This image is for illustrative purposes only and may not/does not represent humanitarian settings as discussed in the article. © Nick Danzinger for UNODC
This Sunday, 10 December 2023, marks the 75th anniversary of the Universal Declaration of Human Rights. This cornerstone document encapsulates the fundamental rights with which every person in any part of the world is endowed, such as the right to an adequate standard of living – including access to medical care.
The right to health means that everyone is entitled to enjoy the highest attainable standard of physical and mental health. It has been enshrined in multiple key international agreements, standards and norms, such as the International Covenant on Economic, Social and Cultural Rights (OHCHR) and the Outcome Document of the 2016 United Nations General Assembly Special Session on the World Drug Problem. The United Nations Office on Drugs and Crime (UNODC)-World Health Organization’s International Standards for the Treatment of Drug Use Disorders have been developed to ensure accessible, quality and human-rights based treatment for all in need.
Yet increased conflict, climate change, and inequalities have made the right to health more difficult to obtain for many. As Ms. Ghada Waly, Executive Director of UNODC, has emphasized, “…crises of conflict, climate, and economic hardship have left more than 110 million people worldwide displaced, making them more vulnerable to drug risks and more difficult to reach with treatment.”
Ecuador, and the Latin American region as a whole, is no exception. According to the United Nations High Commissioner for Refugees (UNHCR), there are around 500,000 refugees and migrant populations in Ecuador, of which 11 to 21 per cent are believed to be hosted in the provinces of the northern border of the country (Esmeraldas, Carchi, Imbabura, and Sucumbíos).
This region has historically been a route for cocaine trafficking and is vulnerable to other illicit activities, such as trafficking in human beings and illegal mining. All of these crimes work to undermine the security and development of the communities living in the region. Esmeraldas, for instance, had a rate of 511 homicides per 100,000 inhabitants in 2022.
Promoting the availability of and access to care for these migrants and refugees, including treatment of substance use disorders, is fundamental to safeguarding their human rights and dignity. With this in mind, the United Nations Office on Drugs and Crime (UNODC) organized a three-day workshop on the provision of substance use disorder treatment and care for people in human mobility in the northern region of Ecuador.
Participating health and social professionals strengthened their technical skills in providing care to these specific populations and learnt about the application of substance use screening tools like the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and psychosocial counselling.
Ruth Enríquez is a psychologist from Alas de Colibrí, a civil society organization working with displaced populations in the northern border of Ecuador. She shared her impressions with UNODC below.
This training helped me understand that substance use is not an isolated event within humanitarian contexts. It is clear to me now that the risk factors that exist within humanitarian emergencies can aggravate the initiation of consumption of a type of substance. The substances allow the person to feel more able to cope with the situation.
I think the biggest obstacle to people accessing treatment in humanitarian settings is, above all, discrimination within the sectors that provide treatment to this population. Perhaps there are not many humanitarian principles in place, so this results in care being denied, very limited, or difficult to access.
To facilitate access to substance use disorder treatment for migrants and refugees, it is critical to reinforce the person's own skills, overall resources, and capacities, while strengthening community acceptance and multidisciplinary treatment.
UNODC would like to thank the US State Department/Bureau of International Narcotics and Law Enforcement Affairs and all donors of the global project on Partnerships for the Treatment of Drug Use Disorders for their continued support.
