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Sahil Quarterly Magazine April-June 2009 Sahil against Child


									                                 Sahil Quarterly Magazine
                                      April-June 2009

                                 against Child Sexual Abuse


Adolescents at Risk
Treatment and Prevention of drug Addicts
Psychosocial Correlates Of Drug Abuse in adolescents
Solvent Abuse among Street children in Pakistan
Sheesha…. Yes or No!
We can all make a Difference
Cruel Numbers Jan-June 2008
We are only eight!
What’s On at Sahil

Senior Editor
Manizeh Bano

Rubina Shams
Wajeeha Anwar

Title: Sarwat Batool
In recent years illegal drug consumption has increased throughout the world, and despite the lack
of reliable data, there is enough information to show most of the countries in the Asia are
following this rising trend. The prevalence of heroin abuse and serious related health effects are
particularly worrisome in the region as is the recent rapid rise in the abuse of synthetic drugs.

Abuse problems are most apparent among socially and economically disadvantaged groups
including unemployed youth, street children, the homeless, ethnic minorities, prisoners, migrant
and commercial sex workers. Drug abuse is also becoming increasingly diverse in terms of the
substance used, the characteristics of the user, and the situations in which drug abuse occurs.
Studies show that by age 14, about 35% of youth have engaged in some form of illegal (illegal)
drug use in the United States. By the end of high school, more than 50% will have tried at least
one illegal drug. Teens who begin using illegal drugs before the age of 15 are more likely to
develop a lifelong dependence on illegal substances. And if we take the instance of Pakistan, as
young as 8 years old street children have been involved in abusing drugs.

Parents may not realize just how easily drugs are available to their children. They may not
realize how very young children can begin to experiment with different types of drugs. Statistics
can be sobering, and can alert parents to the need to communicate with their children about the
dangers of substance abuse and help them develop strategies to cope with peer pressure.

We are trying to suggest ways that young people can adopt to prevent themselves from getting
into this menace, by presenting the statistics of some researches done on this issue. This issue
focuses specifically on drug abuse among adolescents to give an insight not only to parents about
what their children are doing, but also to children who are using drugs just for fashion sake or to
keep up with their social friends.
                      Adolescents at Risk: Illegal Drug Use
                                    By: Rubina Shams

It is important to teach students about              declining, 12th graders' use by
drugs, for their own good. Drugs can                 means of inhaling is increasing.
cause nothing more but a death at a                 Cocaine has been a serious drug
younger age. We are in charge of our                 problem for almost a century.
lives so we have to be very careful in              According to the National
choosing what is right for us.                       Institute on Drug Abuse (2001),
                                                     5% of 12th graders reported
Studies world over show that with the                using cocaine in 2000.
onset of puberty, nearly 35% of youth
have engaged in some form of illicit           Teens at Risk
(illegal) drug use. Teens who begin
using illicit drugs before the age of 15       Factors associated with increased risk
are more likely to develop a lifelong          for any type of illicit drug use include at
dependence on illegal substances. Below        least one or more of the following:
are a few of the most common drugs
used by youth.                                      Poor parent-child relations.
                                                     Studies show that living in a
    Marijuana is the most prevalent                 stressful home environment with
     illicit drug used by teens because              relatively little parental support
     it is easily accessible. In fact,               and monitoring places
     most of the teenagers who use it                adolescents at greater risk for
     state that obtaining marijuana is               drug use.
     virtually trouble-free, and nearly             Low self-esteem. Adolescents
     40% of 10th and 12th graders                    who do not have positive views
     reported smoking marijuana.                     of themselves, or who lack
     Teens who use this drug are more                support and encouragement from
     likely to initiate the use of other             others are more likely to use
     drugs (e.g., cocaine and heroin).               drugs.
    Ecstasy is also a prevalent drug               Poor school achievement. Teens
     that is highly accessible and used              who have negative attitudes
     at teen parties. Over the past few              toward school and low
     years, ecstasy use by teens has                 expectations of academic success
     increased: one in thirty 8th                    are at increased risk of drug use.
     graders and one in twelve 12th                  Also, teens who use drugs
     graders reported using ecstasy.                 typically exhibit declines in
    Heroin is primarily injected into               grades, and inconsistent
     the vein but can also be inhaled                attendance at school.
     nasally and smoked. While 8th                  Peer drug use. During
     graders' overall use of the drug is             adolescence, peers become a
     major influence because of the            continued drug habits into and
     increased time spent with them            through adulthood.
     outside of the home. Some teens          Involvement in other illegal
     feel pressured to fit in and do           activities. Drug use has been
     what their friends are doing.             linked to higher tolerance of
     Consequently, teens that have             deviant behavior among
     friends who use drugs are more            adolescents. This results in
     likely to use drugs themselves.           increased criminal activity for
    Family environments that                  drug users compared to non-drug
     model drug use. Adolescents are           using peers.
     more likely to use drugs if              Increased likelihood of death.
     someone in their home uses                Drug use increases the odds of
     drugs. For example, parents who           death from accidental or
     use drugs may practice poor               intentional drug overdoses as
     parenting which may increase the          well as engagement in other
     risk of drug abuse for                    unsafe behaviors (e.g., driving
     adolescents. Also, parental or            under the influence).
     sibling drug use sets a model of
     acceptable inappropriate             What Can Parents Do?
     behavior for teens, makes it seem
     like a normal part of life, and      Communication is key in dealing with
     may encourage its acceptance by      any type of risk taking behavior during
     youth.                               the teen years. The hectic pace of work
    High risk communities. Living        and school can sometimes estrange
     in communities where drug use is     family members, especially parents and
     widespread not only makes drug       teens. But make the effort to keep in
     accessibility easier, but also       touch with your teen. Find out what is
     normalizes the act of using drugs.   going on in your teen’s life. During
                                          adolescence, parents may feel that their
What Are the Consequences?                influence over their teen's life is waning,
                                          but in fact, you have more power than
The effects of drug use vary by type of   anyone to prevent your child from using
drug and frequency of use, however,       drugs.
some consequences may include the
following:                                Here are some things that you can do to
                                          encourage your child to "Just Say No."
    Mental and physical health
     problems. Teens who use drugs              Stay connected with your teen.
     are at greater risk for developing          Keeping up to date with your
     a number of health problems                 teen's interests and friends is an
     including attention deficit                 important step in creating a
     disorder, anxiety disorders,                warm, communicative, and open
     phobias, and depression.                    environment. If your teen feels
    Increased likelihood of drug                that you are available and easy to
     use later in life. Early drug use           talk to, then he or she will be
     has been linked to positive                 more likely to share concerns
     attitudes toward drug use.                  that might lead to risk taking
     Consequently, teens who begin               behavior.
     drug use early are at risk for
   Begin an ongoing conversation         Take advantage of teachable
    with your teen instead of giving a     moments. These include talking
    one time speech. Make it clear         about scenes in movies or news
    that drug use is not an acceptable     headlines that deal with drug
    behavior in your family and be         associated topics. Explain your
    sure to talk about the reasons         position on these topics and ask
    why. Talk about the                    your teen how they feel about
    consequences of drug use. Help         what they are viewing.
    your teen visualize two futures,      Encourage healthy activities that
    one that includes drug use and         promote the use of your teen's
    one that remains drug free.            interests and talents. Most teens
    Where do these paths lead?             are curious and are eager to try
    Discuss your teen's life goals and     something new and challenging.
    how drug use can hinder them           High school is the peak time for
    from reaching them.                    both beginning substance use and
   Empower your teen. Teens tend          beginning lifetime habits that
    to want to rebel against their         include using illegal substances.
    parents' standards or advice.          Your parental example, support,
    Rather than dictate what your          and monitoring has a great
    child should or should not do,         influence on your teen's
    remind him or her that they have       behavior. Talk early and often
    the power of choice and that you       about the consequences of and
    trust that they can and will make      alternatives to using illicit drugs.
    good decisions.
   Teens sometimes abuse
    substances as a way of
    alleviating stress. Some
    experiences in life (e.g., not
    winning the match, poor
    performance in schools etc.) are
    both stressful and painful. Drugs
    are often sought as a means of
    temporarily easing pain or stress.
    Talk to your teen about any
    stressful events that are going on
    in his or her life and ways they
    can effectively handle them.
   Know your teen's friends. You
    can influence your teen's choice
    of peers by talking with them
    about the qualities that make a
    good friend.
   Encourage your teen's self-
    esteem by praising their efforts
    and achievements. Help them to
    master the things that they are
    good at. Show them you care
    through your involvement in
    their lives/activities.
Trea tment & P revention of Dr ug
            A ddicts
     By: Mr . Arbab Kashif Noor
Treat me nt Coordinator , Dost Welf are

