Island of Mauritius - NATReSA

Transcription

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NATReSA
Republic of Mauritius
Patterns & Trends of Alcohol
and Other Drug Use
( PTAODU ) Series
Treatment at Rehabilitation Centres following substance abuse
Methadone Substitution Program
Needle Exchange Program
Control of dangerous drugs
Drug use and HIV
Selected national alcohol consumption indicators
Alcoholic beverages trade
Alcohol-related morbidity and mortality
2010
Island of Mauritius
Volume 6
Port Louis, September 2011
National Agency for the Treatment and Rehabilitation of Substance Abusers (NATReSA),
Max city, 16 Poudrière Street, Port Louis, Republic of Mauritius.
http : //www.gov.mu/portal/site/natresa - email : [email protected]
Patterns & Trends of Alcohol and Other Drug Use (PTAODU) , Volume 6.
2010
Preface
The initiative to set up an information system , The Mauritius Epidemiological Network on Drug Use
(MENDU), was implemented in collaboration with the UNODC in 2001 . This project was a
collaborating effort involving the National Agency for the Treatment and Rehabilitation of
Substance Abusers (NATReSA), Non-Governmental Organizations (NGOs) through their respective
Rehabilitation Centres and other stakeholders in the area of control and prevention of substance
abuse. MENDU was revised in 2007 and a new data collection system was put in place, titled
“Patterns & Trends of Alcohol and other Drug Abuse”, more commonly known as PTAODU. The first
PTAODU volume was published in 2007.
This present documentation covers information for the period January to December 2010. It is the
6th volume of the PTAODU series.
Care should be taken in the interpretation of information related to activities at rehabilitation
centres for treatment following substance abuse. The information should be treated as “reported
statistics” and not as the results of a representative sample study from which inference can be
made about Alcohol or drug use for the whole population of the Island of Mauritius.
Rigorous efforts have been made through the analysis exercise to minimize data collection errors ,
omissions , duplications and other data limitations . The quality of data submitted by rehabilitation
centres still needed considerable improvement.
Consequently, for information related to
rehabilitation centres, limited cross-sectional, patterns and trends analyses have been worked out.
This report is not legitimate as a source of information for legal decisions on matters pertaining to
substance use or abuse rates in the Island of Mauritius or any matter pertaining to such use or
abuse.
Given the HIV concern in Mauritius , especially its link with intravenous drug users (IDUs), and also
given the non-negligible presence of alcohol use and abuse , this report contains in addition,
specific documentations which pay special attention to information on HIV, to the national
methadone substitution therapy program , to the Needle Exchange program [NEP] , to national
indicators on alcohol in Mauritius , to routine information on alcohol treatment in various health
care institutions and to alcoholic beverages production and consumption. A chapter has been
included regarding information on selected drug control activities.
The inclusion of these secondary information suggests that, far from being a comprehensive study
on the subject concerned, this routine report rather aims at being a retrospective and regular
timely documentation on general aspects of substance abuse in Mauritius.
Assistance given by Directors of NGOs gearing the rehabilitation centres, in providing information
for this publication, is gratefully acknowledged. Gratitude is also put on record to all workers in the
rehabilitation centres who, although very taken up with administrative and treatment activities,
have kindly contributed one way or another to the success of the information system operations.
The AIDS Unit, the Harm Reduction Unit and other different units of the Ministry of Health, the Police
Department and the National Methadone Substitution Centre have also important inputs in this
documentation.
2010
Acknowledgments
The National Agency for the Treatment and Rehabilitation of Substance Abusers (NATReSA) is expressing its
deep appreciation to all stakeholders mentioned below and is much thankful to them in providing all
factual information for producing this report successfully.
o
Centre de Solidarité Pour une Nouvelle Vie, Rose Hill.
o
Help De Addiction Centre, Cassis.
o
Mahatma Gandhi Ayurveda Centre, Calebasses.
o
Sangram Sewa Sadan, St Paul.
o
Centre D’Accueil de Terre Rouge.
o
Dr Idriss Goomany Treatment Centre.
o
Etoile D’Esperance, Moka.
o
Lotus , Beau-Bassin Detention Centre
o
Police Department
o
Ministry of Health
o
AIDS Unit
o
Harm Reduction Unit
:
:
2010
Contents
Page
Alcohol & dangerous drugs (highlights)
Rehabilitation Centres
1
Methadone substitution program
1
Drug use , HIV & viral hepatitis
2
Needle Exchange Program
Alcohol
2
2-3
3
Introduction
Methodology
4
5
Constraints and data limitations
5
Situation overview of alcohol use and abuse & dangerous drugs in Island of Mauritius
The network of rehabilitative care
Attendances at Rehabilitation Centres
6-7
8
Age & marital profile of patients
8
Referral sources
9
Treatment cases recorded at Rehabilitation Centres, by primary substances reported
Primary substances used, reported at Rehabilitation Centres, by residential region of patients
9
9 - 10
Inpatient rehabilitative care, psychotherapy
10 - 11
and Methadone substitution
Male rehabilitation in correction centre
12
Female alcohol abuse treatment in specialized rehabilitation centre
12
Control of
13 - 15
dangerous drugs
Drug use, HIV & Needle Exchange Program
15 - 16
Alcohol trade, consumption and abuse
Hospitalization and mortality following consumption of alcohol
17 - 18
18 - 19
Concluding remarks
19 - 21
2010
Page
PART I - Rehabilitation Centres
1 (a)
1 (b)
2
3
Figure 3
4-5
6-7
8
9
Availability and type of rehabilitation centres
Availability and type of rehabilitation centres , by regional level
Infrastructure and availability of rehabilitative services and detoxification
Treatment cases at rehabilitation centres, by sex
Treatment cases at rehabilitation centres, by primary substance used
Treatment cases at rehabilitation centres, by age of patient
Treatment cases at rehabilitation centres, by residence of patients
Treatment cases at rehabilitation centres, by inpatients treatment
Treatment cases at rehabilitation centres, by behavioral & pharmacologic treatment
PART
Figure 4-6
10–12
13-16
7
8
9
10
Figure 11
23
24
25
26
27
28
29
29
- Control of dangerous drugs
Arrests of foreigners for drug offense.
Arrests of foreigners for drugs offences, by substance & international region of origin
Arrests and seizures for dealing & possession of drugs
PART
Figure
Figure
Figure
Figure
II
23
III - Intravenous drug users (IDUs)
31
32
33 - 35
and HIV
Monthly incidence of HIV - January 2009 to December 2010
Annual incidence of HIV and HIV tests carried out - 1987 to 2010
Trend of female HIV incidence - 1998 to 2010
Evolution of IDU incidence - 2000 to 2010
37
Trend of HIV tests carried out among low & high risk groups -
39
PART
2003 to 2010
37
38
38
IV - Alcohol
Figure 9
Figure 12 &
13
Trend of abusive alcohol consumption - 1987 to 2009
Alcoholic beverages trade (Local production , imports & exports)
41
17
Alcoholic beverages trade (Local production , imports & exports)
41
18
Trend of alcohol cases treated as inpatients in Government Hospitals- 2001 to 2010
43
19
Trend of alcohol cases treated as inpatients in Government Hospitals- 2001 to 2010, by cause
44
20
Trend of alcohol cases treated as inpatients in Private Clinics- 2004 to 2010
44
21
Deaths registered in whole Island of Mauritius due to alcohol-related diseases- 1996 to 2010
45
Figure 15
Causes of deaths due to alcohol-related diseases
45
2008 & 2010
41
Alcohol
2010
Island of Mauritius
and dangerous drugs
Highlights
2010
 Rehabilitation Centres
For the last three years 2008, 2009 and 2010, the number of treatment cases recorded at eight
rehabilitation centres , was 1698, 1649 and 1760 cases respectively.
In 2010, among patients known to have undergone treatment at six rehabilitation centres, 97% were
male patients against 3 % females patients.
For male patients known to have benefitted treatment at six rehabilitation centres in 2010 , those using
primarily Subutex accounted for 62% , 21% for those using primarily Heroin , 14% for Alcohol and 3%
for other substances.
Among male patients known to have benefitted treatment at six rehabilitation centres in 2010 , 66%
admitted they started using their respective primary substances when they were aged under 20 years.
However, it was observed that only 3% of those who attended the rehabilitation centres in 2010 for
treatment were aged under 20 years.
In 2010, female patients attended rehabilitation centres mainly for alcohol problems while a nonnegligible proportion of Subutex cases were observed among them and few cases of Heroin as well .
56% of male alcohol patients were from urban residence , 81% of male heroin patients were from
urban residence and 69% of male subutex patients were from urban residence.
Among male patients, only 4% undergone inpatient rehabilitative treatment .
Alcohol was the main reason for male inpatient rehabilitative treatment with 51% of male inpatient
rehabilitative treatment followed by Subutex 36% of male inpatients.
 Methadone substitution program
As at December 2010, 3600 clients were on methadone maintenance, representing 92% of total clients
induced since 2006 through the government methadone program.
As at December 2010, the total clients on methadone maintenance represented a coverage of 36% of
the estimated total Intravenous drug users (IDU) population in the country.
As at December 2010, clients on methadone maintenance were distributed across various government
dispensing points as follows : 51 % were under the mobile caravans service in 7 localities, 20% were
served by the 5 Regional General Hospitals , 12% at Brown Sequard Psychiatric Hospital, 7% at Dr
Bouloux Area Health Centre and 10% at Mahebourg District Hospital.
As at December 2010, considering the methadone mobile caravans service only, mobile points situated
in Port Louis and Pailles combined, absorbed nearly 78% of the total mobile clients . The remaining
22% mobile clients attended mobile points in the district of Plaines Wilhems . Dispensing units located in
the district of Port Louis accounted for 51% of total clients on methadone in the country.
1
2010
 Drug use, HIV and viral hepatitis.
In the Island of Mauritius , for the last four years , the number of newly detected HIV+ cases was 546
cases in 2007, 538 in 2008 , 548 in 2009 and 568 in 2010. As at December 2010 , the total number of HIV+
cases registered since 1987 amounted to 4,787 with around 477 estimated to have passed away.
Newly detected female HIV+ cases in 2010 represented 24% of all newly detected cases with a sex
ratio of 3 new male cases for every new female case. In 1998 it was 1 male per female and was 8
males per female in 2004.
In 2010, intravenous drug users (IDUs) constituted 76% of all newly detected HIV+ cases registered at
the Ministry of Health through the routine HIV surveillance . It was 94% in 2005.
Between 2004 and 2010, annual number of HIV tests carried out, ranged between 11,000 - 23,000 tests
annually among high risk population and between 66,000- 72,000 tests annually among low risk
population. (See Page 37 for definition)
The positivity rate of HIV among antenatal cases, screened through routine tests performed in
public laboratories , was 0.2% in 2007, 0.3% in 2008 , 0.2% in 2009 and 0.3 in 2010,
made on
15,527 , 14,789 , 14,107 and 14348 annual tests respectively .
Based on a national study of the Ministry of Health, the population of IDUs in 2009 was estimated to be
around 10,000 in the Island of Mauritius, 90% were males against 10% females.
Based on the same abovementioned national study, 47% of the IDU population were infected with HIV
and 97% were infected with Hepatitis C. Almost all those who were HIV+ were also infected with
Hepatitis C.
Recent provisional indicators derived from a national study of the Ministry of Health carried out in 2010,
indicated that 29% of the population of female sex worker (FSW) were infected with HIV and that 44%
of them were infected with Hepatitis C.
 Needles Exchange Program (NEP)
In 2010, among all NEP sites , Ministry of Health(MOH) NEP sites constituted 80% against 20% for
NGOs. MOH catered for 89% of clients against 11% for NGOs.
67% of NEP sites (MOH & NGOs) were situated in the urban region.
In 2010, the overall return rate of used needles (MOH & NGOs) was around 80% (90% for MOH and 74%
for NGOs). The national NEP coverage ( MOH & NGO) was 53% of the total estimated IDU population
of the country according to routine service data.
 Control of dangerous drugs
Between January and December 2010, there were 377 arrests for dealing of drugs . Between July 2008
and June 2009, there were 267 arrests for dealing of drugs compared to 422 arrests for July 2007 to June
2008.
Between January and December 2010, there were 1,415 arrests for possession of drugs .
Between July 2008 and June 2009, there were 1,593 arrests for possession of drugs compared to 1,917
arrests for July 2007 to June 2008.
2
2010
For the period January to December 2010, 55% of arrests for drug dealing were related to
Canabis/Hashish, 11% for Heroin, 25% for Subutex and 9% for sedatives.
During July 2008 and June 2009, 63% of arrests for drug dealing were related to Canabis, 25% for
Heroin, 12% for Subutex and 1% for sedatives.
In 2010, 20,247 units of Subutex were seized. There were seizures of 23,140 units of Subutex during
July 2008 and June 2009 compared to 1,978 units of Subutex for period July 2007 to June 2008.
