'Alcoholic Beverage and Personal Communication Essay\r'

'Introduction The intent of a range of medicine types, including inebriant, atomic topic 18 part of the traditions of numerous, if non all, communities in Fiji. The Fijian and Indo-Fijian communities defecate long traditions of psycho-active dose determination in the shorttext of rite and ceremony. 1,2 It has been noted that seaf arrs, together with apprenticed labourers, brought dissolvenabis or Indian hemp traditions to Fiji, with the sugar welt plantations providing fertile ground for cultivation. 2,3 Mean speckle, kavakavakava was widely cultivated and consumed by ethnic Fijians.\r\nThe Indo-Fijian community tardily adopted kava swallow rituals and gradually former(a)(a)s began to affix their manipulation. In addition, marijuana wasting malady emerged and dispersed with increasing popularity amongst youth, oddly males. 2-5 This literary returnions check explores the sure rule-g everywherened and extracurricular medicate incident in Fiji. It considers peer-re feelinged articles identi? ed recitation Pub Med, Health mesh make Work Access to interrogation Initiative (HINARI) searches and ‘grey’ literature, including produce and un produce accountings, and web establish resources (e.g. UNDOC, WHO).\r\nThe review lay pass that in that location is limited entropy on hand(predicate) to assist in ca enforce the current dapple and associated harms in Fiji, alone notes more studies and makeups waste examined intoxi formalismic make happy using up patterns and associated amicable problems when comp bed with studies on illicit dose custom. 1, 5-15 inebriant use in Fiji concord to the WHO ecumenical condition line on alcoholic beverage, information from the 1993 subject argona Nutrition eyeshot indicate that uptake of boozer family unit brew use is widespread in Fiji, as in separate Paci? c nations.\r\nThese beverages usually contain up to three clock times the inebriantic be verage content of commercially produced beer and argon in the main drunk by three-year-older decease force. 16 by and by 1995, unrecorded alcoholic drink expenditure in Fiji was estimated to be 1. 0 litre of pure alcohol per capita for the population older than 15 old age (estimated by a group of key alcohol experts). 17 Although in that respect argon no latterly published statistics on the make out of drinkers and abstainers, the resembling survey open up chance(a) drinkers to be 1. 4% among males and 0. 8% among females aged 12 societal classs and over.\r\n18 Estimates from alcohol experts acquaint that the harmonise of adult males and females who had been abstaining (in the year prior to the survey) was 74% (males) and 98% (females). 17 Research shows that iodin insobriety sessions with a noble rate of alcohol exp expiryiture ( usual practice among Fijian youth) can cause abrupt biliousness swings resulting in violence, accidents and ? ghts, exaggerated e motions, untypical behaviour, memory loss, impaired judgement, communion problems, sleepiness, coma, stupor and death (at very noble intake) and suicide attempts.\r\n overeat drinking has too been upholded in schizophrenic and an separate(prenominal) psychiatric episodes. 19 clxv retrospect peaceable health dialog swear out 201 1, VOL. 17, zero(prenominal) 1 While in that location is limited current sirement on the rate and consumption patterns of alcohol, halter and kava among new tidy sum,1,6,9 several studies2,3,8,11 were conducted to analyse the extremity of baccy and alcohol use among younker mickle in Fiji in the 1990s and betimes 2000s.\r\nOne of the studies4 found that alcohol is widely consumed in star form or other among girlish masses, with about 2 in 5 of the materialisation tidy sum surveyed having tasted it. The percentage of young people classi? ed as current drinkers ranged from a elevated of 26% among males to 9% among females. 4 Of a llude was the high counterpoise of binge drinkers: about 3 in 5 young people account having had 5 or more strong drinks in wiz session. The hit the books4 indicated that the high prevalence among 13-15 year olds poses a serious have-to doe with, and highlights the subscribe to for faithfulness enforcement and intervention programs to make water an purlieu that promotes responsible drinking.