                                                     like psycho paths, have diffic ult y
Treat ment is seldom nece ssary for youn g
people who are expe ri ment al or soci al            admi tti ng     to     any       psyc hologic al
drug use rs. The y eit her stop taki ng drugs        probl ems; typi cal ly t hey deny ne edi ng
of thei r own wil l or use wa ys t hat do not        help and resist cl ose or trusti ng
ge t them i nto psyc hologic al diffi cult y.        re lat ionships wi th psychot herapists and
Medi cina l a nd a ddict ive use of drugs, on        counse lors. In many cases, onl y a
the other hand, t ypica ll y int erfac es wit h      re si denti al rehabi lit ati on program , in
norm al devel opment and c all s for                 whi ch a thera peuti c en vironme nt c an be
profe ssiona l int ervent ion.                       provi ded over an ext ended peri od of
                                                     tim e, holds any
The      t reat ment     of     drug-abusi ng        prom ise for di re cti ng addi cted young
adolesce nts foc use s on t he parti cular           people to a sat isfying li fe styl e tha t is not
persona l, soci al and fa mil y fact ors             drug de pendant
associ ate d with an i ndivi dual youn g
person’s drug taki ng. Various forms of              Be cause the c hronic nat ure of a ddic tive
indivi dual and group psyc hotherap y,               drug use ma kes i t so di fficul t to modi fy,
fa mil y counsel ing, a nd comm unit y               most expert s i n t he fiel d beli eve tha t the
acti on programs have be en deve loped to            only real ly effe cti ve way of overc omin g
help the se adolesce nts improve thei r              it is to prevent it from occ urring in the
coping skill s, at tac h t hemsel ves to drug        fi rst pla ce. W ith this in m ind, e norm ous
                                                     re sourc es have bee n poured int o
fre e m odels and l ife st yles, fi nd a
support ive c lim ate at hom e, and resolve          progra ms of drug educ ati on over t he past
what ever psyc hologic al conce rns have             20 yea rs or so. These program s were
contribut ed to t heir dru g abuse .                 base d i nit ial ly on the expec tat ion that
                                                     adolesce nts who were inform ed about
Medi cina l drug users who are se ekin g             the ha zards of usin g drugs woul d not use
esc ape from fe el ings of anx iet y or              them . Howeve r, no evi dence ever
depressi on oft en re spond well t o                 emer ge d tha t pa rtic ipat ing i n a dru g
treat ment program s of t his kind that are          educat ion program dete rs adol escent s
aim ed at easing thei r tensions a nd                from drug use . To th e cont rary, ma y
helpi ng t hem m anage diffic ult sit uati ons       investi ga tors found t hat providi ng
in t heir l ives m ore e ffe ct ivel y.              adolesce nts wit h informat ion about
Addi cti ve drug use rs howe ver, l ike              drugs wa s producing a boomera ng e ffe ct
charac ter logic al de linque nts, are               that inc re ased ra ther than decre ased t heir
mani fe st ing m ore of a li fe st yl e t han a      level of drug involve ment .
re act ion      to      c urrentl y    t roubli ng
circum st ance s. Henc e drug addic tion             The ea rly effort s at drug educa tion were
oft en presents the sam e kinds of                   unsucc essful not bec ause the y were i ll
obst acle s t o effec tive trea tm ent. Addict s     concei ved but bec ause t hey were too
                                                     lit tle a nd t oo l ate . Most adole sc ents who
are goi ng to ha ve drug-rel ate d problem s      Detoxification symptoms—both physical
have alre ady be gun drug use b y the ti me       and mental—may appear when you alter
chil dre n ent er thei r t eens; hence,           your lifestyle by starting something new,
provi ding fact ual i nformat ion about           such as changing your diet or exercising,
drugs to chi ldren of 14 yea rs or more           or by discontinuing a current habit, such
cannot be expect ed to a ccompl ish ve ry         as eating chocolate or drinking coffee.
much. Li kewise, sca re tac tic s or              The symptoms may be of short duration
morali stic preac hing ai med a t t eena ge rs,   and slight irritation, or they could last
when the ir value system s have a lread y         longer and cause you considerable
been large ly sha ped b y fam ily and peer        discomfort.
influenc es, ca nnot be expe cted to fi nd        Because these symptoms are the same as
re cept ive e ars.                                those that show up in certain illnesses,
                                                  changing your diet or lifestyle can result
Wit h t his in mi nd, drug educ ati on in the     in misunderstanding: If I am doing
school s wa s gradual ly shift ed t o the         something that is supposed to be good
lower grade s, a nd focusing on the               for me, why do I have these symptoms?
hazards of usi ng drugs has been repla ced        Why do I feel worse, and not better?
by focusing on the bene fit s of avoidi ng        Understanding           this     apparent
them . At the sam e time , progra ms of           contradiction is perhaps the first, and
drug-a buse preve ntion pa id speci al            most important, hurdle you must get
att enti on to hel ping young pe ople             over when making a dietary or lifestyle
become suffic ient ly asse rtive and              change.
