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Tower Hamlets circa 1998 involved,
on the one hand, an ever-increasing heroin smoking problem as
well as increasing crack use amongst young Bengali's while on
the other hand, existing services that were being inundated with
Bengali clients who were ill-equipped and lacked the community
involvement and cultural/spiritual connection with the Bangladeshi
community which is a key requirement for progressive engagement.
Yes, there were time limited, under-funded, Bangladeshi services
that developed diversionary initiatives while acting as a point
of first contact for Bengali drug users. However, drug related
community outreach work as a means of drugs prevention, education
and access to treatment was not widely available. Also, little
work was taking place with the families/partners of users and
there was very little sustained community based prevention work
with the Bangladeshi community as a whole. Education work with
young people was generally felt to be inadequate. What little
was provided wasn't being co-ordinated in a strategic fashion.
There was a general lack of awareness amongst providers in regards
to the Bangladeshi community's social, religious and cultural
needs and orientation. Treatment and support for drug misusers
between 11 and 18 was a major area of need. In addition, despite
the obvious need and size of the community, (the 10 - 17 year
old population of the Borough is made up of 51% Bengali) there
are not enough treatment focused Bengali drug workers in Tower
Hamlets. Lastly, alarming figures from the Tower Hamlets Youth
Offending Team and local drug services, as well as lobbying from
an evolving group of local professionals from youth related projects,
began to highlight the fact that the history of short-term measures
were highly inadequate and that there was an urgent need for change.
This was, in a nutshell, the context
that fuelled the formation, in 1998, of a management committee
in Tower Hamlets that later became known as The Bangladeshi Drugs
Project, BDP. This team was made up of the same concerned locals
mentioned earlier. They came together with the sole intention
to see to it that a culturally specific drug service would be
developed in Tower Hamlets. However, what would be the nature
of this service? What would be its configuration? Also, what did
the community and existing service providers feel about what was
already on offer and what was needed in addition to this?
In order to pull together the necessary
information to inform the model, through consultation with stakeholders
as well as the knowledge base of BME professionals, the BDP drew
on the expertise of consultants from In-Volve, a national organisation
based in the London Borough of Newham. This systematic process
led to the production of the document, 'An inclusive approach
to working with Bangladeshi drug misusers'. The consultation process
and resulting document formed part of the overall effort that
led to the securing of central funding and continues to serve
as a guide and reference point for the ongoing development of
the Nafas service.
The name given to the service, 'Nafas',
was chosen because the root of this word, 'nafs', relates to that
raw energy of basic drives within human beings that must be harnessed
by our intellectual and spiritual self if one is to have self-control
and work for the short/long term good of the self and others rather
than solely individualistic desires. The word 'Nafas' means breath
of life and freedom.
Nafas is a multifaceted specialist
resource established to meet the drug and drug related needs of
primarily the Bangladeshi community in the London Borough of Tower
Hamlets. There are three interconnected components to the service,
outreach, schools and community based education and treatment.
The outreach team, which has always comprised of local Bengali
young people has been able to access networks which other services
would term 'hard to reach' simply because they are of the community.
One of their objectives is to seek out those drug users who have
never been in contact with services before and in the 2 years
of operation they have been highly successful in this. As well
as making contact with drug users the outreach workers also seek
to ensure that the community in general know of Nafas and the
services we provide. Their target is to make contact with 2500
individual per year. We have found that relentless street based
outreach work is critical if we are to ensure that we keep tuned
in to the thoughts and feelings of those who have never made contact
with services before and remain responsive to their needs.
Schools and community based education
work has been taken forward by one male and one female worker.
This is necessary if we are to provide educational services that
can cater for the cultural/religious requirements of the Bangladeshi
community and remain credible. As well as this, in order to be
fully accessible as an education service, there are language considerations.
Many of the community based drug related workshops, particularly
those facilitated for parents need to be conducted in Bengali.
Nafas school based education has become the major drug related
service provider in the Borough completing 250 workshops with
a total participation from 6600 people. Nafas has evolved its
school based sessions away from the mainstream method of simply
informing pupils about the 'facts' regarding particular drugs.
The overriding aspect of Nafas educational work can be seen as
exposing drug related myths within the context of self-exploration.
In this way the educational experience becomes deeper and broader
than simply drugs, taking into account an exploration of attitudes,
beliefs, Identity, love and respect and so on. Other Education/Prevention
achievements include :
· Ocean Estate Parents Against
Drugs (OPAD) educational video in Bengali and English funded by
New deal for Communities.
· The booklet 'Living with a drug user' in English and
Bengali developed in collaboration with ADFAM.
· Bengali and English leaflets on Heroin, Crack and Cannabis.
Another aspect of the education service
that is rooted in the initial consultancy document is Nafas based
training courses. The vision here was for outreach, as well as
other referral sources to pave the way for access to the treatment
service. Treatment, in the form of a day programme with natural
therapies, in-house sauna, talk therapies, groupwork and recreational/social
interventions would work with drug users for up to 12 weeks or
longer in some cases. The after-care element would then include
a training course that would begin to orientate ex-drug users
towards community based work and eventual voluntary work, employment
or further education. We are now at the stage where we are realising
this vision with 5 ex-drug users as well as local non-drug users
gearing up to commence our latest course.
The treatment service in the form
of an individually tailored day programme has learnt many lessons
since it began operating in January 2001. From the first steps
within the infancy of Nafas to the present day it has been necessary,
and no doubt it will remain necessary, for the service to seek
a balance between the needs, wants and expectations of various
sections of the community and services in Tower Hamlets. The vast
majority of our service users are heroin smokers who have been
locked into this activity for approx 1 to 3 years. 18% of these
service users are women. The average age of clients is 18years
old and this has led to the need to evolve our outlook, responsiveness
and mode of treatment. To begin with, the day programme began
as an overly therapeutic treatment model with too many groupwork
sessions and natural therapies such as acupuncture and shiatsu
that were alien and often viewed with suspicion by our target
group. Alterations to the weekly amount of these therapies and
additions of a sauna and recreational pursuits have drastically
raised the level of attraction. Nafas assisted 13 clients to become
drug free and 38 clients to reduce their drug use in the first
year of operation, 01-02. However, a lack of culturally sensitive
residential/detox services has meant that most try to 'make do
with what they've got', often opting to travel to Bangladesh to
pay for private treatment or spending £2500 at UK based
quick fix private detox services. For Nafas these considerations
and others have served to remind us (as stated in our consultation
document) that:
"The service would need to acknowledge that the climate of
need which exists within the Bangladeshi community is constantly
shifting. Thus, the service would also need to be fluid and open
to constant change. The service would need to recognise that it
is within this climate of change that cutting edge performance
should be realised, innovation achieved and the needs of the Bangladeshi
community would be most effectively met."
What makes Nafas different? Certainly from a client viewpoint
it is the style of support, empathy and familial environment that
is made offered and the progress that our clients make. We are
able to interact with those who use our service in a manner that
is in tune with and understanding of their cultural/religious
orientation. Yet we are broad enough to be accessible by those
from other sections of the wider community. We seek to be mentors
to those who use Nafas. Yet we understand that they have much
to teach us. We are able to access and be accessed by mainstream
schools and agencies. Yet we can engage in productive discourse
occurring within Mosques, cultural centres and amongst elders
where culture, religion and language would otherwise be a barrier.
We look forward to the development of similar services in the
UK that can also take part in assisting those who desire assistance.
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