Prelude:

A lot of special needs assessment, work studies, surveys, interviews, etc on HIV/AIDS, Drug Abuse situations in Manipur has been carried out by various NGOs, voluntary organisations, societies and others in the State working in the said field since 1980. At present there are more than 110 NGOs empanelled under MACS and many non-empanelled NGOs under MACS with more than 10,000 NGO workers and others have been physically, mentally exercising their home works so as to fight the two dreaded diseases.

However, the number of addicts in 1992 numbering 20-40,000 has remained more or less the same till date. It may be mentioned here that Health Minister of Manipur in his speech on International Day against Drug Abuse and Illicit Drug trafficking on 26th June 2006 stated that, 'There were 40,000 addicts in the State'.

The number of HIV+ cases - 961 in 1990 has risen to 24,198 cases as on 31-09-06. It can be attributed to several factors - the dedicated works by the concerned workers, volunteers, well wishers and the general public leading to better coverage of awareness with positive attitude and healthy behavioural practices.

The better availability of health facilities, care and support services for free confidential counselling, free HIV testing, free CD4 count for patients under BPL fund others at Rs 250, free ART up to CD4 count 300m3 with WHO AIDS stage III and IV, free Niverapin Therapy in PPTCT.

The number of HIV detected cases is higher than that of the death cases. The better facilities for drug abuse with respect to investigation and thereby enhancing detoxification, treatment and management services, etc. The increase in drug addicts is also related to drug dependence nature itself and the high rate of relapse as high as 85%. With the full recovery of 15% only in many of the studies, to increase the number of recovery addicts/fully recovered addicts is an uphill task.

Introduction:

The Drug abuse especially the heroin abuse in Manipur could be traced back to the students of the State studying outside the State (Manipur) in Pune, Mumbai, Delhi, Kolkota, etc. The Drug Abuse was started in the State in 1979. By 1984, it reached an explosive situation.

A research study in 1984 identified 335 heroin users including 35 females. 72% of the Heroin users were IDUs. By 1986 the HIV sero-surveillance was started. There was, no incidence of HIV infection among the IDU in Manipur from 1986 to 1990. But in February 1990 the first HIV positive in Manipur was reported from a cluster of 6 IDUs from blood samples of October 1899.

Further, the 1991 ICMR survey estimated that there were 15,000 IDUs in Manipur. The 1992 Voluntary health Association of lndia in their study estimated that there were 40,000 drug users out of which 20,000 were IDUs.

It is true that perhaps Ukhrul district launched the first anti-drug awareness campaign against drug abuse, alcoholism, smoking as early as in 1980 in Manipur with some social activists, well wishers like, Mr. Luingam Luithui, International Human Rights Activist, now a citizen of Canada, Mr. Sebastian Muishang Hongruy, Supreme Court Lawyer, New Delhi, and Human Rights Activist, Dr. ASK. Felix, Specialist PH, Professor Ms. Chonmila Lungleng and others.

The first 3 cases were detected and recorded by Dr. ASK Felix in 1981 in Ukhrul. They were two girls and one boy. The boy was detoxified, treated by him and later got treated at Silver Jubilee Memorial Hospital, Hundung, under the care of Sister, Dr. Visitation, MD; Child Specialist trained in West Germany. He fully recovered from drug adduction and went to study to Delhi and become an electronic engineer.

It is accepted that the peak level of drug abuse in the state was from 1984 to 1992. One of the first detoxification camps was held under the supervision of Dr. P. Narendra, MD, renowned Physician and National AIDS Trainer, Dr. ASK Felix and others at PHC, Ukhrul in 1985.

Drug Abuse and HIV/AIDS Situations in Ukhrul district

It was a joint effort of the above mentioned persons with many Tangkhul NGOs, Social organizations, like Tangkhul Mayar Ngala Long (TMNL/Tangkhul Youth Council - formed in 1984), Tangkhul Shanao Long (Tangkhul Women Organization), Ukhrul Town Women Committee, Ukhrul and others. The Youth Council carried out surveys on drug abuse, prohibition and smoking from 1983 (15 addicts) till January 2006 (4,000 - 5,000) with five surveys.

In 1983 there were about 200 villages in Ukhrul district and every village has/had Youth Club, Students’ Union, Women Society, etc. Surveys were carried out by the trained youth volunteers on Drug Abuse in the villages. It was/is not difficult to know the addicts in the villages as the people belong to a closely knitted community/society.

This TMNL led the campaign on war footing. Today a number of NGOs/Social organizations like Tangkhul Youth Organization, Elshadai Resource Centre, Tangkhul Shanao Long (TSL/Tangkhul Women Association), Tangkhul Science Association (TSA), Tangkhul Catholic Youth Federation (TCYF), Tangkhul Catholic Shanao Long (Tangkhul Catholic Women Association- TCSL), Voluntary Network and Rural Technology (VANART), Kamphasom Shanao Long (Kamphasom Women Society), Ukhrul, St. Andrew Women Society, Ukhrul, Citizens Alliance for Re-empowerment (CARE), PASDO, UNP+, SOAR/EHA, DSSS Community Based AIDS & Drug Programme, Hundung, other NGOs, other religious organizations, etc are less actively or actively involving in the fight against HIV/AIDS and Drug Abuse. Ukhrul district today has 1164 HIV+ cases out of 3595 screened as on 31-09-2006 with estimated 4,000- 5,000 IDUs.

Further Needs Assessment

We need to do a deeper situational analysis. We need to further analyse the situations - HIV/AIDS situations, Drug Abuse situation, prevalence of STDs, Level of HIV/AIDS Awareness, the prevalence of high risk behaviour in the community, prevalence of drug injecting or prevalence of HIV among a particular high risk group, availability and accessibility of health care facilities/services, extent of stigmatization, discrimination, violation of human rights, the strengths and weaknesses of NGOs, Social organizations and CBOs, the political climate/commitment, the social and economic context, etc.

More detail assessment may be done in the area of the programme - considering the geographical area, local context, problem we want to handle and the likely response that we are likely to get from the community, other NGOs, Governments, funding agencies, stake-holders etc.

Our interest relates with Sexual health especially adolescent sexual health, and STDs or Drug Abuse or Sex workers, injecting Users and AIDS, Street children, destitute, migrant workers which constitute marginal population. Truckers and STDs or purely in the area of capacity building and training or IEC or Counselling, or Advocacy and social mobilization has to be taken into account.

The assessment study cannot be purely confined to HIV/AIDS and Drug Abuse but will be based on holistic health approach of all different health components, disciplines, etc. with special reference to the above two mentioned diseases. In a nutshell, the study will be based on the given specifications with data as minimum essential requirements with certain modified additions whenever situation arises.

1. The population, its age and sex structure
2. Statistics of morbidity and mortality
3. Epidemiology and geographical distribution of different diseases - HIV / AIDS, Drug Abuse, STDs and other opportunistic Infections (Ols).
4. Medical care facilities such as hospitals, health centres, private clinics, nursing homes, dispensaries and other health facilities in HIV/AIDS and Drug Abuse - VCCTC, Prevention of Parent To Child Transmission (PPTCT), Antiretroviral Therapy/Treatment (ART), STD Clinics, Drug De-Addiction Centres, Community Care centres, etc. They may belong to both public and private.
5. Technical Manpower of various categories
6. Training facilities available
7. Community response, Government response, responses of the NGOs/Social Organisations/CBOs, Women Societies, Churches and Church(es) Organisations, Political Leaders, Religious Leaders, Women leaders, Community Leaders, Educationists, Medical Personnel, the general public and others.