Alcohol policy champion Hon. Betty Nambooze has vowed to renew her efforts to bring forward an Alcohol Law in Uganda to ensure comprehensive development and implementation of WHO-recommended alcohol policy during her new Parliamentary mandate.

In 2017, the Parliament of Uganda revived a private member’s Bill that sought to regulate the alcohol industry. The Alcoholic Drinks Control Bill, 2016, was initially brought forward by Betty Nambooze, the Mukono Municipality Member of Parliament (MP).

In 2016, MP Nambooze and a delegation of other MPs and their assistents joined Movendi International in Sri Lanka for a capacity-building trip, visiting with the Alcohol and Drug Information Center (ADIC), the National Authority on Tobacco and Alcohol (NATA), and attending workshops with Movendi International – on the margins of the alcohol policy conference Movendi International and ADIC had organized.

The “21st Century Alcohol Policy and Prevention Conference” brought together policy makers and advocates from around the world, including H.E. the President of Sri Lanka, Maithripala Sirisena, other decision-makers from the South-East Asian region as well as East African leaders, including MP Nambooze.

In 2019, just five months after the government’s sachet alcohol ban, the cabinet approved the new alcohol control policy for Uganda, the so called “National Alcohol Control Policy (NACP).”

The new policy aims to prevent and reduce alcohol harm through the following three measures:

1. Strengthening the regulation of the production, packaging, distribution, marketing, sale and consumption of all alcohol beverages;
2. Raising community awareness about the magnitude and determinants of the health, and the social and economic problems associated with alcohol use; and
3. Enhancing capacity and increasing technical support for prevention of alcohol and management of associated alcohol use disorders.

From policy to law – through parliamentary leadership

While the adoption of the National Alcohol Control Policy (NACP) is to be celebrated, there is more to be done to develop and adopt an Alcohol Law in Uganda as envisioned by Betty Nambooze. An alcohol law is necessary to implement the NACP in the country. Almost two years after adoption of the NACP, a resulting alcohol law has yet to be adopted. Betty Nambooze who was elected again to the 11th Parliament of Uganda has vowed to renew her efforts to make this alcohol law a reality.

An alcohol law would provide for the regulation of alcohol manufacture, packaging, licensing, sale, and consumption; and the restriction of alcohol advertising, promotions and sponsorships; as well as the protection of alcohol control policies from commercial and other vested interests of the alcohol industry.

The road to the Ugandan alcohol control policy was in no way a smooth one due to the alcohol industry’s aggressive interference in the policy making process.

Fortunately, the member organizations of Movendi International and other civil society organizations came together to form the Uganda Alcohol Policy Alliance (UAPA) – supported by the Swedish IOGT-NTO movement. Together they rallied to ensure a public health centric alcohol control policy.

It is a time for the public health champions to show face again, to see a proper law if the gains made in the policy shall be consolidated,” David Kalema, President of UAPA and founder and Executive Director of Hope and Beyond.

David Kalema, President, Uganda Alcohol Policy Alliance (UAPA)

USE OF MOBILE TRUCK SENSITISATION

In early March, 2020, the world was hit by a pandemic of COID-19, which has affected the lives of millions global.

Coronavirus disease (COVID-19) is an infectious disease caused by a new virus and spreads primarily through contact with an infected person when they cough or sneeze. It also spreads when a person touches a surface or objects that has the virus on it, and then touches their eyes, nose, or mouth.

The government through the ministry of health adopted preventive stay home measures which limited nearly all physicalinteraction activities in the communities including the closure of bars, this created room for  alcohol consumption in homes which has resulted into alcohol related harms especially domestic violence which is being reported to be on an increase.

Information on preventive measures is wholly aired on media channels including radio, TV and social media sites most of which are not easily accessed by the communities due to lack of radios, Tv set, smart phones ,interference in signals, lack of data to visit social media this  has kept many in the dark with only access to information got through word of mouth from colleagues which some time is inaccurate, Fear and misinformation have generated dangerous myths and misconceptions that consuming high strength alcohol can kill the CIVD-19 virus. 

The use of a mobile track sensitisation approach came in handy to address gaps in information and clear myths held in the communities.

Most of the notable myths held in the community included;

• “Drinking alcohol helps kills the virus in the body, whenever one takes it his body is fully set to fight a waragi will quickly burn it out of the body” one gentle man lamented in Bibo village in Gombe division.

• ”Corona is for people living in towns, working congested people with limited air but us here in the village we can freely do what we want drink our alcohol with no limitation, government lock down is wastage of our high life’ a young person in Matugga shared.

