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The Kenyan Coast has long been a sunny paradise with a slower pace of life, but a darker
underside is emerging – one where heroin addicts do anything to score their next hit. Health,
government and community officials debate the solution, but on the ground the problem
continues to grow By Jill Craig
underside is emerging – one where heroin addicts do anything to score their next hit. Health,
government and community officials debate the solution, but on the ground the problem
continues to grow By Jill Craig
Just minutes from the glistening, white powder sands of Diani beach is a lush mango grove
overlooking a football pitch where young men gather every evening to practice their game and
socialise with friends. But this forest is no ordinary one; it is inhabited by about 30 female sex
workers between the ages of 16 and 31 and their male clients. Coming from different towns and
cities across Kenya, a number of the women are former models and beauty pageant winners,
and many have children. But what they all have in common is their addiction to heroin, also
known as smack, the hard drug of choice at the coast.
overlooking a football pitch where young men gather every evening to practice their game and
socialise with friends. But this forest is no ordinary one; it is inhabited by about 30 female sex
workers between the ages of 16 and 31 and their male clients. Coming from different towns and
cities across Kenya, a number of the women are former models and beauty pageant winners,
and many have children. But what they all have in common is their addiction to heroin, also
known as smack, the hard drug of choice at the coast.
If the women are not undergoing withdrawal symptoms, they will sell their bodies for KSH 50 –
or perhaps a bit more on a good day – to the men venturing into the forest for a quickie. These
are men who construct houses, push handcarts containing water-filled jerry cans, sell fruit on
the streets and wooden carvings on the beach, and who solicit passengers from the side doors
of matatus. Others wear nice suits, detouring through the forest on their way to or from the
office or perhaps stopping by on their lunch breaks.
or perhaps a bit more on a good day – to the men venturing into the forest for a quickie. These
are men who construct houses, push handcarts containing water-filled jerry cans, sell fruit on
the streets and wooden carvings on the beach, and who solicit passengers from the side doors
of matatus. Others wear nice suits, detouring through the forest on their way to or from the
office or perhaps stopping by on their lunch breaks.
Sometimes the men may pay even less. When a woman is experiencing heroin withdrawal,
for example, she might accept as little as KSH 20. Since a sachet, or hit, of heroin in Mombasa
costs about KSH 300 and injecting users shoot an average of three to six sachets per day, these
women often have sex with at least 20 men daily to support their heroin addiction. And as Teens
Watch Treatment Centre Programme Manager Cosmus Maina says, “If they can sell their bodies
for 20 shillings, what can’t they do?”
for example, she might accept as little as KSH 20. Since a sachet, or hit, of heroin in Mombasa
costs about KSH 300 and injecting users shoot an average of three to six sachets per day, these
women often have sex with at least 20 men daily to support their heroin addiction. And as Teens
Watch Treatment Centre Programme Manager Cosmus Maina says, “If they can sell their bodies
for 20 shillings, what can’t they do?”
Heroin – The Scourge of the Coast
Miriam Bashir Hussein Ali, aka Mama Kukukali, is the coordinator of the
Defence Drugs
Women community-based organisation. She organises various support groups for
community residents affected by drug use – one group for women who contracted HIV
from their drug injecting husbands, another for women whose children are drug addicts,
and one to educate village elders on the subject of drug abuse.
Women community-based organisation. She organises various support groups for
community residents affected by drug use – one group for women who contracted HIV
from their drug injecting husbands, another for women whose children are drug addicts,
and one to educate village elders on the subject of drug abuse.
She says that the drug problem in Mombasa is particularly bad because it is
a port city, and as
such the supply comes right off the boat. Distributors and suppliers abound. Drugs come from
the East and land in Mombasa as they make their way to Europe and beyond. Mama Kukukali
says that she started seeing heroin crop up in Mombasa around 1999, and by 2005 it was a big
problem. Now it seems to be spiralling out of control.
such the supply comes right off the boat. Distributors and suppliers abound. Drugs come from
the East and land in Mombasa as they make their way to Europe and beyond. Mama Kukukali
says that she started seeing heroin crop up in Mombasa around 1999, and by 2005 it was a big
problem. Now it seems to be spiralling out of control.
Why Do They Start?
