Research on Substance Abuse (Alcohol, Tobacco, Drugs) Use In Adolescent Population in Dhanghadi Municipality

Abstract

Introduction: The Center for Integrated Community Development (CICD) is a non-profit organization that is working in the field of Human Resources Development in Kailali/Kanchenpur and others districts of the Far Western Development Region of Nepal. CICD trains Auxiliary Nurse Midwives (ANM) and Laboratory Assistant students in an intensive clinical and community based program, and operates a Reproductive Health Center on campus. CICD's goal is to involve students in every aspect of community work, including research, so they can become confident practitioners and community workers in their own careers. Dhanghadi is a Terai bazaar town and Zonal Center, 1 km from the border of India (Uttar Pradesh). It has approximately 70,000 (Nargapalika statistics, Feb. 2004) people of various ethnic and religious backgrounds. Due to the insurgency the population has been steadily increasing, and more children and adolescents are migrating with their families from remoter villages. This has increased the burden on schools, particularly government schools. The Kailali Multi-Campus is also situated in Dhanghadi, and this school has an enrollment off approximately 3000 students, most of them in their early 20's. Despite this, Dhanghadi is still in the Far West Development Region, which is the most underserved and poorest Districtin Nepal. Early marriage and pregnancy rates are still high, as is female illiteracy as well. There is a high unemployment and underemployment rate in the area, exacerbated by the increasing population and migration. Most people in the area still rely on subsistence farming only to support their families. Migratory workers to India, especially with the close proximity of an open border, adds additional social pressures on families. According to the United Nations (UN Office on Drugs and Crime, March 2003 Nepal country file) "cannabis is being grown increasingly in the Terai region close to the Indian border ". On the other hand, often other drugs are easily obtained across the border in medicine shops in India and other cross border supplies (Chatterjee, et al). Tobacco and alcohol are both readily available and sold openly. Advertisements for these substances are seen throughout the municipality and like other parts of the world young people are increasingly targeted by advertisers as a new market. CICD recognizes, as health professionals, the increase of drug abuse and addiction in the area, especially among young people and adolescents, is growing. Not only does this affect individual health, but impacts family health, children's health, as well as the health of pregnant women, their unborn children and newborns. With an increase of injectable drug use, an increase of HIV/AIDS is being seen in the area as well. The social implications of drug use and abuse are also of great concern among health professionals in the area, as in all of Nepal. The setting of this research was in three separate wards of DhanghadiMunicipality. These wards were chosen to represent three different but representative populations of young people in the area. Ward 2, Bhansar was chosen as it is on the border with India. Dhanghadigau, 8, was chosen as it has a predominantly Tharu (Rana and Chaudhary) population. And Taranagar Gau, 5 was chosen as it is a mixed community (Brahmin, Chetri, Tharu). All three wards are within the municipality and close to the main bazaar, but still have their own sense of community and are agricultural based villages. In each ward 50 students were selected, making up 150 total. The target group of the study was adolescents (defined here as ages 15-20), but youth (defined here as ages 20-25) were also included in the study to further test out, in later studies, the differences and/or similarities in KAP in this area.