decisive to resist soc ial i nfluenc es t hat
wi ll ge t them int o troubl e; that is, t o be   The hardest thing for many people to do
able to say “ NO” to drugs. Program s of          is accept that they are not sick and
this kind a ime d at j unior high and             realize that the body is cleansing itself.
espe cia ll y el eme ntar y school student s      Once you get beyond this psychological
are showing promi se for i ncreasi ng             barrier, the process becomes easy. The
knowl edge about the impl ica tions of            most important thing to do can be
drug use , gene rati ng negat ive att it udes     summed up in one word: Rest.
toward becom ing invol ved wi th drugs            Rest, and let the body do what it needs
and re ducin g the subseque nt fr equenc y        to. If you have the luxury of staying
of dru g use.                                     home, do so! If not, cut back on social
                                                  engagements and perhaps even cut back
Drug Abuse Tr eatment                             on any exercise you are getting. Give
Drug t reat ment is c omposed of the              your body as much energy as possible to
fol lowing sta ge s:                              do its job. Eat light foods that are easy to
                                                  digest—consume fruits and vegetables
       Det oxifi cat ion                         and drink plenty of water.
       Pri mary Reha bili tat ion
       Se condary Reha bili tat ion              Detoxification is the first phase in the
                                                  treatment process, and lasts for 10 to 15
       Foll ow up & Aft erca re.
                                                  days, during this period physical
                                                  withdrawal of the drug takes place and
1.     Detoxi ficati on                           the patient feels very uncomfortable
Detoxification is the term used to                during this stage. He might attempt to
describe the process your body goes               commit suicide and can cause injury to
through to get rid of toxins.                     himself.
  The main features of detoxification             3)     Se condar y Rehabil itation
  therapy include;
                                                     Main features of this phase
         Symptomatic Medical Treatment.          include.
  (Treatment for symptomatic problem)                Skill Training according to
         No Substitute Drugs. (Never use         individual needs.
  substitute drugs, if situation is very             Regular training sessions.
  sever, we can)                                     Micro enterprise development.
         Hydro Therapy.                             Job placement and follow-up on
   (Giving patients a shower)                     job.
         Individual Counseling.(counselor
  takes session with the patient)                 4).    After Car e /F ollow Up
         Peer Support. (Old patient gives
  time to new patient and encourage him)             Relapse                Prevention
  Detoxification process can be very                 Narcotics anonymous meetings.
  painful and can cause the following                Letters and telephone calls.
  effects:                                           Home visits of ex-clients.
                                                     Follow up on street sites and at
    i.    Severe pain in the body                 Drop
   ii.    Skin problems (rash)                          in centers.
 iii.     Nervous system
  iv.     Temperature                             Prevention of Drug Abuse
   v.     Insomnia (Loss of sleep)
  vi.     Vomiting                                Primary prevention:
 vii.     Bleeding from Nose or mouth
viii.     Anxiety                                       Drug abuse prevention at the outset by
  ix.     Gastro Intestinal problems              information dissemination
   x.     Loss of Appetite                              Developing self esteem and enhancing
  xi.     Absent mindedness                       decision making skills.
                                                        Problem solving and resistance skills.
                                                        Recognizing risk factors and providing
  2.       Primar y Re habi litati on:            healthy alternative to drugs abuse.
  When       a pa tie nt goes          th rough
  detoxi fica tion, he is re ferred t o a         Secondary Prevention
  Pri mary Reha bili tat ion Are a. Primary
  Rehabilitation phase lasts for 08 weeks         Early intervention by early identification and solution
  and includes;                                   of drugs problem in the initial stages
         Individual Treatment Plans.
         Individual & Group Counseling.
                                                        Support to prevent recurrence.
         Drug Abuse Education.
                                                        Family involvement in the Treatment process.
         Behavior Shaping.
         Therapeutic Duties.
                                                  Tertiary prevention
         Peer Support & Social Learning.
         Recreational & Sport Activities.
                                                       Treatment and rehabilitation of drug
         Family Program.
                                                  dependents and their families.
       Establishing     a   community
network of self help /NA groups to
provide extended after care and support
to the recovering addicts.

