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| Vol. 4, Issue 5 May 2012 |
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Reporting & Essays |
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Reportage |
The Needle and the Damage Done
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| Death and decay in a Delhi neighbourhood where chemists serve as drug dealers |
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PHOTOGRAPHS BY ENRICO FABIAN |
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| An addict makes one of his daily drug purchases at a
pharmacy.
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| D |
HARMINDER WAS JUST 17 YEARS OLD when
his half-naked body was found one morning
in an alley near Jahangirpuri station,
the northern terminus of the Delhi Metro’s
yellow line. The teen’s body was slung onto
a vegetable cart and covered with a blanket
that left his bare toes exposed as he was wheeled down the
main road leading from the |
Metro station to the morgue.
Dharminder’s official autopsy from Babu Jagjivan Ram
Memorial Hospital describes various external injuries to
his ribs, chest, abdomen and shoulders, caused by a “blunt”
implement. On arrival, he was wearing “pants only, soiled
with faecal matter”. The document guesses his age incorrectly
at 18 or 19, but it doesn’t matter. Dharminder was a
junkie, and the locals disparage junkies—they steal, they
carry disease; they’re untouchable beyond caste.
No one is exactly sure how he expired, but 23-year-old
Nikhil Kumar, who works in a nearby metal-cutting shop,
believes Dharminder was beaten to death by three other
junkies the night before his body was discovered. Whether
it was for the drugs or money he may have been hoarding,
no one willing to talk knows for certain.
This area in northwest Delhi is best known for the Azadpur
Fruit and Vegetable Market, but across National Highway
1, Jahangirpuri is home to another roaring industry:
hawking products with longer sell-by dates than the tonnes
of bananas and tomatoes that come through Azadpur—illicit
pharmaceuticals. This is not the only neighbourhood
in Delhi with a drug problem—areas like Yamuna Bazar and Seelampur are also notorious for the numbers of addicts
trawling their streets. What makes Jahangirpuri so
dangerous is that here, the chemists are the drug dealers.
This would be easy enough to hide—if the Jahangirpuri
chemists who sell prescription pharmaceutical drugs over
the counter actually felt the need for discretion. But they
don’t. It’s as easy to obtain and shoot pharmaceuticals here
as it is to get a free meal at the nearby Sikh temple and save
money for another hit.
For Dharminder, like many before him and many others
sure to follow, Jahangirpuri truly was the end of the line.
| "Y |
OUNG PEOPLE GET OLD here very quickly,” says Rajiv,
a 47-year-old ex-user with a pronounced limp
in his left leg, as he roots around in a hidden compartment inside his blue track pants for a match to keep his beedi going.
He lights the undecided ember into a glow under his
push-broom moustache and exhales. “Here, in every house
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you have a junkie.”
Rajiv would know. After years of drug abuse, he has been
staying at a centre in Saket, in South Delhi, run by Sahara,
an NGO that treats and houses injecting drug users (IDUs).
Sahara opened a treatment centre in Jahangirpuri in 2001,
and in 2006 received expanded funding as part of the United
Nations Office on Drugs and Crime’s (UNODC) Project
H13, intended to curb the spread of HIV/AIDS in South
Asian countries. But it didn’t last long—as Mike Marshall,
the former director of projects at Sahara, tells me, “All UNODC
projects in India lost their funding and had to close
due to the global recession.”
There has been no recession, however, for those who cater
to the addictions of India’s abject. Chemists here know
what users need, and they have conveniently bundled the
requisite gear into a kind of Japanese bento box: a two-millilitre
ampoule of diazepam—a tranquilliser better known
as Valium, also used to stop seizures and aid in alcohol
withdrawal; a 2 ml ampoule of buprenorphine—a synthetic
opioid like methadone used to treat addiction to opiates;
and a 2 ml bottle of Avil—an antihistamine meant to be injected
intramuscularly, though many IDUs prefer a 10 ml
bottle so they can use the larger receptacle to mix all three
drugs. Users say the antihistamine is good for preventing
rash, but it’s mostly to increase the volume of a shot. Completing
the set is a syringe and two detachable needles. One
Jahangirpuri chemist, to attract new customers, has begun
to throw in a digestif of a Netrovet 10 tablet, a strong sedative.