Foreigners arrested for drug offences , between January and December 2010, were from 6 different
nationalities compared to arrests of 14 different nationalities between July 2008 – June 2009.
Between January and December 2010, French represented 50% of 20 foreigners arrested due to
dangerous drug offence, Malagasies (30%), followed by other nationalities accounted each for 5% .
Between July 2008 and June 2009, Malagasies represented 32% of 31 foreigners arrested due to
dangerous drug offence,
French (16%), followed by South Africans (10%) while other nationalities
accounted each for either 7% or 3% .
From January to December 2010, female foreign drug offenders arrested accounted for 20% of all
foreigners arrested for drug offence compared to 32% for period July 2008 and June 2009.
From January to December 2010, 50% of Malagasies arrested were females compared to 60% for period
July 2008 and June 2009.
55% of foreigners arrested from January to December 2010, were found with Canabis/Hashish, 35%
with Heroin 5% with Subutex and 5% with Sedatives .
From July 2008 to June 2009, 55% of foreigners arrested were found with Heroin, 42% with
Canabis/Hashish and 3% with Subutex .
 Alcohol
In 2010 , local production of alcohol beverages figured up to 55,741, 000 litres with beer accounting
for 67% of total local production against 65% in 2009. In 2009, 53,839,000 litres of alcohol beverages
were produced locally.
In 2010, imports of alcohol beverages amounted to 4,781,000 litres while 6,634,000 litres were
exported. In 2009, imports of alcohol beverages amounted to 2,676,000 litres while 4,620,000 litres
were exported.
In 2010, out of 7106 cases treated as inpatients in government hospitals for alcohol, 69% were associated
with alcohol dependence syndrome and alcoholic psychosis , 14% with alcoholic gastritis, 6% with liver
problems and 11% with non-dependent abuse of alcohol or acute alcoholic cases.
In 2010, 46% of inpatients cases treated ( 59% among males, 17% among females) at the specialized
Brown Sequard Psychiatric Hospital were associated with alcohol abuse. Cases treated as inpatients at
the Government Brown Sequard Psychiatric Hospital represented one third of all alcohol inpatient cases
treated at all government hospitals.
In 2010, while female alcohol inpatients were 11% of all alcoholic admissions in Government Brown
Sequard Psychiatric Hospital , the corresponding proportion was 9% in Government General Hospitals.
In 2010, 77% of national alcohol-related deaths registered were associated with liver diseases. In
2010, female deaths due to alcohol was 14% of the national alcohol-related deaths.
In 2009, a national study of the Ministry of Health revealed that 16% of male adults , aged 20 years
and over , consumed alcohol abusively. In 1998 it was 16% as well. Female adults abusive alcohol
consumption prevalence was 0.6% in 2009 and was 0.5% in 1998 . In 2009, overall consumption of
alcohol, whether light or abusive, was 49% ( 66% among male adults and 34% among female adults)
3
2010
Introduction
Several reports in the past have exposed the use of dangerous drugs and abuse of Alcohol in the
Mauritian population and that all social groups are at risk even if the degree of risk may vary from one
group to another.
The most recent popular drugs are Heroin and Subutex (Buprenorphine) amongst
others. Added to these, Canabis , often used as a “soft drug”, is also widespread.
A Rapid Situation Assessment (RSA) on Substance Abuse was conducted in Mauritius in January 2004 by the
Ministry of Social Security, National Solidarity, Senior Citizen Welfare and Reforms Institution with the
technical support of the United Nations Office on Drugs and Crime (UNODC). The RSA revealed that the
main drugs used by the interviewers were tobacco (97%) followed by heroin (96%) and Cannabis (95%)
Drugs which were regularly used by that group remained Brown Sugar (97.0%), followed by psychoactive
substances, Codeine (55%), Buprenorphine (44%), Tramadol (9%), Rivotril (14%) and Rohyphol (22%). Age of
initiation among them was below 18. It also indicated that 60% of them shared needles.
A rapid situation assessment carried out in 2004 among Intravenous Drug Users (IDUs), by the Ministry of
Health & Quality of Life, showed that 95% of Heroin users were using injecting method. In addition, 80% of
the IDUs had ever shared injecting equipments.
In 2009, the population of IDUs was estimated to be around 10,000. Furthermore, infectious diseases were
highly present among IDUs. The 2009 national IDU study revealed that HIV prevalence was 47% among
IDUs, Hepatitis C was 97% among IDUs, while 9% of IDUs were positive with Hepatitis B.
In 2010, routine surveillance statistics of the Ministry of Health and Quality of Life showed that 76% of new
HIV+ cases detected were IDUs.
On the other hand, according to national Non-Communicable Diseases (NCD) surveys of the Ministry of
Health, alcohol is consumed by a large number of male Mauritians (66% in 2009) and seems to be an integral
part of the Mauritian social life. A significant proportion of male drinkers consume alcohol abusively (16% in
2009) and the consequences have been evoked in different other reports , namely , serious morbidity
conditions, domestic violence, crimes including sexual offences and road traffic accidents amongst
others.
In its strategy to reduce risk factors of cardiovascular diseases and also to reduce other health and social
problems resulting from abuse of alcohol, Government has passed on regulations under the Public
Health Act Regulations 2008 for prohibition on advertisement, sponsorship , restriction on sale and
consumption in public places of alcoholic drinks. These regulations came into operation in March 2009 and
a severe fine has been prescribed for those who would commit offence by contravening such regulations.
Similar regulations are also operative for tobacco sale and consumption as from 2008.
4
2010
Methodology
This documentation is the 6th volume on Patterns and Trends of Alcohol and Other Drug Use in Mauritius.
The documentation has been organized in four parts. Information in Part 1 is based on data submitted
by the rehabilitation centres listed below :
I.
II.
III.
IV.
V.
VI.
VII.
VIII.
Sangram Sewa Sadan, Saint Paul,
Centre d‟Accueil de Terre Rouge,
HELP De Addiction Centre, Cassis,
Dr Idriss Goomany Treatment Centre, Plaine Verte,
Centre de Solidarité Pour une Nouvelle vie, Rose Hill,
Etoile d‟Espérance, Moka,
Mahatma Gandhi Ayurveda Centre, Human Service Trust, Calebasses,
and Lotus, at Beau Bassin Prison.
All the above centres are Non-Governmental Organisations helping in treatment and rehabilitation of
substance abusers that are working in collaboration with NATReSA, and which offer help advice and
information about a wide range of issues including Alcohol/drugs problems and related aspects.
Part 1 of this report has been developed upon the use of a standard questionnaire completed at the level
of each rehabilitation centre. All the indicators for Part I of this report are based on information related to
characteristics of cases reported at rehabilitation centres for treatment following substance abuse. Thus
the information is essentially of “reported” nature and not the results of a representative sample study
from which inference can be made about Alcohol or drug use for the whole population of the Island of
Mauritius.
Part II to Part IV
related issues.
of the documentation are considered as secondary information on alcohol and drug
Part II is about information on selected activities of the Police Department in the area of drug
control.
Part III develops a general overview of the trend of HIV AIDS in the country with emphasis on
intravenous drug users (IDU) using routine service statistics and a few national survey figures.
Part IV is an outline of alcohol issues in Mauritius, namely ; production, consumption, and its
impact on health status of individuals and on the health care system . This is presented through
official routine statistics and also through national survey-based indicators.
Constraints and limitations of data submitted by rehabilitation centres
Rigorous statistical data cleaning has been performed to minimize problems associated with database
management. While remarkable efforts have been deployed by rehabilitation centres to provide the
data, the quality of data submitted still needed considerable improvement . The various data difficulties
encountered were ; large duplication of records, missing data , absence of completeness, inconsistent
data and bias answers amongst others.
The proportion of questionnaires with no National Identity Cards ( NIDs ), incomplete NIDs and errors in
NIDs was substantial , such that the use of NIDs as unique identifier was not possible . This situation has
complicated database management exercises as a whole. Consequently, in Part 1, some analyses with
cross-sectional dimensions showing association and other patterns and also trends analyses have been
avoided. Data have been analyzed only for patients whose National Identity cards were available and
thus all analytical information in Part I relate to “patients known to have undergone treatment ” within six
abovementioned rehabilitation centres participating to this annual exercise.
Data are given separately for two other centres ; one treating male inmates of a correctional institution
and the second one specialized in the rehabilitation of female alcoholic patients.
5
2010
Island of Mauritius
Alcohol and dangerous drug in 2010
Situation overview
This documentation attempts to describe the pattern of alcohol abuse and use of dangerous
drugs in the Island of Mauritius for the annual period January to December 2010. The
documentation has been structured in four Parts. Part I is based on information related to cases
reported at rehabilitation centres affiliated to the National Agency for the Treatment and
Rehabilitation of Substance Abusers ( NATReSA ) . Part II to Part IV of the documentation are
considered as secondary information on alcohol and drug.
Part II is about information on the Police Department selected activities in the area of drug control.
Part III develops a general overview of the trend of HIV AIDS in the country with emphasis on
intravenous drug users (IDU) using mainly routine service statistics and a few national survey figures
from the Ministry of Health & Quality of Life. Part IV is an outline of alcohol issues in Mauritius,
namely ; trade, consumption, and its impact on health status of individuals and on the health care
system . This is presented through national survey-based indicators and also through official routine
statistics.
For Part I of this present review , out of 13 rehabilitation centres collaborating with NATReSA, in the
Island of Mauritius, only 8 centres participated to this annual data collection and analysis
exercise and analyses are carried out only for six centres and for two other centres some basic
tables are presented due to the nature of their respective data collection constraints.
Regarding Part 1 of this documentation, while committed efforts and remarkable generosity have
been deployed by rehabilitation centres to provide the information, the quality of data submitted
still needed considerable improvement. As a result, due to data limitations and constraints as
already explained in the methodology section, most indicators in this present documentation are
indicative and give a reflection of the general tendency.
The different forms and sources of information integrated in this review make this present paper a
documentation on aspects of drug use and alcohol abuse prevailing in the country. The inclusion
of these information suggests that, far from being a comprehensive study on the subject
concerned,
this routine report rather aims at being a retrospective and regular timely
documentation on aspects of substance abuse. These information are expected to be useful for
planning and the strategies to be adopted, as well as for program orientation. Social workers, as
well as the public in general, will also find in these information, stones they would wish to add to the
edifice of substance abuse prevention.
The network of rehabilitative care and availability of services
In Mauritius, the rehabilitation system comprises of 3 phases, namely, the first contact as the 1 st
phase, secondly the treatment process which consists of medical treatment, counseling,
occupational and recreational activities and thirdly the follow-up and aftercare which includes the
psycho-social support.
6
2010
Alcohol detoxification is essentially provided by the Government General Hospitals and the
Government Brown Sequard Psychiatric Hospital. Psychosocial support and follow-up of many of
these patients is ensured by treatment and rehabilitation centres funded by NATReSA. A
comparatively small proportion is done in the private sector. Substitution therapy of narcotic
drugs clients is maintained under a network of Methadone dispensing units, headed by a
National Methadone Substitution Centre. Still many other substances abusers who opt for drugfree treatment call at those treatment and rehabilitation centres which provide a panoply of
services to them.
Availability of rehabilitative care
In 2010, the network of rehabilitative treatment around the Island of Mauritius, continued to offer a
range of infrastructural services , namely ; day care services, residential stages, exclusive female
alcoholic rehabilitative treatment and rehabilitative care within a detention centre amongst
others.
For a total of nine rehabilitation centres, out of the 9 districts of the Island of Mauritius, there were
only 5 (56%) districts with at least one rehabilitation centre. The four districts without any
rehabilitation centre were; Rivière du Rempart, Flacq, Grand Port and Savanne, all four being rural
districts.
Apart from the abovementioned nine centres, in 2010, there was one more centre in the district of
Port Louis, treating both males and females for alcohol and drug use . In Mahebourg, in the district
of Grand Port, a group of volunteers a few years back started an initiative to welcome patients in
view of rehabilitation but this group was not yet delivering full-scale rehabilitative treatment and
was contributing to direct patients towards specialized centres , specially for Methadone therapy.
Drug abuse substitution Centres ( Methadone)
As at December 2010, government infrastructure for the national Methadone substitution
program , consisted of a national substitution centre in the district of Plaines Wilhems , one day
care centre in the district of Grand Port, 5 Methadone dispensing points at the level of Regional
General Hospitals situated in five districts, namely, Port Louis, Pamplemousses, Plaines Wilhems,
Grand Port and Flacq. Methadone dispensing services were also available at the Government
Brown Sequard Psychiatric Hospital in the district of Plaines Wilhems, the Bouloux Area Health
Centre in the district of Port Louis and finally through mobile caravans substitution services in
selected targeted localities situated in the district of Plaines Wilhems and Port Louis. See Table 2
on Page 24 and map on page 25.
