Between two trucks on an abandoned, garbage-strewn railway, teenagers openly shoot up drugs as children pass by on their way to school — a daily scene in Karachi, where heroin is undermining Pakistan’s efforts to combat the spread of HIV.
“You can find any drug you want in Karachi,” Shahzad Ali said, his left hand swollen by repeated injections, one of tens of thousands in the city of 20 million lured to cheap Afghan heroin.
Like others, he stumbles around on the old railway line in the district of Musa Colony, where young people shoot up near mounds of smouldering garbage into which scavengers dig for anything that might be consumed or resold.
Pakistan has an estimated 1 million heroin users, half of whom use needles.
There are fears that the country’s addiction is set to deepen, with neighboring Afghanistan’s opium production hitting a record of 5,500 tonnes this year — even before the withdrawal of NATO forces next year.
A former male prostitute and heroin addict, NGO worker Mohammad Imran knows all too well the ravages of the drug.
“Because I belonged to this environment not so long ago, I can feel their feelings, their problems and everything else very clearly,” he said.
He witnessed first-hand the rise of heroin in disadvantaged neighborhoods, where a shot can be bought for as little as a few cents — a fraction of the cost in the West.
Despite using for 20 years as a sex worker, Imran escaped HIV infection and AIDS.
Tarak Abbas was not so lucky. Diagnosed two years ago, his cheeks hollowed by years of drug abuse, he is now trapped, homeless on the streets of Karachi.
“Whenever young kids come to me I tell them: ‘Look at me, no one cares about me now,’” he said.
Tarek is not alone. In Pakistan — known as “The Land of the Pure” — almost 30 percent of those who inject heroin are HIV positive, one of the highest rates in the world and up from 11 percent in 2005.
Afghanistan produces 90 percent of the world’s heroin, with almost half of its production channelled through Pakistan on its way to Europe or Asia, hidden in containers shipped from Karachi, a sprawling port on the Arabian Sea.
However, the drug does not just pass cleanly through Pakistan. It picks up addicts along the way.
“Pakistan is a transit hub, but has also become a consumer,” said Cesar Guedes, head of the UN Office on Drugs and Crime in Pakistan.
Karachi has in recent years seen a new crossover between the Afghan heroin destined for Europe and Asia and imported South American cocaine, fueling speculation of collaborations between Latin American cartels and Pakistani drug lords or the Taliban, who are partly funded by the traffic.
“There are no boundaries, there is no nation, there is no religion, it is about money. They have joined hands to get more money,” said Akbar Khan Hoti, chief of the drug unit at Pakistan’s Ministry of the Interior.
Local customs at the port of Karachi have only one sniffer dog, according to internal sources, and lack the ability to scrutinize the contents of the 3,000 containers that are scanned daily.