\r\nInterestingly, the study found that when compared to smoking, alcohol and kava use, the proportion of young people development cannabis was relatively low. 4 A follow up survey of 2147 students in 2004 by the National total do by Advisory Council (NSAAC) found a general doorion in warm lovingnessedness use among secondary students (see tabularise 1). Table 1: juvenility kernel use of unplayfuls and services in Fiji (Comparison of the results for Fiji in the 1999 planetary Youth Tobacco slew by UNICEF and WHO and 2004 follow up survey by NSAAC). Substance Tobacco Alcoho l kavakava Marijuana GYT Survey (1999) 32.\r\n3 40. 3 51. 9 12. 8 NSAAC (2004) 43 51 61 13 Signi? cant variations hold up in the drinking habits of males and females in Fiji; in that respect are m just about(prenominal) more male drinkers than in that location are female drinkers. 11 Ordinarily males consume the tidy sum of the alcohol in the telephoner of other males, usually during drinking sessions with no special occasion, while most women drink alcohol during accessible functions or in night club settings in the company of men and other women. While women occasionally enrol in drinking sessions, typically it is an exclusively male activity.\r\n11,13 It is at these drinking parties where the most abounding amounts of alcohol are reportedly consumed. Thus, when males drink, they tend to drink bigger amounts of alcohol in one sitting than women do. outlaw(a) dose use in Fiji sharpness Security and medicate obtain Limited information live on to aid in discernment i llicit dose use and the associated harms crossways the Paci? c. In addition, in that location are no watch systems. 20 However, Fiji by meritoriousness of its geographical position is set about with the twin problems of illicit drug traf? cking and increasing use.\r\n21,22 These are nevertheless aggravated by the rapid jumpional and friendly changes arising from urbanization. These developments create an atmosphere which exposes entire communities to greater adventure associated with drug use (Personal talk †Fiji guard part, 2008). nominal use of drugs such as heroin, morphine, cocain and hallucinogens occur, only if this review found that Fiji is considered a transit area for smuggle. [20-23].\r\n doses such as heroin, meth f numbers and 166 peaceful health talks meet 201 1, VOL. 17, no. 1 canvas cocaine are not communally employ due to their high apostrophize when compared to the average income. Raw cocaine has reportedly been found in Fiji and three Chinese men and a Fijian credentials guard were murdered in what was thought to be an nonionic criminal offense execution associate to drugs. 22 National enforcement agencies involve responded to curb traf? cking as is re? ected by the large seizures of illicit drugs. 24,25 In spite of this response, a drug laboratory found in Fiji in 200625 financings the view that organized crime groups could heighten their activities in the Paci? c islands.\r\n21,25 A raid at an industrial estate in Suva, involving practice of practice of law from Australia and unexampled Zealand and Fijian tradition Of? cer followed a major(ip) heroin seizure in 2000. 21,25] The lab identi? cation also designates a transition of Fiji (and possibly other Paci? c Nations) from a transhipment transport to a production base. According to the New Zealand practice of law, to succeed in future operations identical to the Suva bust, interested agencies wishing to work towards having â€Å"robust commu nication systems” crosswise organisations to keep them connected and sure on crime in the region.\r\n21 It is reported that thither are about viosterol0 vessels transiting in the Paci? c on any given day. 21,24 Large shipments may be unloaded from a mother ship to little vessels, and can subsequently go in hiding at the some(prenominal)(prenominal) small, uninhibited islets and atolls, waiting for the next step. 21 Fiji has youthfully established a trans depicted object Crime whole (TCU) with the Fiji Islands tax income and custom Authority (FIRCA) as one of the key law enforcement agencies involved. This unit has been vigilant in promoting the cooperation amid border organizations in order to assist the TCU in controlling the borders.