Pubdate: Wed, 24 May 2000
Source: Globe and Mail (Canada)
Copyright: 2000, The Globe and Mail Company
Contact:  http://www.globeandmail.ca/
Forum: http://forums.theglobeandmail.com/
Author: Geoffrey York

HEROIN AND HIV SWEEP THROUGH RUSSIA 

Dirt-Cheap Afghan Drugs Ravage Young People

St. Petersburg -- Katya had it all. The beautiful daughter of a
wealthy businessman and his lawyer wife, she was one of Russia's
golden youth, the privileged elite of an impoverished society.

She took her vacations in Paris and Prague. She hobnobbed with
foreigners as a tour guide in St. Petersburg's palaces and museums.
She was a final-year student at a prestigious law school.

But Katya had a secret. Twice a day, she searched for a vein in her
arms, prepared a needle, and injected a quarter-gram of heroin.

Last year, unable to pass her exams, Katya was expelled from
university. She tried to quit drugs, but failed. Now she pays for her
fix the only way she can, by working as a street prostitute.

Heroin addiction has exploded to devastating levels in Russia in the
past two years. Production in near-by Afghanistan, the world's
largest source of heroin, has skyrocketed. Vast quantities of Afghan
drugs are flooding into Russia from smuggling routes in the mountains
of Central Asia. Dealers are also making their own synthetic versions.

Heroin has become so cheaply and freely available that it lures
hundreds of new addicts every month, from Siberia to the Baltic Sea,
even in small provincial towns and remote northern cities. At the
equivalent of $50 a gram, heroin in St. Petersburg is a fraction of
the price in North America.

"Heroin is easy to get," Katya says. "It's a lot easier than marijuana
now."

Igor, a 23-year-old addict in St. Petersburg, began using drugs when
he was a teenager, but he switched to heroin in 1998 because it was
the easiest drug to buy. "It's a strange situation," he says. "There's
so much of it. Within a kilometre of here, there are 20 places you can
get heroin. You can't buy anything else these days."

The number of Russian drug users has more than tripled in the past six
years, authorities say. They estimate that Russia now has almost three
million drug users, including 500,000 addicts. Of these, about 80,000
are addicted to heroin, and the number is rising exponentially.

Largely because of the heroin epidemic, Russia is suffering one of the
world's fastest-growing rates of AIDS and HIV infection. The number of
new HIV cases in Russia last year jumped by an astonishing 350 per
cent, and 90 per cent of the new cases were drug addicts who caught
the infection from sharing needles.

The vast majority of the latest HIV-infected Russians are less than 30
years old. "An entire generation will perish," warns Dr. Vadim
Pokrovsky, a leading Russian epidemiologist.

In Moscow, the number of people infected with the AIDS virus in
January was five times greater than a year earlier. Almost all were
drug addicts. In many provincial cities, the rate of increase is even
more dramatic. In the Siberian region of Irkutsk, the number of HIV
cases has soared from barely 200 to about 5,000 in the past year alone.

Because of its financial woes, Russia has budgeted less than
$2-million for AIDS prevention this year. Its hospitals, already
overcrowded and impoverished, are straining with the burden of the new
AIDS patients.

"Russia's health-care system is completely unprepared for this," says
Vinay Saldanha, a Canadian who co-ordinates an AIDS training project
in eight Russian regions with $1.5-million in Canadian government financing.

"Nobody was expecting it to spread so quickly," he says. "Most of
those infected haven't got sick yet, but they will get sick. They will
all need hospital care in the next few years -- and there's nowhere to
put them."

In some regions, such as the Baltic seaport of Kaliningrad, as many as
70 per cent of drug users are infected with the AIDS virus, he says.
"They've almost lost the battle."

Officially, only 36,000 Russians are infected with the virus, but
experts believe the number is closer to 300,000. At the current
spiralling rate of increase, as many as 10 million Russians could be
infected by the year 2005, according to Dr. Pokrovsky.

This, in turn, would contribute to the demographic catastrophe that is
causing a steady decline in the Russian population. By the year 2050,
Russia's population could fall below 100 million, compared to its
current population of 146 million, some analysts say.

In some of Russia's hardest-hit regions, up to 90 per cent of the
street prostitutes are infected with the AIDS virus -- mostly as a
result of their drug addiction.

On the mean streets of St. Petersburg, most prostitutes are aware of
the AIDS threat. "In the place where I work, in our 'office' on the
street, they say there are three girls who have it," Katya says.

At the age of 23, her face is pale, her voice is hoarse, and she is
recovering from hepatitis. Blood is clotted on the skin of her wrist
where she injects the drug.

"They say one of them is already sick. I'm really scared of it. I try
to use each needle only once. Very often my friends ask me for
needles. I'll give them one, but I never use an old needle."

She takes her old needles to an anonymous-looking bus parked on a back
street near the biggest concentration of prostitutes. There she
exchanges the old needles for new ones, along with a package of
sterilized tissues and condoms.