Unemployment, boredom, idleness, curiosity, and stress relief seem to be the primary
motivators for a young person to try heroin. On the coast, there’s no particular tendency when
it comes to users, there are locals and people who have moved there from upcountry. Like drug
abusers around the world, many simply started after watching their friends do it. Peer pressure
is a strong force.
motivators for a young person to try heroin. On the coast, there’s no particular tendency when
it comes to users, there are locals and people who have moved there from upcountry. Like drug
abusers around the world, many simply started after watching their friends do it. Peer pressure
is a strong force.
Many injecting drug users, commonly known as IDUs, say they tried alcohol, cigarettes, and
marijuana in primary school. These so-called gateway drugs opened the door to heroin use.
Sporting aviator sunglasses and a Chicago Bulls cap, 33-year-old recovering addict Alex* says that
after experimenting with these drugs he started smoking a heroin cocktail (street name, Brown
Sugar), which is a mix of heroin, marijuana and tobacco. Sheer economics made him switch to
injecting; Alex says one cocktail joint costs KSH 250, but he would need to smoke about 10 of
them a day to get the same effect as three hits of heroin. This was a difference of KSH 2,500
versus KSH 900. For him, the choice was clear.
marijuana in primary school. These so-called gateway drugs opened the door to heroin use.
Sporting aviator sunglasses and a Chicago Bulls cap, 33-year-old recovering addict Alex* says that
after experimenting with these drugs he started smoking a heroin cocktail (street name, Brown
Sugar), which is a mix of heroin, marijuana and tobacco. Sheer economics made him switch to
injecting; Alex says one cocktail joint costs KSH 250, but he would need to smoke about 10 of
them a day to get the same effect as three hits of heroin. This was a difference of KSH 2,500
versus KSH 900. For him, the choice was clear.
A five-minute taxi ride from the Diani beaches where Kenyan and foreign tourists splash in the
ocean with their children, sip cocktails from the cocoons of their beachfront hotels, and
decide whether to get a massage, take a camel ride, or learn how to kite surf, is the
Teens Watch Treatment Centre, where Maina serves as programme manager for the
IDUs who come for counselling, HIV testing and free condoms. The centre is located at
the show grounds in Ukunda, right down the road from Nakumatt. It’s a bit hidden away,
so you’d likely not even notice it as you zipped by on your way to the beach. But it is
here that IDUs know they can come for some support from a man who knows firsthand
their difficulties.
ocean with their children, sip cocktails from the cocoons of their beachfront hotels, and
decide whether to get a massage, take a camel ride, or learn how to kite surf, is the
Teens Watch Treatment Centre, where Maina serves as programme manager for the
IDUs who come for counselling, HIV testing and free condoms. The centre is located at
the show grounds in Ukunda, right down the road from Nakumatt. It’s a bit hidden away,
so you’d likely not even notice it as you zipped by on your way to the beach. But it is
here that IDUs know they can come for some support from a man who knows firsthand
their difficulties.
A heavyset man in his mid-forties and reminiscent of a jovial high school basketball coach,
Maina is also a recovering addict, which he says gives him the necessary patience for helping
the IDUs who come to his treatment centre. He started smoking marijuana in primary school;
by high school, he was taking alcohol and miraa. After graduation, he opened a discotheque
in Malindi and started dating an Italian woman who provided him a seemingly limitless supply
of marijuana, alcohol, miraa and heroin. He continued injecting heroin for the next four years
before going to rehab – he’s now been clean for 15 years.
Maina is also a recovering addict, which he says gives him the necessary patience for helping
the IDUs who come to his treatment centre. He started smoking marijuana in primary school;
by high school, he was taking alcohol and miraa. After graduation, he opened a discotheque
in Malindi and started dating an Italian woman who provided him a seemingly limitless supply
of marijuana, alcohol, miraa and heroin. He continued injecting heroin for the next four years
before going to rehab – he’s now been clean for 15 years.
