Pubdate: Wed, 19 Apr 2000
Source: New York Times (NY)
Copyright: 2000 The New York Times Company
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Author: Barry Bearak

ADDING TO PAKISTAN'S MISERY, A HEROIN EPIDEMIC

KARACHI, Pakistan -- Raees Khan sleeps most nights on a pillow of
dust. His home is a median strip along the busy Liaquadabad Road,
across from a mosque. A little before dawn a loudspeaker announces the
first call to prayer, a reminder to the holy that before Allah all men
are naught.

This noisy summons fails to awaken Mr. Khan. Though a Muslim, he does
not pray five times a day. Other rituals command him: emptying a tiny
bag of heroin into a plastic bottle cap, adding water and heating it
on a small flame, drawing the hypnotic broth into a syringe, hunting
for a plump vein and feeding into it the fluid warmth.

After a decade of addiction, locating the vein is the hardest part.
Most of those conduits have long ago collapsed. One recent morning,
Mr. Khan, 30, and a helpmate searched his arms, hands, feet and groin
before settling on a faint line in his right biceps.

The shot was transporting. His head lowered sideways as if he were
laying it on a platter.

But a few moments later he was up again and grumbling dissatisfaction.
He scavenged in his pocket for another bag of the brown powder, and
this time he inhaled it.

"I am flying now," he said, though this was merely the view from
within. Actually, he was staggering toward the street, just another
Karachi dope fiend on open display.

Pakistan, which does not lead the world in much, is most likely No. 1
when it comes to heroin addicts. Reliable country-by-country numbers
have not been compiled, with social science a low priority in the
third world and addicts hard to poll anyway. But the United Nations
estimates that 1.5 million heroin addicts live in this nation of 150
million, the unfortunate result of geography, geopolitics, corruption
and poverty.

"I think we can be quite definite that Pakistan has the largest heroin
population," said Bernard Frahi, who heads the United Nations drug
program office for South and West Asia. "And whatever the total is, it
seems to be getting quite a bit worse."

Karachi itself, a city notorious for lawlessness, political killings
and gargantuan slums, has 600,000 heroin addicts, according to the
nation's anti-narcotics officials. And while that total seems
exaggerated -- for it would mean that about 1 in 15 adult males is
hooked -- the city is replete with the dope-addled in each section of
its troubled sprawl.

Addicts are everywhere and nowhere, easy to overlook from a car but
impossible to miss on foot. They are huddled together on the sidewalk,
under the bridge, behind the truck, against the fence, along the prime
begging space beside the shrine.

"Heroin is written in my fate," said Mohammad Aslam, 40, who had a
needle in his arm and a prayer cap on his head. "No one can change the
decree of fate."

Their days fill with the customary gamut of degradation: the craving,
the begging, the scheming. Mr. Aslam has been shunned by his wife --
or perhaps it is the other way around. He sleeps near the city's main
drainage ditch, just a few feet from raw sewage.

With the veins in their extremities withered, addicts often tug down
their pants, injecting near the groin. Jan Sher, 29, does this. He is
a theatrical man who lives beneath the girders of a walkway. Dirt is
on him like plaster and there are crescents of sweat under his arms,
but he handles a syringe so deftly that it may as well be an extra
finger.

"This is Karachi," he said, letting the needle linger, drawing blood
in, letting it out. "You can drop your pants in a police station and
shoot up, and no one would care."

A dose of heroin, known as a token, costs about $1 -- about a tenth of
what it would cost in Brooklyn. The quality is bad, with barbiturates
often mixed in. But with the price so cheap, a three-bag habit is
affordable to anyone whose hands can beg small change or steal an item
off a shelf.

A syringe, heroin's most efficient conveyance, sells for 10 cents.
Addicts reuse them until the point becomes painfully blunt. They know
the sermons about hepatitis and H.I.V., but many still share needles,
playing the odds in a kind of microbiological roulette.

The more favored practice, though, is referred to as panni, or what in
America is called chasing the dragon. The heroin is spread on a strip
of tin foil and heated from below. The addicts, who are overwhelmingly
male, inhale the fumes through a straw, sniffing at the curl of smoke
like an excited hound following a scent.

An entire colony of panni sniffers has settled into the concrete
hollows beneath the Sohrab Bridge, along the main highway. Dogs roam
all over, and while the attraction for them may be in the ample
rubbish, addicts insist that the animals themselves are hooked.

At the steps around Aurangzeb Park, in the oldest part of the city, a
hundred or so addicts gather each evening. From a distance they appear
to be in prayer, kneeling over candles or matchsticks, entering a
trance in the delicate sadness of nightfall.

Mixed among the bedraggled are a few addicts who have clean clothes
and barbered hair. They work at jobs and go home to families. And
while their normal lives have yet to be entirely forfeited, they seem
without illusions about the eventual surrender.

"There are more of us every day," Faeez Hussain said a little
boastfully, "and people from good families, too. You'll find
university graduates among us."

Merchants with stores near the park are exasperated. "We have had some
of these people beaten, to the point of almost killing," said Abid
Ahmed. "But they get up as if nothing had happened. Beating them is of
no use. They will have to die on their own."