Within a period of two weeks , the National Substitution Centre on average registered 45
patients‟ discharges following Methadone substitution residential care . Patients obtained
discharges on stable Methadone dose and were recommended to be on a minimum of 6
months maintenance, taking their daily doses in the morning at the nearest convenient dispensing
point. An account of the Methadone substitution system and its performance in Mauritius as at
December 2010 , is given in a further section on page 11.
Detoxification Centres (Alcohol )
Medical treatment for alcohol abuse and alcohol detoxification were performed essentially at the
Government Hospitals . In 2010, inpatients alcohol medical treatment or detoxification at the
private clinics accounted for only 4% of both government and private sector cases combined.
7
2010
Attendances at rehabilitation centres
In contrast to the previous years, the 2010 analyses were patient-based oriented instead of
focusing on treatment cases which normally include re-entries and follow-up cases and usually
do not allow appropriate examination of the characteristics of patients.
In 2010, based on patients for whom the national identity card numbers were available, data
were available for only six rehabilitation centres and a total of 1301 patients were known to have
undergone rehabilitation treatment within these six centres .
However regarding treatment cases including possible re-entries or follow-up cases, data
submitted by eight rehabilitation , in 2010, suggested that the trend for the period 2007 to 2010,
ranged roughly between 1600 and 2000 cases annually. 97% of patients know to have
received rehabilitative treatment were males against 3 % female patients.
Age and marital profile of patients at rehabilitation centres
Among 1,258 male patients known to have undergone rehabilitation treatment , 86% were in the
age group 20 - 49 years, while 9% were aged 50 – 59 years. Males aged under 20 years
represented 3% and those aged 60 years and over accounted for 2%.
Out of 175 males reported for treatment linked to primary abuse of Alcohol, 35% were in the
age group 40 – 49 years, followed by those aged 30 – 39 years (30%), 50 – 59 years (21%), 20 29 years ( 8%) , 60 years and above represented 3% and less than 1% for no stated age.
Within a reported total of 266 males using primarily Heroin , 42% were in the age group 30 – 39
years, followed by those aged 20 – 29 years (29%), 40 – 49 years (15%) , 50 – 59 years (3%) and
less than 1% for no stated age.
Among 782 males reported for using primarily Subutex , 36% were in the age group 30 – 39
years, followed by those aged 20 – 29 years (32%), 40 – 49 years (21%), and 50 -59 years ( 9%) .
29% of male patients asserted that they started using the primary substances reported when they
were aged under 15 years. 37% started between 15 and19 years, 23% started between 20 and
29 years, 7% started between 30 and 59 years and 4% no stated age.
Among male Subutex patients , 70% started using Subutex for the first time when they were
still under 20 years. 14% of male alcohol patients reported they started consuming alcohol under
the age of 15 years and 45% for those who started under 20 years .
30% of male Heroin patients started with Heroin when they were aged under 15 years while it
was 68% for those having started under 20 years .
Overall, 66% of male patients asserted they started with their respective primary substances
reported when they were under 20 years.
8
2010
Treatment recorded at rehabilitation centres, by primary substances reported
With the same pattern as for previous years , in the year 2010, male treatment cases recorded at
rehabilitation centres revealed that Subutex , Alcohol and Heroin remained the three major
primary substances used. These three primarily used substances represented roughly 97% of all
primary substances reported for treatment cases recorded.
In 2007 and 2008, there was an indication that Heroin was the leading primary substance reported
at rehabilitation centres followed by Subutex and Alcohol , both at rather the same level. In
2009, Subutex was the most popular primary substance reported at rehabilitation centres with
around 45% of treatment cases recorded, then came Alcohol with 27% cases and in third place
Heroin accounting for 24%.
In 2010, based on male patients known to have undergone rehabilitation treatment, Subutex was
once again the most prevalent primary substance reported at rehabilitation centres with around
62% of patients, followed by Heroin 21% and Alcohol with 14%.
Primary substances used , reported at rehabilitation centres, by residential region of patients
As for the previous years, in 2010 patients seeking rehabilitative treatment converged to
rehabilitation centres from all geographical parts of the Island. Based on treatment cases
recorded at rehabilitation centres, the use of drugs and abuse of alcohol , as in the past, were yet
again most popular for urban clients , characterized by the two urban districts, namely , Port
Louis and Plaines Wilhems.
It is also worth noting that the district of Pamplemouses was the most concerned rural district. This
can be explained partly by accessibility , availability to treatment centres and by the fact that
this district lies at the periphery of the district of Port Louis which itself was the second most
important area in terms of high attendances at rehabilitation centres. In fact , in 2010 , based on
patients known to have undergone rehabilitation , patients residing in Port Louis and
Pamplemousses combined , represented around 37% of treatment cases recorded , that is, just
above one third of all cases recorded at all centres.
Among the nine districts of the Island of Mauritius, Plaines Wilhems was the district of residence
most popularly reported , accounting for 40% of all male patients who visited rehabilitation
centres. In second position , was male patients residing in Port Louis district , accounting for 29% ,
followed by Pamplemousses district with 9% and the remaining six districts accounted each
for 3% to 5% of patients . On the other hand, 69% of male patients were from urban region
against 31% from rural region .
As regards pattern of primary substances reported by district of residence of patient, for the
period January to December 2010, 38% among male patients with primarily Alcohol problems
reported that their district of residence was Plaines Wilhems, followed by Port Louis with 18% ,
Flacq with 9%, Pamplemousses, Rivière du Rempart , Moka and Black River each with around
5% to 7% and finally Grand Port district with 2%.
Most of the male patients with primarily Heroin problems reported Plaines Wilhems (61%) as their
district of residence,
followed by Port Louis (20%), Grand Port (8%), Port Louis (6%) and the
remaining five other districts of residence accounted each for 1% - 2 % of total Heroin patients.
9
2010
35% of male patients who used Subutex primarily, reported Port Louis as their district of
residence,
followed by those who reported Plaines Wilhems (34%), Pamplemousses (11%),
Black River (5%) and the remaining five other districts of residence accounted each for 2% - 4 % .
Mauritius being a small Island of 2000 km2 with a high population density of 667 inhabitants per
square kilometer , thus , most social phenomenon can be expected to stretch , proliferate and
vary sporadically throughout the different geographical areas. Drug use , as well, is not an
exception to the rule. In 2010, drug use and alcohol abuse were present in almost all regions of
the Island. The severity at which different localities were affected varied obviously ,
as
commonly known, for various economic and social reasons.
Alcohol abuse was both an urban and rural scourge. Heroin was definitely an “urban” drug
although its use in the rural region was not negligible. Subutex also was predominant in the urban
region while being significantly present in the rural region.
Type of treatment and services delivered (Inpatient, psychotherapy & Methadone)
Inpatient rehabilitative care managed by rehabilitation centres
As in the previous years, a proportion of rehabilitation centres offered both outpatient and
inpatient treatment , but inpatient rehabilitative treatment as a whole, was still a marginal
service and its availability or utilization remained quite rare, at least for male cases. In 2010,
for instance, out of 1258 male patients only 49 (4%) went through inpatient care within
rehabilitation centres .
Among the abovementioned 49 inpatients rehabilitative cases, Alcohol inpatient cases
accounted for 51%, Subutex inpatient treatment represented 36% and Heroin inpatient cases
was 10%.
Pharmacological and behavioral treatment
The main therapies employed were ; counseling by staff, psychosocial support by psychologists,
substitution therapy, detoxification and traditional medicine.
Within rehabilitation centres , based on patients known to have undergone rehabilitation
treatment, around 81% were referred for detoxification. There was on the other hand, an
indication that most centres managed to maintain a counseling performance through either
group or individual psychotherapies, with 88% patients reported to have undergone counseling.
Most centres admitted the determinant role of individual counseling in the rehabilitation process
, but they complementarily performed counseling in group and had even privileged
involvement of friends, acquaintance and family in the rehabilitative process. Some centres
are in favor of a qualitative assessment of behavioral treatment instead of quantitative
evaluation , arguing that generally complex multifaceted underneath works
are often
tactfully carried out to reach acceptable results.
Among the reasons evoked for clients not attending psychological support were ; taken by
work, transport difficulties, fear following use of illicit drugs, relapses and those who were
naturally or perhaps psychologically or socially ,
not motivated and not interested in
psychological support.
10
2010
Methadone substitution program
In the need to reduce harm of drug use , Methadone as a maintenance treatment is now
clearly recognized worldwide , namely in preventing opioid withdrawal , in reducing or
eliminating drug cravings. The use of Methadone has become determinant in protecting health
of people who use opioid drugs regularly and who are infected with HIV or hepatitis C while
reducing the risk of spreading infection through needle sharing.
In Mauritius , following the HIV epidemic shift from heterosexual to injecting drug use in 2002, an
action plan was worked out by governmental and non-governmental stakeholders to prevent the
spread of the disease. The action was constructed on three strategic pillars namely; supply
reduction, demand reduction and harm reduction.
The components of the demand reduction strategies have been set out as ; primary prevention,
medical detoxification and social reintegration. In this context, Methadone in the rehabilitative
care , as a maintenance treatment , was expected to play a fundamental role in both demand
and harm reduction strategies to help the patients avoiding dangerous drugs and to reduce the
use and sharing of contaminated injecting equipment.
Backed by the National Aids Committee in April 2006, the Methadone substitution therapy started
in November 2006. The initial objective was to reach 3000 Methadone clients , starting gradually
in 2007 with 500 then moving to 1500 and then to 3000 by 2009-2011.
Based on information available at the level of substitution centres, as at December 2010, there
was an indication that the abovementioned target of 3000 clients on Methadone maintenance
has been attained. In fact, as at December 2010, 3600 induced methadone patients were
registered while an estimated 92% of the induced patients were on maintenance.
In 2010, the distribution of clients on Methadone maintenance by government dispensing points ,
was as follows; 51% for the mobile caravans, 20% for the five Regional General Hospitals , 12%
for Brown Sequard Psychiatric Hospital,
7% for Bouloux Area health Centre and 10% for
Mahebourg District Hospital .
Within the mobile caravan methadone service points , clients on Methadone maintenance
were distributed as follows; Plaine Verte accounted for 24%,
Saint Croix 31% , Vallée Pitot
12%, Vacoas 11% , Rose Hill 10%, Pailles 5% and Plaine Lauzun 6%. It is to be noted that
, as at December 2010, the number of clients on Methadone maintenance sustained by mobile
caravans at Plaine Verte and Sainte Croix , both combined, represented 28 % of total clients
at all dispensing points in the Island of Mauritius.
Figure 1
Island of Mauritius
Distribution of Clients
on methadone maintenance
at dispensing units
as at December 2010
Government Regional
General Hospitals
20%
Mobile
caravans
51%
District Hospital
10%
Bouloux Area Health
Centre 7%
11
Government
B. Sequard Psychiatric
Hospital
12%
2010
Male rehabilitative services in correctional institution
In 2010, 79 male rehabilitative treatment cases were reported in a correctional institution,
through its drug rehabilitation unit. 1% of these treatment cases were related to patients
aged less than 20 years, 46% for age group 20 – 29 years and 53% for those in the age group
30 years and above.
Regarding marital status, 44% were associated with single patients, 20% married, 29% in a
union and 6% divorced or separated . The age at first use of drugs was reported to be
under 20 years for 77% of cases .
Subutex was the most popular drug reported as primary substance used, with 73% of cases
followed by Canabis , 19% and Heroin with 8% of cases.
In 2010, 94% of the treatment cases in the correctional institution have ever had HIV tests
with an overall positivity rate of 52%.
Female specialized alcohol abuse rehabilitative care
In 2010, 161 female treatment cases were reported in a specialized female alcohol abuse
rehabilitation centre. 6% of the reported cases were associated with women aged less
than 30 years, 32% in the age group 30 – 39 years , 31% in the age group 40-49 years, 27% in
the age group 50-59 years and 4% for 60 years and above.
There was indication that most of the abovementioned women seeking rehabilitative
treatment following alcohol abuse were married (55% of cases). Other marital status were
distributed as follows ; 15% for widowed, 13% for divorced / separated, 9% for single and 7%
for those in a union. In short , 91% of these women somehow have ever had a living
partner.
Nearly 60% of the abovementioned cases treated came from the urban region against 40%
rural areas and most were primarily referred for rehabilitative treatment following hospital or
clinical care (43%) . The secondary referral source was by family support , thirdly by social
and religious organizations . Around 5% only were cases referred by friends.
Regarding the period they started consumption of alcohol , 75% of cases were related to first
use of alcohol under 20 years of age.