Important points to follow during the
treatment process;

1)      Appreciate the patients for
accomplishments and efforts
2)      Criticize action not the child
3)      Give responsibility
4)      Show love and affection
5)      Freedom to make decisions
instead of following the crowed.
6)      Respecting your body and
desiring for a good life
7)      To be in control of your own
8)      Make children understand the
9)      Teach      children     to    value
10)     Explore      the    meaning      of
friendship to your child
11)     Make rules at home for everyone
12)     Use positive peer pressure

Preventing your child from focusing
on drugs out of boredom or ideal

As we are working with drug addicts,
and according to our experience a lot of
adolescents fall into drug addiction out
of boredom. Therefore as adults, it is our
responsibility    to    create    healthy
alternatives for our children like sports,
hobbies, school activities with out
pressuring to always win or excel.

Do creative activities with them
yourselves. Children appreciate the time
spent with them even if doing household
chores are involved.

If parents and teachers take interest and
play an active role in the drug prevention
then the child is likely to take an interest.
     By: Wajeeha Anwar
South-Asia has centuries old history of      Prevalence statistics of drug abuse
use of opium and cannabis use                and smoking:
sanctioned      by society.      Pakistan,
according to the World Drug Report           The prevalence rate for drug abuse was
2000 of the United Nations Drug Control      34% and cigarette smoking was 52%.
Program, is one of the countries hardest     The percentage of males & females who
hit by narcotics abuse, in the world.        smoked cigarettes was 33% and 19%
An examination of social and                 respectively. 21 % of males and 12.3 %
demographic factors revealed that 71.5       of females reported drugs abuse. 10%
% of drug abusers were less than 35          students at school level and 25%
years of age with the highest proportion     students at college level reported drug
in the 20-30 years age group. Of all the     abuse. 67 students reported their parent’s
drugs abusers almost 50%were illiterate      indulge in drugs and 68 students
and surprisingly similar percentages         reported that their best friends abuse
were un-employed. In Pakistan the youth      drugs.
comprise more than 20% of the                The findings of present study revealed
population and unfortunately they are        that the prevalence rate of drug abuse
the worst target.                            was 34% among adolescents. Nearly
In Pakistan the rates of substance abuse     35% of students from college and school
by teens are rising steadily, thereby        level reported drug abuse.
resulting in serious health and social              Type of drugs:
implications. A recent survey conducted      The most common drug abuse reported
in the affluent class of Karachi shows       by students was alcohol, ecstasy and
that almost 90% of the boys belonging to     hashish. In most of the cases students
the elite class as young as 10 years old,    reported more than one drug abuse.
admit to having experimented with drugs      Teens who use drugs at a younger age
and drink, at some point of their lives.     are more likely to initiate the use of
Approximately four in ten indulge            other drugs through the journey of their
themselves regularly.                        lives (e.g., cocaine and heroin)
An investigative study was done to                  Demographic variables           of
determine the psycho-social correlates of    participants:
smoking and drug abuse among                 Highly significant positive correlations
adolescents in Karachi, a sample of 300      exist between adolescent’s drug abuses
high school and college students             with parents’ marital status. Significant
between 16-21 years were taken               positive correlation is also present
randomly. These participants were from       between students’ education level and
different educational institution of         drug abuse. The correlation value is not
Karachi. Out of these 64% were males         highly significant for gender differences.
and 36% females. Relationships with          A research identified various personality
parents, peer relations, self-control and    characteristics that correlated with
coping skills of participants were           substance use. These included self-
assessed.                                    indulgence, impulsivity, aggressiveness,
insufficient      coping    ability,   and           Relationship between drug
antisocial, neurotic, and sensation-          abuse and positive parental relations,
seeking characteristics.                      peer relations, coping skills and self-
        Comparison of drug abusers           control:
and non-abusers:                              Studies have revealed that lack of
Comparison of drug abusers and non-           parental support, monitoring, and
abusers (Relations with parents, peer         communication have been significantly
relations, self-control and coping skills)    related to frequency of drug abuse and
showed significant differences.               drinking. Negative correlation, students
As expected, we found that non-abusers        who abuse drugs are likely to have poor
have better coping abilities than drug        relationship with parents, poor peer
abusers as indicated by their responses       relations, poor self-control and poor
on coping skill items. In this study 61%      coping ability. In present survey17% of
of non-abusers reported having good           the drug abusers belonged to broken
techniques to cope with stressful             homes.
situations, 74% participate in sport          Children often acquire substance using
activities, 83%have hobbies to keep           behaviors through modeling of the
themselves busy and 74% reported              parent’s own behaviors as well as the
stability in their behaviors.                 quality of the parent—child relationship.
Among adolescents, we observed that           Parents who maintain a warm, nurturing
students who endorsed more proactive          relationship with their children are most
self-control responses predicted less         likely to influence their children’s values
substance use. (45%) who abused drug          and behaviors positively.
affirmatively replied that they have          The findings also elucidates that good
little/no control over important things       relations with parents were lacking for
that happen in their life. 58 % were not      most of the abusers. Specifically, 75% of
confident that things will go well in their   frequent abusers reported that they do
life and 67% think that their life was        not go to their parents for advice, 49%
generally not peaceful or calm for them.      reported they were not close to their
        Comparison of smokers and            parents, 64% said they cannot freely
non-smokers:                                  converse with their parents and 43%
Comparison of scores of students who          reported they have family arguments
smoke cigarettes and non-smokers              most of the time.
revealed that most of the smokers scored             Validations and motivational
low on the subscales of parental              factors for abusing drugs/smoking:
relations, self-control and coping skills
than non-smokers. The differences are          Almost 32% of the students reported
statistically significant.                    that they try drugs when forced by their
Drugs offer an escape from social and         friends and 68% started drugs or
family problems, although their long-         smoking on their own. Nearly 66% of
term consequences can be harmful              students identified that it “helps in
which is not perceived and apprehended        improving concentration” and “helps to
at this stage of life. Conversely, drug       forget about problems”. 54% reported
abusers in this survey belonged to the        that they use drugs “to socialize with
privileged class only but possessed poor      friends”. 73% abuse drugs as “they
coping skills. The finding of the study       become habitual of using drugs”. Most
showed that 50% of frequent drug              of the students reported more than one
abusers reported positive family history      motivational     factor.   Some     other
for psychiatric illnesses.                    motivational factors for drug abuse were
identified through open-ended question.
23% of students abuse drugs “just for
fun”, 22% took drugs as “they felt like
trying drugs once”, 14% abuse drugs for
“relaxation” and 18% started taking
drugs for interpersonal problems.
       Guilt feelings about using
Nearly 41% of students who abuse drugs
or smoke cigarettes reported “guilt
feeling for abuse or smoking”. Most of
the abusers who feel guilty reported that
their guilt feelings were related to
forbiddance of drug abuse by religion
(16%) and parents (10%) or both (15%).

