Instituto Superior e Educação a Distancia (ISCED)

Licenciatura em Direito
(Inglês)

Staying healthy in a country such as Mozambique: Drinking, eating, smoking habits and
drug abuse

Nome do Estudante Nome de Tutor

Domingos Mostafa

Nampula, 10 de Junho de 2018

Staying healthy in a country such as Mozambique

Drinking, eating, smoking habits and drug abuse

Alcohol is considered a drug of the type depressor, because it diminishes the cerebral activity.
Drug is any substance that acts on the brain, altering the psyche. However alcohol is lawful and
accepted socially. This means that it can be bought and consumed freely.

At least 517 national citizens and 23 foreigners were charged in Mozambique during 2009 for
committing a crime of drug use, according to the Annual Report of the Central Office to Combat
Drugs on the Evolution of Trafficking and Illicit Drug Use.

The report highlights that there are still a large number of drug users in the country, with
alcohol, which accounts for 48% of all registered cases, is one of the most consumed substances,
followed by cannabis sativa, '. It also consumes heroin and cocaine.

Among the most prolific drugs, alcohol ranked first, with 1023 patients being treated at the end
of last year, followed by cannabis sativa, popularly known as serruma, heroin with 46
individuals, and cocaine.

Alcoholism is one of the pathologies that afflict individuals and collectivities, because of its
particularities and history through time is as old as man himself. Alcoholic beverages were
present in almost every culture known to date.

Thus, even in vulgar knowledge, it is accepted that alcoholic beverages: help in hard and daily
work; relieves hunger; gives energy to the weak; it gives warmth in the cold; refreshes in heat;
differentiates children from adults; serves as a consolation, and many other representations.

However, although alcohol was known from earliest times, biblically remembered and
associated with sex and lust, it was only in the eighteenth century that the problem became the
focus of medical attention when Benjamin Rush described his effects on the body and in the
human mind, conceiving this condition as infirmity.

Alcoholism and another drugs as a Disease

In 1849, Magnus Huss (quoted by SAS, 1994), the designation Alcoholism and another drugs,
not referring to excessive intake of drink and smok, but to the somatic consequences resulting
from such practice and the harmful effects that chronic ingestion provided. Despite this, the
ingestion of alcohol still continued to be considered as addiction or weakness of character.
This representation lasted for decades, until the World Health Organization (WHO) began to
consider alcoholism as a pathology and, more recently, Alcohol Dependence Syndrome (SDA),
idealized by Edwards & Gross (1976) as an element for its diagnosis.

The Alcohol Dependence Syndrome, treated as chronic alcoholism and another drugs, should
be understood as the beginning of the ingestion of drinks until it reaches a situation of
dependence, and characterized as an interrelated group of symptoms, behavioral and
physiological. On the other hand, alcohol-related disabilities consist of physical, psychological,
and social dysfunctions that directly or indirectly result in excessive drinking and dependence.

Illness is conceptualized as: '' Any and all individual conditions that bring pain, suffering of
own or others, of any etiology, and that due to this condition brings decrease, limitation,
incapacitation, worsening quality of life, either on a provisional or permanent, partial or total.
"In this way, alcoholism meets the requirements established to be recognized as an illness.

Alcoholism brings pain, suffering, limitation, impediment and / or incapacity in the exercise of
activities on a regular basis contrary to the concept of health as the balance, harmony, and bio-
psychosocial well-being adopted by WHO.

Sensitivity to alcohol and another drugs

Although it is currently known some risk factors and protection of adolescents in relation to
psychoactive substances, it is necessary to emphasize that besides availability and publicity,
access to alcohol and drugs by adolescents is easy, that is, socio-cultural vulnerability to alcohol
and drugs . Also, it is not excessive to repeat an important fact: there is no alcohol and drugs
consumption without risk, or, it is not necessary to be an alcoholic and addict to have problems
with alcoholic beverage and addict in drugs.

