Health

Women Wed to Addiction Find Relief at Kabul Center

Sunday, December 7, 2008

Drug addiction is mounting in Afghanistan as wives get hooked on the smoke their husbands exhale. A women-only treatment clinic opened last year in Kabul, where the clinic's director estimates about one-third of the women in the city are addicted.

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Nazdana is addicted to her husband's opium smoke.

KABUL, Afghanistan (WOMENSENEWS)--In a bullet-pocked cement building wedged into a hillside in a crime-ridden neighborhood, a group of drug-addicted women are gathered in the two barren rooms occupied by a family there. Most hold babies as they listen to a social worker passionately urge them to check themselves in to Afghanistan's sole women-only clinic for treatment.

"If your husbands smoke heroin, sisters, or you yourself take opium as medicine, it is like eating poison," said Nadara Saee, squatting before the women. "Besides, it is a big sin against Islam. And it makes you unable to take care of your children. Please listen to me. You must get treatment."

"Before God, I want to come," murmured 45-year-old Torpakai, who like many Afghans, goes by one name only. "But I don't have my husband's permission yet. God willing, he will give it tomorrow."

"We will return tomorrow then, sister," promised Saee.

Nazdana, 33, addicted to opium and painkillers and in whose home the group was gathered, spoke up. "I am ready. I will go."

Saee nodded in satisfaction. One success for the day. On average, it takes at least 15 visits to persuade a woman to check herself in and then deal with a range of complications such as husbands' consent or child care, she says. Some can never be persuaded.

Addiction in Afghanistan has doubled over the last few years, according to United Nations figures, and drug money is helping fund the Taliban, which controls many of the smuggling routes. Thus, making inroads in the war against addiction is increasingly crucial to the country's future, Afghan officials and aid organizations agree.


Threats From Husbands and Dealers

Nowhere is that belief more firmly held than in the Sanga Amaj Women's Drug Treatment Center, where doctors and social workers like Saee reach out daily to the capital's most dangerous districts, sometimes enduring threats from the women's husbands or drug dealers.

 A female addict is examined by a doctor.

Begun in June 2007 with foreign contributions, the center offers stays of up to three months with food and medicine free and can accommodate 20 women at a time. The center has helped more than 500 women since opening. But it is a drop in the bucket: According to the center's estimates, as many as 35 percent of Kabul's women are addicted.

Addiction occurs here primarily in response to poverty, war trauma or the chronic lack of medical care, specialists say. The per capita income is less than $1,000 a year and average life expectancy is 43. Many women are never seen by a health professional during pregnancy or childbirth. In the past, Afghan grandmothers often kept a little opium in a corner in case someone got sick. These days, drug dealers sell tiny packets of heroin or opium at prices attractive even to beggars in an effort to develop a regular, addicted clientele.

Like most female addicts here, however, Nazdana is an indirect user. Her husband smokes opium several times a day, and she and her five children became addicted from the smoke he exhaled and that hung in the air of their home. At first the addiction didn't worry her, but Saee taught her that his chronic drug use makes both her and her children more susceptible to disease.


Striking a Chord

This warning struck a chord. Nazdana already paid to have a mullah, or religious leader, make "taveez"--sayings from the Quran sealed into tiny green envelopes--to hang around the necks of each of her children. Despite that, they continually fall ill. She's decided it's time to do more.

Nazdana's husband works as a cleaner for the city, leaving at 6 a.m. and returning at 3 p.m. to smoke opium. Afghanistan is the world's largest producer of the narcotic, which comes from poppy grown in Taliban-controlled southern provinces.

Nazdana told Saee she would take her youngest, an 8-month-old boy, with her to the clinic. Her oldest, 12-year-old Marzia, was given the responsibility of mothering the other three, making sure they are somehow fed and their illnesses treated. She must also make certain they don't fall into the hands of kidnappers, who take young children to sell as labor in neighboring Pakistan. "Of course I am worried about being left in charge," Marzia said as her mother prepared to leave. "But it's my obligation."


Married to a Secret Addict

Another day, in another home about 10 minutes away from Nazdana's, Saee visits Jamila, 32. Her husband was already hooked on heroin when they wed, but it was an arranged marriage and his family kept his addiction secret. They lived in Logar Province until his father kicked them out four years ago. She and their six children, ranging in age from 13 to 4, have all become addicted from the smoke he exhales.

"When he smokes heroin, we all feel better and the children fuss less," Jamila admitted. "When we are away from his smoke for a day, we get fevers and diarrhea and I feel pain all over, deep in my bones."

Her husband begs for the money he squanders on heroin while she works as a tailor to support the family, and is proud that she feeds her children three times a day on a non-varying diet of chai and nan. Recognizing she cannot break the addiction until her husband does, Jamila won't check herself in to Sanga Amaj unless he agrees to go to a treatment center for men. So far, he's refused.

"I'm really angry with him," she said as one of her children rested his head on her lap. "When I was a child, I always told everyone I would grow up to be a doctor. Instead, my parents made me drop out of school in 6th grade to get married. But if he won't be treated, what can I do?"

She shrugs. "Of course I cannot leave him. I am an Afghan woman."

The center's director, Dr. Shaista Hakim, 41, believes there is no more important work in her country, and fighting addiction is akin to fighting against the Taliban. She remembers vividly the day the Taliban entered Kabul in 1996. She was hanging laundry on her balcony, head uncovered, when a passing car screeched to a halt. A man glared up at her and she moved quickly inside. He came upstairs and banged on her front door. "I took off my glasses, put on a scarf and opened the door," she recalled. "I was very scared. He said no woman is allowed on a balcony without a burka."

The very next day, she and her family left for Turkmenistan. She returned in 2002, soon after the U.S. invasion ousted the Taliban, and immediately began working with addicts. "If I think too much about how big the problem is, I will become an addict myself," she says with a laugh, but then grows serious. "I am determined to help."

Masha Hamilton, http://www.mashahamilton.com, is the author of three novels, most recently "The Camel Bookmobile," and has reported extensively from the Middle East, Russia, Africa and Afghanistan.

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