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Macau is an overseas province of Portugal, comprising a peninsula and two islands. It is situated about twenty-five miles from Hong Kong. Its area is fifteen square kilometres in all, five square kilometres being the area of the peninsula. It is joined to the mainland of China by a narrow causeway, closed by a barrier. The fixed population totals ,, but there is a very important floating population which brings the total into the vicinity of , mainly people coming from Hong Kong, either as tourists or on short visits. The two islands are Taipa and Coloane. They are sparsely populated. The great majority of the population is of Chinese stock, with about 10 per cent of Portuguese, Indian, etc. Macau has a Portuguese administration: a Governor and a Council of Government with one member representing the Chinese community. It has very little agricultural or industrial production; its main source of income is the tourist trade. Macau is linked with Hong Kong by three ferry services and one small plane, but it has no airport the plane is a hydro-plane. There is no restriction on the entry of people from the Chinese mainland. Trade is carried on with the mainland, especially the buying of foodstuffs; almost all other merchandise comes from Hong Kong. Macau is a free port and has no customs whatever. It should be made clear that Macau is a very small territory, with no cultivation of the opium poppy or cannabis plant, nor any manufacture of narcotic drugs except for clandestine manufacture of morphine from opium and of heroin from morphine. All raw material comes from Hong Kong. Import, export, distribution of, trade in, and use or possession of drugs are limited exclusively to medical and scientific purposes, the authority responsible for drug control being the Director of Health and Welfare. Since 28 August , however, when the Drug Addiction Control Board Centro de Combate a Toxicomania was created, it has functioned as the authority in charge of all aspects of the narcotics problem. The control of import there is no export and internal trade and distribution presents no difficulty and follows the usual lines, applying the international narcotic drug conventions to which Portugal is a party. The illicit traffic is of importance, especially the illicit manufacture. Drug addiction exists in the form of opium and heroin addiction. A number of people of the lower classes smoke opium, but there are no regular dens Macau being small, a den could be too easily spotted because of the smell. Smokers congregate in the open near the sea-shore or sometimes in small sampans or in rickshaws one or two smokers will hire a rickshaw, put up a curtain, and smoke. The main drug of addiction is heroin, which is used either by injection or smoked mixed with barbiturates ' chasing the dragon ' , or more often added to ordinary cigarettes. It is difficult to ascertain the number of heroin addicts. It was estimated at about 1, by the police. Morphine is used by injection and sometimes also smoked in ordinary cigarettes. There is no cocaine and no cannabis addiction. Welfare work for drug addicts in Macau was officially inaugurated in December with the promulgation of ordinance No. Up to then, addicts were treated in the city hospitals, and particularly at the government hospital, provided that they applied voluntarily for medical care, or, in the case of persons in prison, the authorities took the initiative in providing treatment. By the regulations introduced under the above-mentioned ordinance, the aim of which was to provide a social improvement scheme, two treatment centres for drug addicts were set up - one in the Conde S. Januario Hospital the government hospital , and the other in the public gaol. In the first, treatment was given to voluntary patients, while in the second the patients treated were serving sentences for various offences. Thus a form of welfare work which had been in existence for as long as there had been drug addicts and hospitals at Macau was legally established and organized; the purpose was to ensure that the work should be carried out methodically; that techniques should be improved; and that the scale of operations should be enlarged by co-ordinating the medical aspect of this difficult problem with the steps taken by the authorities to intensify measures to suppress the traffic. Under this arrangement, 6, narcotic drug addicts were treated in Macau between January and December ; 2, of them were treated in the government hospital and 3, in the prison. Experience, however, showed that these methods, useful though they were, were not sufficient to ensure the return to society as able-bodied persons of the majority of the patients treated. The mere provision of medical treatment for drug addicts was, after all, no more than a single stage, though an important one, on the long road towards the establishment of the more constructive social measures of a preventive nature called for in a matter of this kind, measures which are an essential and decisive feature of any attempt to solve the problem created by the illicit use of narcotic drugs. Generally speaking, the Macau drug addict belongs to the lower classes; he will be a member of a humble family, possessed of modest means. If he has an