In adolescence, when the first experiences with alcoholic beverage and addict in drugs, there is
the weak adolescent and the adolescent strong in relation to alcohol and drugs. The weak
(sensitive) teenager to drink is one who with one or two 2M meds or small portion of any
alcoholic beverage and addict in drugs already feels upset and at the same time can go awry.
You can not drink or smoke more than that because you do not feel well. The day after the use
or abuse of alcohol or another drug, the weak drinker can not see alcohol in front of him. Feel
the effects of alcohol or another drugs: malaise, headache, abdominal problems, malaise.

The strong (tolerant) adolescent to drink or smoke is the one who supports drinking larger
amounts without much change. He also develops, through learning to drink or consume drugs,
the ability to perform tasks even under the influence of alcohol. He is the one who is praised by
the crowd for having to drink or consume drugs. It is what helps to take home a colleague who
did not enjoy the drink and consume drugs, that is, the weak colleague to drink and consume
drugs. The next day, the strong to drink, even felt some effects of the previous day's alcohol
consumption, shows willingness to drink and consume drugs again.

In sensitivity, alcohol and another drugs may be a positive reinforcer, but the bad effects
experienced by the body from the use of alcohol and drugs can make alcohol and drugs an
aversive stimulus.

The weak to drink and consume drugs, so by its sensitivity, imposes a limit on the drink. Not
the strong. Always willing to drink. And being praised by the cohabitation group as someone
who is strong to drink and consume drugs, since adolescence is a period of self-affirmation,
you are commended for it, which reinforces your drinking and consuming drugs behavior.

Although what we present is a theoretical study, the identification of these early parameters of
alcoholism and addict in the adolescent who consumes alcoholic beverages and drugs may be
of importance for prevention, and also to promote quantitative research to confirm or reject the
hypothesis presented.

It is reasonable to say that the problems involved in the consumption of alcoholic beverages
and drugs grow as nations develop and, at the same time, alcohol and drugs is forged as one of
the main limiting factors of the social and economic development of the country.

However, we have seen that alcohol is a consumption drug, but as friendly as it appears to be,
it leads to the loss of several human lives (physical deaths) and reduces in a certain way the
capacity of a person to reflect, to act cycle capacity).

Alcohol, HIV, tobacco and other drugs are social ills that threaten to destroy the youth of many
students across the country, and this is a call to unite all the living forces of society so that we
can face and eradicate these evils protect future generations from these dangers, "warned the
minister.

Speaking of the students' exposure due to the fact that some schools are close to informal
markets where alcoholic beverages are sold, Jorge Ferrão called for greater responsibility on
the part of the informal agents, calling them to be partners of the Ministry of Education in
eradicating the phenomenon.
"Of course we have tents around our schools, in the spaces that have been taken over by the
informal trade. We respect people who engage in informal commerce, but we would like with
them to make a pact and appeal that they only sell alcohol and another drugs to people over 18
years and not children, because our area of jurisdiction is to the limit of the school itself, "he
exhorted.

Mozambique is the first African country to host this initiative that has been in existence in the
United Kingdom for almost 11 years, having already climbed several countries such as Ireland,
Vietnam, Jamaica, among others. In the first phase, the project will cover for many students
from schools in the District of our country.

Poverty

Maputo, December 21, 2016 - Between 1997 and 2009, for each percentage point of economic
growth in Mozambique, poverty has decreased by 0.26 percentage points in the country,
approximately half of what is observed in the sub-Saharan Africa region, reveals the most recent
publication of the World Bank that deals with the problem of poverty and its causes in
Mozambique. The publication titled 'Accelerating Poverty Reduction in Mozambique:
Challenges and Opportunities' also advances that poverty has declined more sharply since 2003,
having fallen by only 4 percentage points to reach 52 percent in 2009.

On the other hand, poverty reduction performance is uneven across regions of the country, with
the central and northern regions showing disproportionately high poverty rates. In general,
urban provinces tend to have lower poverty rates than rural provinces. Thus, the City of Maputo,
for example, has the lowest levels of poverty in the country with 10 percent of the poor. At the
other end of the distribution Zambezia has a poverty rate of 73 percent. Instead of shrinking
like the rest of the country, poverty worsened in 2003-2009 in the provinces of Zambézia,
Sofala, Manica and Gaza. These five provinces together accounted for approximately 70
percent of the poor in 2009, up from 59 percent in 2003. The provinces of Zambezia and
Nampula together represented almost half of the country's poor in 2009 (48 percent), up from
42 percent in 2003.