Twenty-eight-year-old Alexis* is one of the women who works in the mango grove. She wears
a tattered red tank top, dilapidated red Bata flip-flops and a threadbare corduroy skirt to cover
the skimpy shorts she wears in the forest to attract men. She doesn’t own much else. Alexis
began sex work eight years ago when she saw her friends doing it and making good money. Her
parents begged her not to start, saying that although the family was poor, they could share
what they had. Ignoring their pleas, Alexis became a sex worker and started injecting heroin
with her friends to cope with the stress of her new lifestyle.
a tattered red tank top, dilapidated red Bata flip-flops and a threadbare corduroy skirt to cover
the skimpy shorts she wears in the forest to attract men. She doesn’t own much else. Alexis
began sex work eight years ago when she saw her friends doing it and making good money. Her
parents begged her not to start, saying that although the family was poor, they could share
what they had. Ignoring their pleas, Alexis became a sex worker and started injecting heroin
with her friends to cope with the stress of her new lifestyle.
Life as a Heroin Addict
Most IDUs are quite thin because they spend almost all of their income on heroin, to the
detriment of their own and their family’s needs, including school fees, rent and food. They
have an almost vacuous look in their eyes. They can talk about family, shooting up, or being
sex trafficked with the emotion we would use when ordering a hamburgerat McDonald’s. Only
when they ask you for money do they perk up a bit.
detriment of their own and their family’s needs, including school fees, rent and food. They
have an almost vacuous look in their eyes. They can talk about family, shooting up, or being
sex trafficked with the emotion we would use when ordering a hamburgerat McDonald’s. Only
when they ask you for money do they perk up a bit.
Alexis speaks openly when she describes the things she and her colleagues are willing to do to
get the next sachet of heroin. She claims that other sex workers at the coast look down upon
the addicts because they wear torn, dirty clothing, they rarely bathe, and they don’t take care
of themselves. The customers also treat them with disdain, often they know that if one woman
won’t agree, another certainly will. According to Alexis, it is common for men to beat them,
engage in brutal sexual acts, leave without paying and refuse to use condoms. And the
women usually accept whatever is demanded in their quest to get some fast cash before
withdrawal symptoms set in.
get the next sachet of heroin. She claims that other sex workers at the coast look down upon
the addicts because they wear torn, dirty clothing, they rarely bathe, and they don’t take care
of themselves. The customers also treat them with disdain, often they know that if one woman
won’t agree, another certainly will. According to Alexis, it is common for men to beat them,
engage in brutal sexual acts, leave without paying and refuse to use condoms. And the
women usually accept whatever is demanded in their quest to get some fast cash before
withdrawal symptoms set in.
Heroin withdrawal is a miserable experience, although usually not life-threatening, and can
start as soon as five to six hours after the last hit. Symptoms include abdominal pains, vomiting,
diarrhoea, chills, joint pains, gooseflesh, dilated pupils and dry mouth. Once the person injects,
these symptoms disappear. So the IDU becomes obsessed with getting that next hit as quickly as
possible.
start as soon as five to six hours after the last hit. Symptoms include abdominal pains, vomiting,
diarrhoea, chills, joint pains, gooseflesh, dilated pupils and dry mouth. Once the person injects,
these symptoms disappear. So the IDU becomes obsessed with getting that next hit as quickly as
possible.
As a result, petty theft is common. When a heroin addict is in such a state, he or she will steal,
sell, or do whatever it takes to get the drug. Joseph* is a 28-year-old addict who has been using
heroin for the last six years. He wears denim shorts and a white Billabong t-shirt that exposes
track marks on his arms from many years of heroin injection. He says he has previously stolen
three mobile phones and a radio from his friends to pay for heroin. He makes money driving a
boat to take tourists to the coral reefs, but he doesn’t steal from them. The reason, he says, is
that, “If I steal from them, they won’t come again. That’s why I steal from my friends.”
sell, or do whatever it takes to get the drug. Joseph* is a 28-year-old addict who has been using
heroin for the last six years. He wears denim shorts and a white Billabong t-shirt that exposes
track marks on his arms from many years of heroin injection. He says he has previously stolen
three mobile phones and a radio from his friends to pay for heroin. He makes money driving a
boat to take tourists to the coral reefs, but he doesn’t steal from them. The reason, he says, is
that, “If I steal from them, they won’t come again. That’s why I steal from my friends.”