occupation at all, he may be a tricycle driver, a coolie, or an unskilled labourer; or he may be a vagrant, making his living by begging and by the clandestine sale of heroin for the pittance paid him by the trafficker. Or again, he may be a criminal engaged in sinister activities of some other kind. He will often be unaccustomed to productive work, and his friends will be among the other addicts and the traffickers. He has no interest in family ties, and his sole ambition is to obtain his drug easily. His life is spent in the realm of psycho-pathology; his world seems as strange to the normal person as the latter's life seems absurd and incomprehensible to the drug addict. As a result, action by the authorities must necessarily take the form of eradicating the influences responsible for creating and organizing the kind of world which produces addicts of this description and keeps them in that condition; it is a campaign in which the medical and police aspects are associated with economic and social features. In most cases, a person who has received treatment in the hospital or the prison soon becomes a recidivist when released; because, after he has left, his only friends are those whom he had before; although he has been ' disintoxicated ', he did not, during his stay in the institution, undergo a psychological transformation of such a kind as would have enabled him to meet temptation without succumbing afresh. Such a transformation can take place only if the right atmosphere exists in the treatment centre - that is to. The Centre for Treatment and Rehabilitation of Narcotic Addicts in Macau 3 say if the groundwork for new feelings and new ideas is laid by sound methods such as organized work under supervision, life in the fresh air under healthy conditions, recreation and education. It was therefore necessary that this branch of welfare work should be planned in a different way. Ordinance No. By an executive order dated 17 January , the Governor established a committee 'to investigate and make proposals concerning the best means of carrying on the campaign against the illicit use of narcotic drugs and to treat patients so as to bring about their social rehabilitation'. As a result of this committee's work, an organization called the Drug Addiction Control Board Centro de Combate a Toxicomania was set up by executive order No. Its text is as follows:. In the light of the proposals made by the committee appointed under my Executive Order No. That a body, to be known as the ' drug Addiction Control Board ' be established in this province in order to co-ordinate the campaign against the illicit traffic in narcotic drugs;. That this Board comprise the following members: a chairman, the post to be held in rotation for periods of one year by the Deputy Inspector of Criminal Police and by the Officer Commanding the Public Security Police, the latter to be the first incumbent;. To supervise and co-ordinate the activities of the various official and private bodies engaged in the campaign against the illicit use of, and traffic in, narcotic drugs;. To direct the activities of the Social Rehabilitation Centre in the campaign against drug addiction;. To propose whatever measures it may deem appropriate to ensure the success of the campaign against the illicit use of, and traffic in, narcotic drugs;. To draw up and put into operation the rules to be observed in conducting propaganda against the illicit use of, and traffic in, narcotic drugs;. Thus at the beginning of the decision was made to establish the Centre. The Commissioner of Police, the co-author of the present article, undertook, as first Chairman of the Board, the creation of the Centre itself. He immediately met with a difficulty of a financial nature: it was too late to provide for the Centre through the regular budget allowance, and therefore it was necessary to raise the money by other means. The erection of the Centre was the result of an informal co-operation between various officials and the public. There was on the island of Taipa a place which had been intended as a home for beggars and vagrants established in An ordinance of 20 May provided that the responsibility for the administration of this institution should be entrusted to the Public Security Police under the Commissioner of Police; and since the great majority of drug addicts were persons without any occupation it was decided that the welfare work should be extended to the rehabilitation of persons who, as a result of their economic and social circumstances, were on the point of succumbing to the illicit use of narcotic drugs, although they were not yet listed as addicts. The home for beggars and vagrants was thus amalgamated with the rehabilitation centre; this was an important step towards the adoption of the preventive measures regarded by the Drug Addiction Control Board as an indispensable part of its activities. The building occupied by the home for beggars and vagrants was utilized and is now being adapted for the reception of patients who must be kept isolated. Thus the Government gave to the Centre the grounds and the buildings which were standing on it. In addition, it gave the usual facilities such as water, etc. The food during the end of the year was also provided by the Government. As for the money for the re-fitting