First Published in the October 2012 issue of Destination Magazine:
The Kenyan Coast has long been a sunny paradise with a slower pace of life, but a darker underside is emerging - one where heroin addicts do anything to score their next hit. Health, government and community officials debate the solution, but on the ground the problem continues to grow By Jill Craig
A Family Affair:
Many addicts want to quit heroin because of the suffering they are inflicting upon their families. The recovering addicts have really turned their lives around, and while you'd expect them to look back on their bad times with pain and wax poetic, they are as unemotional as those still injecting. While heroin use saps at a person's sentiment, so does the weary relief of kicking it - simply, their families are happy now and they are satisfied.
Alex decided to enter rehab because he wanted to stop hurting his loved ones. While staring down at the open pages of his Narcotics Anonymous book, Alex says quietly, "It pained my family so much and especially my mom. That is why I had to quit, because she was so sad. Someone had to come and talk to me about this. He said I was killing her in a way. They [my family] didn't have any respect outside anymore because people were talking badly about them. And it was all because of me."
Alexis has two daughters, aged 11 and 13, who live with her family in western Kenya. She has not seen them in over a year. She had her first daughter when she was 15 years old, a child herself. Alexis says she has never been able to provide for them, since almost all of her money goes toward the heroin. She wants to be a good mother, but admits that she is currently unable to do so, explaining with a slight tremor in her voice, "I am feeling very bad because they are ladies, and I don't take care of them. I am afraid that they will become prostitutes like me. They don't have a parent's love and I feel very bad about that. I want to change my life, by going to rehab, so I can take care of my children."
Kenyans are not the only IDUs at the coast - foreigners also support the drug trade. Jack* is an IDU who makes his living selling curios to tourists on the beach. He often sells them heroin as well. This side business provides additional funding to feed his own addiction; he can sell a tourist a sachet of heroin for KSH 3,000 - 10 times what he pays.
Ibrahim* is a taxi driver operating from Mombasa. Claiming to detest the influx of drugs at the coast, he admits that once he becomes "friends" with his foreign clients, he will arrange for whatever they request, including heroin. He says, "I'm okay getting the drugs for them because they have a job and they can handle it. The heroin addicts on the coast are idle, they are unemployed, and they are basically wasting their lives away. They have nothing."
Drug abuse on the coast is not limited to Africans and tourists alone. Heroin usage by local whites is well known, especially in the coastal towns of Diani and Lamu where seaside venues are popular and frequented by sons and daughters of some of the local residents. However, it is very difficult to determine these numbers correctly because the white experience with hard drugs is more private. White Kenyans can do drugs much more discretely than their counterparts, and generally, they're not the ones stealing cell phones or selling their bodies for it, so they don't cause as much of a public nuisance.
But recovering addict Tom* insists that it doesn't matter who you are - as a drug addict you end up losing everything. Holding a university degree, Tom had a good job after graduation. His addiction caused him to lose his wife, his home and his savings; he ended up living on the streets for over a year. He says that no one is immune from the devastation of drug use.
Rehabilitation programmes may vary slightly from centre to centre, but they all aim to instil a sense of discipline in their clients. Recovering addicts are required to help with the daily cooking and cleaning of the centre. They are taught not to blame others for their addictions - one of the first things they learn is that they alone are responsible.
Recovering addicts often become friends and can be found sipping juice in the courtyard, watching TV, or even meditating. Rehab provides them time for reflection and goal setting - luxuries they've rarely, if ever, had before. Most of the rooms resemble college dorms, with two to four sets of bunk beds and motivational posters adorning the walls. Unlike most dorms, however, these rooms feature well-made beds and no clutter - all part of taking responsibility for one's self.
Recovering addicts in rehab usually don't look like stereotypical "addicts." They are clean, well-dressed, and take care of themselves. They learn how to deal with the factors contributing to their drug abuse in the first place, which seems to give them a sense of peace. And the vast majority appear excited to have the rare opportunity to turn their lives around.
That opportunity doesn't come easily. At the coast, there is one public facility, which recently opened at the Coast Provincial General Hospital. It has occupancy for only 13. As of now, patients must be enrolled in the National Hospital Insurance Fund (NHIF), but very few heroin addicts are.
There are 10 private rehab centres, but the problem is the cost - centres range from KSH 45,000 to KSH 195,000 for three months, but both ends of that spectrum are out of reach for most addicts. Yes, heroin is an expensive addiction. A typical three-month supply can be extrapolated to KSH 81,000, but using addicts are also doing whatever they can to earn money, an option removed in rehab.
This is where a supportive family or sympathetic donor comes in. Some addicts are fortunate enough to have one or the other, but most do not. As a result, a very small percentage of IDUs at the coast are getting the medical and psychological help they need.
According to the Kenya National AIDS and STI Control Programme, the numbers of IDUs in Kenya are reaching astronomical levels. Although exact figures are difficult to determine, a March 2012 report suggested that there are now more than 26,000 on the coast alone. Within IDUs, HIV rates have skyrocketed, with 18 percent of men testing positive and, astoundingly, nearly half of the women.
While many community leaders and addicts think more affordable or even free rehab centres would help curb the rising epidemic, the government is looking towards a controversial new plan based on recommendations from the World Health Organisation and the United Nations Office on Drugs and Crime.
The basic idea is to make sterile, one-use needles freely available to addicts, in an effort to stop disease transmission. The programme would also have educational and treatment components, as it is a sure fire way to get IDUs in a place where they'd have to listen.
However, many community leaders, especially from the large Muslim population on the coast, argue that giving away needles will only make drug use easier, and that addicts could still share the syringe if they were sharing a single dose. Another issue is that the needles wouldn't be properly disposed, so used, and statistically diseased, syringes would be scattered where non-users and children could accidentally be stuck.
There are also those who say the supply side will benefit. They think the most effective solution would be for the government to prosecute the drug barons, and allege that it doesn't happen because government officials are involved in the illicit trade. And their allegations are likely founded - in 2011 the United States banned four Kenyan government officials and a prominent businessman from travel over suspected drug activity. Mama Kukukali insists that the government needs to stop the drugs from entering the country, and one way of doing so is by meting out the death penalty to drug barons.
According to Saad Yusuf Saad, the National Secretary of the Coast Community Anti-Drugs Coalition, even the dealers escape punishment. "We can go to Old Town [Mombasa] right now and I can show you where the drugs are being sold. The police will arrest the middlemen and once they are taken to court, the charge sheet is changed from 'caught with heroin, 1kg,' to 'caught with bhang [marijuana], 50mg.' Then, by the end of the day, the same middlemen are back in the streets."
While these policy decisions are being debated, the young women in the mango forest continue to sell their bodies for pocket change in order to score another sachet. As long as heroin-induced fog provides them transient relief from daily reality, concerns of needle-sharing and condom usage will float behind the more pressing question of how to get that next hit.
*Names have been changed
Originally published in the October 2012 issue of Destination Magazine, authored by Jill Craig.
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