A set costs  50-60.
Before Sahara shut its doors here, this is where Rajiv
spent most of his reclaimed time after his withdrawal period,
doing the legwork he and other independent aid workers
describe as crucial: knocking on doors and talking to
families who have no idea about how to stop this surge of
over-the-counter pharmaceuticals from stealing away their
loved ones.
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An addict sprawls on top of concrete water pipes next to
the busy main road. |
Rajiv, like the independent aid workers who have effectively,
albeit unofficially, replaced Sahara and H13, says that
the door-to-door canvassing is the only thing they see making
a real difference.
“Dharminder’s case is very common,” an aid worker
whom I’ll call Sita later tells me. “We find dead kids on the
sides of the road here all the time.”
Dharminder left Harpalpur in Uttar Pradesh when he was
12, where he was already sniffing away his pickpocketing
profits in glue and solvents. In Jahangirpuri, he scavenged
for scrap metal and took advantage of the tight-packed
transience in the sprawling Azadpur market to reappropriate
carelessly placed wallets. Before he died, Dharminder
said he made 50-100 a day.
Rajiv takes shelter from the afternoon sun near the alley
where Dharminder’s body was found. National Highway 1
and its last run of elevated Metro line are a few hundred
metres away, just after the stretch of houses that look like
a dinosaur has bitten their fronts off, just past where the truckers park their ‘goods carriers’ and bring local, often
casual, prostitutes to assuage the loneliness of the road. A
little further east are the various recyclers who buy the materials
from scavengers, who often then circle back to an
alley adjacent to Mahendra Park to shoot up. Then it’s back
across the road to scour Azadpur for enough money to complete
the circuit again.
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Two addicts inject into their groins. |
Before long, an elderly woman nearby recognises Rajiv
and hurries over with a frantic tale, pointing to her son,
who is rocking on his haunches in front of a nearby door. Rajiv explains something quietly to the child—he can’t
be more than 13, 14 tops—who plants his forehead on his
knee-hugging arms and begins to cry. Laying out the consequences
that await users, Rajiv proffers himself as an example,
pointing to his leg with the limp.
Neju, a junkie from an older generation, scampers over
and squats, opening the buttons of his grease-sheened shirt
to show Rajiv how his shoulder has healed. Most of the cap’s
muscle, where an abscess had been successfully removed,
looks like an old shark bite. Sita tells me that abscess management is a big part of their work—much more than detoxification. According to an UNODC
report ending in April 2009, Sahara treated abscesses in up
to 30 people each month when they operated in Jahangirpuri.
This cauterised circuitry is Neju’s good news to share.
As he shows off his healed shoulder, a long knife falls from
the left pocket of his pants.
“Put that away,” Rajiv scolds him.
“It’s for cutting fruit,” replies the Kolkata native, who
credits his longevity to his moderate pharmaceutical intake,
filing the blade back into his pocket.
“Probably true,” whispers Rajiv. “For real fights, they
keep a surgical blade that’ll cut you to the bone hidden in
their mouths.”
The woman thanks Rajiv for his counsel and takes his
card as she leads her son away. This boy is one of the more
fortunate addicts. He has a home: access to regular meals
means his rate of decay will be slower than those who sleep
on these streets. For him, there’s no competition with fellow
scavengers at the end of a hard day’s work to divvy up
the remains of a pharma cocktail and be tempted to take
that little bit more than he should. Maybe that’s what
killed Dharminder.
| A |
LOOK AT ANY SURVEY by any government or nongovernment
agency shows that HIV/AIDS transmission
in India involves three primary cohorts—sex workers,
truckers and IDUs. Jahangirpuri’s concentration of all three high-risk groups makes it a locus of India’s HIV
problem. The truckers who may contract the disease here
will soon be
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on the road to all corners of the country, while many local prostitutes—by one count, almost 600 have tested HIV-positive—will return home to their families, and be back in Azadpur market for their night shift, and the next round of truckers.
