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A little understanding and a practical approach
A large number of injection users and heroin smokers in the city come from an extremely depressed social setting and with a dependence on drugs is simply cut off by the rest of society to languish in poverty, abomination and deprivation. Unknown to many, these people are also at risk of contacting and spreading HIV and other diseases. However, at the drop-in centers run by CARE, Bangladesh, these people are given counseling, a normal and dignified environment and taught to sidetrack HIV by being practical, writes Towheed Feroze
FOR Masum, the initiation to addiction began pretty early when he was encouraged to take gul (ground tobacco) by his friends. Desperate to be deemed a ‘man’, he yielded to peer pressure and that was the start. Gul made way for cigarettes and this led to marijuana and, eventually, injections. Now, Masum’s everyday lingo consists of three major words: Bono, Tono and Madrasi. In case you are wondering, Masum’s Bono is not the famed singer but the shortened form of Bonogesic, an ampoule injected by addicts. ‘Every day my main objective is to get the three doses that I need to survive,’ he adds. But what about getting the much desired high? ‘That stopped long ago, now I take injections because the body has become accustomed to it and without the ‘push’ I cannot function.’ Without work and the damned signboard of an addict hanging around his neck,
Masum is ostracized by society, jeered, shunned and treated as dirt. However, for the likes of Masum there is hope and that comes from the strategically placed drop in centers (DIC’c) operated around the city by CARE with the help of the government. ‘We come to this Nayabazar DIC because once we are here, we are not social outcasts but people who made mistakes,’ comments one Masud Rana, an injection pusher and adds, ‘it’s unfortunate that our problem is not regarded or addressed with understanding. People treat us as criminals and clearly create a line between us and the society and, it’s this chasm that confines us within the dreaded cycle of addiction.’
But what is a drop-in center? Interestingly, society in its mad Faustian rush for material gains is not aware that right here in this city there are places that address addiction, HIV, safe sex and the delicate issue of social belonging. ‘Here, at the drop in centers for women and men, we take a very considerate yet rational approach to addiction, syringe usage and indiscriminate sex,’ comments the male DIC in charge Nazrul Islam and adds, ‘Once the users come here, we provide them with proper health related advice because most addicts are ignorant about basic hygiene. And then, we treat abscesses developed on the bodies of injection users, provide them entertainment, give them syringes to discourage needle sharing and distribute condoms to promote safe sex.’ So, won’t the distribution of needles encourage the users? ‘A superficial look into our program might give such an idea but in truth, our foremost focus is on counseling, referring addicts to rehabilitation centers and providing an environment of understanding,’ observes Shushen Chandra Mandal, the field officer managing the Nayabazar DIC and says, ‘now, once this part of the program goes on, we cannot expect that a user will stop immediately after a session. He will continue and, as long as he does, we want to ensure that he follows it with basic safety procedures so as to avoid contacting and spreading HIV or even Hepatitis.’
Sitting in a circle in the TV room and luxuriating in the warmth of human touch on a winter morning, the users are not so concerned about HIV as they are with the chance to be treated as normal people. ‘See, out there we are nobody, we do not have the opportunity to savor some of the basic pleasures of life like watching a film, getting a shower or a treatment for skin problems,’ says Tipu, a user and continues, ‘but here, we can have some link to a normal life that does not revolve around drug only. Then, there is the counseling and the follow up. Many of us used to take ten to twelve ampoules a day but now we have managed to come down to three. It was the motivation at the DIC’s, the treatment and words of hope that brought us this far.’
Tipu also said that now they took injections not to get high but to meet a physical demand. ‘It’s not about getting stoned anymore; it’s about countering abnormal spasms and unnatural behavior stemming from a physical system that has come to rely on the drug,’ he adds. ‘But, by using new syringes every time we take drugs and by using condoms we are also ensuring that HIV does not break out in an epidemic,’ states Ruhul Ameen, another user.
At the Nayabazar female DIC, most of the women are floating sex workers who are the main physical partners of male injection pushers and heroin users. And, as many of them are injection pushers themselves they are also at risk of contacting and spreading HIV. Like their counterparts, they have similar facilities offered to them at the DIC but it takes one glance to measure the depth of their plight. ‘In the first place they are women from a socially depressed background, then they are sex workers and, finally, they have a drug habit. All these combined make them the most vulnerable,’ says Salma Yasmin, in charge of the female DIC.
‘Women come here, they get counseling, information about safe sex and other social issues and on the lighter side, they chat, watch films, share their stories with us,’ adds Salma. She also reiterated what her counterpart at the male section said: it’s a process and as part of that we take a very logical approach. The ultimate aim for the supply of the syringes along with the counseling and rehabilitation related aid is to help these people come out of drugs. ‘See, if we had not taken this approach then they would have never come to us. But now they listen to us, find time for counseling because they feel an affinity and that has happened because of the practical approach,’ says Shushen. For the drug users whose main source of income is through scavenging, the DIC is a refuge from the world of neglect and abhorrence.
‘Once we are here, we feel at home; out there no one bothers about us, but at least once we are here we feel that someone is there, waiting to serve us,’ is their unanimous observation.
As this writer was about to leave, a man, bleeding profusely stood at the gate of the male drop in center. ‘I have done no harm, I was picking discarded shoes and they beat me up,’ he said as blood trickled from several parts of his face. Nearby shopkeepers, untouched by the scene, shooed him away but the DIC authority asked him in and took him to be dressed and cleaned.
‘We get seven to eight people who come in to have their abscesses cleaned but if one of our users is beaten up or is hurt due to an accident, we also take care of him,’ says Harun ur Rashid the man in charge of providing first aid and medical dressing. ‘See, if we don’t care about them, then who will?’ he asks, almost rhetorically and in that line, the whole objective of the mission goes beyond the practical and becomes something more humane.
Facts
511 injection users and 205 heroin smokers come to the male DIC at Nayabazar.
The female section has 25 injection users and 33 heroin users.
Every day 7-9 patients come to have their abscesses cleaned.
The female DIC provides a chance for the women to cook and share their food.
The outreach worker distributes 25-30 ampoules and condoms every day.
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