Pubdate: Mon, 30 Aug 2004
Source: Mail and Guardian (South Africa)
Copyright: Mail & Guardian, 2004
Author: Wendell Roelf
Bookmark: (Treatment)
Bookmark: (Youth)


Shocking new research exposes some of the South Africa's drug
rehabilitation centres as poorly run institutions where physical and
psychological ill treatment of patients is rife.

"The government needs to take responsibility. They need to pay
attention to the programmes that are offered at the centres and not
just concentrate on clean kitchens and toilets as some of the main
criteria," said Smaragda Louw. She studied 33 rehabilitation centres
and psychiatric clinics offering in-patient treatment to adolescents
for her doctoral thesis.

Louw's as-yet-unpublished research takes place against the backdrop of
increasing drug use among youth, and lingering public outrage
following reports of assault and even death at the Noupoort Christian
Care Centre in the Northern Cape.

Tracing a series of unacceptable treatment practices, Louw said
adolescents between the ages of 12 and 17 were often further
traumatised by poorly run centres.

"Because there is no national data base that sets out information on
clinics and programmes offered, parents are helpless in choosing a
suitable rehabilitation centre and often rely on hearsay," said Louw.

Louw echoed an international journal which said it seemed some
treatment centres were taking advantage of the prevailing drug
hysteria in South Africa, by deliberately blurring the lines between
use and abuse, and scaring parents into putting their teenagers in
treatment with "as little provocation" as having a beer or smoking a

Louw said the effect of this was that teenagers who used drugs over a
weekend then found themselves in the company of heavy users, mostly
adults referred to facilities by the courts.

She said the research showed parents were paying high fees for
programmes that did not work.

"The financial implications are huge for the parents. They can pay
more than R53,000 for a so-called programme of 32 weeks."

Louw gave the example of a former bank manager who bought a farm in
Mpumalanga and was now charging R2000 per patient per month. According
to Louw, the man, who is the "owner, director and presenter" of the
programme, had very little knowledge of drugs, rehabilitation and the
development of adolescents.

A typical day meant waking up a 6am, attending Bible study until 8am
and then working for the rest of the day on the kibbutz-style farm.

She spoke of "appalling" physical conditions in which patients were
forced to live, such as a centre outside Port Elizabeth, where adult
and teenaged patients were forced to live in old municipal buses
converted into bedrooms.

Louw said this centre, run by an ex-member of the Special Forces, was
one of six centres, including Noupoort, which did not run a programme
based on a recognised theory or model.

"In fact, one can hardly call what they do in 32 weeks a programme,"
said Louw, adding that these centres were of the opinion that a
"biblical experience" will solve a teenager's drug problem.

Compounding the situation, Louw said professional services of
psychologists and psychiatrists were often eschewed. Former patients
were used not only to treat the drug problem, but also to deal with
associated traumas such as sexual abuse and dysfunctional family

At another centre in the Southern Cape youngsters wear placards around
their necks proclaiming their so-called sins, as part of the centre's
"behavioural modification programme", which according to Louw only
served to further alienate already vulnerable teenagers.

Louw said that programmes currently offered at various centres did not
address teenage problems. One of the main problems was that, "without
exception", none of the centres worked with parents as part of the
rehabilitation process.

Louw said she also came across centres where patients did not
understand a word of English or Afrikaans, but were nonetheless
compelled to complete a short programme of about three weeks.

Pierre Viviers, deputy director responsible for substance abuse in the
Department of Social Development, government was aware of the
functioning of facilities and the standard of service.

"Because of deficiencies, the Prevention and Treatment of Drug
Dependency Act is being reviewed to address the current issues and to
ensure improvement in the quality of services," he said.

Viviers said the department had developed norms and standards for
in-patient treatment centres, and together with partners were also
developing "best practices treatment" models for children and youth.

He said any treatment centres unwilling or unable to provide an
acceptable standard of service will be closed down.

"A number of treatment centres are being established in the country
and the department is putting in place mechanisms to deal with the
issue and all unregistered treatment centres will be given notice to
register soon," said Viviers, stressing that un-registered treatment
centres are operating illegally and could be prosecuted. -- Sapa 
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MAP posted-by: Richard Lake