of the buildings, it had to be raised without any real financial assistance from the State at the beginning, and when the Centre was inaugurated there were no cash reserves to cover the day-to-day operations. It entirely depended for its success on the goodwill of the people and organizations desirous of making an effective contribution to the solution of the grave medical and social problem caused by the abuse of narcotic drugs. The shortage of money was remedied in the following ways: first, His Excellency the Governor of Macau, who had taken the necessary steps to establish this institution and whose goodwill and enthusiasm were ever present at each stage in the development of the project, granted through his private secretary's office sums to cover some of the running expenses - namely, about 3, patacas between May and September The creation of a public opinion hostile to the illicit use of narcotic drugs is a factor of inestimable value from the point of view of prevention. The soliciting of funds to bring help to patients under conditions likely to lead to their being cured provided at the same time an opportunity for arousing a very large part of the population from the state of indifference which, owing to traditional usages and customs, had come to be the natural attitude. From time immemorial the illicit use of narcotic drugs had been regarded by a large proportion of the population as something of no particular importance or at most as a minor peccadillo about which the authorities made an unnecessary fuss. It was therefore essential to bring about a change in the mentality of the people and to inculcate new ideas which would gradually transform each member of the community into a person actively hostile to notions that are not only mistaken but harmful to the common weal. Realizing this, the Public Security Police organized an anti-narcotics campaign in the streets of the town and at places of public entertainment. Police cars equipped with loud-speakers were driven all over Macau for several days, broadcasting speeches by former addicts against the illicit use of narcotics. Posters were affixed to walls of buildings, describing in appropriate pictures and words the physical and moral degradation of the drug addict, contrasting this with the wealth of the trafficker and emphasizing the latter's criminal instincts. For several weeks the same posters were also shown on the screen in all the cinemas of the town at the beginning of the normal programme. This campaign will be resumed shortly and lectures on the perils of drug addiction will also be given in all schools in Macau, where there are some 60, schoolchildren in a total population of , We attach great importance to this campaign amongst young people, and we trust that the ideas instilled into them will bear fruit in due course. Adults born and brought up when opium was tolerated are unlikely to change their basic views about it despite the fact that the anti-narcotics campaigns have shaken them out of their normal indifference and may induce them to co-operate with us, which they often do in ways that are as unexpected as they are useful. But it is on the young people that we rely to bring about the definite achievements which we wish to see in the future, and it is in them that we place our best hopes. The initial campaign of fund-raising was a success. All sorts of means were used to raise money, such as soccer matches organized by the Public Security Police and Criminal Police, sales of various kinds, donations by Chinese, supporting clubs, etc. In all, enough money was raised to get the Centre running, and in addition Chinese business men, the American organization called CARE, Catholic welfare bodies and a number of other organizations donated large quantities of foodstuffs, tools, medicines and utensils of various kinds. It should be added here that in the years to follow the running of the Centre will be budgeted in the regular budget of the State under the item 'Public welfare ', a sum of 37, patacas having been included in the budget to meet the expenses of the Centre; also, medicines are regularly furnished free to the Centre by the Macau Health Department. The propaganda campaigns will continue from time to time, since it has been noticed that they should not be continuous, but repeated at intervals so that their efficacy be augmented. In order also to make the situation better known inside and outside Macau, the Board publishes a monthly report Relatorio on its activities. The island of Taipa has an area of four square kilo-metres. The journey to the city takes about thirty minutes by the regular ferry. The island is a pleasant spot; the Centre is situated high up, looking towards the sea, and is thus in the healthiest possible situation. The island is administratively under a civil chief who has nothing to do with the Centre. The administration of the Centre is under the direction of the police, the administrative director being the police superintendent. There are several buildings: the main building was formerly used to house the Taipa police. The largest building has two floors. On the first floor, in the left wing, are the administrative offices director's office, the secretariat, store rooms, dormitory for the staff, etc. In the left wing of the second floor