Mon, Aug 29, 2011 - Page 4 News List

FEATURE: Few treatment options for Afghans as drug use rises

NY Times News Service, KABUL

Once a river flowed under the low Pul-i-Sokhta bridge in Kabul, but now the thin stream is clotted with garbage, the banks are piled with refuse and crowds of heroin and opium addicts huddle in the shadows, some hanging like moths near the bridge’s supports, then slumping in the haze of narcotic smoke.

When outsiders venture in, dozens of the addicts — there are 200 or 300 here on any given day — drift over to see the newcomers. Most of the visitors are healthcare workers trying to persuade the addicts to visit their clinic for a shower and a medical screening.

This is another of Afghanistan’s afflictions: growing drug addiction and all the ills that come with it, not least HIV, which can be transmitted when addicts share needles. There were about 900,000 drug users in Afghanistan last year, according to the UN Office on Drugs and Crime, a marked increase from previous years. About 7 percent of the adult population of 14 million is using narcotics.

A vast majority take opium-based drugs, which are extraordinarily pure and very cheap — about US$3.50 for enough to get high, addicts say. Afghanistan is the world’s leading producer of opium poppy and the opium produced and sold here and its derivatives, including heroin, are among the most potent on earth. About 150,000 of those using opium-based drugs are injecting heroin, according to the WHO.

An indicator of the problem is a recent report by the Ministry of Public Health, in partnership with Johns Hopkins University, that found HIV present in about 7 percent of drug users, double the figure just three years ago, said Fahim Paigham, who until recently directed the Ministry of Public Health’s AIDS control program. In Afghanistan, the primary transmission of HIV is through shared needles.

The Pul-i-Sokhta bridge — which means “burned bridge” — is a refuge for many of Kabul’s heroin and opium addicts who used to gather in the ruins of the Russian cultural center on the east side of the city. They were forced out late last year. Some remained in the neighborhood, but many came to the bridge.

Some come every day to buy and use narcotics, crouching in dark corners to shoot up or gathering in groups to heat the opium powder until it melts into a black liquid and gives off smoke to inhale.

The ground under the bridge is thick with discarded syringes. Six mornings a week, a team of former addicts, nurses and a couple of social workers from the French non-profit healthcare organization Medecins du Monde forge ahead with large plastic disposal jugs in one hand and long-handled pincers in the other to pluck needles from the garbage. It is not uncommon to pick up 160 or 170 needles in a morning. They hand out fresh needles and alcohol swabs. The nurse treats the addicts’ seeping wounds where they have injected themselves too many times.

Not all the addicts are sure they can tolerate treatment, and some are so high they make little sense.

“I am the Bobby Devil of this town,” said a tall, bony young man in aviator glasses, sprawled next to a small group smoking heroin.

Bobby Devil is the stage name of an Indian actor well known here.

“I’ve been using for four years,” he added. “Last night, I went home with money and fresh fruit, and my wife and children told me to go away. They said, ‘You are a drug addict, you are a dog.’”

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