12
2010
In its ongoing fights against dangerous drug trafficking , government passed on a new law
related to drug problem in the year 2000 , the “Dangerous Drug Act 2000” . The objective was to
further discourage individuals to get involved in drug trafficking . This law was amended in 2003 to
enhance control on sale, manufacture and store of dangerous drugs. Furthermore the amended
law aimed at strengthening collaboration between local and international authorities.
International passenger traffic
Arrivals of passengers from abroad (excluding inter islands traffic) amounted to 1,226,428,
1,156,579 and 1,252,038 for the years 2008, 2009 and 2010 respectively.
In 2010, out of the 1,252,038 arrivals, there were 934,827 tourist arrivals representing 74% of all
arrivals. The distribution of category of tourist arrivals was as follows ; 92% for visitors on holidays, 3%
for visitors on business , 0.6% were in transit , 0.4% for visitors on conference, 0.2% for sports, and
3% not stated type of tourist arrivals.
In Mauritius, in 2010, arrivals by air accounted for 96% (1,202,351) against 5% (49,687) by sea.
Mauritian residents arrivals by sea constituted only 2% of all sea arrivals ( excluding crews).
For the same period January to December 2010, among tourist arrivals , based on country of
residence, European tourists represented 65% , with mainly French, British , Italian, German and
secondarily Austrian, Belgian , Dutch, Spanish, Swedish , and Swiss amongst others .
African tourist arrivals accounted for 24% , with mainly South Africans and residents from Reunion
Island and secondarily with Malagasies and residents from Seychelles .
Asian represented 8% of tourist arrivals with mainly Indians and Chinese and secondarily with
residents from United Arab Emirates , Singapore, Malaysia , Japan and Hong Kong amongst others.
America and Oceania tourist arrivals combined, contributed to 3% of tourist arrivals .
Arrest of foreigners
During the period January to December 2010,
there has been regular monthly arrests of
foreigners for dangerous drugs offences, except in May and September. For the same period,
monthly arrests of foreigners ranged from 1 to 4 arrests per month . Female offenders were 20%
of all foreigners arrested.
Regarding nationality of foreigners arrested, offenders were from 6 different nationalities . French
accounted for 50% of foreigners arrested ,
followed by Malagasies (30%) and the remaining
20% were German, Italian , Swiss and Indian. Malagasies were mostly females and were involved
in mainly Heroin while French , being essentially males , were involved in Canabis / Hashish.
55% of foreigners arrested for dangerous drugs offences were involved in Canabis / Hashish
while 35 % were involved in Heroin, 5% for Subutex and 5% for sedatives.
13
2010
Arrests for drug dealing
For the period January to December 2010,
377 arrests were registered for dealing of drugs
compared to 267 arrests for the period July 2008 to June 2009 and 422 arrests for the period
July2007-June2008.
During the period January to December 2010, 203 arrests (53%) for dealing of drugs were related
to Canabis , 96 arrests for Subutex (25%), 42 arrests ( 11%) for Heroin, 33 arrests (8%) for sedatives
and 3 arrests for Hashish.
During the period July 2008 to June 2009, 168 arrests (63%) for dealing of drugs were related to
Canabis , 67 arrests (25%) for Heroin , 31 arrests (12%) for Subutex and 1 arrest for sedatives.
The corresponding arrests for dealing of drugs in the previous period July2007-June2008
amounted to 266 arrests for Canabis(63%), 137 arrests for Heroin(32%)
and 19 arrests for
Hashish(5%).
Dealing of drugs and Seizures
For the period January to December 2010, in connection with dealing of drugs , 11.1kg of
Cannabis , 3.7kg of Heroin , 20247 units of Subutex , 19317 units of sedatives and 0.1 kg of
Hashish were seized.
For to the period July 2008 to June 2009, in connection with dealing of drugs , 7.0 kg of Cannabis
, 7.9kg of Heroin 418 units of Subutex and 12 units of sedatives were seized compared to the
period July2007-June 2008 with seizures of 25.1 kg of Cannabis, 10.7 kg of Heroin and 24.2 kg of
Hashish.
Arrests for drug possession
For the period January to December 2010, there were 1415 arrests registered for possession of
drugs compared to the period July 2008 to June 2009 with 1593 arrests and 1917 arrests for
period July 2007 to June 2008.
During the period January to December 2010 , 577 arrests (40%) for possession of drugs were
related to Canabis , 564 arrests (39%) for Subutex , 165 arrests (11%) for Heroin , 99 arrests (6%)
for sedatives , 8 arrests for methadone and 2 arrests for Hashish.
During the period July 2008 to June 2009, 546 arrests (34%) for possession of drugs were related
to Canabis , 831 arrests (52%) for Subutex , 137 arrests (9%) for Heroin 70 arrests (4%) for
sedatives and 9 arrests for Hashish. The corresponding arrests for possession of drugs in the
previous period July2007-June2008 was 619 arrests for Canabis(32%), 507 arrests for Heroin(26%)
, 418 arrests for Subutex (22%), 281 arrests for Opiods (15%) , 70 arrests for sedatives(4%) , 21 arrests
for Hashish ( 1%) and 1 arrest for Ectasy.
The corresponding arrests for possession of drugs in the previous period July2007-June2008 was
619 arrests for Canabis(32%), 507 arrests for Heroin(26%) , 418 arrests for Subutex (22%), 281
arrests for Opiods (15%) , 70 arrests for sedatives(4%) , 21 arrests for Hashish ( 1%) and 1 arrest for
Ectasy.
14
2010
Drug offences reported
According to Economic and Social Indicators of the Central Statistics Office, for the years 2008,
2009 and 2010 , there were respectively 4156, 4081 and 3839 drug offences registered by the
Police Department, giving offence rates of 4.4 per 1000 adult population aged 15 years and
above in 2008,
4.2 per 1000 in 2009 and 3.9 per 1000 in 2010. On the other hand, in 2010,
out of 3687 prison convicts , drug offenders represented 17%.
Drug use and HIV
Intravenous Drug Users (IDUs)
The changing configuration of drug use from smoking to injecting of drugs has given rise to heavy
outbreaks of HIV infection among intravenous drug users, their sexual partners and children.
In 2009, a national study of the Ministry of Health and Quality of Life , revealed that the population
of Intravenous Drug Users (IDUs) was estimated around 10,000 with 90% males against 10%
females. The prevalence of HIV among this population was 47% while prevalence of Hepatitis C
was 97%. The study also showed that prevalence of HIV+ among the male homosexual
population was 8% and was 29% among the population of female sex workers .
From routine reported statistics of the Ministry of Health , the percentage of newly detected HIV
infected intravenous drug users (IDU) on total newly detected HIV cases reported in Mauritius,
was 20% in the year 2000, then increased to 86% in 2003 and continued to increase to reach a
peak of 94% in 2005. From 2005 there has been a constant decrease to 76% in 2010.
Routine HIV tests
From the year 2004 to 2010, the number of HIV tests carried out annually has been around 11,
000 – 23,000 tests among the high risk group, which comprised prison inmates, sex workers, drug
users and tuberculosis patients amongst others.
For the same period, the annual HIV tests carried out ranged between 66,000 – 72,000 tests yearly
among low risk group , i.e, blood donors, pregnant women, dialysis patients, cardiac surgery
patients, outgoing citizens requesting visa amongst others.
The positivity rate of HIV observed through routine tests performed in public laboratories , was
0.66% in 2008 , 0.67% in 2009 and 0.69% in 2010, made on 84,435 , 83,350 , and 84,432 tests
respectively.
15
Routine HIV
2010
surveillance
The monthly average number of newly detected HIV cases reported per month was 45 cases for
the year 2008 , 46 monthly cases for 2009 and 47 monthly cases for 2010. The annual number of
newly detected HIV+ cases registered, was on average 542 new annual cases for the three
years 2006, 2007 and 2008. In 2010, 568 newly detected cases were registered against 548
cases in 2009.
A sharp rise was observed for reported HIV/AIDS cases in Mauritius as from 2003 and was most
likely depicted due to the increased HIV testing carried out, particularly among IDUs in various
institutions (prison, rehabilitation centres, outreach services)
Since October 1987, when the first case of AIDS was registered, the total number of HIV/AIDS
cases detected, up to the end of December 2010 in Mauritius, amounted to 4,787 ( 3,862 males
and 925 females ). 477 Mauritians registered as HIV/AIDS cases were known to have passed away
since 1987.
Female HIV cases
The percentage of annual newly detected female HIV cases decreased from 44% in 1998 to 12%
in 2004. However, annual increase in the percentage of new HIV female cases detected was
observed as from 2005 to reach a figure of 24% in 2010 .
The sex ratio (males per female) of registered newly detected HIV+ cases was 1 male per female
in 1998 then increased to 8 males per female in 2004 followed by a constant decrease up to 3
males per female in 2010. The positivity rate of HIV among antenatal cases screened through
routine tests performed in public laboratories , was 0.2% in 2007, 0.3% in 2008 , 0.2% in 2009
and 0.3 in 2010. Tests were made on 15,527 ,
14,789 , 14,107 and 13,512 subjects in 2007,
2008 , 2009 and 2010 respectively .
Needle Exchange Program [ NEP ]
Needle exchange schemes provide access to sterile syringes and other injecting equipment to
reduce the risk of intravenous drug users (IDUs) coming into contact with other users' blood. There is
clear evidence that needle exchange programs (NEP) have reduced HIV transmission rates
among injecting drug users in areas where they have been established. The World Health
Organization (WHO) released a report in 2004 that reviewed the effectiveness of needle exchange
programs in many countries, and examined whether they promoted or prolonged illicit drug use.
The results produced convincing evidence that needle exchange programs significantly reduce
HIV infection, and no evidence that they encourage drug use.
In Mauritius, the HIV epidemic which started in 1987 with intensification around 2002 is actually
classified as concentrated with the IDU population as a significant contributing factor in HIV
transmission. This situation led the country policy decision makers to adopt the HIV and Aids Act in
2006 to enable implementation of a Needle Exchange Program (NEP) as part of a harm reduction
strategy together with the previously described Methadone Substitution Program .
In Mauritius, the NEP is sustained both by NGOs and by the Ministry of Health (MOH) through its
Aids Unit and the Harm Reduction Unit . By June 2010, MOH services accounted for nearly 80%
against 20 % for NGOs in terms of the number of NEP sites operated.
16
2010
The MOH‟s NEP functions with mobile caravans geared by nursing officers and assisted by
health care assistants . The essential services are ; provision of clean injecting equipment for a
whole week, return of used ones, counseling, HIV testing , referral , condoms distribution,
preventive education. Daily activities are run from Monday to Friday with morning and afternoon
sessions. In 2010, out of 35 NEP sites of MOH , 37 % was in Port Louis, 29% in Plaines Wilhems, 14%
in the northern region, 11% in the south east region and the remaining 9% in the eastern and
western region. 20% of these 35 sites were serviced with additional support of peer leaders.
Regarding functioning of NEPs by NGOs, in 2010, 8 sites were in operation on a daily basis.
These NGOs‟ programs were operating under the aegis of the Ministry of Health in term of
provision and control of materials by its NEP section.
In 2010, the total number of clients reached was around 5300 (53% of the estimated national IDU
population) with 89% for the Ministry of Health against 11% NGOs „ clients . The monthly
number of syringes supplied, both by MOH and NGOs , turned around 35,000 – 40,000. Based on
2009 data, the overall return rate of needles was 80% ( 90% for NGOs and 74% for MOH)
HIV tests carried out among clients within the Ministry of Health NEP in 2009 , among selected
574 subjects , revealed a positivity rate of 15%. The national IDU survey of 2009 showed an HIV
prevalence of 47% among the IDU population.
Alcohol
Alcohol beverages trade
In 2010 , imports of alcohol beverages amounted to 4, 781,000 litres while 6,634,000 litres were
exported. The local production of alcohol beverages figured up to 55,741, 000 litres with beer
accounting for 67% of total local production against 65% in 2009.
Imports of alcoholic beverages added to local production after exports, amounted to 53,888,
000 litres in 2010 against 51,915,000 litres in 2009 which gave a per capita of 113 litres of
alcohol beverage per male aged 15 years and above in 2010 or a per capita of 55 litres per
population aged 15 years and above .
Alcohol in the monthly family consumption expenditure
According to the official Household Budget Report 2007, out of the total local sales of alcoholic
beverages and tobacco, 80% were consumed by households. The report showed that
household monthly expenditure on alcoholic beverages and tobacco as a percentage of
monthly total household consumption expenditure , was 9% in 2002 and 10% in 2007.
It was also demonstrated that, regarding average monthly consumption expenditure , alcoholic
beverages and tobacco ,as an item , was ranked in 4 th position of importance of monthly
expenditure just after food, secondly transport and thirdly household utilities like water, electricity,
housing , gas and fuel.