"The robust growth that the country has seen in recent times has mainly benefited the non-poor,
signaling a poor inclusion in today's economic growth model," said Mark Lundell, World Bank
Director in Mozambique. "The country needs to focus on public policies and investments
focused on social and economic inclusion," he added.
Mozambique has high levels of inequality. High inequalities tend to reduce the impact of
economic growth on income growth for those at the bottom of the distribution scale. In other
words, economic growth in Mozambique could have had a much greater impact on poverty
reduction if its effects had not been affected by the increase in inequality over the same period.
The absence of inclusive growth policies has affected the expansion of shared prosperity. To
expand shared prosperity requires a growing economy that brings more benefits to the lower
echelons of income distribution compared to the rest of the population. It is estimated that more
than 2 million additional Mozambicans would have been lifted out of poverty if gains in
economic growth between 1997-2009 had benefited everyone equitably.

The report also focuses on the poor economic opportunity of the poor compared to the non-
poor, as well as the issue of access (lack of) schooling as contributing factors to the generational
passage of poverty among the poor. According to data from 2014/15, more than half of
individuals aged 20-30 years in poorer provinces are illiterate. The report also looks at what is
behind the high poverty rates in the central and northern provinces and concludes among other
things that these provinces denote a low level of asset return compared to other provinces. If
the average return on population assets had increased in the provinces of Nampula and
Zambezia at the same rate as in the rest of the country, poverty would have reduced by about
half in these two provinces, he adds.

Finally, the report recalls that while Mozambique has a huge potential for agro-geology that
remains largely untapped, low productivity and limited growth in market-based agriculture are
major contributors to slow poverty reduction. Inadequate access and low market participation
by farmers accounts for up to 70 percent of differences in changes in poverty rates between the
poorer provinces and the rest of the country. On the other hand, the effects of natural disasters
on the economy of the country as a whole are exacerbated by the weight of agriculture in GDP.
For example, in the year 2000 cyclone Eline, which caused record levels of precipitation, caused
costs estimated at 20 percent of GDP.

Medical care (The Health System)

The National Health System in Mozambique comprises the public sector, private for-profit
sector, private sector for non-profit and community. The public sector, which is the National
Health Service (NHS), is the main provider of health services nationwide. The NHS is
organized into 4 levels of care, level I being the most peripheral and it is where the Primary
Health Care (CSP) strategy is implemented, and level II to serve as a reference for the clinical
conditions that have no response in the level I, such as complications of childbirth, injuries,
medical and surgical emergencies, etc. Levels III and IV are fundamentally oriented towards
more specialized curative actions and are a reference for lower levels.

As for the for-profit private sector, it is developing gradually, especially in large cities.
However, the further growth of these operators is conditioned by the increase in household
incomes. The current health policy recognizes the role of the private sector in providing health
care to citizens, public-private relations are being explored in the country, initiatives to contract
services to non-governmental organizations (NGOs) are ongoing. The process of health care
delivery by the private non-profit sector is still incipient. This is done mainly by foreign NGOs
and some religious entities in agreement with the Ministry of Health (MISAU).

In order to complete the structure of the NHS in Mozambique, it is important to take into
account the existence of service activities at the community level, with emphasis on traditional
medicine. It is estimated that more than half of the Mozambican population seeks and receives
care provided by traditional medicine practitioners [1] in their various forms and prophets.

Very recently, the Government has decided to recognize the traditional sector and its role as
providers of health services. The Government recognizes that a part of the population has
traditional medicine, the only source of health care and that the potential of this component of
the NHS has not been fully valued. The Government also recognizes that collaboration with
traditional medicine needs to be improved. And to streamline this process was created in 2007
the Institute of Traditional Medicine (IMT) subordinate to MISAU.

HIV and related issues

The word AIDS means acquired immunodeficiency syndrome, in the event of deficiency of the
immune system, the body's defenses decrease in relation to the appearance of pathogens. An
advanced deficiency in the immune system can lead to the development of serious diseases or
even death.