\r\n24 The Unit also compiles info for tidings risk assessments throughout the year. It supports a Case Management intelligence activity System (CMIS), whereby relevant discipline from the Police Department, Immigration Department, local anaesthetic Government Authorities, Financial intelligence operation Unit, and other Law Enforcement Agencies24 are automatically linked in the system. A sum up of cases which the TCU r all(prenominal) been investigating include a Tongan syndicate smuggling drugs from Fiji to Tonga.\r\nIn a modern ex adenosine monophosphatele of program cooperation a number of TCU surveillance targets were start outed during a Police roadblock in Sigatoka (personal communication, FIRCA, 2008). Domestic Issues Cannabis is by far the most common and widespread illicit drug used in Fiji. 11 Like many other countries in the region, anecdotal show up suggests on that flush has been a wide increase in drug use among young people4 contempt the relatively small increase suggested by the 2004 NSAAC study (see table 1). However, it is not clear if the ii studies they reported were directly comparable.\r\n entropy collected by the St Giles infirmary and the Fijian Police Department support th e view there has been an increase in use. Admissions data for St Giles infirmary reports on cannabis induced psychosis and other disorders. In 1987, ? ve young men were admitted to St Giles Hospital with cannabis related genial disorders. In 1988, the number ruddiness to ? fteen with many more unreported cases. 26 The 2005 hospital data revealed that a total of 612 patients were seen at outpatients department diagnosed with a mettle tread disorder.\r\nThese included 386 (63%) patients for marijuana, 59 (10%) alcohol, 99 (16%) kava and 99 (16%) tobacco use issues. In 2006, 272 admissions to St Giles Hospital were reported as drug related, consisting of 66% Fijians, 20% Indo-Fijian and 14% belong to other ethnic groups. It is probable that the semipolitical troubles in 2006 impacted on the number of admissions, but no data were available to con? rm or reject this view. Police arrest data report possession (see Table 2).\r\n8,13,26 Statistics provided by Fiji Police showed 259 drug related crimes were committed in 2008. There was a 21 per cent drop from 2007 which had 329 drug-related 167 reassessment PACIFIC health DIALOG MARCH 201 1, VOL. 17, no 1 crimes. 27 There are also reports of increasing cannabis cultivation as a form of inter-seasonal cash curb substitution among farmers. It is estimated that Fiji has between 500 to 1000 cannabis producers, some of them citing the country’s change state economy as the bonus for production (personal communication, Police medicine Unit, no.ember 2008).\r\nFor generations, the villagers of Navosa discombobulate travelled for hours across rugged terrain to reach a road to the trade to trade their produce with no warranty their produce will be sold. Facing the same hardships as their ancestors, many of these villagers report having no choice but to vivify to marijuana festering because â€Å"The product is lighter, it has a steady market and is sparingally viable” (Personal communication with gr owers, December, 2008). Production is predominantly for local consumption. Table 2: upstart Crime Data ( medicate offences recorded by the Fiji Police Forces from 2000 to 2006).\r\nYear dose offences 2001 433 2002 417 2003 417 2004 312 2005 312 2006 333 The stay fresh the Children gillyflower in Fiji reports that the go along political and economic derangement in the country has also led to a grass more children working as drug traf? ckers or prostitutes. [28] engage over the increasing number of children involved in drug traf? cking was sparked by the recent arrest of three school children caught interchange drugs in an amusement pump in Labasa. The Fiji Women’s Crisis kernel reported an increase in young Indo-Fijian girls working as prostitutes in urban centres.\r\nFurthermore, the National Manager for Save the Children Fund in Fiji, says there is a growing trend among poor families to send their children out onto the streets. 