A Brief Purview
A project of the Rotary Cochin Harbour and the I M A Cochin West, the RHIMA De- addiction & Rehabilitation Centre, is designed to be a centre devoted to the promulgation of quality health care among the residents of the Cochin West. The activities of the centre would therefore be initially concentrated to benefit the Cochin West residents - an area which encompasses the residents of Fort -Kochi, Mattancherry, Palluruthy, right up to Kannamally with a population of 5 lakhs. Although the gamut of activities is aimed at benefiting all the residents of the area, special attention would be devoted to the residents of the coastal belt, where fishing is the main stay and alcohol abuse is comparatively more prevalent, Mattancherry where drug and substance abuse dominates and the teenage population who at this impressionable age is more suspect to the pressures of indulging in these deleterious activities The centre aims to be a nodal point for the effective implementation of these activities.

ACTIVITIES
The activities of the centre will be threefold
1. Health Education
2. Rehabilitation and Integration
3. Promotion of Social Health

Health Education
The objective of this activity is to impart health education to the local population. Paramount is the awareness and education of the lay public on the deleterious effects of alcohol, substance abuse, demystifying the disease, demolishing myths and fallacies of this social problem and means to successfully reintegrate the patients as useful members of the society. The centre would also play a role in preventing communicable diseases, prevent epidemics from recurring, ex - typhoid etc, and educate the lay public in order to mobilize public opinion. Effective focus of this energy could play an important role in influencing the elected representatives of the area to improve the standard of living of the population.

The centre would also be involved in conducting scientific studies, collating data and publishing articles on health issues affecting the residents of the area. The modus of operandi would include the following.

Health talks at various locations in a systematic manner so as to cover the entire Cochin West area in conjunction with local bodies - Ayalkootams (local gatherings), Service organizations, Religious bodies, Corporation of Cochin etc.,

Seminars at the centre for lay leaders- This would help in dissemination of information and effective implementation at the grass root level.

Health Seminars for the public.

Classes for different groups addressing the health requirements specific to them - Women, teenagers and school children, men.

Continuing Medical Education for the professional community through conferences, Skills Transfer courses, Library and Internet facilities etc.

Rehabilitation and Integration
The activities at the centre are manifold. Pre eminent among these is the Alcohol, Drug De addiction and Rehabilitation Centre. This centre would cater specifically to Substance Abusers, Alcoholics, HIV and AIDS infected patients and the particularly vulnerable section of the society - the school children and teenagers. Substance Abuse and Alcoholism, HIV & AIDS is a psycho social problem and therefore the approach would be to provide a whole range of services including awareness generation, treatment and rehabilitation. With a view to reducing the demand for and consumption of alcohol and dependence producing drugs the thrust will be on preventive educative programmes and reintegration of the addicts into the society. The centre would therefore provide the following services to the community.

The aim therefore of this "Drop in" counseling Centre is the prevention of ALCHOHOL & DRUG ABUSE by inducing behavior change in vulnerable people through counseling and strengthening the coping skills of people already affected by these infections.

Target Groups
One of the foremost activities of the centre is Primary Prevention i.e preventing the vulnerable person from taking the first step in the direction of acquiring the disease. This involves providing them access to information and resources, promoting a climate of understanding, and offering counseling and care so as not only to give them succor in their hour of need but also to prevent further transmission of the disease itself.

Take for ex school children. The socio cultural scene does not permit open communication in matters of sex, substance and alcohol abuse and the physiological, psychological and the emotional changes of adolescence. Therefore the youth often rely on friends and media for information on the subject. The images and messages they so gather often leaves them misguided or confused, resulting in exploratory behavior among peer groups or renders them subject to exploitation by seniors and adults.

Through counseling we provide information on various aspects of transformation to adulthood, skills for self assertive behavior and the power to say No to any situation that exposes them to the risks of smoking, alcohol, drugs and sexual infections. The centre aims to provide a congenial atmosphere with the availability of trained, sympathetic professionals for people to walk in for counseling and treatment.

CARE & SUPPORT OF PATIENTS WITH ALCHOHOL& DRUG ABUSE
The centre would provide viable therapeutic facilities for de addiction of the patient as well as work towards successfully reintegrating the patient back into the society. The successful treatment of patients is largely dependant on Counseling and follow-up. The patients would also be introduced to support groups like the Alcoholics Anonymous group etc both during and after the treatment in addition to group therapy and family counseling. Despite more than a decade of "Awareness" campaign the malaise continues. Both Alcohol, Substance abuse and HIV disease manifests in the form of numerous opportunistic infections like fungal infections, TB and others that are expensive to treat. Management of the infections becomes a major expenditure in the budget for the health care of these individuals. Government Hospitals are very often inadequately equipped while treatment in the private sector may be expensive. Therefore in a resource poor countries home based care is advocated to cut costs. This can be achieved by training the care providers in the family with first aid measures and necessary skills, financial assistance to manage opportunistic infections among the needy, providing home employment to enhance the financial situation for the affected.

The centre would also host the Rural epilepsy centre of the Indian Epilepsy Association. This rural centre would be involved in the screening and providing treatment to patients suffering from epilepsy.

PROMOTION OF SOCIAL HEALTH
We hope to liaison with various NGOs (Non governmental organizations), Kudumbashrees, Ayalkootams (local groups), and Like minded service organizations in order to reach effectively the society as a whole. The Centre would serve as a scientific nodal point where various symposiums, seminars, instruction courses will be conducted for the lay public.

In addition the centre would also host various screening and medical camps of different subspecialties during the year and probably also provide subsidized treatment for deserving patients.

Last but not the least A Blood Bank to cater the ever increasing demands of the Cochin West remains an objective to be achieved, But this can take form only after the infra structure is in place.