Alex used to snatch gold necklaces from ladies’ necks to sell to local black market dealers. He
was caught twice, which he says was a (temporarily) sobering experience. According to Alex, “In
the beginning, I found it [the drug use] interesting and attractive but later on, I didn’t because it
was so disgusting. At the end of the day, you’re not satisfied. The more you use, the more you
end up with nothing. It’s risky and it’s scary. You wake up the next morning, and are teetering,
so you find someone else’s needle, you rinse it with water, and you use it. So that was not
good.”
was caught twice, which he says was a (temporarily) sobering experience. According to Alex, “In
the beginning, I found it [the drug use] interesting and attractive but later on, I didn’t because it
was so disgusting. At the end of the day, you’re not satisfied. The more you use, the more you
end up with nothing. It’s risky and it’s scary. You wake up the next morning, and are teetering,
so you find someone else’s needle, you rinse it with water, and you use it. So that was not
good.”
A Family Affair
Many addicts want to quit heroin because of the suffering they are inflicting upon their families.
The recovering addicts have really turned their lives around, and while you’d expect them to
look back on their bad times with pain and wax poetic, they are as unemotional as those still
injecting. While heroin use saps at a person’s sentiment, so does the weary relief of kicking it –
simply, their families are happy now and they are satisfied.
The recovering addicts have really turned their lives around, and while you’d expect them to
look back on their bad times with pain and wax poetic, they are as unemotional as those still
injecting. While heroin use saps at a person’s sentiment, so does the weary relief of kicking it –
simply, their families are happy now and they are satisfied.
Alex decided to enter rehab because
he wanted to stop hurting his loved ones. While staring
down at the open pages of his Narcotics Anonymous book, Alex says quietly, “It pained my
family so much and especially my mom. That is why I had to quit, because she was so sad.
Someone had to come and talk to me about this. He said I was killing her in a way. They [my
family] didn’t have any respect outside anymore because people were talking badly about them.
And it was all because of me.”
down at the open pages of his Narcotics Anonymous book, Alex says quietly, “It pained my
family so much and especially my mom. That is why I had to quit, because she was so sad.
Someone had to come and talk to me about this. He said I was killing her in a way. They [my
family] didn’t have any respect outside anymore because people were talking badly about them.
And it was all because of me.”
Alexis has two daughters, aged 11 and 13, who live with her family in western Kenya. She has
not seen them in over a year. She had her first daughter when she was 15 years old, a child
not seen them in over a year. She had her first daughter when she was 15 years old, a child
herself. Alexis says she has never been able to provide for them, since almost all of her money
goes toward the heroin. She wants to be a good mother, but admits that she is currently unable
to do so, explaining with a slight tremor in her voice, “I am feeling very bad because they are
ladies, and I don’t take care of them. I am afraid that they will become prostitutes like me. They
don’t have a parent’s love and I feel very bad about that. I want to change my life, by going to
rehab, so I can take care of my children.”
goes toward the heroin. She wants to be a good mother, but admits that she is currently unable
to do so, explaining with a slight tremor in her voice, “I am feeling very bad because they are
ladies, and I don’t take care of them. I am afraid that they will become prostitutes like me. They
don’t have a parent’s love and I feel very bad about that. I want to change my life, by going to
rehab, so I can take care of my children.”
Non-Despondent Users
Kenyans are not the only IDUs at the coast – foreigners also support the drug trade. Jack* is
an IDU who makes his living selling curios to tourists on the beach. He often sells them heroin
as well. This side business provides additional funding to feed his own addiction; he can sell a
tourist a sachet of heroin for KSH 3,000 – 10 times what he pays.
an IDU who makes his living selling curios to tourists on the beach. He often sells them heroin
as well. This side business provides additional funding to feed his own addiction; he can sell a
tourist a sachet of heroin for KSH 3,000 – 10 times what he pays.
Ibrahim* is a taxi driver operating from Mombasa. Claiming to detest the influx of drugs at the
coast, he admits that once he becomes “friends” with his foreign clients, he will arrange for
whatever they request, including heroin. He says, “I’m okay getting the drugs for them
because they have a job and they can handle it. The heroin addicts on the coast are
idle, they are unemployed, and they are basically wasting their lives away. They have
nothing.”
coast, he admits that once he becomes “friends” with his foreign clients, he will arrange for
whatever they request, including heroin. He says, “I’m okay getting the drugs for them
because they have a job and they can handle it. The heroin addicts on the coast are
idle, they are unemployed, and they are basically wasting their lives away. They have
nothing.”
