Department of Human Services A Preliminary Review of the Social, Economic & Health Effects Attributed to Khat Chewing of Somali Community in Melbourne Said Aden (Public Health Fellow -Victorian Public Health Training Scheme-Department of Human Services) Malina Stankovska (Project Supervisor)--VTPU Steven Klimidis-VTPU Victorian Transcultural Psychiatry Unit hosted the project.

Purpose of the presentation : To discuss the results of a survey conducted in Victoria about the prevalence of Khat use Social and health problem associated with its use International literature Khat plant

Methodology Key informant interview was used: Forty key informants were selected from Somali community on the basis of : Their ability to contact a large number of people from the community Their involvement and knowledge of Somali community issues. The survey included: People of different ages, educational and occupational backgrounds. 20 males and 20 females were interviewed. The main roles of the key informants in the community were: Advocacy Working with local community organisations Providing advice Employment/Welfare services Interpreting services

Occupation of informants occupationFrequencyPercentage % Community Development Workers Interpreters Youth workers 12.5 Health promotion 37.5 Family Day Care Workers 25 Unemployed/Retired 410 Small Business 410 Health Officer 12.5 Students

Extensive use of Khat How extensive is Khat use in your community? 8o% of the respondents said that many people among the Somali community use Khat freq% I don’t know 12.5 A few people use it Many people use it 3280 Total40100

Frequency of Khat use. People who use Khat, how frequent is their use generally? Frequency Percent I don't know Once per month Once per fortnight Once per week Several times per week Daily Total Majority of the respondents said that Khat is used once per week.

Gender of Khat users In your view, among the Khat users what proportion would be male and female? Frequency Percent I don't know Mainly male More males than females Equal proportion of males and females Total Khat use is more frequent among the males.

How concerned are you about the age groups using Khat?

What proportion of Khat users and their families are affected financially by its use? 35 respondents out of 40 said that Khat users are affected financially.

What do Khat users say about the benefits of using Khat ? (Benefits). Benefits of using Khat (from users’ perspective) YES (Frequency) No (Frequency) Personal Benefits 31 (77.5%) 9 (22.5%) Interpersonal Benefits 27 (67.5%)13 (32.5%) Health Benefits 15 (37.5)25 (62.5%) No benefits 7 (17.5%)33 (82.5%) Others 3 (7.5%)37 (92.5%)

What do you think are the benefits of using Khat? Benefits of Khat (Key informants' perspective) Yes Frequency/Percentag e No Frequency) Personal benefits 14 (35%)26 (65%) Interpersonal Benefits 12 (30%)28 (70%) Health Benefits 12 (30%)28 (70%) No Benefits 20 (50%) Others 4 (10%)36 (90%)

What do Khat users say are the negative effects of using Khat? Difficulties associated with Khat (from users) YesNo Personal difficulties 21 (52.5%)19 (47.5%) Interpersonal relationship difficulties 22 (55%)18 (45%) Work and education difficulties 23 (57.5%)17 (42.5%) Financial problems 26 (65%)14 (35%) Health problems 19 (47.5%)14 (35%) No negative effects 6 (15%)34 (85%) Others 2 (5%)38 (95%)

What do you think are the negative effects of using Khat? From key informants’ perspective YESNO Personal difficulties 25 (62.5%)15 (37.5% Interpersonal relationship difficulties 29 (72.5%)11 (27.5%) Work and education difficulties 29 (72.5)11 (27.5%) Financial problems 30 (75.5%)10 (25%) Health problems 27 (67.5%)12 (30%) No side effects 0 (0%)40 (100%) Others 5 (12.5%)35 (87.5)

What is the effect of Khat on family relationships between spouses? YesNo Conflict/Argument/Di ssociation 34 (85%)6 (15%) Interference with roles and responsibilities 34 (85%)6 (15%) Other 12 (30%)28 (70%)

What is the effect of Khat on children under the care of Khat users? YESNO Negligent 36 (90%)4 (10%) Interference with education 31 (77.5%)9 (22.5%) Interference with socialisation 21 (52.5%)19 (47.5%) Others 4 (10%)36 (90%)

Does using Khat affect peoples’ health related behaviour? Health behaviours I don’t knowLessMoreTotal Sleep7 (17.5%) 27 (67.5%) 6 (15% ) 40 (100%) Smoking6 (15%) 6 (15%) 28 (70%) 40 (100) Coffee and tea 5 (12.5%) 6 (15%) 29 (72.5%) 40 (100%) Unsafe driving 11 (27.5%) 8 (20%) 21 (52.5%) 40 (100%) After effects (Fatigue) 7 (17.5%) 7 (17.5%) 26 (65%) 40 (100%) Irritability15 ((37.5%)8 (20%)17 (42.5%)40 (100%)

Do the people in the community know that khat is illegal in Australia except under permission for personal use? 70% OF KEY INFORMANTS INDICATED THAT THE COMMUNITY IS NOT AWARE THAT KHAT IS ILLEGAL IN AUSTRALIA EXCEPT WITH PERMISSION FOR PERSONAL USE.

Should there be a law to discourage and prevent people from using Khat? 72.5% of the key informants encouraged legislation to prevent people from using Khat, while 27.5% of the informants disagreed.

INFORMATION ABOUT KHAT Have you ever read any information about Khat?  YES: 25 (62.5%)  No: 15 (37.5%) Do you think the community would benefit from receiving information about Khat?  Yes : 35 (87.5%)  No: 5 (12.5%)

What is the best way to provide the community with information about Khat? Access to hotline: Yes: 20% Brochure: Yes: 47.5% Somali radio: Yes: 60% Internet: Yes: 12.5% Others Yes: 12.5%

ANY SUGGESTIONS

Acknowledgment Key informants Malina Stankovska, A/Professor Harry Minas, Steven Klimidis (VTPU) Victorian Public Health Training Scheme (Department of Human Services)