17
2010
Alcohol use and abuse
According to the 2009 national Non-Communicable Diseases(NCD) Survey of the Ministry of
Health and Quality of life , among adults aged 20 years and above , 49% consumed any
alcohol (66 % among male adults and 34% among female adults). Those classified as ex-drinker , i.e ,
who had stopped for more than 6 months , accounted for only 2% ( 2% among male adults and
2% as well among female adults ).
Abusive consumption of alcohol
The abovementioned study showed that crude prevalence of abusive alcohol consumption
among male adults was 16% . The trend for different similar national surveys was 18% in 1987,
14% in 1992,
16% in 1998 and 19% in 2004 . Among female adults , prevalence of abusive
alcohol consumption was 2% in 1987,
2% in 1992,
0.5% in 1998, 2% in 2004 and 0.6%
in 2009.
The 2009 national study also revealed that the prevalence of abusive alcohol consumption by
age group among males , was 12% among those aged 20-29 years , 16% among males aged
30-39 years,
19% among males aged 40-49 years,
13% among males aged 60-69 years and 9% for 70-79 years.
For females it was 1% among females aged 20-29 years,
0.9% for 30-39 years,
0.4 % for
40-49 years,
0.4% for 50-59 years,
0.6% for 60-69 years and 0.6 for 70-74 years.
Alcohol-related health problems
Alcohol abuse and hospitalization
The average annual number of cases (admissions and re-admissions) treated as inpatients in
Government Hospitals, due to Alcohol, was 6623 per year for the period 2004 to 2006 and was
on average 6784 annual cases for the period 2007 to 2010.
In 2010, the annual number of cases was 7106. 91% of the 7106 cases in 2010, were male cases
against 9% female cases.
Considering the last three years, 2008, 2009 & 2010 , alcohol inpatient cases (admissions + readmissions) at the public specialized Brown Sequard Psychiatric Hospital , represented 29% of all
Alcohol cases treated as inpatients in all Government Hospitals. It should be understood, that there
might have been patients moving from Government General Hospitals to the specialized Brown
Sequard Psychiatric Hospital and inversely within the same period of time.
Thus, this information should be regarded as a proxy indicator of the burden of alcoholic
patient treatment and its impact on the country‟s whole health care system and resources.
18
2010
Alcohol and morbidity
Out of the previously mentioned 7106 cases of alcohol-related diseases treated as inpatients in all
Government Hospitals for year 2010, 69% were cases of dependent abuse of alcohol, persistent
use of alcohol and alcoholic psychosis, 14% were alcoholic gastritis, 6% cirrhosis and liver
diseases linked with alcohol and 11% were cases of non-dependent abuse of alcohol.
Alcohol and mortality
The number of deaths registered due to alcohol was 252 in 2010 representing an average of 265
annual deaths due to alcohol registered between 2006 and 2010.
For the last five years, there
has been 250 – 300 annual deaths registered due to Alcohol . Considering data for 2009 and
2010, 77% of deaths registered due to alcohol-related diseases were attributable to alcoholic
liver diseases including cirrhosis , while alcohol dependent syndrome represented 23%. Deaths
registered in whole Island of Mauritius due to Alcohol, occurred mainly in the age group 40 years
and above .
Female deaths registered in whole Island of Mauritius , due to Alcohol, represented 14 % of all
deaths registered due to Alcohol.
Concluding remarks
a.
Between July 2008-June 2009, most arrests for dealing of drugs were related to Canabis
and most arrests for possession of drugs were associated with Subutex. For the whole
year 2010, arrests for dealing of drugs was again most popular for cannabis cases but
regarding possession of drugs , Canabis and Subutex were almost at the same level of
mostly arrested cases.
b.
The constant figure of 6000 – 7000 cases treated as inpatients in Government Hospitals
annually from 2001 to 2010 suggested that Alcohol abuse was still persistent in Mauritius.
Even if Government General Hospitals treated a substantial proportion of these cases ,
(28%) needed specialized treatment at the government Brown Sequard Psychiatric
Hospital.
c.
d.
In 2010, within the specialized Brown Sequard Psychiatric Hospital itself, Alcohol inpatient
treatment accounted for 59% among all male inpatient cases and 17% among all
female inpatient cases. Most alcohol cases were either dependent abuse or persistent
use of Alcohol according to the International Classification of Diseases (ICD 10).
This is the 6th edition of the PTAODU series which started with a first volume published for
the first semester of 2007.
Insignificant
interest in the information system is still
perceptible and has not yet received full advocacy. Interest in information support for
evaluation and monitoring of services and activities need to be promoted and scaled up
at all levels of the rehabilitation system.
It is understood that there are priorities at rehabilitation centres and that data collection
can be accepted to be secondary but this should not be optional and consequently be
neglected . The information system is actually very user-friendly and does not require high
level training .
19
2010
e. In 2010, Alcohol, Heroin and Subutex were again the three major problems for which
male patients attended rehabilitation. Subutex was again the most popular drug for
which patients looked for treatment in 2010.
f.
Overall, 66% of male patients asserted they started with the primary substance
reported when they were under 20 years.
g. The drug harm reduction strategy , adopted in 2006 by the Ministry of Health, is making
its way optimistically. The 2006 preset target of 3000 clients on methadone maintenance
by 2009-2011 , has been fullfilled. The use of Methadone as a substitution therapy
coupled with the “Needle Exchange Program” , is contributing in the containment and
reduction of problems associated with drug use like the spread of infectious diseases as
well as all the complications linked to dangerous drug cravings. For instance , the
percentage of IDUs registered among new HIV+ cases has decreased from 95% in 2005 to
76% in 2010.
h.
Although the benefits of Methadone in terms of economic, health and social promotion
are unanimously recognized, some actors in the rehabilitation system still expressed a
feeling of unfinished work regarding the Methadone long-term
or permanent
treatment . This school of thought emphasized that the positive role of Methadone
long-term treatment should not refrain rehabilitative care providers to work towards a
holistic accomplishment , that is, to work towards
a total drug-free state of the
individual.
i.
Despite its remarkable development and progress since it was launched in 2006, the
Methadone Substitution Program still confronted a sizeable challenge in 2010 . The 3,600
methadone clients on maintenance, by December 2010 , yet represented only one third
of the estimated population size of IDUs in the country . In 2009, the Mauritius national
Integrated Biological Behavioral Sampling Survey (IBBS) estimated this population to be
around 10,000. However, the encouraging note was that , according to routine data, 53%
of the estimated IDU population were complying to the exigencies of the national
needle exchange program.
j.
Set up in 2006, the Needle Exchange Program ( NEP) started with a few NGOs . In 2010,
this program was being sustained by both the Ministry of Health and NGOs, with 80% of
services being fulfilled by MOH against 20% for NGOs. According to the World Health
Organization (WHO) recommendation, the desirable minimal performance should be a
coverage of at least 60% of the IDU population. In 2009 , the Integrated Biological
Behavioral Sampling Survey (IBBS) revealed that 60% of IDUs have ever visited the NEP
services.
k.
In Mauritius, the rehabilitative system is a complementary work between government and
NGOs. The public health care largely tackles the medical and detoxification part while
the psychosocial support is sustained by the NGOs. As for previous years, rehabilitation
centres reported that they had maintained a psychosocial support program and a
variety of approaches was evoked, ranging from professional to untrained counseling .
20
2010
2010 data suggested that nearly less than 10% of patients known to have undergone
rehabilitative treatment did not go through any counseling session. No formal assessment
were carried out to determine whether for those who received psychological supports ,
the minimum requirements were met in terms of level of psychological treatment, since
there were no basic standard programs or common activity framework to guide the
different centres .
Nevertheless, the main argument was that , since all centres were working towards a
common result , the diversity of behavioral therapies delivered by the different centres
had the advantage that it allowed and respected creativity , flexibility and adaptability
while taking into account the different specificities , nature and vision-mission statements
of the NGOs.
l.
Rehabilitative treatment following alcohol abuse remained the leading cause for female
attendances at rehabilitation centres. However female cases of Subutex were nonnegligible and fewer cases of Heroin were also registered.
m. Even though the country has , during recent years , developed several strategies to
combat HIV and that encouraging results have been observed , in 2010 the situation still
called for vigilance by considering the prevalence of HIV among specific risk populations
, specially the intravenous drug users and female sex workers, as was found out in a
national study carried out in 2009 by the Ministry of Health. A quasi hundred percent of
IDUs was infected with Hepatitis C and 47% of this population was infected with HIV. The
situation among female sex workers also was a concern with 29% HIV positive and 44%
infected with Hepatitis C. . In the national study, it was important to note that nearly 40%
of female sex workers reported they had ever injected drugs. Among them 31% had
done so in the previous three months and more than 50% of those who had injected
drugs were infected with HIV while 90% female IDUS were infected with Hepatitis C.
n.
Regarding control of drug trafficking , there was indication that the origin of dangerous
drug entering the Island of Mauritius from abroad, was quite opened . Foreign drug
trafficking were expected to come from a wide variety of countries. This was illustrated
by the 14 different nationalities involved in Police arrests between July 2008 and June 2009
showing the different continents of origin concerned , namely , Europe, Africa and Asia.
In year 2010, 6 different nationalities were involved in Police arrests , namely Malagasy,
French, Indian, Swiss , Italian and German . Among these 6 nationalities 5 were already
involved in 2009.
o.
The two main weaknesses are , firstly, data submission which is considerably delayed
and secondly the quality of data itself needs to be improved.
In 2010, the main problems persisted with omission of information on very basic but
important variables like the national identity card number, age, sex , residence, services,
primary and secondary substances used, HIV tests, needle sharing amongst others.
There is need to reiterate emphasis on accurate filling and completing of the
questionnaire as well as at the level of data entry on computer to improve the quality of
data in order to enable proper and enhanced analysis of the situation, specially crosssectional study.
21
2010
Part 1
Attendances at rehabilitation centres following substance abuse
Period January to December 2010
22
1.0
2010
Attendances at rehabilitation centres
1.1 (a) Infrastructure for treatment and rehabilitation of substance abusers.
For the year 2010, in the Island of Mauritius, among nine main centres attached to NATReSA, 4 centres
(44%) delivered day care services only, while 5 centres (56%) offered day and/or residential services.
There were 2 female residential centres , 2 male residential centres and 5 centres for treatment of
both sexes (4 exclusive day care + 1 day/residential) .
Rehabilitation and treatment were delivered for both Alcohol and drug abuse problems by 8 (89%)
centres. Only one female centre provided treatment and rehabilitation exclusively for Alcohol problems .
All centres with day care services only , treated both male and female patients.
Table 1(a) - Nine centres by type and availability of services , 2010
CENTRE
CENTRE FOR
FEMALE ONLY
CENTRE FOR
MALE ONLY
CENTRE FOR BOTH SEXES
TOTAL
DAY CARE SERVICES
ONLY
ALCOHOL
and DRUG
na
na
4
4
AVAILABILITY OF SERVICES
DAY & OR
RESIDENTIAL SERVICES
ALCOHOL
ALCOHOL
ONLY
and DRUG
1
1
na
2
na
1
1
4
TOTAL
NUMBER OF
CENTRES
ALL CENTRES
ALCOHOL
ONLY
1
na
na
1
ALCOHOL
and DRUG
1
2
5
8
1.1 (b) Infrastructure at regional level
2
2
5
9
na : no service
Considering a total of nine centres, out of the 9 districts of the Island of Mauritius, there were only 5
(56%) districts with at least one rehabilitation centre. The four districts without any centre were ; Rivière
du Rempart, Flacq, Grand Port and Savanne. Only four districts had residential centres (2 for males and 2
for females).
Table 1 (b) - Nine rehabilitation centres by district - 2009
DAY CARE SERVICES ONLY
DAY & OR RESIDENTIAL SERVICES
CENTRE
DISTRICT
MALE
FEMALE
CENTRE
CENTRE
CENTRE
FOR
MALE
FEMALE
BOTH
CENTRE
CENTRE
SEXES
PORT LOUIS
2
PAMPLEMOUSSES
1
ALL CENTRES
FOR
MALE
FEMALE
BOTH
CENTRE
CENTRE
SEXES
Total
CENTRE
BOTH
SEXES
number
of
centres
-
-
2
1
-
1
2
RIVIERE DU REMPART
-
-
-
-
1
2
FLACQ
-
-
-
-
GRAND PORT
-
-
-
-
SAVANNE
-
-
-
-
1
-
2
3
-
1
-
1
-
1
-
1
2
2
5
9
PLAINES WILHEMS
1
1
MOKA
BLACK RIVER
ISLAND OF MAURITIUS
1
1
1
4
2
2
1
It is to be noted that annual data are submitted and received at central level by only part of the above centres.
