Interview 11/08/2002

The supporting arms of SEDQA

Mario Schembri Wismayer pays a visit to Mrs Sina Bugeja, Chief
Executive Officer of SEDQA. Mrs Bugeja explains how the large organisation is linked up internally, how it functions and what it offers to the public it serves.

One immediately realises that Mrs Sina Bugeja is an busy woman. But she courteously downs tools and gives me her attention once I settle down across her desk. My first question deals with the meaning of the word SEDQA. Is it an acronym? "No sedqa actually means to succour in Maltese. Given what we do, it is a very apt name." I ask Mrs Sina Bugeja for her views about alcohol consumption. "I am very concerned about young people abusing alcohol. This is a rising trend and it owes its origins to many factors. We have a rough idea of the drinking habits of the general population. About one thousand of them are our clients. We are trying to work out how many alcoholics we have per capita." So is all consumption of alcohol to be seen in a bad light from now on? "From a cultural point of view drinking of wine during a meal is acceptable, so long as it does not mean that minors also take wine.

The problem is that patterns are changing. Before, hard alcohol - whisky, vodka, etc - were only drunk on occasions such as Christmas or maybe during a wedding. Now people will consume a tot or two and sometimes much, much more of the 'hard stuff' at the drop of a hat. People actually go out with the specific purpose of 'knocking back a few'. Obviously this is where abuse and bad habits can form." So, is there no place for moderate drinking? "The trouble with the concept of moderate drinking is that moderation is relative. A bottle or two of wine shared by a number of people during a meal may very well constitute moderate drinking, but that same amount of wine drunk by one or two people might not remain moderate. When it comes to minors, there is no place for moderation.

“Alcohol at that age is harmful. We should protect our children from alcohol; with young people there is no space for compromise about this matter." Sticking to this point, I ask Mrs Bugeja to give me what, in her view, constitutes an acceptable level of alcohol consumption. "Well, with regards to this matter, we can divide the population into two; those that are vulnerable and the rest of the general population. Those that are vulnerable should not take any alcohol at all. Here I am talking about those who were once alcoholics, those who have a tendency to addiction, young people who are at the age where they like to experiment and so on. The rest of the population can consume some alcohol.

“The WHO stipulates that the maximum weekly consumption of alcohol should not be above 21 units for men and 14 units for women. The great qualifier here is the word 'healthy'. If people are not enjoying perfect health, or are taking medication, then the amount of alcohol consumed should be drastically reduced or preferably stopped completely. It is important to keep in mind that these levels quoted by the WHO are the maximum levels. Anything beyond that will start to have negative impact. In fact consumption should be below these maximum levels." Referring to the policy of the Netherlands,

I ask Mrs Bugeja for her view about the legalisation of certain substances, such as cannabis. "I had occasion to meet the Dutch minister responsible for the passing of that law. He said that it had turned out to be a big mistake. It was initially introduced to regulate the situation in the coffee shops where such substances as hashish are sold. SEDQA's position is that it is totally against decriminalisation." We changed subject and started to discuss SEDQA in the context of other groups, such as Caritas and Oasi. "Heroin abusers are referred to the detox centre of SEDQA. Clients may choose were to receive treatment. They can opt to go to Caritas or Oasi if they so wish to.

“We have a healthy relationship with the other organisations and hold regular meetings to keep each other abreast. Having said that, other groups have their own criteria and priorities when it comes to accepting clients. SEDQA, on the other hand, is the executive arm of the government and we accept to help everyone." So, what are the objectives of this organisation? "SEDQA is primarily concerned with primary prevention. We have a blanket policy approach towards the whole population. 93 per cent of the population knows what it is doing.

“We are also concerned with secondary prevention - the people who are at risk. We use educational means to inform and to arm people with the right facts so that they will be able to make the right choices from a position of power. At a tertiary level, SEDQA help people with problems such as drug or alcohol addiction and gambling.