A Project H13 survey from 2008-09 found that 98 percent
of all IDUs in Jahangirpuri were men, who by virtue
of proximity to Azadpur and its free flow of drugs have had
easy access to heroin, a party favour for many in the 1980s.
It was the chemists providing pharmaceuticals over the
counter to men with expensive heroin addictions that created
the IDU epidemic in the mid-1990s. Rajiv, along with
every recovering addict in Sita’s care, tells a similar story.
They’d drink with friends, then someone would suggest
they smoke some heroin, which would soon become regular
beyond the point of weekend recreation. That would get
too expensive, and pharmaceuticals presented themselves
as the next logical step. Even after business hours, a couple
of pharmacists would sell the drugs from their homes, providing
24-hour access. Some still do.
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A 17-year-old boy’s body lies in the back of a cycle
rickshaw. The day before, an argument between him and other
addicts led to a fight and he was beaten to death. |
The only time you’ll see dealers on the streets is when
there’s a shortage in the pharmacies. That hasn’t happened
“in quite a while”, says Urdip, a 45-year-old autorickshaw
driver, as he sits in Sita’s centre with one leg tucked under
the other, leaning against the wall, his shoulders in line
with the ring of accumulated filth that demarcates the sitting area. “It feels good to get away from drugs,” he tells
me, though he knows that at this stage, just going out on the
street would be too great a temptation to shoot up again.
According to the World Health Organization, an IDU’s
full physical recovery can take up to three years, but “the
craving never dies in the mind”, Rajiv admits, squinting one
eye from the smoke of another beedi.
“These people come from the lowest castes,” Rajiv explains,
“so the women don’t have the social freedom to go to
the wine shop or to the chemist like the men. A lot of them
still have to stay inside with their heads covered… The husband
doesn’t give a fuck about the house, kids, but a woman
will be more sensitive to the needs of the children, to taking
care of the children. She may whore to make money, but she
won’t inject.”
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An addict looks at the abscess spread over his left knee. |
Either way, HIV/AIDS is here, whether it comes from the
area’s drug use or prostitution or whether it’s transferred
from one partner to another as a result of the drug use or
prostitution. I accompany Sita to the nearby hospital, Babu
Jagjivan Ram, to pick up the results of an HIV test. She’s
negative, but most women in the area, she tells me, have to
sneak away to avail themselves of the free HIV testing at
the hospital. Should they test positive, Sita says, they are
rarely able to undergo the continued treatment required
because they keep the results hidden from their families.
Locals and aid workers say street junkies are not welcome
at the hospital, unless, of course, it’s to the separate building
at the back where their corpses are incinerated.
The National AIDS Control Organisation estimates the
number of HIV-positive IDUs in India at eight percent,
but most involved feel the number in Delhi, especially in
Jahangirpuri, will turn out to be much higher. As the first
to gather specific numbers, Sahara, in conjunction with
other groups, has begun a two-year research project in five
Delhi neighbourhoods suffering from endemic drug use,
but until they’re done, there are still no hard figures on
how many IDUs there are in Jahangirpuri, or how many
are HIV positive.
When I return to Sita’s new centre, three more addicts,
along with Urdip, have sought her out. They all sit against
the concrete, their varying shoulder heights contributing to
the wall’s dark stripe, like the rings of a Saturn made of soot
and held together by sweat. Like the boy whose mother approached
Rajiv, these men now detoxing had the advantage
of a home and relative nutrition, but they’re getting old.
They look dejected. They look ill. Their stories vary, but
they overlap more. These men want to get clean for their
families. They want to start working again.
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Readers' Comments |
Total Comments
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Tarun
16 June 2011
10:11 PM
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beautifully documented and written!
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Ayesha
27 April 2011
04:10 PM
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Brilliantly written. Fantastic reporting, story that never grows stale no matter how many times it is told
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Rohan
24 April 2011
07:39 AM
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God this is a tough read. I couldn't get past page 1. Just hope things change for the better for some of these people.
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