there is a women's section with dormitories, toilets and a veranda. On the same floor and in the same wing there is a library for the use of the inmates which is under the supervision of a convalescent patient. On the right wing of this floor there are men's dormitories and a barber's shop. About fifty metres away from this building there is another building with only one floor used by auxiliary services - namely, the kitchen, the electric generator and the detention cells. In a former shed close to the beach which has been largely rebuilt by the present inmates, there are workshops for tailoring and the making of baskets, brooms, mats and shoes out of tyres, and leather goods; the knowledge and professional skill of many of the patients are thus made use of and improved. This department today constitutes a useful centre for occupational therapy. Farther off, at an isolated point on the road from the headquarters of the Social Rehabilitation Centre to the landing jetty, alterations are being made to the former Home for Beggars and Vagrants, which comprises two buildings each containing four spacious rooms. Patients suffering from mental disorders, tuberculosis, and other diseases requiring them to be isolated will be accommodated here. It is also proposed to install in this building a small plant for making fitas de massa , a kind of macaroni which in this region is commonly used in the preparation of soup. As mentioned before, the administration of the Centre does not come under the administrative authority of the Taipa Island, but is autonomous. He has a staff of nine men who perform the various administrative duties such as secretary, caterer, assistant caterer, registry clerk, foreman in charge of work, chief cook, and quartermaster. These men are members of the Public Security Police. The technical staff, on the other hand, comes under the Department of Health and Welfare. The Clinical Director, Dr. Cotta Guerra, co-author of the present article, is the psychiatrist of the public health services of Macau. Cotta Guerra is in charge of the technical aspect of treatment of drug addiction. There is also a resident medical adviser, who lives on the island and is fully employed in the Centre. He takes care of the ailments from which the inmates may suffer in addition to their addiction. He is Dr. Finally there is a male nurse named Antonio Fong, who is Sino-Portuguese, an ex-addict and very enthusiastic in the work. This nurse comes under the police administration. In addition to the above-mentioned staff there are inmates who act as foremen and cooks and receive a monthly pay. The Centre is still at the beginning of its working life, and therefore it is not yet very easy to give comprehensive statistics. However, statistics as complete as possible are given in the above-mentioned report published monthly by the Centre. Patients in the Centre come under two categories: first, the voluntary patients who come to see either the clinical director or the police and ask to be hospitalized; they are in the great majority Chinese of the lower class, with a few Portuguese. They receive treatment and are taken care of free of charge, including food, uniform, etc. Once they are in, they are submitted to the same regime as the other addicts. They do not sign any pledge to stay, but it is extremely uncommon for them to wish to leave the Centre. There have been very few cases of flight up to now. In fact, some of them express the hope that they could stay for ever. Drug addiction being for most of the Chinese in Macao a sort of scourge sent by the gods, the family of the addict is often pleased to see him in the Centre, since he is in any case useless economically, and therefore they do not try to get him out. Such patients represent about one-third of the total. Apart from the lower-class volunteers, there are some rich addicts who volunteer for treatment, but do not want to go to the Centre for reasons of prestige. These enter the General Hospital, where they are cured, but they have to pay for their stay and treatment. The majority of the population of the Centre is formed by remanded patients; if the police find a person in possession of narcotics, they bring him to court the police tribunal, in which the Chief of the Judiciary Police acts as judge. If this person is found to be an addict, he is sent to the Centre, and he will remain there for the duration of his jail sentence. If a man is arrested for a crime other than the possession of narcotics, and is found to be an addict, he is sent to the Centre for six months; but when he is cured he will be sent back to Macau for the rest of his term. Most of the people arrested for possession of narcotics state that they are addicts, because they prefer to go to the Centre rather than directly into prison. In a few cases, such persons stated that they were not addicts 4 cases ; they were examined by the Clinical Director, and those found not to be addicts were sent directly to jail. It should be noted here that, for the time being, the sentences for the possession of narcotics are the same whether the possessor is an addict or a trafficker; but this will be changed by a new law, now being studied, which will provide for higher penalties for traffickers. When this is effective, there will be a medical