Sunday, October 5, 2008

On the streets of Mumbai (with addicts)

In Mumbai, Sam and I were invited to visit the drug rehabilitation center, Sankalp. We met Eldred, the founder, in Pune where he was being recognized for his work.
Eldred is a brilliant entrepreneur not only for founding Sankalp but because he has challenged a process. He has created new rehabilitation techniques, that were first criticized but now are well respected and replicated all over the world. Eldred has also challenged the way many think about drug users and he pushed others including myself to look at drug users from a different perspective.
We began our day with a visit to one of their clinics, where Eldred offers the men a place to “hang out” during the day. At the clinic the men are able to consult a doctor, play chess, have their wounds dressed, and enjoy a small lunch. While the men eat, a nurse and counselor will speak with the men about general hygiene. The men pay a few rupees for their lunch, specifically for the men to understand that their money can be used towards their health as opposed to drugs.
Eldred came in and spoke to the men in the morning and I have never seen men listen so intently. It was as if he was preparing to reveal Jessica Simpson from behind a curtain. They listened to Eldred because they understand he comes from a similar background and he knows how to overcome the same challenges the men face.
He is tough on the guys, during our convo when a 70 year old man broke into tears about his family leaving him. Eldred told him to
“suck it up and to stop being a baby! Yes your family left you, good, you need to get your life together before you can rejoin your family.”

Eldred explained later after he saw the shock in Sam and I’s face that it was necessary for him to be hard on the old man, most of the time they just want a little sympathy out of you which they would translate as forgiveness. Forgiving these men does not help them take control of their lives, they need to do that on their own.
These conversations may or may not work, most of the men visiting the day clinic had used intravenous drugs within 24 hours and some of them were still high. Eldred explained to us that the main purpose of the clinic is to provide a safe place for them to stay during the day. It is not so much an opportunity to stop doing drugs, but an opportunity to stop the spread of HIV amongst the drug users. Most of the men we met were HIV positive and obviously the ones who were not were at high risk because of shared needles.
If he can keep them from using for a needle day, that is one day that a needle is not contaminated with HIV.
Sankalp does offer a rehabilitation boot camp for the men, but they have to make the choice to attend.
At 6pm we were greeted by Shitaya (he asked us to call him “Shit“ for short), who took us on an one of his outreach visits. Sankalp has 29 outreach coordinators, including Shit. Their responsibilities are to visit the areas known to have many drug users. During the visits he records the users name, age, and where they are from. After information is recorded they will exchange needles, collecting the dirty needles in exchange for a clean one. Also if the men are sexually active the coordinators will provide the men with condoms.
Our first visit was to an 18 and 22 year old, we arrived as soon as the 18 year old had stuck a dirty needle into his foot. He quickly removed the needle and exchanged dirty for clean and after a short conversation the 18 year old began to prepare the clean needle for injection. We walked away as he reinserted the needle into the side of his foot. (see photo above, taken with permission though while he was taking "brown sugar")
On the way to our next stop we drove through another red light district. Apparently Sam and I are very good at finding red light districts in just about all of the countries we visited.
Our next stop was a busy railway station. Many drug users find shelter near these stations and out on the tracks, they inject on the tracks because no one will bother them out there. While this may provide a haven away from other people the trains are still coming and they show little sympathy for someone passed out on the tracks. Many of the men we met during the day were missing a limb and disfigured.
Sam and I understood that our target audience was the men asleep on the ground, or out on the tracks. Normally I would have taken little interest in this men cast aside on the sidewalk, I would have ignored them as I walked by. Tonight they were men I recognized, men I had met at the clinic during the day. I knew their stories and struggles, I knew their names. It was a surreal experience, especially when they shouted my name and greeted me as a friend. That was something I would never forget.

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