• “Sanitizers are made from alcohol, so what is wrong with buying alcohol you drink while washing your hands?

• “A drunkard is immune to the COVID19 virus, because his body is alcohol filled with alcohol, so no need to sanitize, body is already sanitized” a lady in Sanga shared.

 During the community sensitisation drive, the team consisting of a social worker, community development officer, health personnel from Buwambo health center up-to-date and accurate information about COVID-19 especially relating to alcohol use clarified on the myths and misconceptions as they transversed the villages while also emphasizing the guidelines by the ministry of health.

The community was informed that;

• alcohol has a deleterious effect on the immune system and cannot stimulate immunity and virus resistance so it is important to avoid alcohol all together so that one does not undermine his or her immune system and health and do not risk the health of other. 

• Ensure that children and young people  don’t  have access to alcohol and do not let them see you consume alcohol –be a role model

• Discuss with children the problems associated with drinking and COVID-19 such as violations of quarantine and physical which can make the pandemic worse.

Kye point

‘Under no circumstance should you drink any type of alcohol product as a means of preventing COVID 19 infection’

These efforts were greatly appreciated by the community especially the local leaders who informed the team that many people fill the virus is far away from them and since no one has died, there is no cause for alarm but now the community has got the information and will now behave with a lot of caution.

Background:

The COVID 19 pandemic globally has had a devastating negative impact especially in low income countries like Uganda who have fragile health system and can’t manage many cases. Governments declared lockdown and everything stood at stand still for over 75 days. Children and their families depending on small informal business closed, capital eaten up and didn’t know what to happen next.

Our entire 9 Drop in centers/safe spaces were closed and over 2000 slum youth and poor children scattered and a few went home. We received distress calls from some our young people we serve daily in our drop in centers that life had become unbearable, there was a lot of hunger, and some violence was inflicted on children. It is estimated that another 3 million Ugandans are expected to fall into abject poverty as a result increasing the number to 23 million people.

Children trying to cope in the pandemic were far worse off and some taken play by the exploiters in the name of giving food (exchange for sex). There was a spike and increase of sexual exploitation and abuse of children in the informal settlement and slums. Gladly we requested for support from University of California Los Angeles (UCLA) through Dr. Mary Jane Rotheram and OAK Foundation, who responded positively to this emergency to assist and help over 1500 children in Kampala city who were scattered in the city. UYDEL received USD $ 25,000 from OAK Foundation towards support for procurement and distribution of food relief and other basic necessities to young people to contribute to their welfare and also prevent infections of COVID 19 in the communities.

UYDEL Response: With support from our donors, we have put together hygiene basket composed of wash stands with buckets, soap and Dettol, with informational brochures that were distributed through our networks and with our partners in urban communities, and in support of local government leadership. We are mobilizing and supporting youth in our networks who know how to sew to make artisanal face masks that can be made available to the wider community on sale at reasonable cost.

UYDEL also tapped into the COVID 19 response fund under the EASY U25 Project to provide funds worth 96,726,000/= to cater for Foods and emergency support for vulnerable slum youth and their families under the project, Personal Protective Equipment (PPE) and support to Slum youth and UYDEL Staff while at the drop-in centers and Secretariat and Provide Foods and emergency support for vulnerable slum youth and their families under the project.

In these few weeks we have seen families living in extreme poverty being hit even harder by the crisis as prices for basic food items and supplies skyrocket.  We are lobbying our networks for support and once this is realised then we plan to provide these families with additional cash subsidies to help keep food on the table. For homeless people and children this is worse. The UYDEL communication and M&E team has worked on critical messages to share as the risk for violence and exploitation of women and children - especially girls – increases significantly in times of crisis. These messages will be shared on community radio, on Whatsapp networks, by text messaging and other ways UYDEL usually communicate.

Conclusion: This has so far been a successful activity since many young people have benefitted from the relief items. We still have some leftover food to reach some more young people. However, many numbers of youths are still unreached and they need food now since the lock down has been extended for another 21 days. Many will not start immediately any enterprises to improve their survival and coping.  We anticipate many parents will not be able to support their children in the immediate future and many children are likely to be enticed into sexual exploitation, homelessness ness.

The way forward goals are to reach 1,300 (900 girls and 400 males) at UYDEL training centers and 9 city youth drop in centers. Vulnerable poor hit by pandemic as a short term measure to reduce trauma, dependency, sexual exploitation, trafficking, and violence and encourage recovery and also to build resilience and social capital for full recovery and reduce trauma and sexual exploitation.

