Connect to share and comment

Helping Kabul's female heroin addicts

They are hidden by their husbands and accidentally overdose their children. But one clinic offers hope for Afghanistan's female drug addicts.

Addicts smoke heroin in Kabul. (Jacky Naegelen/Reuters)

KABUL, Afghanistan — The bed trembles in rhythm with Marzia’s body, which has been denied heroin for nine days.

At the age of 14, she married a drug smuggler working between their home country of Afghanistan and Iran.

“We were well off but I was always alone and I was tired of always worrying about my husband,” says the frail woman, whose gaze is alert, and curious, despite the abstinence-induced shivering.

The family lived in Iran for seven years. Drugs are easy to come by there and many Afghan refugees fall into addiction. Marzia’s friends introduced her to heroin as a way to calm her nerves while her husband ran drugs.

The 27-year-old mother of four returned to Afghanistan one year ago. Her husband has married a second wife and has threatened to leave her for good if she doesn’t kick her habit.

“It’s shameful to be addicted and shameful if he leaves me, that is why I am here,” she says.

It is the second time in a year she has come for help to the Sanga Amaj rehabilitation center in the capital. Two doctors and four nurses care for the 20 women receiving treatment at any one time. An additional six social workers go out into the community, caring for women in the home if they don’t want or don’t have their husband's permission to come to the shelter.

Since Sanga Amaj's spartan but clean center opened in 2007, more than 850 women have received treatment in the 45-day program.

It is primarily Afghans returning from Iran and Pakistan, where financial difficulties abound, who use drugs, said Muhammad Zafar, deputy minister of counter narcotics. Over 90 percent of the world’s opium and heroin comes from Afghanistan’s poppy fields, much of it transported through Pakistan and Iran into Europe via the Balkans, then traveling further west and north.

Zafar is honest about the difficulty in offering an alternative cash crop to impoverished farmers that is as lucrative as opium. Yet he remains hopeful the problem can be diminished. School textbooks now include information about drugs and addiction, where they didn’t two years ago. In addition to Sanga Amaj, the cities of Herat and Mazar-e-Sharif have treatment centers especially for women, many of whom are introduced to the drug by their husbands.

At Sanga Amaj, the chief doctor, Toor Paikay Zazai, estimates that about 20 to 25 percent of women relapse, despite her staff keeping in touch with women for two years after treatment.

There is no access to methadone. Her team tries to quieten the patients' agony as much they can the first few days with regular painkillers, then uses prayer, group therapy and education to keep the women away from opium, heroin, hash and glue. Zazai worked for seven years in Peshawar, Pakistan, where many downtrodden Afghan refugees are easy prey for drug pushers.

“The abstinence pains were worse than giving birth, I thought my bones would break from itching,” said Fawzia, 35, stroking her arms to show the extent of her suffering.

Fawzia didn’t understand the strength of the opium she gave her 2-year-old daughter to help her sleep. “When I came back, she was dead,” she said quietly.