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close this bookMigrants, Displaced People and Drug Abuse: A Public Health Challenge (International Center for Migration and Health - ICMH, 1998, 60 pages)
View the document(introductory text...)
View the documentPROJECT LEADERS
View the documentSummary report
View the document1. Terms of reference
View the document2. Participating cities
View the document3. Project Leaders
View the document4. Local infrastructure (project teams)
View the document5. Establishment of local steering groups
View the document6. Regional Steering Group
View the document7. Scientific Advisory Group
View the document8. Site visits
Open this folder and view contents9. Methodology
View the document10. Local project administration
Open this folder and view contents11. Outcomes
View the document12. Minority group meeting
Open this folder and view contents13. Summary
View the document14. Overall conclusions
View the documentANNEX 1
View the documentANNEX 2
View the documentANNEX 3
View the documentANNEX 4 - Selected Tables




The group consisted of seven persons, four born in Suriname, two in the Dutch Antilles and one in Amsterdam. The age range was 34-53 years. Educational background was: primary school (4), administration (2), and nursing assistant.

Topics covered:

· Lack of structure in daily life.
· Lack of support systems
· Feelings of alienation in receiving country.
· How to cope with stereotyping
· Tendency to marginalisation
· Cultural disorientation
· Lack of integration
· Surinamese society is closed and has a high threshold for health care seeking
· Importance of professionals from within migrant community being involved in care
· Lack of perspective and lack of openness can lead to addiction.
· Ghetto's have to be avoided, and open housing promoted
· Prevention should be embedded in family context and families supported
· Schools, social groups, work place etc. should be used to reach people
· Ways need to be found to maintain intra-generation contact and advice
· Host society should require more from migrants in terms of integration
· Migrants should be made aware of the treatment facilities


· Illiteracy, poor education and rural background are obstacles to social integration

· Children in particular are caught in a dual culture and language dilemma

· Migrant children start school with fewer skills and linguistic capacities

· Persistence of traditional culture in homes is strong and not necessarily productive

· 60% of children do not graduate from high school and remain behind Dutch peers

· Moroccan teenagers run a high risk of confrontation with police and judicial system

· Disproportionate police/legal trouble compared to Dutch of similar socio-economic background, and for same behaviour

· Most noticeable crimes are physical abuse, overt violence, drug possession/use, theft and burglary

· Father-son relationships often disrupted because fathers worked abroad

· When reunited, younger generation still has to cope with a culture shock

· Family structure shattered and parent lose confidence for child-raising

· Many children in "multi-problem families" and parents busy with own survival

· Social assistance seen as ineffective because not linked to perceived migrant needs

· To make things worse, assistance is often provided too late and in fragmented way

· When problems reach attention of social services often too late

· Social services departments use difficult terms and do not cooperate

· Too little information is provided and not much expertise with cultural minorities

· Assistance would be more effective through mediators with knowledge of language

· Allochtonous staff produce better results

· Social assistance does not meet the needs, expectations, wishes of Moroccan families

· Does not fit life circumstances and prevention done from a Dutch point of view

· Moroccan drug addicts often isolated from families as well as main society

· Alcohol and drugs too easily available and children like to experiment

· Peer pressure is also important

· Moroccan drug users often belong to families which need lot of assistance and support from different social departments that do not coordinate well

· There is a problem of anonymity and many Moroccan drug users are unknown to social services

· Help is practically non-existent at the neighbourhood level and people are not being made aware of the seriousness of their problems

· Much what assistance is available is more of a problem-treatment nature than of preventive

· Mainstream society and the "the outside world" is seen as enemy, and within the family children are taught totally different values and standards than at school

· Social control within the Moroccon community has decreased considerably

· Education and guidance by parents is difficult for adolescents

· Adolescents are not being sufficiently stimulated by parents for education and social cooperation

· Unemployment among Moroccan parents is high (up to 50%). These and many other circumstances hamper integration of, and development in, the Moroccan community

· Situation is characterised by poor housing, low wages, discrimination and isolation

· Traditional attitudes of parents to children and education cause despair

· Parents feeling of helplessness to teenagers, and outside the family, young people regarded as a threat and an annoyance.


· The Netherlands is a highly developed country with very well structured facilities, among which institutions for addict care and assistance for drug addicts.

· Nevertheless allochtonous addicts do not easily make themselves known

· Care is not sufficiently directed to solve their specific needs, and organizations for drug prevention do not know how to handle their questions

· Lack of knowledge and expertise about the background of allochtonous addicts results in the inaccessibility and unrecognisability for Moroccan clients

· After 30 years of immigration Moroccans still have to cope with a lack of information about social services in their neighbourhood

· They also have impression these services interfere with private matters e.g. child care issues

· Community centres provide better access but problem families difficult to reach

· Moroccan families try to keep and solve problems within their own community as much as possible because they fear honour would be lost

· There is still a taboo on making problems public

· Families try to contact mediator first but then help from an allochtonous professional would be more appreciated.


· Effective information and advice on a local level, if possible in their own language

· Parents, care services, schools and organisations should be better informed through courses and information meetings, and teach teenagers to make their own choices, to deal with risks and to keep them under control

· Give youngsters clear information about the advantages and risk of alcohol and drug consumption

· Development of written campaign material

· Work more in a preventive than a problem solving way

· Start prevention campaign as soon as possible, before things go wrong

· Implement a different policy if possible

· Employ more staff with allochtonous background in key sectors such as education, social services, police, juvenile correction

· Cooperate with all institutions

- To teach basic skills by means of courses and information meetings.

