Afghanistan's Most Wretched Battle Addiction

For tens of thousands of heroin addicts, just 10 rehab beds are available.

ByMATT GUTMAN

KABUL, Afghanistan, Jan. 8, 2008— -- Assadullah's blackened hand pushes up a jacket sleeve. As if it were a trophy, he presents a skinny arm notched with track marks. The Afghan heroin addict's veins have gone flat, making the featureless landscape of his forearm look like a child's.

Rolling down his Shawal Kamis trousers, he then displayed the only entry point left on his body: his femoral vein high up on the inside of his thigh.

Assadullah's fellow addicts impassively watch the spectacle here at a bombed out cultural center, built by the Soviets in the 1980s and promptly destroyed by Afghan warlords during the civil war in the early 1990s. The Soviets called it the Center of Knowledge and Culture.

Ghostly figures slouch through the structure, beneath the spot where Lenin's dour face has been chipped off an enormous mural. Piles of syringes and feces are left where junkies dropped them.

Assadullah, 37, is one of tens of thousands of Afghan addicts. They crowd the city's bombed-out buildings, often deploying by the thousands to score a dose, and then slouching back to these fetid lairs.

Their ranks have swelled the past two years, thanks largely to two years of bumper poppy crops and a botched narcotics war waged by the Afghan government -- whose own woefully paid police and anti-narcotics officials either smuggle the drug or turn a blind eye to it if bribed well enough.

Corruption is by no means limited to anti-narcotics officials. Border police at the Kabul Airport often find invented "contraband" on foreigners, in the hopes of coercing "bakshish," or a bribe.

Afghanistan has cornered the poppy and heroin market, now producing more than 90 percent of the world's heroin. That huge supply has driven down the street price for the drug here. A 1-gram dose now goes for 60 Afghan rupees, or about $1.10.

The poppy industry has also set off a "secondhand" epidemic; children and spouses of heroin or opium refiners have become hooked from the particles on spouses or father's clothing.

Dr. Nasimullah Bawar, the director of Zindag-i-Nawin, one of the city's 40 rehab centers, says his 10-bed detox center, not far from the Center of Knowledge and Culture, can't possibly handle the volume.

"We have thousands on our waiting list," Bawar said. "They come here looking for help, but we don't have the resources or the beds to treat them. So we tell them to start reducing their use and come back."

Assadullah is one of those rejected by the rehab centers. Short of stature and boyish of face, he is of Hazara descent, a minority ethnic group of at least partial Mongol descent. Assasullah's story is punctuated by a rattling cough.

Assadullah got hooked on heroin 10 years ago, and he has been gripped by addiction ever since. Before he became an addict, he was a machine gunner for the Hazara militia, Hezb-e-Wahdat, during the so-called jihad against the Soviets, but he was kicked out of Kabul by the Taliban in the late 1990s.

"I found himself working construction in Iran," he says. "It was hard work. I was always hurting. One day my boss offered me a toke of opium."

He inhaled, felt his body warming from the inside out, and quickly graduated to smoking heroin. After two years, smoking wouldn't slake his thirst for the drug. Injections shortly followed.

He takes me upstairs to the second floor of the bombed-out theater. We climb the remnants of a staircase where the snow drifts in, as he leads me to his favorite shooting up spot on the second floor. "Heroin makes you feel warm," he says, hugging himself for effect.

As we talk, he darts between euphoric proclamations that he'll join the Afghan National Army, to disconsolate depression.

"I am disgraced. I haven't seen my family in six months, I can't go home like this. It is shameful," he says.

In Afghanistan, shame appears to be one of the strongest motivations for rehab.

Crouched by a vomit stain on the carpeted floor of Bawar's rehab center, Khan Mamat is 48 hours into detox. Like the rest of the emaciated sunken-eyed inmates, the 22-year-old's head was buzzed.

"They have lice and when they arrive, their hair is so matted, we have to cut it off," explains Bawar.

His eyes are glazed over. The razor-stab pains he says he felt during the first 24 hours are abating. It was during those first hours that he, like so many of Bawar's inmates, tried to toss himself out of the detox room's window. Others have smashed the window and sliced at their wrists with fistfuls of glass.

He lost his car and his family to heroin. "What made me quit? My brother told me either I quit heroin or I quit the house."

The Afghan government and the international community have been sluggish to respond to the soaring rate of addiction, and a concurrent rise in HIV. Official government estimates put the total number of HIV-positive Afghans at about 350. Bawar says the number is likely much higher.

However, with the government's assent the center has begun to distribute sterile needles at places like the Center of Knowledge and Culture. But it's a battle Bawar says he can't win.

Assasullah knows he has already lost. In a flicker of lucidity, he points to his groin and says, "If I lose this vein, then I am dead."

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