28 dose and alcohol jurisprudenc e and policy According to the literature, there is no regional-based illicit drug policy for the Paci? c and hardly a(prenominal) treatment programs. 20,29 Information from the Paci? c Island forum Secretariat (PIFS) indicates that Fiji’s adulterous do drugss bid forge is an adaptation of the regional exemplar Law on the Control of Illicit drugs which was developed by the Secretariat.\r\nThere was no black-tie committee, but it was endorsed by a Cabinet sub-Committee on code which was chaired by the then Attorney-General. both the Fijian Government and PIFS are advocating for a regional legislative framework to respond to the increase in illicit drugs in the region (personal communication, PIFS, 2008). Amphetamines are a key drug of concern with the region’s geographical vulnerability highlighted as a key factor in the rationale for this approach. At the time of writing, Kiribati and Fiji are the only ii PIFS member countries to have neutered and enacted the model law.\r\nFurthermore, a reckon of Practice has been developed by PIFS to assist stakeholders such as law enforcement agencies and pharmacies to classify, register and pitch of illicit drugs (personal communication, PIFS, 2008). It may be adapted by Forum member countries with modi? cations to suit national legal and administrative arrangements. legislative control on the consumption and sale of alcohol to bush league has not been widely and in effect implemented. While pocket-sizes are legally barred from overpowering alcohol, the sale of alcohol beverages to under-age drinkers is common throughout the country.\r\n11 For the minor who is unable to gain access to commercial alcohol beverages, homebrew is an easily obtained alternative. Anecdotal depict suggests that minors make up a large and undetected percentage of consumers of alcohol beverages. 168 PACIFIC HEALTH DIALOG MARCH 201 1, VOL. 17, NO. 1 REVIEW end upually Transmitted Infections Sexually Transmitted Infect ions, including human immunodeficiency virus, are emergent public health problems in Fiji. 13 A recent WHO report indicated that the rise in the number of human immunodeficiency virus cases, in addition to increasing number of patients accessing STI clinics, in an ongoing concern.\r\nIn 2006, MOH statistics indicated30 that Fijians comprised 83% of con? rmed human immunodeficiency virus diagnoses, Indo-Fijian 13% and ‘others’ 4%. Since 2004, Fijian males had replaced females as having the highest number of cases. Overall, males comprised 59% and heterosexual transmission accounted for 85% of all cases. By the end of 2004 a total of 182 HIV infections had been reported in Fiji13 and the number of new cases reported each year has increased for the locomote ? ve years. In Fiji, reported cases of pox and bang have ? uctuated between 1998 and 2004. In 2004 there were 852 reports of syphilis and 1182 gonorrhea.\r\nThe number of cases reported for 2008 were 1004 for syp hilis, 1064 gonorrhea and 283 HIV cases. 27 youthful statistics from Fiji’s Health Ministry on Sexually Transmitted Infections are a cause for concern with the high rate of STIs among people aged 20 to 29 increasing the risk for HIV infection. 31,32 Fiji’s Director of common Health notes that statistics gathered over the past eight years by the Ministry show that clack and syphilis are the most oft reported STIs in the country, which â€Å"highlights the underlying concern of unsecured sexual behaviour among young people” and the â€Å"same high-risk behaviour for the transmission of HIV.\r\n” He also said that â€Å"sex is serious business” and that â€Å"anyone, especially young people, who participates does so at their risk, in view of the gloomy consequences of infection from so many STIs including HIV, pelvic in? ammatory disease and infertility. ”32 Risk/ fostering(prenominal) Factors Some spectral groups in Fiji, such as Isla m, purely forbid the use of alcohol. Christian denominations such as the Assemblies of God, overlord’s Witnesses and the S nonethelessth solar day Adventist Mission also repeal the consumption of alcohol. Individual members of these religious groups vary in the decimal point to which they adhere to these principles.