Cold turkey at Vietnam’s compulsory drug rehab centers

This picture taken on November 2, 2017 shows staff handing a dose of methadone to a recovering drug addict at a treatment clinic in the northern city of Bac Giang. During four years of compulsory rehab in Vietnam, Trung spent his drug-free days gluing together false eyelashes as part of what authorities billed as valuable 'work therapy' for his heroin addiction. But critics say the work of Trung and tens of thousands of others is tantamount to forced labour that rarely helps users extinguish their addiction. (AFP)
Updated 11 December 2017
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Cold turkey at Vietnam’s compulsory drug rehab centers

HAIPHONG, Vietnam: During four years of compulsory rehab in Vietnam, Trung spent his drug-free days gluing together false eyelashes as part of what authorities billed as valuable ‘work therapy’ for his heroin addiction.
But critics say the work of Trung and tens of thousands of others is tantamount to forced labor that rarely helps users extinguish their addiction.
Police sent Trung to a state-sponsored rehab center on the outskirts of Hanoi, one of 132 in Vietnam, where he says he faced routine beatings from guards and hours of labor for nominal pay.
“Life there, from eating, to walking, to sleeping, to working — there was no human rights at all,” explained the 50-year-old, who first began using drugs some three decades ago.
He started using again soon after his release in 2014 — up to 80 percent of addicts from the centers relapse, according to official figures.
Trung’s labor therapy has since been replaced by a daily shot of methadone from a government-run drop-in clinic, which he insists is the only effective treatment he’s had.
Today he says he is keeping the addiction at bay, and is trying to mend ties with his only son.
Between 2014 and 2016 more than 65,000 addicts cycled through the centers, usually a mix of compulsory patients sent by police with those admitted by exasperated relatives.
Sometimes they house other marginal groups — the mentally ill and disabled, the homeless, the elderly — along with addicts like Trung, who support the treatment model on paper even if they resent the abuse inside.
Most will stay for one or two years, or up to four if they are deemed unfit for release, and are subject to a range of daily labor — from farming cashews to making sportswear for Western clothing brands, which they can sometimes earn a meagre salary from.
Rights groups accuse officials at the centers of skimming from those salaries or pocketing boarding fees paid by some users’ families, and say addicts are detained against their will.
“These are a failure in terms of drug treatment, but they’re incredibly successful in terms of generating money for government functionaries who run the centers,” said Richard Pearshouse, an associate director at Human Rights Watch who authored a report about the facilities.
Though similar centers exist throughout Asia, experts say the term length and the sheer number of facilities in Vietnam set it apart.
Conditions inside vary widely, though several overcrowded centers have experienced mass breakouts.
The government has acknowledged the need to reform the facilities and has softened drug policies, piloting community-based treatment and methadone clinics.
“Vietnamese laws and regulations are being perfected, especially when it comes to drug rehabilitation and treatment, to consider drug addicts patients,” said Le Thanh Tung, director of the Department of Social Evils Prevention in Hai Phong city.
The center houses some 500 addicts — mostly admitted by relatives — who after an initial period of cold turkey withdrawal behind padlocked doors are moved to dorm rooms.
Once clean, they are put to work sewing shoes or tending vegetable gardens and can receive vocational training as electricians or carpenters.
Many in Vietnam think the scheme is a good thing.
“Drug addicts do nothing good for the family or the community, they should be locked away,” said Ms Luong, mother of two heroin-addicted sons.
“When you have a drug addict in your house, you live in hell. I have two as such,” she told AFP in tears.
Her sons used to pawn her furniture to fund their habit, prompting her to send one to a rehab center. She kicked the other out and hasn’t seen him in years.
Like most of the 200,000 registered drug addicts in Vietnam, her sons were hooked on heroin, though methamphetamines are increasingly popular among Vietnam’s youth.
Several organizations are trying to roll out community-based care to allow recovering addicts to lead normal lives, and even keep steady work.
But some programs have struggled to gain traction.
“The number one obstacle for us is the lack of awareness about how complex addiction treatment is, people want to have a silver bullet,” said Oanh Khuat, executive director of the Center for Supporting Community Development Initiatives (SCDI), an NGO that promotes voluntary and community-based programs.
That approach is one that heroin addict Quan thinks could work for him.
He spent three months and nearly $900 on a voluntary program — another rehab option run by the government — hoping for better treatment he might have received at a compulsory center.
But he quickly started using again after he left.
“The rehab model in Vietnam isn’t efficient,” the chain-smoking 46-year-old told AFP.
He’s home again with his family, but jobless and getting high every day.
“We see no help, nothing from the local authorities,” he said. “They have always created trouble for me, supervising me as if I was a criminal.”


Expert calls for self-examination for early detection of breast cancer

One in every eight women will suffer from breast cancer in her lifetime. (Shutterstock)
Updated 23 October 2018
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Expert calls for self-examination for early detection of breast cancer

  • Women in Saudi Arabia have become more aware of the disease and receive support from their families

JEDDAH: In honor of Breast Cancer Awareness Month, Dr. Amel Merdad is providing a helpful guide about the disease to women .
Recent statistics from the World Health Organization (WHO) indicate that more than 1.2 million breast cancer cases are diagnosed worldwide each year. Breast cancer kills more than 500,000 women a year. The disease ranks second in cancer incidence, after lung cancer, worldwide.
One in every eight women will breast cancer in her lifetime.
The evolution of scientific research and increased awareness have contributed significantly to the increase in recovery rates, as a result of early detection of the disease.
Ten percent of breast cancer cases occur as a result of genetic mutations inherited by the generations in a family.
The incidence of breast cancer increases with age, and it usually occurs after age 40. The average age of breast cancer patients in Saudi Arabia is 48 years and it is so worldwide. Dr. Merdad provided her advice on early screening methods. “Periodic self-breast examination helps women to be aware and familiar with their breasts so they can take care of them, being healthy and not only pretty.
Dr. Merdad added that self-breast examination is to be done once a month on the sixth or seventh day of the menstrual cycle from the age of 20 and forward. “In the case of menopause, self-examination takes place on the same date every month,” she said.
She also gave these useful guidelines:

Self testing
Stand in front of the mirror and look at the breasts to check for anything unusual, such as the presence of lumps or differences in the size of the breasts or the presence of swelling or changes in skin or nipple.
Put your hands behind your head to notice in the mirror for any difference in the lower part of your breasts. Put your hands on your waist and bend forward slightly with the pressure of the shoulders and elbows forward to check for any change in the shape or size of the breasts.
Lift your left hand and use three fingers from the right hand to examine the left breast in a circular way from the outer edge of the breast and in the direction of the nipple, focusing on the area between the breast and armpit and area under the armpit.
Repeat this step with your right breast. Press the nipple gently to observe any abnormal discharge. Repeat the previous steps while lying on your back.

Screening
Age 20-40 years old: Self-examination is recommended monthly. Also check with your doctor every three years. An ultrasound is recommended for the breast examination only if necessary.
Age 40-65 years: Self-examination is recommended monthly and check with the doctor every year. Mammograms are indicated once every one to two years for all women.
More than 65 years: Monthly self-examination and check with your doctor annually. Schedule a mammogram every two to five years.
Dr. Merdad said that taking care of a woman psychologically plays an important role in enhancing the cure rate.
“To all women. Protect your health, have a great life, and screen yourselves for breast cancer,” she added.