevalence of drug use among teenagers and children below 15 years of age. However, the NDA claimed that it would be possible to replicate such a study using a similar methodology used in its most recent report.
In terms of the report methodology researchers were sent to 35 of the country’s inhabited islands, where it used four separate questionnaires to try and screen interviewees to ascertain if they may have had experience using drugs
According to researchers these included an initial questionnaire with lighter questions such as whether a respondent knew anyone who had been a drug user. For subjects anticipated of having used drugs, picture cards depicting various drugs available in the country, along with both their English and Dhivehi names, were distributed in order to try to gage familiarity among respondents with the drug scene.
“We had a 90 percent response rate, people wanted to give us information,” said the researchers.
Respondents were also asked to sign a confidentiality agreement and consent form expressing that findings would not be shared with law enforcement authorities, with no individual records said to have been kept.
Future focus
With the report now complete, NDA Chair Lubna Mohamed Zahir Hussain stressed that a heightened focus on corporate social responsibility (CSR) programmes and greater coordination between state and civil society bodies had been highlighted as key aims for its efforts during 2013.
Lubna highlighted “budget difficulties” as a key challenge going forward, particularly in terms of providing placements and work opportunities as part of rehabilitation programmes.
“The budget will be difficult for 2013, so we are looking for possible CSR partners. This is something that we started back in June 2012 with groups like John Keels by providing opportunities in the hospitality sector,” she said.
According to the NDA, thirteen individuals last year undertook the programme, which was based around the food and beverage sector.
Lubna added that authorities were increasingly seeking corporate partners to assist with the programme, not just in terms of providing work experience for recovering addicts, but to also provide potential financial assistance to sponsor placements assisting with the rehabilitation of others.
Providing support to users undergoing Methadone Maintenance Therapy (MMT) was among the key areas where support was being sought, however the state budget was deemed insufficient to do so, according to Lubna.
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