UGANDA YOUTH DEVELOPMENT LINK

Alcohol Harm Prevention Project

Radio Talk Show Report

Discussion Topic: Situation analysis of Alcohol abuse among young during the COVID 19 lock down

Station: Tiger FM 102.5 frequency  located in Nansana Municipality

Date:11th June 2020; 9:00AM to 10:00AM         

Guests: Mr. Mutaawe Rogers; Senior Programme Manager & Mr. Lubega Andrew; Project Officer

Objectives:

• To discuss the situation of alcohol abuse among young people during the COVID 19 lock down
• To share experiences about the effects of risky behaviours among youths in Uganda.
• To offer solutions to address the challenges of alcohol use that affect youths.
• To share the way forward towards supporting the youths during this “new normal” in Uganda

Background information

This is a morning flagship programme conducted in the local language Luganda on Tiger FM. The radio set aside every Thursday to discuss key salient issues that concern health of people in the community hence the topic of the day.

Summary of the proceedings

Way forward

Mr. Mutaawe concluded by thanking the host for inviting him to share his experiences with young people and also teaching the youths values of self-reliance and survival to address the unemployment problem. He thanked the station for the opportunity and urged the management to always create time for developmental programs. He urged the young people to stay resilient and calm as the Nation grapples with the lock down.

On the other hand, Mr. Lubega urged the youths to avoid alcohol use and abuse by being in presence of good peer groups, applying life skills, and engage in productive ventures. He noted that UYDEL will continue working closely with Nansana Municipality to develop alcohol bylaws to regulate alcohol sale and consumption. He called upon the business owners to always consider public health and safety as they sale alcohol. They should not sale to minors.

UGANDA YOUTH DEVELOPMENT LINK

PRESS RELEASE
RE: Alcohol and COVID-19; Two pandemics colliding 

Introduction:
 In Uganda we have seen a spike and unprecedented levels of drinking leading to increase in domestic violence and addiction levels. Some men are spending more time drinking and hence diverting money meant for food to buying alcohol.
Facts about alcohol in relation to COVID 19
a) Consuming high-strength alcohol does not kill the COVID-19 virus. If adulterated with methanol, can result in severe health consequences, including death.
b) Alcohol is not a food stuff
c) Alcohol is not an essential commodity
Alcohol use is related to COVID 19 in the following ways;
1. There are high chances that some bars and pubs may be operating illegally as they currently yearn for customers to buy alcohol despite the fact that they have been prohibited by government not to operate. This is recipe for the spread of the COVID 19 because there is a likelihood of close contact with patrons without observing social distancing.
2. There have been reported cases of domestic violence which is partly attributable to drunk husbands beating their wives during this crisis situation.
3. Drinking alcohol weakens the immune system and increases the risk of adverse health outcomes which makes it difficult for the body to fight infections like COVID 19.
4. Drinking alcohol affects one’s ability to make sensible choices or decisions to protect oneself from COVID 19.
5. Increased alcohol use among the community members as they try to deal with unemployment, stress, and loneliness during the lock down.

There are other ways to deal with stress without drinking alcohol.
Restricting Alcohol Access during the COVID-19 pandemic
The Uganda Government has issued a variety of “stay at home” orders, nearly all of which ban on-premise food or alcohol consumption and the subsequent closure of bars and restaurants to patrons. These unforeseen and new challenges have led to new approaches to alcohol sales in many areas, including alcohol delivery through food service apps.

 We have seen social media platforms that are promoting online adverts from one of the big alcohol industries in Uganda encouraging the population living in Kampala and Wakiso to visit a website and place an order which would be delivered to the respective patron in line with government movement directives. We condemn these acts in the strongest terms possible.

The Alcohol Industry should not reap from the people especially at this time when people should spend wisely the little they have since the economy is slow now. This is a time to promote healthy behavioural changes; people should stay home sober with their families to avoid likely consequences of alcohol use.
The general population should be reminded to observe the following;

a) Parents/guardians should be role models to their children and young people by making sure they do not have access to alcohol. Parents should talk to them about why drinking affects
 behaviours that can expose you more to the virus.
b) People should stay calm without alcohol. Fear and anxiety are common during the
pandemic. Alcohol only makes them worse. Do not drink alcohol to cope with your
emotions.
c) People should be resilient without alcohol. Drinking alcohol during home isolation increases
the risk of violence and injury.
We therefore appeal to;
1. Government to regulate and impose a complete ban on the distribution, transportation and sale of any liquor and alcohol in any form during this 21-day COVID 19 lock down. Many young people and men are resorting to drinking liquor in homes and urban centers in big groups which compromises social distancing. This is a factor that needs urgent and timely attention.
2. Government should institute another taskforce to support affected communities by providing psychosocial support, and counselling services to cope, adjust and adapt with the current situation.
3. Media programmes need to focus on building and communicating hope, adaptation to the current situation, recovery and successful outcomes post COVID 19 lock down. Less time should be allocated to issues of hopelessness, unemployment, stress and trauma.
4. The COVID 19 prevention messages should be complemented by communicating with the public about the risks of alcohol consumption, and maintaining and strengthening alcohol and drug rehabilitation services.
Signed,
Rogers Kasirye
Executive Director
For further details you may visit www.uydel.org
  

