Mauritius is an example of how approaches globally neglect the stigma and discrimination faced by female users.
Mary (not her real name) was a smart student living in Mauritius who dreamt of becoming a social worker. After losing contact with my childhood friend and classmate in high school, we met up 10 years later. She wasn't a social worker. A struggling single mother of two, she had become addicted to drugs.
The father of Mary's children, also a user, was arrested and imprisoned for drug dealing. Her children were removed to state care, and although she learnt skills in rehab such as handcraft and sewing, she struggled to resume a normal life. Finding work was difficult and she couldn't get custody of her children.
Mary's story isn't unique to Mauritius. It is a common experience of female drug users in Africa and globally. It's also a good example of how in most parts of the world, drug policies, especially those dealing with rehabilitation, often fail to consider the gendered aspect of users, specifically women. While the concept of gender encompasses both males and females, the focus here is on women recovering from drug use.
Mauritius is often hailed as an African country that exemplifies good governance and human development. The island has made some strides in achieving gender equality, ranking 20th in sub-Saharan Africa according to the World Economic Forum's 2017 Global Gender Gap Report.
Woman drug users are seen as being at the bottom of the social strata, below their male counterparts
In the education sector, 58.2% of students in tertiary institutions in 2018 were female. In 2019, women made up around 39% of most senior positions in government services compared to 37% in 2018. Mauritius appointed its first female president, Dr Ameenah Gurib-Fakim, in 2015. In 2019 the World Bank ranked the country as one of the top six economies in addressing discriminatory laws and regulations that limit women's equality of opportunity.
However, these achievements shadow a sinister side to the island. Mauritius had one of the highest rates of drug use per capita in Africa in 2010. Rates of heroin injection were also high, with a prevalence of 61.8% among females and 42.5% among males in 2013.
Mauritius's history of drug policy has been predominantly punitive. The Dangerous Drugs Act of 2000 continues to punish people caught for personal drug use with imprisonment or a fine, or both. These measures haven't led to a decrease in drug consumption. And many negative consequences have emerged, particularly regarding public health. In 2005, 92% of new HIV/AIDS infections in Mauritius were among people who inject drugs.
This health crisis was a turning point for the government, which started introducing harm-reduction services. In 2017, the rate of new HIV infections among people who inject drugs had fallen to 32.4%. It was the first time in over 10 years that females injecting drugs had a lower HIV prevalence at 28.5% than males injecting drugs, at 33.2%.
After rehabilitation, male drug users in Mauritius are more likely to find low-skill jobs than women
Due to the stereotypes of women as society's nurturers, homemakers and caregivers, female drug users globally tend to be stigmatised more than males. Woman users are perceived as being at the bottom of the social strata, below their male counterparts. Those who manage to escape their situation tend to be rejected by their peers and society.
Drug consumption is often driven by poverty and social neglect. However, drug policies mostly neglect these issues, favouring measures that eradicate and outlaw narcotics. And approaches that do consider social problems don't necessarily account for gender. This is because policy generally tends to be formulated to deal with specific situations rather than specific groups of people.
'Policies are documents which often do not reflect the reality of people on the ground,' says Dr Craig Moffat, head of the Governance Delivery and Impact programme at Good Governance Africa. 'From a policy perspective, everyone is treated the same with a level playing [field].'
However, society isn't equal. Patriarchal settings favour males who may be less stigmatised for using drugs due to the gender roles they are assigned. Inadvertently, policy can become a tool of oppression - an example being the rehabilitation aspect of Mauritius's drug policies.
Marginalisation and stigma often propel former female users back into the drug abuse cycle
While the country has made promising advances, the rehabilitation policy mostly fails to account for gender. Its provisions for helping women earn an income and integrate back into their communities are limited. After completing rehabilitation, male drug users are more likely to find low-skill jobs than women, predominantly due to the gender gap in Mauritius's labour market.
To address this gap, organisations have started establishing rehabilitation facilities catering for females only. They help women acquire skills to start micro-businesses in their local areas. While these skills can be helpful, such programmes must guard against perpetuating gender stereotypes by focusing on 'women's work'. As Mary's story shows, handcraft and sewing are often ineffective in helping women earn an income.
When drug policies and implementation plans are designed, they must consider how men and women will be affected. This could be achieved by involving those with direct experience of drug addiction in their drafting and application.
A better understanding is needed of the different ways women are excluded from drug policies and how this omission reinforces stereotypes that cause them more harm. Former head of the African Union unit on Drug Control and Crime Prevention Grace Adetula says a first step is 'to obtain gender disaggregated data on drug users,' without invading women's privacy.
The government could partner with rehabilitation centres to work with community programmes and users' families to dispel stigma and discrimination. Support to women who have recovered from addiction could also include financial assistance and helping them reunite with, and take care of, their children.
The marginalisation and stigma based on gender and gender-based violence are key factors propelling former female users back into the drug abuse cycle. Until drug policies become more gender-sensitive, many women like Mary will continue to be consigned to the lowest rung in society.
Richard Chelin, Senior Researcher, ENACT, ISS Pretoria