Drug abuse on the coast is not limited to Africans and tourists alone. Heroin usage
by local
whites is well known, especially in the coastal towns of Diani and Lamu where seaside venues
are popular and frequented by sons and daughters of some of the local residents. However,
it is very difficult to determine these numbers correctly because the white experience with
hard drugs is more private. White Kenyans can do drugs much more discretely than their
counterparts, and generally, they’re not the ones stealing cell phones or selling their bodies for
it, so they don’t cause as much of a public nuisance.
whites is well known, especially in the coastal towns of Diani and Lamu where seaside venues
are popular and frequented by sons and daughters of some of the local residents. However,
it is very difficult to determine these numbers correctly because the white experience with
hard drugs is more private. White Kenyans can do drugs much more discretely than their
counterparts, and generally, they’re not the ones stealing cell phones or selling their bodies for
it, so they don’t cause as much of a public nuisance.
But recovering addict Tom* insists that
it doesn’t matter who you are – as a drug addict you
end up losing everything. Holding a university degree, Tom had a good job after graduation.
His addiction caused him to lose his wife, his home and his savings; he ended up living on the
streets for over a year. He says that no one is immune from the devastation of drug use.
end up losing everything. Holding a university degree, Tom had a good job after graduation.
His addiction caused him to lose his wife, his home and his savings; he ended up living on the
streets for over a year. He says that no one is immune from the devastation of drug use.
Rehab
Rehabilitation programmes may vary slightly from centre to centre, but they all aim to instil a
sense of discipline in their clients. Recovering addicts are required to help with the daily cooking
and cleaning of the centre. They are taught not to blame others for their addictions – one of the
first things they learn is that they alone are responsible.
sense of discipline in their clients. Recovering addicts are required to help with the daily cooking
and cleaning of the centre. They are taught not to blame others for their addictions – one of the
first things they learn is that they alone are responsible.
Recovering addicts often become friends and can be found sipping juice in the courtyard,
watching TV, or even meditating. Rehab provides them time for reflection and goal setting –
luxuries they’ve rarely, if ever, had before. Most of the rooms resemble college dorms, with
two to four sets of bunk beds and motivational posters adorning the walls. Unlike most dorms,
however, these rooms feature well-made beds and no clutter – all part of taking responsibility
for one’s self.
watching TV, or even meditating. Rehab provides them time for reflection and goal setting –
luxuries they’ve rarely, if ever, had before. Most of the rooms resemble college dorms, with
two to four sets of bunk beds and motivational posters adorning the walls. Unlike most dorms,
however, these rooms feature well-made beds and no clutter – all part of taking responsibility
for one’s self.
Recovering addicts in rehab usually don’t look like stereotypical “addicts.” They are clean, well-
dressed, and take care of themselves. They learn how to deal with the factors contributing to
their drug abuse in the first place, which seems to give them a sense of peace. And the vast
majority appear excited to have the rare opportunity to turn their lives around.
dressed, and take care of themselves. They learn how to deal with the factors contributing to
their drug abuse in the first place, which seems to give them a sense of peace. And the vast
majority appear excited to have the rare opportunity to turn their lives around.
That opportunity doesn’t come easily. At the coast, there is one public facility, which recently
opened at the Coast Provincial General Hospital. It has occupancy for only 13. As of now,
patients must be enrolled in the National Hospital Insurance Fund (NHIF), but very few heroin
addicts are.
opened at the Coast Provincial General Hospital. It has occupancy for only 13. As of now,
patients must be enrolled in the National Hospital Insurance Fund (NHIF), but very few heroin
addicts are.
There are 10 private rehab centres, but the problem is the cost – centres range from KSH 45,000
to KSH 195,000 for three months, but both ends of that spectrum are out of reach for most
addicts. Yes, heroin is an expensive addiction. A typical three-month supply can be extrapolated
to KSH 81,000, but using addicts are also doing whatever they can to earn money, an option
removed in rehab.
to KSH 195,000 for three months, but both ends of that spectrum are out of reach for most
addicts. Yes, heroin is an expensive addiction. A typical three-month supply can be extrapolated
to KSH 81,000, but using addicts are also doing whatever they can to earn money, an option
removed in rehab.