“We also do a lot of work with the 'significant others' that is the people who are hard hit by the actions of, or are in a position to influence those who have a problem." We turn to how the organisation is divided."SEDQA is divided into a number of units. There is Gubjo House which takes care of administration, policy and services development and management of care services, together with the head office which is the seat of the CEO, finance and the drugs community team, which works in and among the people of Malta. Then there is the Lija unit which takes care of family services and also houses the psychology team.

“In Balzan we have the Secondary preventive team. We have a residential centre for drug addicts at Luqa which is called Komunita' Santa Maria. Also at Luqa we have the primary prevention team. We have Dar iz-Zerniq in Floriana, which is a residence for alcohol abusers. We also have a day programme running there.

“Then there is Dar l-Impenn which is an in-patient detox unit. Finally we have a detox out-patient unit just outside St Lukes Hospital." Remaining with the internal structures of SEDQA, I ask if there is place for input from the staff. "The only way we can improve is through the feedback of our workers. We also collect a lot of data to look out for trends. We run a self-feeding system." What about staff training? "Training is an ongoing process. It is an integral part of work. It is impossible not to train workers when you are operating in this field. People are sent abroad, they attend seminars and even university courses." I ask how much liaising goes on with other similar organisations abroad.

"This has expanded vastly. It is the only way to keep up. With no contacts with other organisations abroad it would be too easy to fall into the trap of feeling secure and thinking that you are doing everything you can. It would only be a matter of time before you're overtaken by events. In this regard Malta is lucky in that things usually arrive here a little later than abroad, so by keeping tabs on what's happening elsewhere, we place ourselves in a position where we can anticipate and prepare for the future." I enquire as to the funding and the very beginning of SEDQA. "We are totally government funded. We form part of the Ministry of Social Policy. We also work in close contact with the Ministry of Home Affairs and with the Ministry of Health. With regards to SEDQA's inception, in 1993 a report which finished up being named the Meli report, after the magistrate who conducted it, was commissioned. A task force was set up to see what was being offered in the shape of care services at that point in time. It was stated that the government badly need to set up an organisation to offer a comprehensive approach. An act of Parliament created SEDQA in 1994."

The conversation touched upon SEDQA and education. "We train teachers. We hold in-service courses and seminars. We prepare teaching aids and lesson plans which teachers are very happy to use in their lessons as they feel that they are really able to help children become aware and to take the right lifestyle choices.

Often teachers are the salvation of their pupils." I ask Mrs Bugeja whether SEDQA carry out research. "We do not rely on anecdotal information. We carry out evaluations and we encourage university students to come and carry out research with us. We hold and participate in national and international surveys and we also commission research and longitudinal studies." I ask about the official status of SEDQA. "SEDQA is the executive arm of the government. It is funded by the government and is therefore an agency of the government."

I ask how come there are a relatively high number of methadone patients, when these are supposed to taper off? "This is because not everybody can be tailed down. There are two main forms of therapy.

“There is the substitution therapy, where slowly, slowly, the dose of methadone is reduced. Then there is the maintenance therapy. Not everybody can be tapered off and some people will continue to need methadone indefinitely." What improvements would Mrs Bugeja like to see? "Physical improvements. Our clients are increasing and so we need more space”.

“We operate in a constantly transitional state of improving things. Of course, more finance will improve our services." I ask about the causes of drug and alcohol abuse. "Loss of self-esteem and the lack of skills needed to handle problems. There are some people with a tendency towards abuse. Also the 'apple for every ill' mentality makes people more dependent and less likely to stand on their own two feet and struggle." I ask if violence is a problem. "No it is not. It would not be tolerated.

“Most patients who are forced to come to us adjust very well when they realise that we are all out to help. I think the general public realise that we are doing the very best for them." So who is Sina Bugeja? "The CEO of SEDQA, but I like to keep my private life separate from my professional one. I am a wife, mother, daughter, sister, just like everybody else!" Mrs Bugeja's favourite activities: "I love gardening, water-colour painting and reading." I ask Mrs Bugeja if there is anything that she really can't stand. "People who blatantly lie to me and expect me to believe them, not realising that I can see through them. Ceremonial behaviour which hinders real work."