examination to determine whether the man is an addict or not otherwise all traffickers would pass themselves off as addicts in order to avoid the heavier penalty. When the addict enters the Centre, he is first examined to see if he has any general illness. If so, he is treated for that illness and opium extract is given, so that the withdrawal will not take place. When he is cured, he reverts to the category of the ordinary addict. The ordinary addict, when he arrives in the Centre, is subjected to immediate and total withdrawal. He is given tranquillizers miltown, harmonine - a Japanese-made tranquilizer - or trilafon plus sedatives, neuroplegics, vitamins multi-vitamins , cardio-tonics and general tonics, such as vitamin C, calcium, etc. He is also given a protein-rich diet, especially fish. If the addict is unable to stand the withdrawal this is rare , he is given drops of opium extract and sometimes morphine never methadone. The Clinical Director examines each patient when he enters the Centre and thereafter he sees the patients weekly. In his experience, the addicts are mostly of the same type, and the inquiries that he made did not give ground to any psychiatric classification. The withdrawal lasts, in general, between a fortnight and a month. In a few cases in which the psychological aspects seemed prominent, the addict was submitted to psychiatric examination and follow-up. Once the withdrawal is effected, the addict is put to work according to his age, strength and previous experience. Some of them who have special skills are employed as foremen on construction work, etc. They receive a token salary. Apart from this technical side, the life of the addict in the Centre is mainly one of work, tempered by a number of recreations. We would like to emphasise here that we found it necessary to give the inmates a fairly rich diet and we thought that the best illustration would be to give a table of composition of meals per week with an indication of the weight in grammes of each component both for Chinese inmates table 1 and for non-Chinese inmates table 2. It will be seen that the amount of protein is very high and it was even half-jokingly suggested that the Centre might be too successful and that the food might attract far too many 'customers '. In addition, inmates get tobacco and even wine when they are engaged in the harder forms of labour. Up to summer , the food was supplied already cooked by a local caterer in accordance with the contract made with the Treasury. Since 1 January all the food has been prepared by the inmates themselves; this offers distinct advantages, both from the point of view of both cost and quality. The average daily cost of meals per inmate used to be 1. When the addict is able to work - i. In the first type. In the first type the addicts, according to their strength and skill and under the direction of foremen who are usually addicts themselves, contribute to the building or repairing of whatever is needed for the Centre: they work at stone and gravel quarrying, manufacturing of cement tiles, painting and whitewashing, carpentry, masonry, installation and repair of electrical apparatus, etc. They also contribute to the running of the Centre by making clothes for inmates, preparing meals, gardening, pig breeding, etc. In the the second type they work at trades such as leather work, making bamboo and coconut palm brooms and baskets, making shoes, etc, which can either be used for the Centre or sold outside. Whatever is sold outside is for the benefit of the Centre, all receipts from this being recorded and a current account being prepared for submission to His Excellency, the Governor. The fresh fish on Mondays, Wednesdays and Fridays is cooked. Beans when out of season are replaced by other vegetables in the proportion of grammes to The beef is roasted. The pork is fried. Each ration of vegetable soup must contain grammes of cabbage and grammes of potatoes. The cooked fish is seasoned with oil, vinegar, pepper and salt. It has been found that the addicts with a sufficiency of food enjoy working as teams and also enjoy being paid for it. Recreation is also provided for the inmates on weekdays from 12 noon to 2 p. Facilities for such sports as swimming, soccer and table tennis are provided and also for Chinese chess, mah-jong, etc. There is a small library which the inmates can use. As had been outlined before, it is still too soon to give full sets of statistics, and the following will be rather indications as extracted from the monthly report from the Centre. The addict population at the beginning of - i. At the end of the year it was around , and this figure was maintained during the beginning of The following table will give an idea of the composition of that population:. Another statistic published in the report for May is of interest in drawing a picture of this population, although, again, it should be taken as an example:. Other statistics giving a total of addicts indicated their professions. A great number of professions are indicated 40 , but what is very striking is that 46 addicts are indicated as without profession and 33 as tricycle drivers i. Of the medical profession only one dentist is indicated. Out of the some addicts the origin of the addiction was given in 69 cases as having taken drugs as a