\r\nAny disallow effects of combining tobacco or alcohol with kava use are shortly conjecture, with relatively little work done to explore the disposition of the relationship between these nerve centers in the Paci? c. 1,6,9,26,33 However, anecdotal evidence suggests an inter-relationship exists with social and health consequences. 1, 4-6, 9, 13, 26, 33, 34 Reports of kava drinking followed by a beer chaser, known as ‘washdown’, are not uncommon and suggests the necessity for save exploration of potentially harmful consumption patterns. ebullient drinking, drinking too frequently and too much, often re?\r\nects the drinking pro? le of the ma jority of young people in countries like Fiji. 5, 11, 14 Excessive drinking is reported as a signi? cant contributor to motor fomite accidents, violence and aggressive behaviour, unloved pregnancy, sexually transmitted infections, and whitlow activities. 3, 14, 15, 18, 26 It has been suggested that the alcohol consumption pattern of young endemic Fijian males follows the traditional kava ritual of drinking until there is nothing left in the kava bowl. In many instances, young people often end their kava drinking session by down alcohol (‘wash down’).\r\n[3, 5] It is reported that most youths drink extravagantly to manage their problems, but it may result in new problems like serious sex, crime and violence and until now suicide. 5, 14, 15, 34, 35 A study in Fiji10, 11 revealed that alcohol was a factor in 58% of all homicide between 1982 and 1992 and approximately 80% of the crime in the country is alcohol-related. 10, 18 169 REVIEW PACIFIC HEALTH DIALOG MARCH 201 1, VOL. 17, NO.\r\n1 Furthermore, the effects of alcohol on the physical, mental and social health of Fiji’s citizens have in recent years been the subject of considerable concern amongst health-care professionals and social scientists, as well up as the ordinary citizens. 2, 3, 8, 10, 11, 23, 26, 33 At present there is suf? cient evidence from a variety of research ? ndings1, 6, 10, 11, 34 to suggest that the heavy consumption of alcohol contributes other health problems in Fiji, such as diabetes, heart problems, obesity and hypertension. Among the social consequences of excessive alcohol consumption in the country,10, 11 violent crime, interior(prenominal) violence, and road fatalities have been identi? ed as the most serious.\r\n8, 23, 34 While alcohol and home brew drinking are more common, marijuana cultivation, gross revenue and distribution has become permeating in some Paci? c Island countries. It has been seen as a good source of income. A supercharge emerging essence abuse issue is glue snif? ng among school age children, mostly in their early teens. In addition, unemployment in youths is a major problem in the Paci? c. In Fiji it has been estimated that out of nearly 10,000 youths pursuit employment, only 1500 can be employed. 2, 3, 13 Studies and observations in some urban areas of Paci?\r\nc countries point to an increasing numbers of people between the ages of 15-19 engaging in commercial sex proletarian with some aged even younger. 2, 3, 11, 15, 35, 36 Conclusions There is a range of evidence and data suggesting the potential for increased risk of HIV infection associated with substance use in Fiji, but there is a need to explore this issue further with social behavioural and soft research. While harmful substance use patterns and sexual health risk factors are progressively reported, there is little current analysis regarding the interaction of the two.\r\nOf contingent concern is the current surround of rapidly changing subs tance use patterns with little in the way of structural responses to protect the people of Fiji from the range of social and health-related harms. In addition, dif? cult economic conditions and the tangible bene? ts of cannabis growing and distribution (and potential for antiophthalmic factorhetamine production) lend urgency to the need to investigate these issues further and to develop viable interventions that are assured by robust data and research information. References 1. Goundar R, Kava consumption and its health effects.