The needle-exchange program, run by the private Revival foundation, is
one of the few in Russia. For the addicts, it is a lifesaver. Tests
have found that 12 per cent of the old needles are contaminated with
HIV.

After warming herself inside the bus for a few minutes, Katya is ready
to go back to work. She powders her face, applies her lipstick,
glances into a mirror to adjust her blue beret, and walks out into the
cold, dark streets of this northern city, where she will charge her
customers as little as 500 rubles, (about $27) an hour.

A quarter-gram of heroin costs only 250 rubles. But the prostitutes
have a lot of expenses. They have to pay their pimps. And they have to
bribe the corrupt police officers who patrol the district. The
standard bribe is 50 rubles to every police vehicle. When the police
change shifts, the next patrol vehicle again has to be bribed.
"Otherwise they arrest you and put you in jail for the night," Katya
explains.

She began using soft drugs when she was 16, but she switched to heroin
in 1998 to relieve the stress and nervousness of her university exams.

"I like it," she says. "It makes you feel cool. We like to feel cool.
But then you get addicted. When I get up in the morning, everything is
aching and I need an injection."

For the heroin merchants, the profits can be huge. In Tajikistan, a
mountainous ex-Soviet republic on the border of Afghanistan, a gram of
Afghan heroin can be bought for little more than a dollar. By the time
it is sold in St. Petersburg, the same gram of heroin has a street
value of $55.

The police and border guards can be bribed to ignore the trucks and
airplanes that bring tonnes of heroin from Central Asia into Russia's
major cities. In some cities, small packages of heroin are sold openly
in food markets and newspaper kiosks. In others, such as St.
Petersburg, the dealers sell drugs in secure apartments, using
cellphones and pagers to communicate with customers and warn of police
raids.

"The flood of drugs is colossal," says Svetlana Suvorova, a counsellor
in the needle-exchange program. "The addicts are becoming younger and
younger. We've seen some addicts younger than 13, and they say they've
been taking drugs for years. They can purchase drugs almost anywhere."

The easy supply of drugs is not the only reason for the heroin
epidemic. Analysts link it to the post-Soviet breakdown of order, the
economic collapse, rising corruption, and the loss of ideological
faith. "These people don't have a sense of the future, they have few
economic prospects, and they're looking for an easy way to avoid their
problems," says Mr. Saldanha, the Canadian. "They don't care about
tomorrow."

Igor, the young heroin addict in St. Petersburg, recently collected
142 old needles from drug users in his neighbourhood and took them to
the bus to exchange for new needles. He also took along blood samples
from three friends who want their blood tested for HIV.

"They're afraid to go to their local medical clinic because they would
be officially registered as a drug user and then they'll never get a
job," he says.

"They have nowhere else to go. There's no support for them. Some try
to quit, but it's rare. Even to get into a hospital here, you have to
buy your own medication first."

As he returned to a nearby subway station, he glanced at a row of
prostitutes huddled outside the station. All of them are heroin
addicts, charging their clients just enough rubles to pay for a
quarter-gram of the drug, he says.

Igor remembers the day when a friend introduced him to heroin. "He
said, 'Try it, it's nothing dangerous, it's nothing frightening.' Now
I curse that day. He's not my friend any more."

Dr. Nikolai Vlasov, chief of an AIDS ward at a St. Petersburg
hospital, struggles to cope with 29 patients in a ward with 25 beds.
Two years ago, the ward was two-thirds full. Now the hospital has been
forced to add a second ward with another 12 beds to cope with the pressure.

"Drug use is the engine of the epidemic," he says. "Our drug users
have many bacterial infections, because of their use of non-sterile
needles. They're difficult to treat. We lack good antibiotics at this
hospital. Our financing is not enough."

One of his patients, 24-year-old Maxim, had been using heroin for six
years when he discovered in December that he was infected with HIV.
"It's like when you see a traffic accident on TV -- you never think it
will happen to you," he says.

Now he's in hospital, being treated for pneumonia. "I know a lot of
drug users who are ill, but they never get treatment because they're
afraid of being tested for HIV. So there's going to be a new wave of
infected people in the future."

In a nearby hospital room, 20-year-old Luda is eight months pregnant.
She became infected with HIV from sharing drugs. For years, she had
injected herself with a cooked solution of poppy straw, sharing a
container of the liquid with 10 or 15 other users at a dealer's place.

Luda finally quit drugs, but the withdrawal was six months of torture.
"Every night you're dreaming of injecting," she recalls. "All day
you're thinking about it, 24 hours a day. You can't think of anything
else -- not food or anything. All of your bones and joints are aching,
you can't sleep, you have chills."

Now she worries that her baby could be infected with the AIDS virus
when it is born. Across Russia, about 350 babies have been born infected.

"I try not to think," she says. "I try to go on living. We have to
live." 
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