23
2010
1.2 Infrastructure for detoxification
(Alcohol medical treatment and drug Methadone substitution)
Table 2
Infrastructure and availability of services for general treatment, substitution or detoxification - 2010
Regional General Hospitals
5
√
√
District General Hospital
1
√
√
Specialized Psychiatric Hospital
1
√
√
Area Health Centre (Dr Bouloux)
1
√
National Methadone Substitution
Centre
1
√
Vacoas (nr Police Station)
1
√
√
√
Rose Hill (nr Police Station)
1
√
√
√
Plaine Lauzun
(12.01.2009)
1
√
√
√
Plaine Verte
( 06.04.2009)
1
√
√
√
Pailles
( 11.05.2009)
1
√
√
√
Vallée Pitot
( 18.05.2009)
1
√
√
√
Sainte Croix
( 20.07.2009)
1
√
√
√
√
√
√
√
√
√
√
24
√
Black River
Moka
√
Plaines Wilhems
√
Savanne
Grand Port
Pamplemousses
Flacq
Port Louis
√
Mobile Caravans
Day Care +
residential
Day Care
√
Rivière du Rempart
District location
Methadone
substitution service
Dispensing unit
Alcohol and drug hospitalization treatment
Health point
Number
Services
Figure 2
2010
Map showing infrastructure of rehabilitative , medical and detoxification care
1.3 Treatment at rehabilitation centres following substance abuse
1.3.1 Patients known to have benefitted treatment at rehabilitation centres
In 2010, a total of 1,301 patients were known to have received rehabilitation treatment at six
rehabilitation centres. Out of these 1,301 patients , 1258 were males , representing 97% of patients
against 43 (3%) female patients.
(Data for a significant number of female alcohol cases treated at a specialized female alcohol rehabilitation
centre and a few male patients treated in a correctional institution , are given separately because of data
limitations – see pages 12 for details)
Table 3 Alcohol and drug use - Year 2010
Number of patients known to have undergone rehabilitation treatment
Gender
Number
%
FEMALE
43
3.3
MALE
1258
96.7
Total
1301
100.0
25
1.3.2
2010
Most frequently used primary substances reported.
For the period January to December 2010, based on 1,258 males patients known to have
received treatment at 6 rehabilitation centres , Subutex was the most popular primary substances
reported , accounting for 62%, followed by Heroin (21%), and Alcohol (14%) . All these three
abovementioned substances, represented 97% of all substances reported.
FIGURE 3
Distribution of male patients known to have received
treatment at rehabilitation centres in 2010
by primary substances reported
Other, 3%
Alcohol,
14%
Heroin,
21%
Subutex,
62%
1.3.3 Age distribution of male patients and primary substances reported.
Among the 1,258 male patients reported , 86% were aged between 20 and 49 years, while 9% were
aged 50 – 59 years. Males aged under 20 years represented 3% and those aged 60 years and over
accounted for 2%.
Out of 175 males reported for treatment linked to primary abuse of Alcohol, 35% were in the age group
40 – 49 years, followed by those aged 30 – 39 years (30%), 50 – 59 years (21%), 20 -29 years ( 8%) , 60
years and above represented 3% and less than 1% for no stated age.
Within 266 males using primarily Heroin , 42% were in the age group 30 – 39 years, followed by those
aged 20 – 29 years (29%), 40 – 49 years (15%) , 50 – 59 years (3%) and less than 1% for no stated age.
Among 782 males reported for using primarily Subutex , 36% were in the age group 30 – 39 years,
followed by those aged 20 – 29 years (32%), 40 – 49 years (21%), and 50 -59 years ( 9%) .
26
2010
Table 4
Alcohol and drug use - Year 2010
Number of male patients known to have undergone rehabilitation treatment,
by mostly used substances and age of patients
Age
group
(years)
Not
Stated
10-19
Alcohol
%
Heroin
%
Subutex
%
Other
Total
%
5
2.9
2
0
0.0
7
0.8
1
0.1
3
11
0.9
2.6
23
2.9
2
32
20-29
14
8.0
2.5
97
36.5
228
29.2
9
348
27.7
30-39
52
40-49
61
29.7
111
41.7
283
36.2
13
459
36.5
34.9
40
15.0
164
21.0
4
269
50-59
21.4
36
20.6
9
3.4
69
8.8
2
116
9.2
60-69
6
3.4
0
0.0
14
1.8
2
22
1.7
70-75
1
0.6
0
0.0
0
0.0
0
1
0.1
Total
175
100.0
266
100.0
782
100.0
35
1258
100.0
1.3.4 Age at first use of primary substances .
29% of male patients know to have undergone rehabilitation treatment , asserted that they started using
the primary substances reported when they were aged under 15 years. 37% started between 15 and19
years, 23% started between 20 and 29 years, 7% started between 30 and 59 years and 4% no stated
age.
Among male Subutex patients only , 70% started using Subutex for the first time when they were still
under 20 years.
14% of male alcohol patients reported they started consuming Alcohol under the age
of 15 years and 45% for those who started under 20 years .
30% of male Heroin patients started with Heroin when they were aged under 15 years while it was 68%
for those having started under 20 years .
Overall, 66% of male patients asserted they started with the primary substance reported when they
were under 20 years.
Table 5
by mostly used substances and age at first use of substances
Age group
(Years)
Alcohol
%
Heroin
%
Other
Subutex
%
Total
%
Under 15 years
25
14.3
80
30.1
5
250
32.0
360
28.6
15-19
54
30.9
102
38.3
10
301
38.5
467
37.1
20-29
48
27.4
67
25.2
9
168
21.5
292
23.2
30-39
16
9.1
11
4.1
1
36
4.6
64
5.1
40-49
11
6.3
1
0.4
0
12
1.5
24
1.9
50-59
1
0.6
0
0.0
0
4
0.5
5
0.4
60-69
0
0.0
0
0.0
0
1
0.1
1
0.1
Other / not
stated
20
11.4
5
1.9
10
10
1.3
45
3.6
Total
175
100.0
266
100.0
35
782
100.0
1258
100.0
27
2010
1.3.5 District of residence of patients.
For the period January to December 2010, most of the male patients with primarily Alcohol problems
reported that their district of residence was Plaines Wilhems with 38%, followed by Port Louis with 18% ,
Flacq with 9%, Pamplemousses, Rivière du Rempart , Moka and Black River each with around 5% to 7%
and finally Grand Port district with 2%.
Most of the male patients with primarily Heroin problems reported Plaines Wilhems (61%) as their district
of residence,
followed by Port Louis (20%), Grand Port (8%), Port Louis (6%) and the remaining five
other districts of residence accounted each for 1% - 2 % of total Heroin patients.
35% of male patients who used Subutex primarily, reported Port Louis as their district of residence,
followed by those who reported Plaines Wilhems (34%), Pamplemousses (11%), Black River (5%) and the
remaining five other districts of residence accounted each for 2% - 4 % .
Table 6
by mostly used substances and District of residence of patient.
District of residence
of patient
Alcohol
%
Heroin
%
Subutex
%
Other
Total
%
Port Louis
32
18.3
52
19.5
276
35.3
5
365
29.0
Pamplemousses
12
6.9
9
3.4
86
11.0
6
113
9.0
Rivière du Rempart
13
7.4
1
0.4
17
2.2
1
32
2.5
Flacq
15
8.6
26
9.8
32
4.1
2
75
6.0
Grand Port
4
2.3
0
0.0
16
2.0
6
26
2.1
Savanne
10
5.7
3
1.1
29
3.7
4
46
3.7
Plaines Wilhems
66
37.7
162
60.9
265
33.9
7
500
39.7
Moka
11
6.3
7
2.6
22
2.8
2
42
3.3
Black River
12
6.9
6
2.3
39
5.0
2
59
4.7
Total
175
100.0
266
100.0
782
100.0
35
1258
100.0
Table 7
by mostly used substances and regional residence of patient.
Geographical
region
Alcohol
%
Heroin
%
Subutex
%
Other
Total
%
Urban
98
56.0
214
80.5
541
69.2
12
865
68.8
Rural
77
44.0
52
19.5
241
30.8
23
393
31.2
Total
175
100.0
266
100.0
782
100.0
35
1258
100.0
1.3.6 Inpatient treatment at rehabilitation centre .
Among 1,258 male patients known to have received rehabilitation treatment at six centres, only 49
patients (4%) went through inpatient rehabilitation . Within the 49 male inpatients , Alcohol inpatients
was 51% , Subutex inpatients was 37% , Heroin inpatients was 10% and 2% not stated .
28
2010
Table 8
by mostly used substances and type of service
Type of
treatment
Alcohol
%
%
IN-PATIENT
25
14.3
5
1.9
18
2.3
1
49
3.9
OUT-PATIENT
143
81.7
259
97.4
759
97.1
28
1189
94.5
Heroin
Subutex
%
Other
Total
%
Not stated
7
4.0
2
0.8
5
0.6
6
20
1.6
Total
175
100.0
266
100.0
782
100.0
35
1258
100.0
1.3.7 Behavioral and pharmacological services delivered .
Among 1,258 male patients known to have received rehabilitation treatment at six centres , counseling
was given to at least 88% of patients while detoxification was given to 80% of male patients.
Among males using primarily Alcohol, 66% received counseling only, 12% received detoxification only,
10% received both counseling and detoxification and
3% received traditional medicine .
In
summary, among males using primarily Alcohol at least 78% received counseling and 21% went through
detoxification treatment.
Within male primary users of Heroin, 11% received detoxification only, 82% received both counseling and
detoxification and 7% received counseling only. In short , 93% of Heroin patients went through
detoxification treatment.
Among males most frequently using Subutex,
9% received counseling only , 83% received both
counseling and detoxification, and 7% received detoxification only. In short, detoxification was provided
to 90% of primary users of Subutex.
However, considering a total of 1013 male patients known to have gone through detoxification
treatment for the year 2010, 70% were primarily on Subutex, 24% primarily on Heroin and 3% on Alcohol.
It is to be noted that traditional medicines were provided essentially to those primarily on Alcohol .
Table 9
by mostly used substances and behavioral or pharmacological treatment
Service
COUNSELLING
ONLY
COUNSELLING + DETOXIFICATION
COUNSELLING + TRADITIONAL MEDICINE
DETOXIFICATION ONLY
TRADITIONAL MEDICINE
ONLY
Other / not stated
Total
Alcohol
116
17
4
21
2
15
175
%
66.3
9.7
2.3
12.0
1.1
8.6
100.0
Heroin
18
218
0
30
0
0
266
29
%
6.8
82.0
0.0
11.3
0.0
0.0
100.0
Other
9
6
1
11
4
4
35
Subutex
69
652
0
58
0
3
782
%
8.8
83.4
0.0
7.4
0.0
0.4
100.0
Total
212
893
5
120
6
22
1258
%
16.9
71.0
0.4
9.5
0.5
1.7
100.0
2010
Part II
Statistics related to control of dangerous drugs
30
2.0
2010
During the period January to December 2010,
there were regular monthly arrests of foreigners for
dangerous drugs offences, except in May and September. For the same period, monthly arrests of
foreigners ranged from 1 to 4 arrests per month . Female offenders were 20% of all foreigners arrested.
Regarding nationality of foreigners arrested,
offenders were from 6 different nationalities . French
accounted for 50% of foreigners arrested ,
followed by Malagasies (30%) and the remaining 20%
were German, Italian , Swiss and Indian. Malagasies were mostly females and were involved in mainly
Heroin while French , being essentially males , were involved in Canabis / Hashish.
55% of foreigners arrested for dangerous drugs offences were involved in Canabis / Hashish while 35 %
were involved in Heroin, 5% for Subutex and 5% for sedatives.
2.1
Arrests of foreigners
FIGURE 4
Swiss,
5%
Malagasy,
30%
FIGURE 5
% of foreigners arrested
due to drugs offences
by nationality
January - December 2010
by nationality
July 2008 - June 2009
Indian
6%
French,
50%
African
26%
European
32%
Malagasy
/
Comorian
36%
Italian,
5%
Indian,
5% German,
5%
Sedative,
5%
Heroin,
35%
Subutex,
5%
FIGURE 6
January - December 2010
by type of drug
Canabis
/ Hashish,
55%
31
2010
Table 10
Arrests of foreigners for dangerous drugs offences,
by international region and substances
January – December 2010
Region
Drug
African
European
Indian
Malagasy
All
regions
Heroin
0
1
1
5
7
Canabis
0
6
0
1
7
Hashish
Subutex
Sedative
Total arrests of foreigners
0
0
0
0
4
1
1
13
0
0
0
1
0
0
0
6
4
1
1
20
Table 11
Arrests of foreigners for dangerous drugs offences,
by international region and substances
July 2008 - June 2009
Region
Drug
African
European
Indian
Malagasy
/Comorian
All
regions
Heroin
6
1
1
9
17
Canabis
2
4
1
2
9
Hashish
Subutex
0
0
4
1
0
0
0
0
4
1
Total arrests of foreigners
8
10
2
11
31
Table 12
Arrests of foreigners for dangerous drugs offences
Period (July 2008- June 2009)
and
(January-December 2010 )
July 2008- June 2009
Nationality
January-December 2010
Male
Female
Total
%
Male
Female
Total
%
Malagasy
4
6
10
32.3
3
3
6
30.0
9
1
10
50.0
1
0
1
5.0
1
0
1
5.0
1
0
1
5.0
French
5
0
5
16.1
Ghanaian
2
0
2
6.5
Indian
2
0
2
6.5
South African
2
1
3
9.7
Swiss
2
0
2
6.5
Comorian
0
1
1
3.2
Dutch
1
0
1
3.2
Italian
1
0
1
3.2
Mozambican
0
1
1
3.2
Romanian
1
0
1
3.2
Tanzanian
Ugandan
German
1
0
1
3.2
0
1
1
3.2
1
0
1
5.0
21
10
31
100.0
16
4
20
100.0
Total arrest of foreigners
32
2.2
Arrests
and
seizures
for
2010
dealing of dangerous drugs
2.2.1 Arrests for drug dealing
For the period January to December 2010,
377 arrests were registered for dealing of drugs compared
to 267 arrests for the period July 2008 to June 2009 and 422 arrests for the period July2007-June2008.