· Stimulate job searching by appointment of assistants of Moroccan origin

· Make narcotics illegal and introduce stiffer penalties on sale

· Stimulate migrant organisations in battle against drug abuse

· Local organisations and mosque clergy have to help prevent drug abuse

· Organise meeting places for teenagers and stimulate their associations and activities

· Involve key personalities to stimulate these goals

· Establish sport and cultural activities for drug abusers


· Holland is familiar with migrant workers and refugees

· First generation came from rural areas, were poorly educated and selected for that

· The drug users today are children and grandchildren of these pioneers

· First generation has been taken care of (in terms of retirement payments) and the use of drugs among them is virtually unknown

· Desire of the first generation to return home is rarely fulfilled, and their prospects in Holland are not too positive

· The exact origin of people with Surinamese/Antillean roots not mentioned explicitly

· When we look closely not many Turkish or Kurdish drug abusers, slightly more Moroccans and even more Surinamese/Antilleans

· Social status of all 4 groups mentioned could be defined as low

· Drug abusers are primarily second and third generation, poor education (not true of Surinamese/Antillean), no jobs and stuck between two cultures, feel discriminated and in a marginal position

· Difficult integration is a determinant factor, and without social integration no one is able to survive.

· Often said that low education and difficulties in labour market hamper integration, which in turn can lead to drug abuse

· The higher the education, the less the chance of becoming a drug abuser

· Turkish/Kurdish, Moroccan and Surinamese/Antillean people at risk often live in disrupted families

· In addition they experience barriers in their search for help

· The obstacles are great and asking for help from official institutions is neither easy nor fits into cultural patterns. You do not expose your problem to strangers.

· Once you take this road there is no way back to family and/or friends because the dishonour is too great

· Moroccan adolescents often grow up in very authoritarian families (patriarchal)

· Children who try to escape stringent Moroccan family structures run the risk of social derailment. Dutch family structures are seen as too 'liberal' for them

· However, authority of father stops at front door and parents presume police will take over once their children are on the street

· Fact that there are few Turkish/Kurdish drug users has to do with family structure, strong values and standards

· Islamic religion also plays a vital role, and influence of Imam and Koran important

· Religious Turks are part of strong social structures, and in Arnhem there is an Islamic Centre where religious leaders play big role on defining acceptable social behaviour of adolescents and their parents

· In case of misconduct action is taken

· Position of girls in these families is very protected no female drug users will be found among Turkish/Kurdish and Moroccan families (no known cases). Turks and Kurds consider use of drugs as a sign of weakness. Dealing is smarter (and more frequent)

· Among 2nd generation Surinamese and Antillean people religion no longer important

· Also more concubinage and one parent families

· Surinamese and Antillean people more tolerant of drugs

· Alcohol (often frequent) is not seen as a problem and is may even be good for social image, "a real man drinks too much from time to time"

· In Antillean and Surinamese families (core family) may be of a less tighter nature

· Even so there is always an uncle or an older brother or sister or influential people in the community who can help prevent and give support.

· Abusers (addicts) are very strongly stigmatised within their own communities

· Allochtonous addicts are also stigmatised by the autochtonic population, which has strong impression that many Turkish/Kurdish and Moroccan people are involved in drug dealing

· Among Surinamese and Antillean migrants 'hustling' on the edge of legality is an accepted phenomenon in their countries of origin, but in Holland has a very negative connotation.

· Allochtonous addicts run into more difficulties with police than their Dutch peers, but it would be wrong to conclude allochtonous addicts are more criminally disposed

· Moroccan young people have many problems during adolescence, and have a bad reputation as aggressive and unreliable

· Moroccan fathers have absolute power over family but mothers have no influence on their sons

· Lot of social control in Moroccan society and people expect police to react in a harsh way including severe spanking from time to time

· Parents, especially fathers, don't understand why police do not act in this way

· Police notice that Moroccans have more problems with alcohol, while Turks/Kurds have more gambling problems.

· Getting in touch with parents of allochtonous children on edge of legality is difficult

· This is not so with Antillean and Surinamese parents who are easy to contact and more open to these problems.

· Groups in question not familiar with this psychiatric dimension

· Extreme views held: 'You are crazy, or you are not crazy'

· Dutch psychiatry has not focused on multi-cultural aspects of problem

· Surinamese/Antillean community is acquainted with the so called 'Winti culture' and includes beliefs of haunting by evil spirits. Frequent recourse to mediums.

· There are few Turkish and Kurdish addicts; slightly more Moroccan addicts, and even more Surinamese/Antillean addicts

· Alcohol abuse not common among Turks/Kurds and Moroccans, but accepted within the Antillean/Surinamese community where misuse is not taken too seriously.

· Methadone help for self control

· Alcohol abusers often manage to function socially and many of them and methadone users have jobs

· Working methadone users afraid to be recognised when they receive their medicine at points of distribution.


· The first generation of Turkish/Kurdish and Moroccan migrants are mainly migrants from rural areas, and abuse was not a problem. Situation is different with second generation who feel they have to catch up in many different areas and who suffer from discrimination and difficult integration.

· Many Surinamese/Antillean people some become addicted through experimentation while others face poor future prospects and difficult integration. The better one's education and integration, the less chance there is for addiction.

· Many addicts live in disrupted families.

· Having an addicted family member is seen as a dishonour

· Allochtonous addicts are often rejected by families, and there is no way back

· Treatment/care and social services often put up a barrier for allochtonous patients, and asking for help from these services does not fit cultural habits

· Drug addiction is less frequent within the Turkish/Kurdish and Moroccan community, and is due to family structure, religious beliefs, and social control

· Surinamese and Antillean families have different (less stringent) structure, but help is still given by prominent members within the community and important family members

· Turkish/Kurdish and Moroccan people intolerant of use and misuse of drugs, while Surinamese and Antillean people more tolerant of use and misuse of alcohol

· An existence free from narcotics is hard to reach for allochtonous users, and once they become addicted they have few structures to fall back on for support