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Tanzania

A Trip To Rehab With Zanzibar's Heroin Addicts

Exercising at Zanzibar's Detroit Sober House
Exercising at Zanzibar's Detroit Sober House
Emile Costard

DAR ES SALAAM — Sitting on a stone bench, in a shaded back alley of the historical center of Stone Town, the capital of the Zanzibar archipelago, Ali Nassor Ali is making the most of his last day in the open air. Tomorrow, this 40-year-old man with a gaunt face and eyes reddened by years of drug addiction goes to rehab.

Of the approximately 1 million inhabitants on this island, located about 25 kilometers off the coast of Dar es Salaam, the economic capital of Tanzania, an estimated 10,000 are addicted to heroin. Ali Nassor Ali is one of the them.

Fifteen minutes away from here, past the UNESCO-designated monuments and tourist shops, a bumpy path leads to the entrance of a large house surrounded by a decaying gate. On the other side of the gate a dozen men are talking while smoking cigarettes.

Across the yard a workout session is being improvised. Two giants with sculpted torsos are lifting cement weights in a building that was opened in 2008 thanks to donations by a U.S. NGO from Detroit. It's here, in the Detroit Sober House, as it's called, that Ali Nassor Ali will spend the next few months.

The person behind the project is Suleiman Mauly, 32. Mauly did his own stint in rehab, in Kenya, following a nearly eight-year addiction to heroin. "Back in Stone Town, I wanted to set up a structure and I was backed by a U.S. NGO," he says. "At the time, there was no care center in Zanzibar and in Tanzania. Now, users come from the whole of Eastern Africa to receive treatment here."

Since the early 1990s, Eastern Africa has been one of the world's transit points for heroin traffic. From Pakistan or Afghanistan, the brown powder is then resold on the South African or European markets. The rarity of sea inspections and the porosity of port infrastructures turned the region into a strategic crossing point for traffickers.

The United Nations Office on Drugs and Crime (UNODC) reports that the drug is most often sent off on dhows from Makran, a Pakistani coastal strip. The small, traditional boats make their way from there to the African coast, carefully avoiding large ports.

Zanzibar is one of the gateways for the narcotic. The UNODC claims 22 tons of the drug flood the eastern African coasts every year. This massive influx of heroin made its consumption soar. The region now has more than 500,000 users, half of them in Tanzania, according to an UNODC study from 2011.

Médecins du Monde, a French NGO present in Tanzania, suspects that about 25,000 of Tanzania's 250,000 users consume heroin through injection. The situation isn't any better in Zanzibar. "Today, between 7% and 10% of the population is involved drugs and we count more than 10,000 heroin consumers. Low prices boosted consumption, especially in Stone Town, where a dose costs only 0.50 euros," says Mahamoud Mussa, the drug commission coordinator in Zanzibar.

The archipelago, where issues linked to drug addiction have long been ignored by authorities, now has 11 detoxification centers that have together treated nearly 3,000 people since 2008.

The Recovery Community Zanzibar, the association Suleimane Mauly founded, operates three of those centers. Money is tight. The Zanzibar government helps a bit with rent costs. "But we still lack considerable means and subsist thanks to private donations and the volunteer commitment of former drug addicts," he explains.

The association follows the method employed by Narcotics Anonymous (NA), which is itself based on Alcoholics Anonymous (AA) method. The program calls for total abstinence, days rigorously punctuated with a schedule, and meditation and discussion sessions. And it discourages the presence of outside people: the supervisors of the center are exclusively former drug addicts.

"Here, I feel useful"

Seif, 45, has been living for almost two years at the Detroit Sober House. He previously spent five years in a Pakistani prison for drug trafficking. He admits he's not yet ready to face the outside world.

"I spent my life being a mule," explains the former drug dealer, now a volunteer, whose jaw was destroyed in a car accident. "I went to Pakistan to swallow heroin. Then I'd come back to Tanzania. I also sometimes went to Europe to sell the merchandise, in Naples or Istanbul. To hold on, I snorted heroin. I'm scared of relapsing if I get out. Here, I feel useful."

Every evening, in the common room of the Detroit Sober House, with its walls yellowed by cigarette smoke, the patients gather in a circle. A theme is chosen in the NA book. Then, one after the other, the residents speak for a few minutes. They don't identify themselves. Anonymity is the rule. Instead they introduce themselves by saying, "I'm an addict," and then noting how long they've been sober.

Some are able to weather the withdrawal alone. Others have so much trouble with the symptoms they need to be hospitalized. This past January, one clinic in Stone Town began offering methadone treatment, a heroin substitute prescribed to gradually reduce the consumption, before stopping completely.

Breaking the taboo

Heroin addiction doesn't only concern men in Zanzibar. Hundreds of women also consume the drug, although there are no official figures. "The situation is worrying because women suffer a double stigmatization: some of them resort to prostitution to pay for their addiction. In our conservative Muslim society, they're often rejected by their family," says Kheriyangu Khamis, executive director of the Zanzibar drug commission.

Unfortunately, says Suleiman Mauly, authorities have done nothing to address the problem. "The only two centers for women receive no help from the government," he complains.

Located along an abandoned stretch cluttered with litter where underfed cows are grazing, the Malaika Sober House, which opened in Dec. 2014 and is also a part of the Recovery Community Zanzibar association, receives four women. "We currently have a lot of trouble making drug addicted women come here because their care requires more means, such as the construction of premises that can receive children," Mauly explains.

Several evenings per week, Abdulrahman Abdullah, a former drug addict who is now the association's secretary general, brings the four residents into town to attend the daily NA meeting. In a building opposite the slavery memorial, they meet up with some 30 people who are trying to stay clean outside the care facilities. "There aren't enough girls, so we mix them with the men. We also regularly bring them to meetings at the Detroit Sober House," Abdullah explains.

Sandra, in her 30s, is the mother of two children. Like all of the women here, she discovered heroin for the first time with her ex-husband. She has been in the center for three months and had no plans yet to leave.

"My mother supports me and she's someone I trust. She takes care of my children and pays for my detoxification," Sandra says. "Many women don't have this chance. Left on their own, with no family support, the relapse rates are high and girls are exposed to violence."

Sandra sees her future in a detoxification center. "When all this will be behind me, I'd like to be at the head of a center and raise awareness," she says. "There's still a lot to do to break the taboo of women's drug addiction."

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