The National Drug Agency, woefully inefficient

Abdulla Easa Fulhu (Esa), is a reputed musician, phenomenal lyricist, and the first Maldivian to have been sentenced for life imprisonment for his involvement with illegal substances. Today, alongside Mohamed Naweez Saleem (Akku), he is one of the two most crucial people leading a charge for the sake of humanity and a large population of Maldivians ostracised and neglected. This is the struggle of an ex addict against the system that failed him and countless others.

The National Drug Agency (NDA) was established over nine years ago, to catch up with the rest of the world in terms of addiction treatment and rehabilitation of substance abuse victims. ‘Catching up’ is used loosely, and the concept was even more disappointing in action. According to Esa, who has given time out of his day to describe the situation as it is today, the NDA is built on policies and operating procedures to match other similar agencies around the world. Yet, he points out with mired frustration, they have failed horribly and continue to do so.

He points out that even within the last two weeks, addicts that he had worked with or known briefly, were found dead due to overdoses. These were people enrolled in the rehabilitation process at some point, but the utter incapability of the agency ultimately led to the demise of these people, and more, Esa points out. Obviously, when dealing with addiction, multiple factors come in to play, yet the agency has not met the base responsibilities that could have prevented such meaningless loss of life.

First and foremost, he is a whistleblower in this scenario. With determination and conviction, and with years of experience and loss to motivate him further, he has been extremely vocal in the reformation protests against the NDA. According to surveys done in 2011 and 2012 by the UN, almost 30,000 individuals are said to be victims of substance abuse in the Maldives. Yet, the number of people being given even the bare minimum treatment falls miles short of this number, and today the numbers are expected to be two fold. 

The facilities are inadequate. The law requires a detox facility, a rehabilitation centre, a half-way housing facility, inclusive of community treatment, a remand centre, and then rehabilitation for both juveniles and women separately, yet in execution, Esa explains, the agency has cut corners. On the floor plan of the facility, the rehabs are assigned tiny squares, yet the construction is inadequate and disappointing. The juvenile rehabilitation centre does not even exist, while the NDA proudly reports delivering juvenile treatment.

His findings indicate that there are SOPs that cover all vital bases, but regardless of whether this is outdated by seven years, the NDA does not seem to give much thought to actually following them. This issue is further worsened by the shift changes at the facility, where regardless of reporting or justification, the head councillor can decide differential treatment on a client without much ado, including forced isolation.

There is no progress record. Rehabilitation is a treatment, and the facility should be run as such, not an incarceration, yet the clients taken in for treatment are only assigned a client number and name. There are no addiction counsellors. There are no vocational or educational classes being conducted. There is no case management, no proper planning of an individual recovery program. Victims of non-addictive and highly addictive substances are grouped together, and treated in the same way. Least of all, there is no indicative assessment done in accordance with WHO standards on inducted clients, which needs to be validated and fully understood by the client. This means the facility continues to operate without having the slightest clue on how far gone someone is in their addiction, or how much work needs to be done to assist recovery.

What’s extremely disheartening is to know that all this, and more, is already on the SOP of the rehab facility as well as in the NDA constitution. Following through has not been considered vital enough by the presidentially assigned board members. 

Coupled with unmonitored, unsupervised diagnosing and prescription, the NDA has been causing victims more harm than good, according to Esa. In the process of exiting the facility, Esa reports he was presented with a form that indicated that he had received the required amount of counselling time, had been given the necessary amount of classes and education, and other such vital services. If he had claimed the truth and not signed that document, he believed he would not be discharged, and he knew everyone else was being pressured to do the same as well.

On the much darker, grimier side, some NDA board members are accused of being swayed by both political and criminal will and influences. There have been instances where clients were allegedly taken out of rehab and presented at political rallies or protests to boost numbers. There have been multiple incidents where certain, high profile dealers and abusers have had their sentences allegedly shortened, or a full repeal, in return for a generous sum divided amongst those involved. This fact is reflected in the news, when certain parties involved with expensive drug busts have been released slightly earlier than expected. 

Now, the board consists of ministry representatives, not the ministers themselves, and on certain occasions the representative person seems to switch around as well. This has definitely hindered moving forward, Esa strongly states. While there has been, after an unacceptable four month vacancy, a new CEO appointed to the Agency who has been working tirelessly to fix the system, the powers that be seem a little too entrenched and immobile to bring about meaningful change.

Another embarrassing fact is how alcohol is not included in the same spectrum as substances being abused, and alcoholism is not treated as an illness. This is only in the Maldives, Esa points out, and this is preposterous given how alcohol is the most prevalent ingredient in substance abuse around the world. Another record held by the Maldives is how this is the fourth country in a list of nations with heroin addiction percentages, which alone should have mobilised all forces to combat this social illness.

Hands Together started off with Esa and his old friend Akku trying to work together with other recovering addicts to fix a system that refused to do better. Now a full fledged movement, they have been vocal and physically present in this struggle, volunteering at rehabilitation centres and shouldering burdens that are not theirs to hold. Their work has been hindered by politically motivated agents, yet they still strive together, hands together, to make sure no one is left behind.

They report that follow-ups with recovering addicts is almost non-existent, with so many slipping-up, so many who are not allowed back into the folds of society, and so many who aren’t even offered employment nor accommodation due to their history. The agency has done little to nothing to rehabilitate and reintroduce these citizens back into society, and this lack of attention has led to multiple deaths that could have been avoided.

With such high victim numbers, the fact that not even a ‘drop-in’ centre for recovery yet exists in the Maldives is irresponsible on the part of authorities. The Fenaka CSR project which is a drop-in centre at Muniufaa was to be completed and operational by the end of November, yet visible work does not meet expected results. 

On top of that, with 13 individuals at the Hulhumalé temporary detox centre, 97 at the Himmafushi DTRC including 1 female under the same roof, and 47 at the Gulhi Falhu Remand Centre, the administrative responsibility for the people lies in shambles. Budgets are drawn up yet the money being spent on the human capital needed to run the services as determined by law has been less than acceptable, according to Esa, which further deteriorates what could have been an effective system. 

In terms of the written rules, the Maldives seems to be catching up with the backend of the world in managing the drug epidemic. In action, a large population is left uncared for, ignored, ostracised, and forgotten, yet the hope still remains. While Esa strives against political pressure and stubborn bureaucracy, people may yet find solace. Hopefully, change is yet to come.