The simultaneous appearance of different symptoms of diseases is called syndrome in medicine.

AIDS is the late consequence of an HIV infection (human immunodeficiency virus) which is
why we have talked about acquired human immunodeficiency syndrome.

An HIV infection develops at different stages, proceed and the immune system stage is severely
deteriorated, where serious and lethal diseases such as tumors can develop.
An HIV / AIDS infection can not be cured, however, thanks to the improvement of medical
therapies, there are strong possibilities that an already acquired immune deficiency will be
latent, or if the therapy has started for some time its appearance is delayed for several years . In
some HIV-infected people, medical progress has led to a considerable increase in life
expectancy (conferring combination therapies). An HIV infection is and remains a deadly
disease, however.

Some African monkey species carry a virus very similar to HIV or VIS (simian
immunodeficiency virus). It is likely that HIV was born from the mutation or spontaneous
genetic modification of this monkey virus.

The transmission to men must have happened around the 1930s and then the virus spread. But
only when the usual symptoms began to be observed in America in the early 1980s, until then
were these symptoms very rare, is that the new syndrome began to be misleading.

The HIV virus was discovered in 1983/84, shortly thereafter the existence of the HIV2 virus
was proved, the two viruses and their subgroups, or sub-types, have specific characteristics and
appear in different forms across continents, yet the means of are the same for one or another
type.

HIV can be transmitted from one person to another through unprotected sex, needle and syringe
exchange between intravenous and mother-to-child drug use during pregnancy, at birth, and
during breast-feeding. An HIV test can confirm or exclude AIDS virus contamination. In
general, the results are only reliable after 3 months of exposure to risk (HIV testing)

AIDS continues to generate unfounded myths and beliefs and leads to discrimination and
exclusion. That is why we need to inform, end prejudices and encourage support and help (see
section HIV / AIDS and society).

In Mozambique there are now more than 1,500,000 people infected with HIV (UNAIDS, 2015),
with an estimated 110,000 children aged 0-14 years living with HIV (UNAIDS, 2016). In
epidemiological terms, HIV infection in Mozambique is widespread but considered stable since
2015, with a prevalence of 13.2% in adults aged 15-49 years. The southern region of
Mozambique is the most severely affected by HIV, with the predominance of Gaza province,
with a prevalence rate of 24.4%. HIV prevalence is higher in women than in men (13% and
9.2% respectively), both in urban and rural areas (IMASIDA, 2015).
In 2002, the implementation of the Vertical Transmission Prevention (PMTCT) program was
started in eight (8) health units. In 2004, PTV was integrated into the National Strategic Health
Plan, and in 2006 to the Maternal and Child Health Services. In 2007, the country adopted an
accelerated expansion plan for PMTCT.

In 2003, the Ministry of Health introduced antiretroviral treatment services for adults (patients
15 years) and children (0-14 years). In 2011, only 22% of the eligible children were in pediatric
ART. In 2013, the Ministry of Health initiated universal access to antiretrovirals for all HIV-
infected children under 5 years of age (UNAIDS, 2013). Also in 2011, the Mozambican
Government has joined forces with other committed nations in the struggle for an AIDS-free
world and has taken on international commitments including "Universal Access to ART" and
the "Elimination of Vertical Transmission of HIV" by 2015. These commitments required
countries to achieve 80% coverage of adult and pediatric HAART by 2015; reduction of vertical
transmission of HIV (mother-to-child transmission) to less than 5%, and a 50% reduction in the
number of new HIV infections.

In this context, MISAU has elaborated a plan in which it was defined how the country intends
to realize the commitments and to reach the goals. This Plan for the Acceleration of HIV and
AIDS Response was approved by Hon. Minister of Health in June 2013 and extended to
December 2017. The "Improvement Plan for Pediatric ART" with a period of 2015-2017 was
also drawn up to reach the pediatric goals under the theme "Improving access and quality care
and treatment of HIV-positive children for an AIDS-free generation".

In accordance with the aforementioned plans, the CCS has been acting as a partner of MISAU,
thereby contributing to the achievement of the millennium development goals without leaving
aside the strategic guidelines of its current largest funder the US Government through the CDC
by PEPFAR.