medicament and in 41 cases as having taken them out of curiosity or imitation. It is felt that it is still rather early to try to give statistics of the results achieved by the Centre - i. The cure in the medical sense - i. The difficulty is to keep the addict off the drug after he has been discharged. Therefore an indication of success is the number of recidivists - i. For the time being, as noted in the report for May, the number of patients readmitted was relatively low - i. This number, however, should be taken only as an indication, and it will be some years before a true appraisal of the results achieved can be obtained in a scientific manner. There are a number of projects for the future of the Centre: first to complete the equipment - for instance, building a dining hall and recreation room; construction of a wall around the annex; land levelling in front of the annex; building a cloakroom; making enclosures for pigs, building a carpentry shop, a photographic darkroom, etc. Agriculture and stock breeding will be developed. Also a mosaic factory will be started and stone quarrying will be done on a larger scale. This work should contribute to making the Centre more and more self-supporting. As for recreation, photographic and cinema equipment and development facilities for sports are contemplated. The fundamental objectives which we seek to achieve in our campaign, as a basis for genuine social rehabilitation, are to develop the professional skill of the inmates, to ensure that they learn a different way of life and to bring about a complete change in their outlook. Consequently, in addition to providing the inmates with medical treatment and organized work, it will be necessary to integrate them into the life of the Rehabilitation Centre as able-bodied persons who, to the extent permitted by their varying duties - as group leaders, instructors, propagandists against narcotic drugs, school-teachers, or foremen, etc. Editor's note : The pataca, which is the vernacular name of the currency of Macao, is the equivalent of about U. United Nations. Office on Drugs and Crime. Site Search. Topics Crime prevention and criminal justice. View of the main building of the Centre Macau has a Portuguese administration: a Governor and a Council of Government with one member representing the Chinese community. The narcotics situation It should be made clear that Macau is a very small territory, with no cultivation of the opium poppy or cannabis plant, nor any manufacture of narcotic drugs except for clandestine manufacture of morphine from opium and of heroin from morphine. Creation of the Centre Welfare work for drug addicts in Macau was officially inaugurated in December with the promulgation of ordinance No. Work in the smithy Thus a form of welfare work which had been in existence for as long as there had been drug addicts and hospitals at Macau was legally established and organized; the purpose was to ensure that the work should be carried out methodically; that techniques should be improved; and that the scale of operations should be enlarged by co-ordinating the medical aspect of this difficult problem with the steps taken by the authorities to intensify measures to suppress the traffic. Such a transformation can take place only if the right atmosphere exists in the treatment centre - that is to The Centre for Treatment and Rehabilitation of Narcotic Addicts in Macau 3 say if the groundwork for new feelings and new ideas is laid by sound methods such as organized work under supervision, life in the fresh air under healthy conditions, recreation and education. Its text is as follows: Executive Order No. The sewing shop Basket-weaving is one of the best liked activities of the inmates The Centre for Treatment and Rehabilitation of Narcotic Add icts in Macau 5 The initial campaign of fund-raising was a success. Organization of the Centre The island of Taipa has an area of four square kilo-metres. The work of the Centre The Centre is still at the beginning of its working life, and therefore it is not yet very easy to give comprehensive statistics. Gardening is good rehabilitation work, and also provides fresh vegetables for the Centre A meal taken out of doors The cooks skilled or semi-skilled inmates The Centre for Treatment and Rehabilitation of Narcotic Addicts in Macau 7 Apart from the lower-class volunteers, there are some rich addicts who volunteer for treatment, but do not want to go to the Centre for reasons of prestige. In the first type When the addict is able to work - i. United Nations Office on Drugs and Crime.

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Hong Kong Customs yesterday April 28 seized about 1. Customs officers conducted Customs clearance on an incoming male passenger at Hong Kong Macau-Ferry Terminal yesterday afternoon and found the suspected heroin inside a backpack carried by him. The suspected heroin was believed to be delivered to Hong Kong via Macau from Malaysia. The year-old man was then arrested. Under the Dangerous Drugs Ordinance, trafficking in a dangerous drug is a serious offence. Members of the public may report any suspected drug trafficking activities to the Customs' hour hotline or its dedicated crime-reporting email account crimereport customs.

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