Nongovernment Organizations and Civil Society

Offering Afghan Drug Addicts a Clean Break

A nongovernment organization working in Afghanistan’s capital, Kabul, is trying to clean up addicts in the fight against HIV/AIDS.

In addition to the usual needle and syringe exchange schemes, NGO NEJAT Center is providing simple amenities – soap and shampoo, a bath, a scrub, clean clothes and a haircut – to drug users as a step toward rehabilitation.

With their self-esteem improved after being cleaned up, the drug addicts say they now feel more confident looking for whatever few jobs that are available. And this personal service has been in more demand than any other anti-drug activities.

This was an early lesson for the NEJAT Center in Kabul when it began undertaking activities financed by an ADB regional technical assistance project to prevent HIV/AIDS in Asia and the Pacific.

NEJAT Center has employed a full-time barber and, with the help of 61 new volunteers, extended its services to many afflicted with or at great risk of becoming infected with HIV/AIDS. The 61 volunteers, all former drug users, have become NEJAT’s first batch of peer volunteers working in the field in its outreach team.

Strategy of Harm Reduction

NEJAT realizes that drug addiction and the risk of spreading HIV/AIDS through shared needles are not problems that will be easily eliminated. Rather, it sees a small window of opportunity to help through harm reduction.

As long as Afghanistan remains the world’s leading producer of opium and heroin, faces political and social turbulence, and offers poor job opportunities, an HIV/AIDS pandemic is always likely, especially among its jobless youth. If unchecked, this pandemic would carry long-term consequences for the peace and reconstruction that Afghanistan is struggling to achieve.

In response to these challenges, NEJAT set up centers for needles exchange - giving out new needles and syringes in exchange for old ones, teaching addicts how to inject properly to minimize infections, and how to dress their wounds. But the issue of personal hygiene soon became an important part of its outreach.

The NGO started seeing a demand for personal hygiene services, as most drug addicts are homeless, or have been living in dark, dank alleys with no basic sanitation.

The Government of Afghanistan is supportive of the NGO’s harm reduction strategy, but is in no position to extend any support.

Large Numbers of Injecting Drug Users

NEJAT has over 1,000 drug-injecting addicts on its books in Kabul, of which 42% are Hepatitis C positive, while 3.5% suffer from sexually transmitted infections. SEA-AIDS a regional e-forum focused on HIV/AIDS in the Asia and the Pacific, estimates that there are over 34,000 people injecting drugs throughout Afghanistan.

NEJAT notes that more and more NGOs are getting involved in trying to tackle this drug problem. NEJAT’s work is concentrated in four districts of the country’s capital city. And since the growing demand for its services is larger than NEJAT’s capacity to respond adequately, the NGO suggests that all NGOs involved in harm reduction work in concert with other service providers.

NEJAT wants a regular forum that will allow all NGOs and providers to share knowledge and experiences in each locality. It also wants to create a resource avenue whereby NGOs can have access to and share materials during emergencies, such as blankets for homeless drug users in winter.

Need to Upscale Harm Reduction Activities

This current infrastructure for harm reduction, although minimal, will allow NEJAT to increase its activities in other locations, once additional resources become available.

SEA-AIDS has lauded the harm reduction strategy in Afghanistan as a step in the right direction. Failure to implement the strategy in some Asian countries, it says, has resulted in a 50-70% prevalence of HIV and Hepatitis C infections.

“Now many of these countries are facing drug-related HIV epidemic because they and their service providers failed to react and catch up on the epidemic,” SEA-AIDS has cautioned.

SEA-AIDS has called on all service providers to respond by scaling up their services in Afghanistan in support of NEJAT.