During the period January to December 2010, 203 arrests (53%) for dealing of drugs were related to
Canabis , 96 arrests for Subutex (25%), 42 arrests ( 11%) for Heroin, 33 arrests (8%) for sedatives and 3
arrests for Hashish.
During the period July 2008 to June 2009, 168 arrests (63%) for dealing of drugs were related to Canabis ,
67 arrests (25%) for Heroin , 31 arrests (12%) for Subutex and 1 arrest for sedatives.
The corresponding arrests for dealing of drugs in the previous period July2007-June2008 amounted to 266
arrests for Canabis(63%), 137 arrests for Heroin(32%) and 19 arrests for Hashish(5%).
2.2.2
Dealing of drugs and Seizures
For the period January to December 2010, in connection with dealing of drugs , 11.1kg of Cannabis ,
3.7kg of Heroin , 20247 units of Subutex , 19317 units of sedatives and 0.1 kg of Hashish were seized.
For to the period July 2008 to June 2009, in connection with dealing of drugs , 7.0 kg of Cannabis , 7.9kg
of Heroin 418 units of Subutex and 12 units of sedatives were seized compared to the period July2007June 2008 with seizures of 25.1 kg of Cannabis, 10.7 kg of Heroin and 24.2 kg of Hashish.
2.3 Arrests and seizures for possession of dangerous drugs
2.3.1 Arrests for drug possession
For the period January to December 2010, there were 1415 arrests registered for possession of drugs
compared to the period July 2008 to June 2009 with 1593 arrests and 1917 arrests for period July 2007
to June 2008.
During the period January to December 2010 , 577 arrests (40%) for possession of drugs were related to
Canabis , 564 arrests (39%) for Subutex , 165 arrests (11%) for Heroin , 99 arrests (6%) for sedatives , 8
arrests for methadone and 2 arrests for Hashish.
During the period July 2008 to June 2009, 546 arrests (34%) for possession of drugs were related to
Canabis , 831 arrests (52%) for Subutex , 137 arrests (9%) for Heroin 70 arrests (4%) for sedatives and 9
arrests for Hashish. The corresponding arrests for possession of drugs in the previous period July2007June2008 was 619 arrests for Canabis(32%), 507 arrests for Heroin(26%) , 418 arrests for Subutex (22%),
281 arrests for Opiods (15%) , 70 arrests for sedatives(4%) , 21 arrests for Hashish ( 1%) and 1 arrest for
Ectasy.
The corresponding arrests for possession of drugs in the previous period July2007-June2008 was 619 arrests
for Canabis(32%), 507 arrests for Heroin(26%) , 418 arrests for Subutex (22%), 281 arrests for Opiods (15%) ,
70 arrests for sedatives(4%) , 21 arrests for Hashish ( 1%) and 1 arrest for Ectasy.
33
Table 13
Arrests for dealing of drugs , January to December 2010
DRUG DEALING CASES
TYPE OF DRUGS
NO. OF CASES
Cannabis
203
WEIGHT
KG
UNIT
11kg091.14
Heroin
42
3kg703.54
Hashish
3
0kg102.60
Subutex
96
20247
Sedatives
33
19317
TOTAL
377
Table 14
Arrests for possession of drugs , January to December 2010
POSSESSION OF DRUGS CASES
TYPE OF DRUGS
NO. OF CASES
Cannabis
577
Heroin
165
Hashish
2
Subutex
564
Methadone
8
Sedatives
99
TOTAL
1415
34
2010
2010
Table 15
Arrests for dealing of drugs , July 2007 - June 2009
Arrest
Drug
July 2007 - June 2008
Seizures
July 2008 - June 2009
July 2007 - June 2008
Units
July 2008 - June 2009
Number
%
Number
%
Weight
Weight
Units
Cannabis
266
63.0
168
62.9
25.1 kg
7.0 kg
Heroin
137
32.5
67
25.1
10.7 kg
7.9 kg
Ectasy
0
-
0
-
White Lady
0
-
0
-
Subutex
0
-
31
11.6
418
Sedatives
0
-
1
0.4
12
Opiods
0
-
0
-
Cocaine
0
-
0
-
Hashish
19
4.5
0
-
Total arrests
422
100.0
267
100.0
24.4 kg
Source : Mauritius Police Department
Table 16
Arrests for possession of drugs , July 2007 - June 2009
Possession cases
Drug
July 2007 - June 2008
Seizures
July 2008 - June 2009
July 2007 - June 2008
Number
%
Number
%
Weight
Cannabis
619
32.3
546
34.3
0.62 kg
0.48 kg
Heroin
507
26.4
137
8.6
0.02 kg
0.004 kg
Ectasy
1
0.1
0
-
White Lady
0
-
0
-
Subutex
418
21.8
831
52.2
1978
22,722
Sedatives
70
3.7
70
4.4
1201
1825
Opiods
281
14.7
0
-
181
Cocaine
0
-
0
-
Hashish
21
1.1
9
0.6
1917
100.0
1593
100.0
Total arrests
Source : Mauritius Police Department
35
Units
July 2008 - June 2009
Weight
Units
22
0.01 kg
0.01 kg
2010
Part III
Intravenous Drug Users and HIV
and trend of HIV / AIDS in the Island of Mauritius
36
3.0
3.1
2010
Trend of HIV / AIDS in the Island of Mauritius
Monthly HIV trend in 2009 and 2010.
The monthly average number of newly detected HIV cases reported was 45 cases per month for
the year 2008, 46 cases per month for 2009 and 47 cases per month in 2010.
Figure 7
Monthly new cases of HIV /AIDS detected in 2009 and 2010
60
54
44
45
36
58
57
55
49
43
41
51
51
53
52
58
42
41
39
43
39
43
39
Dec-…
Nov-…
Oct-10
Sep-10
Aug-…
Jul-10
Jun-10
May…
Apr-10
Mar-10
Jan-10
Feb-10
Dec-…
Nov-…
Oct-09
Sep-09
Aug-…
Jul-09
Jun-09
May…
Apr-09
Feb-09
Mar-09
23
Jan-09
70
60
50
40
30
20
10
0
Source : Ministry of Health & Quality of Life
3.2
Annual HIV trend (1987- 2010 )
800
100000
921
80000
548 568
525
600
436
400
433
60000
40000
225
200
Tests
HIV+Male Year
37
20000
HIV+Female
2010
2009
2008
2007
2006
2005
2004
2003
2002
0
2001
1999
28
1998
1997
1996
24
50
2000
20
1995
1994
1992
10
1991
1989
1988
1990
4
0
1993
1
112 135
98
HIV+Both sexes
Number of tests
1000
Figure 8
Yearly new cases (Mauritian) of HIV / AIDS
notified ,1987 - 2010
1987
Number of new HIV+ cases
The annual number of newly detected HIV+ cases registered, was on average 544 new cases annually
for the three years 2007, 2008 and 2009. In 2010, 568 newly detected cases were registered.
Since October 1987, when the first case of AIDS was registered, the total number of HIV/AIDS cases
detected, up to the end of December 2010 in Mauritius, amounted to 4,787 (3862 males and 925 females
). 477 Mauritians registered as HIV/AIDS cases were known to have passed away since 1987. In Figure 8
below , the observed sharp rise of reported HIV/AIDS cases in Mauritius is most likely due to increased HIV
testing carried out, particularly among IDU in various institutions (prison, rehabilitation centres, outreach
services).
3.3
2010
Female HIV trend ( 1998 – 2010 )
Figure 9 below shows the gender-wise evolution of the HIV cases reported annually in Mauritius during
the last decade. The percentage of annual new female HIV cases decreased from 44% in 1998 to 12% in
2004. However, annual increase in the percentage of new HIV female cases detected was observed as
from 2005 to reach a figure of 25% in 2008 . It was 20% and 24% in 2009 and 2010 respectively.
60%
Figure 9
Island of Mauritius ( 1998-2010 )
Trend of annual new female HIV+ cases detected as a percentage of all new cases
and sex ratio (males per female)
44%
8
40%
40%
8
6
5
24%
20%
12%
2
1
10
3
0%
4
2
0
1998
1999
2000
2001
2002
2003
2004
% Female
2005
2006
2007
2008
2009
2010
Sex ratio ( males per female)
Percebtage new HIV+ female cases
The sex ratio (males per female) of registered new HIV+ cases was 1 male per female in 1998 then
increased to 8 males per female in 2004 followed by a gradual decrease up to 3 males per female in
2010.
Sex ratio (Males per Female)
3.4
Annual trend of Intravenous drug Users (IDU)
The percentage of intravenous drug users (IDU) on total HIV cases reported in Mauritius, was 20% in the
year 2000, then increased to 86% in 2003 and continued to increase to reach a peak of 94% in 2005.
From 2005 there has been a constant decrease to 76% in 2010.
Figure 10
Evolution of reported new cases of Intravenous Drug Users(IDU) HIV +
as a percentage of total new cases
2000- 2010
100.0%
80.0%
70.0%
63.6%
60.0%
76.0%
51.0%
40.0%
20.0%
94.0%
85.8%
12.0%
20.0%
21.5%
5.9%
0.0%
2000
2001
2002
2003
2004
2005
2006
Intravenous drug user(IDU)
38
2007
2008
2009
2010
Heterosexual
3.5
2010
Trend of HIV tests carried out.
From the year 2004 to 2010, the number of HIV tests carried out annually among high risk group(HRG)
has been around 11, 000 – 23,000 tests yearly . For the same period, among low risk group (LRG) the
annual HIV tests carried out ranged between 66,000 – 72,000 tests yearly.
[High risk group comprises prison inmates, sex workers, drug users, TB patients amongst others. Low risk
group comprises blood donors, pregnant women, dialysis patients, cardiac surgery patients, outgoing
citizens requesting visa amongst others].
Figure 11
Low risk group
High risk group
Number of HIV tests carried out
by low and high risk groups ( 2003 - 2010 )
All groups
Number of tests
88000
66000
44000
22000
0
2003
2004
2005
2006
2007
39
2008
2009
2010
2010
Part IV
Overview of alcohol issues in Mauritius.
-
Alcohol beverage trade
-
Alcohol consumption, alcohol abuse impact on health status of individuals and on health care system
-
Annual trend of inpatient treatment following Alcohol abuse in public and private health care institutions.
-
Annual trend of deaths due to Alcohol use and abuse.
40
4.0
2010
Alcohol
4.1 Alcoholic beverages production and trade .
From official external trade data, in 2010 , imports of alcoholic beverages amounted to
4,781,000 litres, On the other hand, exports in 2010 figured up to 6,634,000 litres. The total
local production amounted to 55,793,000 litres.
Figure 12
- Alcoholic beverages imports (Litres)
6,000,000
4,000,000
4,781,000
3,844,000
3,031,000
2,882,000
2005
2006
3,283,000
2,676,000
2,000,000
0
Figure 13
2007
2008
2009
- Alcoholic beverages exports (Litres)
8,000,000
6,634,000
6,516,000
6,000,000
4,620,000
3,877,000
4,000,000
2,000,000
2010
1,178,000
1,346,000
2005
2006
0
2007
2008
2009
2010
Source : Central Statistics office ( 2010 figure is provisional)
Table 17
Alcoholic beverages production - 2009 and 2010 ( nearest ‘000 )
Alcoholic beverages production
(Litres)
Local production
Import
Total local production and import
Export
Net( local production + imports) - Exports
(A)
(B)
(A) - (B)
Source : Central Statistical Office and MRA Custom Department. 2010 figure is provisional
‘@ Data on local production are from the MRA Custom Department.
41
Year 2009
Year 2010
53,859,000
55,741,000
2,676,000
4,781,000
56,535,000
60,522,000
4,620,000
6,634,000
51,915,000
53,888,000
4.2
National
2010
indicators on Alcohol use .