Sustained involvement on the part of the
educational institutions to provide
counseling services to students and to
create an environment in which a
dialogue can take place between the
students, teachers and the administration.
Parents can play an important role in
preventing and dealing with drug abuse.
They can do so by fostering healthy and
responsible attitudes in their children.
Reference: A survey of Psycho social
correlates of drug abuse in young adults
in Karachi: Identifying ‘High Risk’
Population to Target Intervention
Strategies by The Psychiatric Clinic &
Stress Research Center, Karachi, 2005

            By: Rubina Shams

 Street children are defined as children
who have to work on the streets because      children in Pakistan by United Nations
their families need money to survive,        Office on Drug Control.
children from poor families who sleep on
the streets, orphan and abandoned            A sample of 416 street children using
children whose parents have died             solvents    from     Karachi,     Lahore,
because of illness or war or for whom it     Peshawar, Quetta, ranging from 9 to 19
was simply impossible to look after their    years, male and female who had been
children.                                    regularly using solvents in the past 6
                                             month for not less than 3 times a week
An emerging problem of solvent abuse         was selected for data collection.
among young people particularly in
street children is a new concept as          Main Findings of the Study
studies indicate street children to be one
of the most vulnerable populations to be     The maximum proportions of children
affected by various deviated behaviours      were between 15 to 16 years of age.
such as substance abuse.                     Seventy two percent of the respondents
                                             were not currently living with their
Solvent Abuse                                families. One third of the children
                                             interviewed belonged to single parent
Solvent Abuse or more accurately called      families with large family size. Almost
Volatile Substance Abuse (VSA) has           three quarters of the children were not
been defined as the deliberate inhalation    currently living along with their families.
of gases, chemical fumes for mind-
altering and recreational purposes in        Family information and Educational
order to get a high similar to the           background:
intoxication produced by alcohol.
Solvents are available in many common        Children complained about their family
products and from adhesives such as          as dysfunctional and parent's attitudes as
glues, typewriter correcting fluids and      indifferent towards them. The apathetic
thinners, hydrocarbons found in cigarette    attitude of parents made them irritated
lighter refills, petrol products, fire       and frustrated which was further
extinguishers and gases such as nitrous      amplified by the teacher's attitude who
oxide are among the compounds or             beat them for being undisciplined, and
products which may be abused in this         impossible to learn lessons properly.
                                             Lack of interest (35%) followed by non
A study was therefore designed in order      availability     of    finances    (23%),
to get a better understanding on the         detestation for teacher (22%), required to
prevalence,   patterns    and     trends,    work (10.5%) and a non-interest of
consequences, knowledge of HIV/AIDS          parents in the child's education (6%)
and associated risk practices of solvent     were the main reasons reported for the
abuse among street                           discontinuation of education.
Types of Solvents used                       More than half of the street children had
                                             heard about HIV/AIDS but information
Adhesive glues is the primary drug of        regarding its prevalence was inadequate.
choice consumed by 90% of the
interviewed street children.                 HIV Risk practices

Frequency & Quantity used                    Several risky sexual practices were
                                             highlighted for contracting HIV. High
Analysis has shown that on an average        proportions (53.4%) of the children were
80 gms of adhesive glues is being used       found to be sexually active. The average
each day. A substantial portion of the       age reported at the initiation of sexual
children (15%) reported that using           activity was less than 8 years. A high
solvents round the clock. These children     number of sexual partners both males
use the solvent through a cloth, which       and females were found. More than 80%
always stays with them.                      of the children reported they had never
                                             ever used a condom.
Effects of Solvent abuse
According to children feelings after
using solvents are described as mixed        A dichotomous strategy should be
feeling of euphoria and contentment and      designed collectively which aims to
a relaxed mood followed by a sound           minimize and to prevent the probability
peaceful sleep, making them forget their     of occurrence.
worries and tensions.
                                             Efforts should be made to raising the
Treatment                                    general public awareness about this
                                             emerging problem including information
When asked if they ever tried to break       on drug abuse among street children.
the habit of solvent use, and how it could
be done, only 20.7% reported to have         Drug treatment & rehabilitation services
undergone any sort of treatment, and that    to the children especially street children
too was a self-treatment. Approximately      involved with solvents or other drugs
70% of the children were unaware of          should be provided.
any organization / institution where they
could be treated and rehabilitated.          References:

HIV Knowledge & Risk Practices               Solvent abuse among street children in
                                             Pakistan, United Nations Office on
Hashish is the most common drug of           Drugs and Crime – UNODC, 2004
abuse among drug users with
involvement in other drugs i.e., Bhang,
Opium and Synthetic drugs (produced          nce_abuse
inorganically). Drug use among street
children is responsible for the growing
incidence of HIV/AIDS and other risk-
taking behaviours such as prostitution,
sexual exploitation and unsafe sex
     SHEESHA…Yes or No!
          By Wajeeha Anwar

Sheesha also known as hookah is a             First of all let’s see what is sheesha
single or multi stemmed (often glass-         made up of?
based) water pipe devise for smoking.
Originating in India, it has gained           Sheehsa is smoked with herbal flavors.
popularity especially in the Arab world;      These contain Sugar Cane Bagasse with
hukkah operates by water filtration and       no tobacco, nicotine or tar. The popular
indirect heat. Sheesha can be used for        brands are Soex, Highlife and Black
smoking herbal fruits. This article of        label. This new method of smoking is
mine discusses and gives an insight           aimed at replacing tobacco and thus
about different myths regarding               eliminating its negative health effects.
sheesha.                                           cancer risks, though studies are
                                                      not      conclusive      (hoffman,
I was very young and residing in Jeddah,              rakower, salem 1983, gupta
Saudi Arabia when I saw sheesha in my                 dheeraj 2001, tendon 1995, lubin
neighbor’s house (Pakistani) for the very             1992, hazelton 2001 and stirling
first time in my life, but then I witnessed           1979). The levels of carbon
sheesha off and on in every house of                  monoxide produced during a
Jeddah as it become very popular in the               hookah session varies widely
Middle East.                                          depending on the type of coal
                                                      used, Japanese charcoals are
I came back to Pakistan in year 2004 and              thought to produce lower
it was more or less at the same time that             amounts of carbon monoxide.
the sheesha craze started in Pakistan,
although traditionally prevalent in rural     The younger generation argues that
areas as, hukkah. Now many clubs and          sheesha is not as frequently used as
cafes are offering this form of smoking       cigarette it cannot be carried with you all
as it has become very popular with            the time, and smoking sheesha
young people for social gatherings,           occasionally would not be as harmful as
functions and events. There are a large       frequent smoking of cigarettes.
number of cafes and restaurants offering
a variety of sheeshas.                        With the passage of time as sheesha
                                              gained popularity in Pakistan so did the
There are many questions which might          criticism against it. On one hand critics
come to one’s mind regarding sheesha as       started writing articles against it while
why do people have sheesha? Why is it         on the other medical opinion was stating
appealing? Is it injurious to the health?     that sheesha was dangerous for the
And last but not the least should we say      health.
“yes” or “no” to sheesha?
       One of the myths related to                    smoker is exposed to the same
        ‘sheesha’ smoking is that it is less           amount of CO as any cigarette
        dangerous than cigarette smoking               smoker and most often he/she is
        because the nicotine content is lower          exposed to significantly higher levels
        and the tobacco toxins get filtered            of CO.
        out by the water in the pipe.