\r\nJournal of fraternity Health and Clinical medical specialty for the Paci? c 2006. 13(3): p. 131-5. 2. Plange, N. K. , fond Aspects of Drug and Alcohol Abuse: An overview of the situation in Fiji. Fiji Medical Journal, 1991. 17(3): p. 5-12. 3. Plange, N. K. , inebriation and Crime among Urban Youth in Fiji. 1991, University of the South Paci? c. 4. UNICEF. , Substance use among adolescents in Fiji: A surveillance Report from the Fiji world(prenomina l) Tobacco Survey. 1999. 5. Rokosawa, M. Alcohol problems in Fiji. 1986 [cited. 6. Moulds RFW, M. J. , Kava: herbal cure-all or liver poison?\r\n[For Debate]. Medical Journal of Australia, 2003(178): p. 451-3. 7. Morrison F, H. F. , Gaylord J, Leigh B, Rainey D. , callow drinking and sex: ? ndings from a daily diary study. aspect on Sexual fruitful Health, 2003. 35(4): p. 162-8. 8. Adinkrah, M. , Homicide-Suicides in Fiji: Offence patterns, situational factors & socio-cultural contexts. Suicide and behavior menace Behavior, 2003. 33: p. 65-73. 170 PACIFIC HEALTH DIALOG MARCH 201 1, VOL. 17, NO. 1 REVIEW 9. Kava, R. , The adverse effects of Kava. Paci? c Health Dialog, 2001. 8: p. 115-18. 10. Adinkrah, M., vehement encounters: A study of homicide patterns in Fiji society.\r\n1996, Fiji Council of kindly Services. : Suva, Fiji. 11. Adinkrah, M. , Crime, deviance & delinquency in Fiji. 1995, Suva, Fiji: Fiji Council of Social Services. 12. Plange, N. K. , Social aspect s of drug and alcohol abuse: An overview of the situation in Fiji. Fiji Medical Journal, 1991. 17(3): p. 4-12. 13. WHO, National shop on Alcohol cogitate Problems in Fiji. 1986. 14. Naiveli, B. , Alcohol and Crime. 1986, kinglike Fiji Police. p. 34,35 15. Kippax, D. D. , The Genesis of Alcohol -Related Problems. 1986, Fiji drill of Medicine. p. 24-28.\r\n16. Na tabili kavoro: The place of alcohol in the lives of Fijian people living in Aotearoa New Zealand. ALAC Research Monograph series: No. 4. Wellington, Sector Analysis, Ministry of Health for the Alcohol Advisory Council of New Zealand, 1997. 17. Alcohol per capita consumption, patterns of drinking and abstention worldwide after 1995. Appendix 2. European Addiction Research, 2001. 7(3): p. 155-157. 18. http://www. who. int/substance_abuse/publications/en/? ji. pdf, WHO Global Status Report on Alcohol 2004: Geneva. 19.\r\nRecommendations for policy to support health promotion. A report to the Minister of Health., N. C. f. H. P romotion, Editor. March 1998. 20. Devanney M, R. G. , Baldwin S, Crofts N, Power, R, Illicit drug use and responses in six Paci? c Island countries. Drug and Alcohol Review, 2006. 25: p. 387-900. 21. Drug Enforcement Administration †erudition Division, Drugs Intelligence Brief: the paci? c islands region, v. Alexandra, Editor. 2004, Drug Enforcement Administration. 22. United States Of? ce on Drugs & Crime, Paci? c Islands: UNODC †Regional Centre for East Asia and the Paci? c. 2003. 23. Ratinisiva M, Drug Traf? cking, Prevention and Control in Fiji. Fiji Medical Journal, 1991.\r\n17(3): p. 5-12. 24. Fiji Islands Revenue and Customs Authority, Annual Report. 2006. p. 17. 25. Louisa, C. , Paci? c ripe for drug ring boom, in NZ Herald. 2004: Auckland. 26. Abusah, P. Y. , The Drug Scene in Fiji. Fiji Medical Journal, 1991. 17(3): p. 21-25. 27. http://www. stats? ji. gov. fj/Key%20Stats/ miscellaneous/15. 7%20crime%20cases%20recorded. pdf. 2008. 28. http://tvnz. co. nz/vi ew/ scalawag/425822/37544, More Fijian youth in drugs, prostitution 2001. 29. Illicit Drugs Control Bill Draft. Fiji: Paci? c Islands Forum Secretariat. 2002. 30.\r\nMinistry of Health, Annual Report †Shaping Fiji’s Health.2007. 31. http://www. health. gov. fj/index. html. 2008. 32. http://www. stats? ji. gov. fj/Social/health_cdeath. htm. 2008 [cited. 33. Council out to Fight Drug Abuse, in The Fiji Times. 34. Caswell, S. , Alcohol in Oceania. 1986, Alcohol Research Unit, Dept of society Health and General Practice, schooltime of Medicine, University of Auckland, New Zealand. p. 25. 35. Kippax D, O. M. J. , Alcohol-Related Problems in Fiji. 1986, Suva: Suva. 36. Ali, S. , Family Life Education. 1986, Ministry of Education. p. 36-39. 171 REVIEW PACIFIC HEALTH DIALOG MARCH 201 1, VOL. 17, NO. 1 172.\r\n'