Pubdate: Sun, 21 Apr 2002 Source: Boston Globe (MA) Contact: 2002 Globe Newspaper Company Website: http://www.boston.com/globe/ Details: http://www.mapinc.org/media/52 Author: Brian MacQuarrie, Globe Staff Bookmark: http://www.mapinc.org/heroin.htm (Heroin) NEW PRIORITIES TAKE AID FROM ADDICTS RAWALPINDI, Pakistan - This is ''a place of peace'' for the heroin addicts of Rawalpindi, says recovering user Noman Shah. It is a haven beside a noxious sewage ditch, crowded inside an alley where the miserable outcasts of a dirt-poor society sniff and smoke the stupefying fumes that get them through another day. It is a place of running sores, of glazed and yellowed eyes, of weeping, and hopelessness, and an elemental shame that drives these addicts into filthy caves to satisfy their daily cravings. Today, it is another casualty of Sept. 11. Since then, the spigot of foreign donations to Pakistani drug programs has dried up, social workers say. Instead, the flow has been diverted to Afghanistan, where the more visible concerns of millions of refugees have prompted a flood of humanitarian aid from around the globe. At New Life, one of Pakistan's leading drug programs, foreign funding ended March 31. Doctors no longer are available at its Rawalpindi drop-in center to treat the chronic medical problems that afflict street addicts. Shah and other outreach staff, although still working, are no longer being paid. Meanwhile, the heroin supply from Afghanistan and Pakistan's frontier areas is plentiful. For $1.50 a day, an addict in Rawalpindi can buy the four small packages needed to produce a nodding stupor. The opiate is sniffed, smoked, or burned on foil and inhaled. To the hundreds of addicts huddled near the drainage ditch, the effect seems devastating. Unconscious users lie in human waste; old men bathe their bandaged feet in sewage; teenagers wail as they plead with Shah to cure them. Outside support for Pakistani drug-treatment programs - $450,000 last year to New Life, for example - does not seem much by Western standards. But in a country that offers little government treatment for drug abusers, the cost of lost funding is measured in lost lives. As a result, an estimated 400,000 street addicts in Pakistan are being left behind as they make a deadly transition from sniffing heroin to injecting it with shared needles, says New Life director Tariq Zafar. For Pakistan, where HIV is all but unknown, any increase in dirty needles could be a crisis in the making. ''There's been a slower response to HIV than to terrorism. Is it an Asian bias?'' Zafar asks. While the West and Pakistan quickly mobilized an alliance to fight the terrorist threat in South Asia, Zafar says, no similar sense of urgency has greeted the skyrocketing increase of HIV and AIDS in India and Myanm ar. Pakistan, he fears, could be next. Part of the problem, Zafar says, lies with the culture of a country where even charities shun the drug fight. ''We don't contact local groups because drug use is very stigmatized,'' says Zafar, who founded New Life after ridding himself of a heroin habit in 1989. ''These are the bums of the society. They're criminals; they're off-track; they need to suffer - that's even from their family and friends.'' Zafar's goal, ambitious as it seems, is to reach every street addict in the drug-plagued cities of Rawalpindi, Lahore, Quetta, and Peshawar. New Life workers such as Shah, a former addict, seek users in putrid places such as the Rawalpindi sewer. His offer: a bath, a shave, and counseling. No fee is charged; no one is refused help. New Life works with 5,000 addicts a year, Zafar says, and has compiled a computer census on a wide array of drug-related data, including specific habits, sexual histories, and criminal records. ''Basically, what we're doing is the state's job,'' Zafar says. Motivated clients are offered detoxification help and rehabilitation at New Life's center in Angoori, where Zafar designed Santa Fe-style adobe buildings to house the users. The complex near Islamabad, built by recovering addicts, is set in a serene glade of tall pine trees and steep hills. On this day, its administrative staff of recovering addicts includes a medical doctor, a graduate of the London School of Economics, and a Pakistan Army veteran. With the loss of outside funding, the center now is supported solely through the work of recovering clients, who restore vintage Jeeps and manufacture woodwork and fine leather goods. Productivity and hope, however, are the possessions of the lucky few who rid themselves of addiction. Most clients vanish from New Life after a few counseling sessions. In Rawalpindi, up a steep flight of narrow stairs, the drop-in center is a start. In one small room, four dazed men and one teenager squat or sit on the floor. They are all heroin addicts, drawn here by hope, shame, or desperation. As the clients listen to Shah, a gaunt man slowly climbs the stairs. He shakes Shah's hand, falls to the floor, and removes a shirt that reveals a skin disease and a row of lacerations on his right forearm. This is Shahod Ahmed, 34, a tribesman from the Afghan border who sobs as he says he has disgraced his family. ''I have three sisters. I want to take care of them. I want to do something for them,'' Ahmed says. That goal might be tomorrow's fantasy, but Shah counts his presence as today's success. Ahmed has decided - for now, at least - to join the living. - --- MAP posted-by: Doc-Hawk