      The reality is that even after it has
      passed through water, the smoke               A research conducted at
      produced by a ‘sheesha’ contains high          Department of Medicine, King
      levels of toxins, including carbon             Abdul Aziz University in Saudi
      monoxide,     heavy     metals    and          Arabia concluded : “Sheesha
      carcinogens. A ‘sheesha’ session lasts         smoking as well as cigarette smoking
      for 20-80 minutes, during which the            will produce similar harmful effects
      smoker may take anywhere between 50            on the function of ventilator capacity
      to 200 puffs. The ‘sheesha’ smoker             of both male and female subjects and
      may, therefore, inhale as much smoke           increase the risk of developing
      during one session as a cigarette              obstructive airway disease, with
      smoker would while consuming 100 or            Sheesha smokers being at a greater
      more cigarettes.1                              risk.”

       It is a well-established fact that
        tobacco smoke contains a range of
        harmful ingredients such as carbon          Another research carried out at the
        monoxide (CO), carcinogens like              American University of Beirut
        tobacco specific nitrosamines, and           involved simulating the smoke
        the notorious drug nicotine that is          produced by the Sheesha by a
        responsible for causing addiction to         specialized machine it proved that
        smokers. A research carried out at           the smoke contains significant
        the Atomic Energy Medical Centre in          amount of nicotine (the addiction
        Multan and published in Journal              agent) along with other toxic heavy
        Pakistan Medical Association in              metals such as arsenic, cobalt,
        1993 indicates that the amount of            chromium and lead. As for tar, the
        carbon monoxide in smoke from the            research stated that under normal
        Sheesha varies from the type of the          conditions, smoke produced by a
        Sheesha and can be as high as 1.40           single Sheesha contains
        per cent compared to 0.40 per cent           approximately the same amount of
        in cigarettes. Even the least harmful        tar (dry particulate matter) as 20
        of the Sheesha, it was found,                cigarettes.
        contained a minimum of 0.38 per
        cent carbon monoxide. The results       When we asked a 14 year old boy his reason
        indicate that at best the Sheesha       for smoking sheesha the same question he
                                                said, “It’s more acceptable. In fact, it’s
1                                               trendy and ‘cool’. My parents won’t
                                                complain, as it is not harmful at all and I
                                                cannot to carry it with me all the time.”
Anything new that hits the market creates a
wave of fascination which produces a
counter-wave of discovery. It is probably the
single most contributing factor resulting in
scores of young and old Pakistanis having a
crack at smoking the Sheesha with the
majority of them continuing to do so as a

It should never be forgotten that smoking
the Sheesha (similar to smoking cigarettes)
involves smoking tobacco, regardless of the
flavor that gets into the mouth. A time bomb
in a gift-wrap is nevertheless a time bomb
and is designed to explode.


The dangers of smoking sheesha are as
great as cigarettes.
   We Can All Make a Difference
             By: Rubina Shams

An estimated 5000 young people live and          Gender inequality plays a significant role in
work on the streets of Lahore.                   the spread of HIV in Pakistan. In general
                                                 Pakistani women have lower socio
These homeless young people are often the        economic status, less mobility, less
casualties of an economic crisis,                education and less decision making power
displacement due to war/conflict, poverty,       than Pakistani men. Young women living on
loss of traditional values, domestic violence,   the streets are often economically and
broken homes, physical and mental abuse.         socially dependent on (or exploited by) men.
                                                 It is difficult for these young women to
 Every young person living on the streets has    access general health and basic re-
a reason for being on the streets.               productive health care and other social
                                                 services. All of these factors increase their
In addition to problems associated with          vulnerability to HIV/AIDS.
living on the streets like substance abuse,
violence and crime, young people on the          Homeless young people are at risk to drug
streets and in particular young women are        use, sexual exploitation, physical abuse, and
exposed to situations that make them highly      crime on the streets of Pakistani cities. Their
vulnerable to sexual exploitation, and           continuous exposure to the harsh
consequently reproductive health problems.       environment of the streets and the lack of a
This further increases their vulnerability to    safe place and visible means of support
HIV/AIDS.                                        increases exponentially their risk of
                                                 contracting HIV.
Of the 138 million people in Pakistan 36
million (or 6 million households) fall below     Faced with these facts it is essential to act
the poverty line. With a high population         now. As it is our responsibility as adults to
growth rate, illiteracy, high un-employment      provide a safe place and opportunities for all
and 30 million young people between the          children (including homeless street children)
ages of 10-19, Pakistan is faced with            and enable them to express their ambitions
daunting challenges in the social                and improve their quality of life.
development sector.
                                                 This is also the visualization of an
Poverty is a major contributing factor to the    organization (NGO) Nai Zindagi who is
spread of HIV/AIDS, and particularly             working with disfranchised groups of people
among young people from poor families as         affected by the use of drugs and associated
it limits their access to information, health    harms to help them move from margins of
care and social services. Poverty also limits    society to centre stage. One initiative
their ability to protect themselves from HIV     pioneered by Nai Zindagi was the SMILE
infection, and, once infected, limits their      Project which was a street based program
ability to access care.                          for homeless young people in Lahore.

                                                 Project SMILE provided free services to
                                                 young street people below 18 years of age.
Services were provided by a team of trained
health and social care professionals and
range from on-street medical care, food and
nutrition, clean clothes, counseling, informal
education and training, referral for advanced
medical care and drug abuse treatment.

Project Smile particularly focused on
assisting and supporting families of these
young people to rehabilitate them, improve
their quality of life and reduce risk related to
living on the streets.

Smile made a difference to the lives of these
young people.

Project SMILE was grown out of close
consultation with homeless young people. It
also focused on combating HIV/AIDS by
providing a safe place, access to
information, basic health care, drug harm
reduction and treatment services and legal
aid to ensure and protect the basic human
rights of these young people.