This is where a supportive family or sympathetic donor comes in. Some addicts are fortunate
enough to have one or the other, but most do not. As a result, a very small percentage of IDUs
at the coast are getting the medical and psychological help they need.
enough to have one or the other, but most do not. As a result, a very small percentage of IDUs
at the coast are getting the medical and psychological help they need.
What Now?
According to the Kenya National AIDS and STI Control Programme, the numbers of IDUs in Kenya
are reaching astronomical levels. Although exact figures are difficult to determine, a March 2012
report suggested that there are now more than 26,000 on the coast alone. Within IDUs, HIV
rates have skyrocketed, with 18 percent of men testing positive and, astoundingly, nearly half of
the women.
are reaching astronomical levels. Although exact figures are difficult to determine, a March 2012
report suggested that there are now more than 26,000 on the coast alone. Within IDUs, HIV
rates have skyrocketed, with 18 percent of men testing positive and, astoundingly, nearly half of
the women.
While many community leaders and addicts think more affordable or even
free rehab centres
would help curb the rising epidemic, the government is looking towards a controversial new
plan based on recommendations from the World Health Organisation and the United Nations
Office on Drugs and Crime.
would help curb the rising epidemic, the government is looking towards a controversial new
plan based on recommendations from the World Health Organisation and the United Nations
Office on Drugs and Crime.
The basic idea is to make sterile, one-use needles freely available to addicts, in
an effort to stop
disease transmission. The programme would also have educational and treatment components,
as it is a sure fire way to get IDUs in a place where they’d have to listen.
disease transmission. The programme would also have educational and treatment components,
as it is a sure fire way to get IDUs in a place where they’d have to listen.
However, many community leaders, especially from the large Muslim population on the coast,
argue that giving away needles will only make drug use easier, and that addicts could still share
the syringe if they were sharing a single dose. Another issue is that the needles wouldn’t be
properly disposed, so used, and statistically diseased, syringes would be scattered where non-
users and children could accidentally be stuck.
argue that giving away needles will only make drug use easier, and that addicts could still share
the syringe if they were sharing a single dose. Another issue is that the needles wouldn’t be
properly disposed, so used, and statistically diseased, syringes would be scattered where non-
users and children could accidentally be stuck.
There are also those who say the supply side will benefit. They think the most effective
solution would be for the government to prosecute the drug barons, and allege that it doesn’t
happen because government officials are involved in the illicit trade. And their allegations
are likely founded – in 2011 the United States banned four Kenyan government officials and a
prominent businessman from travel over suspected drug activity. Mama Kukukali insists that the
government needs to stop the drugs from entering the country, and one way of doing so is by
solution would be for the government to prosecute the drug barons, and allege that it doesn’t
happen because government officials are involved in the illicit trade. And their allegations
are likely founded – in 2011 the United States banned four Kenyan government officials and a
prominent businessman from travel over suspected drug activity. Mama Kukukali insists that the
government needs to stop the drugs from entering the country, and one way of doing so is by
meting out the death penalty to drug barons.
According to Saad Yusuf Saad, the National Secretary of the Coast Community Anti-Drugs
Coalition, even the dealers escape punishment. “We can go to Old Town [Mombasa] right
now and I can show you where the drugs are being sold. The police will arrest the middlemen
and once they are taken to court, the charge sheet is changed from ‘caught with heroin, 1kg,’
to ‘caught with bhang [marijuana], 50mg.’ Then, by the end of the day, the same middlemen are
back in the streets.”
Coalition, even the dealers escape punishment. “We can go to Old Town [Mombasa] right
now and I can show you where the drugs are being sold. The police will arrest the middlemen
and once they are taken to court, the charge sheet is changed from ‘caught with heroin, 1kg,’
to ‘caught with bhang [marijuana], 50mg.’ Then, by the end of the day, the same middlemen are
back in the streets.”
While these policy decisions are being debated, the young women in the mango forest continue
to sell their bodies for pocket change in order to score another sachet. As long as heroin-
induced fog provides them transient relief from daily reality, concerns of needle-sharing and
condom usage will float behind the more pressing question of how to get that next hit.
to sell their bodies for pocket change in order to score another sachet. As long as heroin-
induced fog provides them transient relief from daily reality, concerns of needle-sharing and
condom usage will float behind the more pressing question of how to get that next hit.
*Names have been changed
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