4.2.1 National prevalence on alcohol consumption
In 2009, the Ministry of Health and Quality of life carried out a national Non-Communicable
Diseases (NCD) Survey among adults aged 20 years and above. The study showed that the
proportion of respondents reported consuming alcohol was 49% ( 66 % among male adults and
34% among female adults). Those classified as ex-drinker , that is, who had stopped for more than
6 months, accounted for only 2% ( 2% among male adults and 2% as well among female adults ).
4.2.2 Trend of national prevalence on abusive alcohol consumption
For the abovementioned study , those who were consuming 3 or more drinks in a single day for 2
or more days per week or those who were drinking more than 5 drinks daily were classified as
abusive drinker. The trend of crude prevalence of abusive alcohol consumption among male
adults for different similar national surveys was 18% in 1987, 14% in 1992, 16% in 1998, 19% in 2004
and 16% in 2009. Among female adults the prevalence of abusive alcohol consumption was
2% in 1987, 2% in 1992, 0.5% in 1998, 2% in 2004 and 0.6% in 2009
4.2.3 National age indicators on abusive alcohol consumption
The 2009 national study also revealed that the prevalence of abusive alcohol consumption by age
group for males , was 12% among those aged 20-29 years , 16% among males aged 30-39 years,
13% among males
aged 60-69 years and 9% for 70-79 years.
For females it was ; 1% among females aged 20-29 years,
0.9% for 30-39 years, 0.4 % for 4049 years,
0.4% for 50-59 years,
0.6% for 60-69 years and 0.6 for 70-74 years.
Figure 14
Island of Mauritius
(1987 - 2009 ) National Non-Communicable Diseases Surveys
Prevalence of Abusive Alcohol Consumption (adult 20 years and above)
Prevalence ( %)
25%
20%
19%
18%
16%
14%
15%
Male
16%
Female
10%
5%
2.1%
1.6%
0.5%
1.9%
0.6%
0%
1987
1992
1998
Survey year
2004
2009
4.2.4 Mauritian family monthly consumption expenditure on alcoholic beverages and tobacco
The latest official figures on Household Budget Survey (HBS) of the Central Statistical office dated
back to 2007. According the HBS report 2007, out of the total local sales of alcoholic beverages and
tobacco, 80% were consumed by households. The report showed that monthly expenditure on
alcoholic beverages and tobacco as a percentage of
household monthly total consumption
expenditure , was 9% in 2002 and 10% in 2007. It was also demonstrated that, regarding monthly
consumption expenditure , alcoholic beverages and tobacco ,as an item , was ranked in 4 th position
of importance just after food, secondly transport and thirdly household utilities like water, electricity,
housing , gas and fuel.
42
4.3
Treatment
2010
in public and private health care institutions following use and abuse of alcohol.
`
4.3.1
Trend of Alcohol cases treated as inpatients in Government Hospitals (General & Psychiatric).
The average annual number of cases (admissions and re-admissions) treated as inpatients in
Government Hospitals, due to Alcohol, was 6623 per year for the period 2004 to 2006 and was
on average 6784 annual cases for the period 2007 to 2010.
In 2010, the annual number of cases was 7106. 91% of the 7106 cases in 2010 were male cases
against 9% female cases.
Considering the last three years, 2008, 2009 & 2010 , alcohol inpatient cases (admissions + readmissions) at the specialized Brown Sequard Psychiatric Hospital , represented 29% of all Alcohol
cases treated as inpatients in all Government Hospitals. It should be understood, that there might
have been patients moving from Government General Hospitals to the specialized Brown
Sequard Psychiatric Hospital and inversely within the same period of time. Thus, this information
should be regarded as a proxy indicator of the burden of alcoholic patient treatment and its
impact on the country‟s whole health care system and resources . Table 20 on next page shows
the situation in private clinics.
Table 18
I SLAND OF MAURITIUS, ALCOHOL-RELATED DISEASES
CASES TREATED AS INPATIENTS IN GOVERNMENT HOSPITALS
( 2001 - 2010)
Including re-admissions
Brown Sequard
Psychiatric Hospital
All
Government
Hospitals
General
Hospitals
YEAR
Male
Female
Total
Male
Female
Total
Male
Female
Total
2001
2952
244
3196
3758
312
4070
6710
556
7266
2002
2760
257
3017
3499
323
3822
6259
580
6839
2003
3144
250
3394
3941
359
4300
7085
609
7694
2004
2320
231
2551
4054
338
4392
6374
569
6943
2005
2128
241
2369
4102
335
4437
6230
576
6806
2006
1913
167
2080
3733
308
4041
5646
475
6121
2007
1671
188
1859
4143
401
4544
5814
589
6403
2008
1771
190
1961
4553
434
4987
6324
624
6948
2009
2010
2018
1752
256
219
2274
1971
4327
4690
401
445
4728
5135
6345
6442
657
664
7002
7106
43
4.3.2
2010
Alcohol-related diseases treated in Government Hospitals
Out of the previously mentioned 7106 cases of alcohol-related diseases treated as inpatients in all
Government Hospitals for year 2010, 69% were cases of dependent abuse of alcohol, persistent
use of alcohol and alcoholic psychosis, 14% were alcoholic gastritis, 6% cirrhosis and liver
diseases linked with alcohol and 11% were cases of non-dependent abuse of alcohol.
Table 19
ALCOHOL RELATED DISEASES
Cases treated as in-patients( including follow-ups) in all Government Hospitals
(Including Brown Sequard Psychiatric Hospital)
YEARS 2001 - 2010
DEPENDENT ABUSE OF
ALCOHOL , PERSISTENT USE
YEAR
OF ALCOHOL and
NON DEPENDENT
ALCOHOLIC LIVER DISEASES
ABUSE OF ALCOHOL
ALCOHOLIC
and CIRRHOSIS OF LIVER (with
( Acute intoxication)
GASTRITIS
ALCOHOLIC PSYCHOSIS
FEMALE
TOTAL
MALE
TOTAL
( K70.0 - K70.9 ) + ( K74.0
- K74.6 )
FEMALE
TOTAL
(General Hospitals + B.
Sequard Psychiatric
Alcohol)
(F10.0)
( F10.1-F10.5)
MALE
or without mention of
( K29.2 )
( General Hospitals
only )
MALE
FEMALE
TOTAL
( General Hospitals
FEMALE
( General Hospitals
only )
Hospital)
MALE
TOTAL
only )
MALE
FEMALE
TOTAL
(General Hospitals + B.
Sequard Psychiatric
Hospital)
2001
5201
376
5577
431
44
475
702
41
743
376
95
471
6710
556
7266
2002
4670
381
5051
602
73
675
678
41
719
309
85
394
6259
580
6839
2003
5453
410
5863
579
77
656
698
64
762
355
58
413
7085
609
7694
2004
4355
375
4730
1046
100
1146
695
67
762
278
27
305
6374
569
6943
2005
4613
400
5013
707
88
795
634
42
676
276
46
322
6230
576
6806
2006
4460
314
4774
399
86
485
524
24
548
263
51
314
5646
475
6121
2007
4093
362
4455
515
94
609
866
57
923
340
76
416
5814
589
6403
2008
4734
445
5179
387
62
449
797
61
858
406
56
462
6324
624
6948
2009
4817
468
5285
441
69
510
833
60
893
254
60
314
6345
657
7002
2010
4501
435
4936
674
114
788
897
65
962
370
50
420
6442
664
7106
Table 20 below shows the situation in Private Clinics
Attendance (Including admissions)
due to Alcohol use and abuse in Private Clinics, 2004 - 2010
YEAR
MALE
FEMALE
TOTAL
2004
129
24
153
2005
103
24
127
2006
92
22
114
2007
96
23
119
2008
136
35
171
2009
126
48
174
2010
240
72
312
44
4.4
2010
Annual trend of deaths due to Alcohol use and abuse.
4.4.1 Patterns & trend of deaths registered in whole Island of Mauritius due to Alcohol
The number of deaths registered due to alcohol was 252 in 2010 representing an average of 265
annual deaths due to alcohol registered between 2006 and 2010.
For the last five years, there
has been 250 – 300 annual deaths registered due to Alcohol . Considering data for 2009 and 2010,
77% of deaths registered due to alcohol-related diseases were attributable to alcoholic liver
diseases including cirrhosis , while alcohol dependent syndrome represented 23%.
Deaths
registered in whole Island of Mauritius due to Alcohol, occurred mainly in the age group 40 years
and above .
Female deaths registered in whole Island of Mauritius , due to Alcohol, represented 14 % of all
deaths registered due to Alcohol.
Table 21
ISLAND OF MAURITIUS , ALCOHOL-RELATED DISEASES
DEATHS REGISTERED IN WHOLE ISLAND 1996 – 2010 , ( by cause and sex )
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
252
242
192
193
155
187
198
251
218
207
225
225
264
232
217
Female
27
24
23
19
23
23
24
41
35
28
23
33
30
41
35
Total
279
266
215
212
178
210
222
292
253
235
248
258
294
274
252
Male
Figure 15
Island of Mauritius (2010)
Distribution of registered cause of deaths
due to alcohol-related diseases
Alcohol Dependence
Syndrome
25%
Alcoholic liver
diseases
45%
45
Cirrhosis of liver
( + or - mention of
alcohol)
39%
2010
Annex I
About NATReSA
A Trust Fund for the Treatment and Rehabilitation of Drug Addicts was set up in June 1986 following the
report of the select committee on drug addiction in 1985. In 1996, the drugs related problems were
reviewed by a committee and consequently there was a reorganization of the said Trust Fund into
NATReSA, National Agency for the Treatment and Rehabilitation of Substance Abusers in December 1996.
NATReSA was operating since July 1997 as a statutory body under the aegis of the Ministry of Health &
Quality of Life (MOH & QL), until December 2000 when NATReSA was transferred at the Ministry of Social
Security , National Solidarity, Senior Citizen Welfare and Reforms Institutions (MSS). After a passage under
the MSS, NATReSA was redirected back and is currently under the auspices of the MOH & QL
The main objectives of NATReSA are to co-ordinate and facilitate efforts at National level towards the
implementation of program for the prevention of substance abuse and the treatment, and rehabilitation of
substance abusers. To complement existing facilities for prevention of substance abuse, treatment and
rehabilitation of substance abusers. To mobilize resources locally and overseas for the treatment and
rehabilitation of substance abusers. To set up and manage institution for the treatment and rehabilitation
of substance abusers and provide after-care services for the rehabilitation of substance abusers, and
finally to advise, guide and help voluntary social organizations engaged in the prevention of substance
abuse, and in the treatment and rehabilitation of substance abusers.
The area of activities of NATReSA comprises :
o Substance abuse prevention and ideograph project in schools with the collaboration of the
Ministry of Education and Scientific Research.
o
Youth substance abuse reduction and prevention among the youth with the collaboration of the
Ministry of Youth and Sports .
o
Family substance abuse prevention programs and family with the collaboration of the Ministry of
Women, Family Welfare and Child Development.
o
Vulnerable groups /community based organization and NGOs .
o
Workplace /sectors and trade unions
substance abuse reduction and prevention in the
workplace with the collaboration of the public and private sectors.
o
HIV/AIDS prevention and control among Users of Mauritius with the collaboration of the Ministry of
Health & Quality of Life, AIDS Unit and other NGOs.
o
Recreational alternatives and quality of living project with the collaboration of the Ministry of Arts
and Culture and the Ministry of Youth and Sports.
o
Community
Alcohol/drug reduction and prevention campaigns with the collaboration of the
Sugar Industry Labour Welfare Fund, Social Welfare Division, NGOs, Forces Vives, etc
o
Local Authorities substance abuse prevention with the collaboration of the Municipalities and
District Councils.
46
2010
References
Annual Digests of External Trade Statistics - Central Statistics Office.
Non-Communicable Diseases(NCD) Survey, Island of Mauritius - 2009 – Ministry of Health & Quality of Life.
Annual Health Statistics Reports –Ministry of Health & Quality of Life.
Household Budget Survey - 2006/2007 - Central Statistics Office.
Survey on IDUs & Female Sex Workers - 2009 - Aids Unit , Ministry of Health & Quality of Life (Provisional ).
HIV / AIDS Action Plan for Injecting Drug Users (IDUs) - 2004 - Ministry of Health & Quality of Life.
National Multisectorial
Quality of Life.
HIV and AIDS Strategic Framework [NSF 2007 – 2011] - 2007 - Ministry of Health &
Digest of Crime, Justice and Security – 2009- Central Statistics Office.
Economic and Social indicators-Issue 917-August 2011.Central Statistical office.(Crime & Justice)
Economic and Social indicators-Issue 865-November 2010.Central Statistical office.(Tourism)
47
2010

Island of Mauritius - NATReSA

Transcription

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