Such initiatives are a positive sign of change
for our society and are encouraging
examples which not only gives hope of a
better future but also provides incentive for
all of us to make efforts in our own
individual and collective capacity to make a

          JAN-DEC 2008

      Compiled by Rubina Shams

A total of 1838 children sexually abused in                 Gender Divide of Victims of CSA,
the year 2008.                                                      Jan-Dec 2008
Acquaintances involved in more than 75               2000                                1838
percent of the cases.                                1600
                                                     1400                 1298
Children from 11 to 15 years of age more             1200
vulnerable.                                          1000
Sexual abuse touches every life when it               400
leads to losses of trust, decreases in self             0
                                                            Males        Females         Total
esteem, and development of shame, guilt
and depression. Sexual abuse touches every
life when it leads to psychological disorders,
substance             abuse,          suicide,   The actual figures could be much bigger
promiscuity/prostitution,      and       other   than the reported cases as many such
psychobehavioral issues.                         incidents go unreported due to involvement
                                                 of children’s acquaintances and other
Child sexual abuse is not just an individual     pressures. It is difficult to measure the
or family problem. The effects of sexual         prevalence of CSA in our society because
abuse on victims are devastating and life-       many incidents are not reported, especially
long, and on society pervasive.                  those committed by the children’s family
                                                 members. According to the statistics
Sahil collects data of child sexual abuse        gathered, 1838 children were sexually
through newspaper monitoring and compiles        abused in the year 2008 and of them 70
into a report called “Cruel Numbers”. The        percent (1298) were girls. The number of
purpose of collecting child abuse figures        boys subjected to child sexual abuse was
reported in the press is to educate parents on   540.
the vulnerability of their children to sexual
abuse and ways and means for their               The girls were reportedly abused for a
protection.                                      longer period of time as compared to boys.
                                                 The major categories of the crimes were
Child sexual abuse (CSA) cases are on the        abduction and gang rape of girls and
rise in the country, as in 2007 the number of    sodomy and gang sodomy with boys.
such cases was 5 per day, which rose to
average 5.4 cases daily during 2008
including kidnapping for sexual purposes.
However if we only consider sexual abuse
cases, then 3 children per day are being
sexually abused in Pakistan.
                            700                                                                                                        Males
                                                                      Crime Category
                                            623                                                                                        Females
                            600                                                                                                                                     Males                  Age of Victims
                                                                                                                                                    800             Females
  Sah il S tatistics 2008

                            300                              282

                            200                        173
                                      144                                                140                                                        400

                            100                                                                                                                     300
                                                                                    54                                                                                                               283
                                                                                                     18 21             20 12
                                                                                                                                        5   0
                             0                                                                                                                      200                        146                   168
                                     Abduction       Rape/Sodomy      Gang        Molestation       Molestation         Gang          Attempt of                                                                   169         152
                                                                   Rape/Sodomy                        Murder         Rape/Sodomy     Rape/ Sodomy
                                                                                                                        Murder          Murder      100        43                    135
                                                                                                                                                          1-5 years           6-10 years      11-15 years    16-18 years   Unknown
A total of 3968 persons involved in sexual
                                                                                                                                                                                           Sahil Statistics 2008
abuse belonged to different sections of the
society, out of which more than 75% were
known to the children.                                                                                                                              Province wise cases:
                                                                                                                                                    Sixty eight percent of such cases were
Aquaintances:                                                                                                                                       reported from Punjab, the most populous
Statistics showed that 75 percent of such                                                                                                           province of the country, followed by Sindh
children were targeted by acquaintances and                                                                                                         24 percent, Islamabad 4.5 percent, the
16 percent by strangers. The acquaintances                                                                                                          NWFP 2 percent, Balochistan 0.5 percent
included neighbors, relatives, clerics,                                                                                                             and Azad Jammu and Kashmir cases 0.2
immediate family members, teachers,                                                                                                                 percent. Rural and urban divide shows 70
friends, security guards, employers,                                                                                                                percentage cases from rural areas and 30
shopkeepers etc. The strangers included                                                                                                             percent from the urban areas.
robbers and taxi drivers. Shockingly, around
5 percent female abettors were also involved                                                                                                        Place of abuse:
in this heinous crime.                                                                                                                              Mostly, abuser’s home and victim’s place
                                                                                                                                                    were reported to be places where sexual
4500                                                               Abuser's Category
                                                                                                                                                    abuse occurred the most. Other than that,
                                  3968                                                                                                              schools, markets, under-construction houses,
3500                                                                                                                                                hospitals, madrasas, deserted places,
                                                                                                                                                    mosques, shrines, workshops, graveyards,
2500                                                                                                                                                hotels, guest houses, police stations, jail,
2000                                                                                                                                                parks, poultry farms, factory, canals, farm
1500                                                                                                                                                houses, hostel, train, bank are all the places
                                                                                                                                                    from where CSA cases have been reported
                                                                                                            71                 53
                                                                                                                                                    this year. This shows that no place is safe for
                                  Total           Acquaintance     Stranger      Fe male Abe ttor        Re lative          Incest
                                                                    Sahil Statistics 2008

                                                                                                                                                    In some reported cases, an abuser committed
Age group:                                                                                                                                          sexual crime as a form of punishment or for
The children, both girls and boys, between                                                                                                          the sake of revenge. Some girls were raped
11 to 15 years of age group are more                                                                                                                by those who were interested in marrying
vulnerable to sexual abuse. Thirty percent                                                                                                          them but their proposal was declined either
boys and 21 percent girls victimized by                                                                                                             by the girls or their families. Surprisingly,
sexual abuse were from the same age group.                                                                                                          unlike the past when the stigma attached
with sexual abuse prevented families from
reporting such cases to police, parents of 81
percent victims of child abuse approached
law-enforcers for relief. With some cases
settled out of court, police and courts
processed majority of these cases. Abusers
got death sentence, life imprisonment and
fine depending on the nature of child sexual

We should all individually and collectively
try to provide children self protection
guidelines so that they can protect
themselves when parents or no one is around
them. However, god forbids if ever a child is
victimized by this gruesome act then we
should first of all trust him/her instead of
blaming them and try to help the child in
every possible way to overcome the intense
trauma, which might be life long, instead of
blaming them for the unfortunate happening.
         By: Liaqat Ali Awan,
    A Subscriber of Sahil Magazine

     They are only eight!
    Some have, Some never will
      Every body is the same
Yeah, some are poor, some are rich
 Some have a home, other do not
Some go to school, some never will
         But this is not fair
                Is it?
        Life is already hard
    Do not make it even harder
   Kids in third world countries
         They are the same
        Give them a chance
          Just like we get
   They need a school, not a job
       When they are only eight


Sahil organized a one day training session        Media department attended a four days
with all its volunteers from different parts of   training workshop on Media Relations
Pakistan on 25th March 2009.                      organized by Institute of Media Sciences.