We invite you to register for this free webinar-based training course on Motivational Interviewing (MI). The three week long series is presented by Igor Koutsenok, MD, MS, Professor of Psychiatry at the University of California San Diego, Department of Psychiatry.

Motivational Interviewing is an essential, client-centered, counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence. We are absolutely thrilled to bring you this skills-building opportunity presented by a recognized expert in the field of MI.

The course consists of four sessions to be held during June 2020 (see course descriptions and session dates below).

We highly encourage registration for all sessions.

Course Description

This is a training in evidence-based clinical methods of motivational interviewing (MI). After orientation to the underlying spirit and principles of MI, practical exercises will help participants to strengthen empathy skills, recognize and elicit change talk, and roll with resistance. Research evidence will be reviewed for the efficacy of MI and for the importance of building therapeutic relationships in clients’ outcomes. Integration of MI with other treatment modalities will be considered.     

Course Objectives

The goal is to provide knowledge and practical skill training for various practitioners on effective ways to enhance motivation of patients with substance use disorders that require significant behavioral changes to initiate and sustain positive and healthy behavioral choices. Skill building, and experiential training will be emphasized throughout the course by exercises to develop a therapeutic alliance with patients, assess patient needs, level of engagement in treatment process, structure treatment sessions, select appropriate interventions, and assist patient in maintaining motivation for a sustainable behavioral change.

Participants will learn the basic and advanced skills in motivational interviewing and strategies for engaging patients in collaborative relationship in treatment process and assist them in achieving sustainable positive behavioral changes. The course will:

1. Help participants to acquire a systemic perspective of motivational interviewing and other motivational enhancement strategies;
2. Build necessary clinical skills and attitudes to implement new strategies in working with ambivalent patients.

Learning Outcomes

Upon completion of the course, every participant will be able to:

1. Describe all the aspects of the spirit of MI
2. Explain the differences between MI and other counselling strategies
3. Demonstrate the ability to respond to clients with reflective listening statements
4. Identify change talk within client speech
5. Generate open questions designed to elicit change talk
6. Generate MI-consistent responses to client resistant statements
7. Differentiate commitment language from other forms of change talk
8. Provide and empathetic summary statements collecting change talk

Course Content, Dates & Registration

Session 1: Thursday June 4th 2020

Motivational Interviewing: Basic Understanding

After orientation to the underlying spirit and principles of MI, practical exercises will help participants to strengthen empathy skills, recognize and elicit change talk, and roll with resistance. Research evidence will be reviewed for the efficacy of MI and for the importance of building a therapeutic relationship in clients’ outcomes. Integration of MI with other treatment modalities will be considered.  

Learning outcomes:

• Introduction: Motivation and behavioral change in addiction medicine
• Review of the concepts of Ambivalence, Stages of change, the righting reflex, limits of persuasion.
• Spirit of MI
• Expressing empathy
• Roadblocks to communication
• Four Processes in MI

Time: 9am Pacific / 12pm Eastern / 5pm London

Duration: 1 hour

Webinar Recording 

Slide Deck

Session 2: Thursday June 11th 2020

Fundamental Skills in MI - OARS

This session will focus on Fundamental Skills in MI (OARS), providing practical exercises to help participants to strengthen empathy skills, recognize and elicit change talk, and roll with resistance. Participants will learn strategies for engaging patients in a collaborative relationship in the treatment process and assist them in achieving sustainable positive behavioral changes. Research evidence will be reviewed for the efficacy of MI and for the importance of building a therapeutic relationship in clients’ outcomes. Integration of MI with other treatment modalities will be considered.    

Learning outcomes:

• Open and closed ended questions
• Affirmations
• Summaries
• Rowing with OARS

Time: 9am Pacific / 12pm Eastern / 5pm London

Duration: 1 hour

Webinar recording

Session 3: Thursday June 18th 2020

Fundamental Skills in MI Continued

This third session will continue to focus on MI fundamentals, with a focus on more advanced skills and the integration of MI with other strategies and treatment modalities. Research evidence will be reviewed for the efficacy of MI and for the importance of building therapeutic relationship in clients’ outcomes.       