The police do not arrest the addicts, though the constables of Karachi
are very much feared by them. They extort cash. Two with machine guns
walked toward an older addict with one eye, Sharif Uzzaman. He
prudently scurried away.

"Most days they rough us up and take our money," he said. "They tell
us: if you can afford to pay 50 rupees for heroin, you can afford to
pay 20 more as a bribe."

Such accusations are not to be doubted. Shabbir, an addict in a
pressed shirt, stepped forward to vouch for their truth. He pulled his
police identification card from his wallet, showing his constable
number. He was due at the station in a few hours.

"A policeman is paid only 4,200 rupees [$84] a month, and a man with a
family cannot subsist on this," he said. "We have no options but to
take bribes where we can."

Drug enforcement is usually left to Pakistan's Anti-Narcotics Force,
which is largely a military operation. Its focus is on major busts,
and its chief, Maj. Gen. Zafar Abbas, cites record seizures: "Our
force is small, but 1999 was a very good year."

Addicts scoff at those efforts, for heroin is as available as air.
Even the bigger amounts are easily obtained in well-known spots like
the Ilyas Goth shantytown, a tight cluster of wood and concrete
shacks. An extraordinary percentage of the residents -- men, women and
sometimes children -- are hooked, entire families pulled under.

A melancholy addict named Lassi watched her daughter Fatima snort dope
through a ballpoint pen with its ink cartridge removed. "I did not
force her into addiction," Lassi said defensively, pulling at her
shawl. "It was her own decision."

Hashish and opium claim another two million addicts in Pakistan, the
government says, and for many users heroin is but the next step. From
there the rungs to come seem to be ones of methodology, from sniffing
to panni to the needle.

However far along, addicts are often unsure how to assess their sins.
There is a metaphysical dispute about what qualifies as "haram,"
forbidden by the laws of Islam.

Abdul Qadir, an addict and a locally infamous car thief, was wearing a
clean white prayer cap. He argued, as many do, "The Holy Prophet,
peace be upon him, did not prohibit drugs. He prohibited intoxicants,
and by that he meant only liquor."

Indeed, a ban on alcohol is commonly cited as a reason for Pakistan's
heroin problem. In 1979, as part of his so-called Islamization
program, the military dictator Mohammad Zia ul-Haq declared drinking
to be a "heinous crime," punishable by public flogging. For many,
drugs became the substitute for drinks.

That same year, geopolitics turned this part of the world upside down.
A strict Shiite Muslim government took power in Iran, and many of that
country's drug kingpins found Pakistan a welcome refuge. Then, in
December, the Soviet Union invaded Afghanistan, and the region became
a hot spot for the cold war. The Americans and Saudis financed the
Afghan resistance through Pakistani intermediaries who sometimes found
synergy between the heroin and weapons trades.

Throughout the 1980's and much of the 1990's Pakistan was a world
leader in the production of opium, from which heroin is derived. That
distinction has since passed to Afghanistan, which last year grew 75
percent of the global yield. To reach the world market, the drugs are
smuggled out along well-trod roads and donkey trails into neighboring
Pakistan and Iran. Their populations have become convenient local customers.

General Abbas said the opium trade across Pakistan's porous border was
impossible to stop. Besides, he lamented, "the main problem is a
shortage of drug rehabilitation."

By any measure that would be an understatement. Karachi has the
capacity to treat only 500 addicts, said Dr. Saleem Azam, a highly
respected physician who gave up a prosperous medical practice to treat
drug patients with his own waning funds.

"The people in the government are indifferent to drug rehabilitation,"
he said. "They say there is no money, but they always have plenty to
spend on the military."

Mr. Frahi of the United Nations has found much of the same lack of
interest among international donors. "Other countries are willing to
fund law enforcement projects, but we can't raise a penny for
prevention or treatment," he said.

Most heroin addicts here, like those around the world, profess a
desire to enter a drug program, anything to escape the sheer
everydayness of the despotic routine, the relentless foraging for
money, the guilty uncoupling from their families.

But even if such programs were available, failure rates are high
against so formidable a sickness. The urge to be helped usually proves
subordinate to more immediate cravings.

Raees Khan, the man who lives by the mosque, has tried drug treatment
three times, but it involved nothing more than weeklong stays in a
hospital and sedatives to moderate the agony of withdrawal. On release
he was quickly back to a fatalistic apathy.

"Now I believe this is the way my entire life will be lived," he said
decisively.

In a moment of reflection, Mr. Khan felt a need to visit his mother,
whose modest home is off an alleyway north of the airport. She was
reluctant to let her son through the door. She loves him, she said,
but his addiction is a family disgrace.

"I have a young daughter, and soon we will need to find her a proper
husband," she explained. "We will make a much poorer match because of
our shame."

But finally she softened and allowed him inside. He once had such
potential, she said wistfully, stroking his shoulder. He knew how to
weld. He could do electrical work.

She brought her son a glass of water sweetened with red syrup, and
they began to speak warmly to each other. As he left, he was able to
wheedle the equivalent of $4.

Not long after, he used his nose to empty another bag of heroin,
forgetting his family again and retreating into his medicated self.

He was soon nodding out, his eyeballs rising in his head like two
balloons set adrift.
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