CHILD FRIENDLY NEWSPAPER &                        LAUNCHING             CEREMONY         OF
BEST VOLUNTEER AWARD 2008                         MUSICAL          ALBUM       ON   CHILD
Media department organized Child Friendly         RIGHTS
Newspaper CFN and Best Volunteer Award            Media department participated in the
2008 on 25th March 2009. Daily Express,           launching ceremony of musical audio album
Daily Din Lahore and Daily Kawish                 on child rights organized by SPARC.
Hyderabad won the CFN award and Sahil
volunteer Mr. Hidayatullah Laghari won the        TRAINING DEPARTMENT
Best volunteer award 2008 as he conducted         ACTIVITIES
following activities on voluntary basis:
       Networking with 10 local                  Training department conducted Meri Hifazat
organizations, dissemination of Sahil IEC         trainings in the following areas of
material.                                         Shekhupura, Kasur and Kala Shah Kaku;
       He introduced Sahil in local
organizations and schools and disseminated         Idara Taleem-o-Aagahi in Sheikhupura;
the IEC material.                                   in which 27 participants from 14 schools
       Display of 10 FIR posters in police         took part.
stations and other awareness posters in parks      Thirty seven schools of Kasur which was
and public places.                                  attended by 45 participants.
       He arranged a successful rally in          Shaheen Public School, Kala Shah
November 2008 for children in Sanghar.              Kaku, in which 33 participants from 14
                                                    schools participated.
                                                  Reiki Healing Sessions at JHC:
Media department participated in the
launching ceremony of the report; Violence        Jeet healing centre Organizes free Reiki
against women; Reflections in Print Media         healing sessions on every 1st and 3rd Fridays
& Documentary; Prisoners of Circumstances         at JHC from 4-5 pm. Mr.Sarfaraz Hussain is
organized by National Commission on the           the Reiki Master. A total of 4 plus last time
Status of women.                                  walay Reiki sessions have been conducted
                                                  so far.
Workshops conducted                            boys and Hotel owners from 13-19 January
Executive Director and JHC Psychologist        2009. Total 91 persons interviewed by the
conducted a training session at Modern Age     field researchers supervised by UC Sukkur.
School, Abbottabad which was attended by
43 students of class 9th to 12 th grade.       Media Campaign in Sukkur & Khairpur
                                               on Cable.
JHC Psychologists conducted a two one day      Sahil RU Sukkur started one month media
training workshops on “Stress Management”      campaign for awareness raising on child
in “Women’s Leadership Programme”              protection issues through Cable TV
organized by NRSP – Institute of Rural         networks in Sukkur and Khairpur districts.
Management, Islamabad.
                                               Media Campaign in Daewoo Bus
JHC Psychologist conducted an Inn-House        Karachi: Unit Coordinator Sahil RU
TOT workshop       on    “Care   giver’s       Sukkur monitored Sahil media campaign in
Empowerment by GD-Sanjog at Sahil for          Daweoo Bus from Sukkur, Hyderabad and
Sahil staff.                                   Karachi. UC monitored Daweoo terminals
                                               and recorded the passengers views regarding
Bhaid Training was conducted by JHC            the messages.
Psychologists for children at Child
Protection and Welfare Bureau, Rawalpindi.     Marie Stopes Seminar: Officer counseling
                                               attended a seminar organized by Mother and
JHC Pychologists attended PRHN-                Child Health centre Rohri & Salehpat of
Islamabad meeting organized by at              Marie Stopes Society on; “Stakeholders
SACHET, Islamabad.                             Seminar”.

JHC Psychologists attended Child Rights        Meeting with Baanh Beli: Unit Coordinator
Movement meeting organized by Idara-e-         RU Sukkur held an experience sharing
Taleem-o-Agahi.                                meeting with Director Baanh Beli (a friend
                                               forever) Mr. Younis Bandhani and possible
A session on Counseling Strategies was         collaboration in Thar, Mithi districts of
given to JHC Psychologists by Ms. Jane at      Sindh.
                                               Men Engage Training with Youth Group
ACTIVITIES AT RU SUKKUR                        Lahore. Unit Coordinator Sahil RU Sukkur
                                               facilitated in two days training organized by
Orientation Workshop:                          Sahil RU Lahore on Men Engage (Gender
Mr. Fawad Usman gave one day orientation       based violence) with youth groups in
to Unit Coordinator and field researchers in   Lahore.
RU Sukkur office on how to conduct
“Transport Research study with Drivers,
Helper boys & hotel owners”.

Commercial Sexual Exploitation of
Children (CSEC) Research: Sahil RU
Sukkur conducted five days CSEC research
with Truck/Bus/Traveller Drivers, Helper
Sukkur Men Engage Training Workshop with

Experience     sharing     meeting      Unit
Coordinator Jaffarabad participated in a one
day experience sharing meeting organized
by Mercy Corps District Office Jaffarabad.
Experience Sharing workshop:
Unit Coordinator participated in an
experience sharing workshop organized by
Social Aid, Jaffarabad.
Unit Coordinator and Legal Advisor RU
Lahore attended the “Inaugural workshop
for the Children Complaint Office”
organized by Federal Ombudsman

UC RU Lahore participated in consultative
meeting with NGO’s arranged by SPARC.

UC and POC Sahil RU Lahore participated
in Plan Pakistan’s launching ceremony of
campaign “Learn Without Fear” in Lahore.

POC RU Lahore attended a consultative
meeting on; “Testing Teachers Competency
Frame Work Tool Designed For Gauging
The Effectiveness of Primary School
Teachers” organized by Voluntary Services
Organization in Lahore.

RU Lahore conducted 2 days training
workshop on “Engaging Men and Boys to
End Gender Based Violence” in Lahore.

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