Learning outcomes:

• Recognition and responding to change talk and sustain talk
• Forming reflections
• Levels of reflections
• Recognizing readiness
• Initial and intermediate planning
• Integration with other skills and strategies

Time: 9am Pacific / 12pm Eastern / 5pm London

Duration: 1 hour

Webinar recording 

Session 4: Friday June 19th 2020

The fourth and final session will continue to build on MI Fundamentals covered in Session 3, increasing your knowledge of advanced MI skills.

Time: 9am Pacific / 12pm Eastern / 5pm London

Duration: 1 hour

Webinar recording 

We look forward to you joining us for these virtual sessions! Please contact info [at] issup [dot] net if you have any questions.

About Professor Koutsenok

Dr. Igor Koutsenok is а Professor of Psychiatry at the University of California San Diego, Director of the Center for Addiction Research, Training and Application, Director of the SAMHSA PEPFAR International Addiction Technology Transfer Center-Ukraine, and a co-director of the SAMHSA PEPFAR South East Asia Addiction Technology Transfer Center. He is also a Vice-President of the International Consortium of Universities on Drug Demand Reduction.

In 1983 he graduated as a medical doctor from the National Medical University in Kiev, (Ukraine). In 1986, he completed his psychiatry residency training and received degree as psychiatrist from the Medical University in Sofia (Bulgaria). In 1993-1996 he received a degree in addiction psychiatry at the University of London, Department of Addictive Behavior and Psychological Medicine at St. Georges Hospital Medical School. In 1996, he was recruited by the University of California San Diego, School of Medicine, Department of Psychiatry and since then he serves as faculty member of the Department. In 2013-2016 he served as Chief of Prevention, Treatment, and Rehabilitation at the United Nations Office on Drugs and Crime, United Nations Office in Vienna.

Over the last 25 years Dr. Koutsenok led the design and implementation of multiple training and technical assistance programs for mental health and addiction treatment practitioners, primary health care and social work practitioners, criminal justice professionals in the United States and around the world. He is also directing the UCSD Summer Clinical Institute - the second longest running Summer Institute in the United States (over 40 years). Dr. Koutsenok is also a member of the International Motivational Interviewing Network of Trainers (MINT). 

For many years, Dr. Koutsenok taught general and addiction psychiatry to medical students, psychiatry residents, psychology trainees, social workers, criminal justice professionals, and policy makers around the world. He is a recipient of numerous national and international awards. He has authored and co-authored over 50 scientific publications, one monograph, and contributed to 4 book. Dr. Koutsenok has been invited as a presenter and trainer to hundreds of conferences and workshops in the USA and more than 40 countries around the world. He is a proud father of three.

The Smart Club Contract Concept: An Evidence-Based Primary Prevention Method for Children in East Africa

by Lubega Andrew (UYDEL)

The Contract Concept is a means or tools for children and adolescents to lead better lives with Human Rights, better school attendance and results and growing up without the burden of alcohol/drugs and other substances.

SMART’s contract method is locally based and includes components such as

• individual contracts with participating children / adolescents
• guardian's written approval
• temporary membership
• voluntarily to be a member (or abstain) and the right to exit
• the right to come back (even after any exclusion)
• consequence in breach of contract
• positive reinforcement, encouraging the good choices (benefits)

Everyone (in the target group) is equally welcome, regardless of creed, race, and gender.

The goal is to support children and adolescents to gain control of their lives s, assist them in making better and informed smart choices, demanding for their fundamental Human, Gender Rights.

By introducing a Smart Club Concept we empower kids to never to start drinking/smoking/sniffing solvents or even trying narcotics but. Instead they can engage in fun or educative activities, make new friends and become aware of their Rights. They start demanding equal rights, democratic decisions. Some change from truants, who seldom go to school, to become interested in education, understand that it’s up to them how their grown-up lives will be. We work for making them change attitudes and show ambitions hence contributing to sustainable goal 3 and 4.

The concept was introduced by Smart International’s Slim Liden and the first Smart Club in Uganda –was established at Makerere COU Primary School by Uganda Youth Development Link followed by subsequent clubs in Kiteezi center for learning and disability by My self-Uganda  and one Children And Youth Empowerment Link in Kanyanya.

The contract concept is also being implemented in Kenya by Mr. George Ochieng under the Slum child Foundation and in West Africa.