About the Author: James O'Gara is an INL Advisor in Helmand province, Afghanistan.
The governments of countries that produce or transit drugs have gradually faced up to their narcotics problems, prompted in part by the adverse social effects as drug production is siphoned off for local use. Epidemiological studies are still in progress, but it would appear that Afghanistan is no exception to this trend: Most experts agree that injection drug use is a growing problem in that country, as is the common practice of giving opiates to sick or distressed children to quiet them.
The Department of State's Bureau of International Narcotics and Law Enforcement Affairs (INL) is helping Afghanistan tackle its drug problem from the “demand side.” It funds a network of treatment clinics in Afghanistan, including Kandahar City's Wadan Center, a clinic with both inpatient and outpatient operations. Additional funding helped double Wadan's inpatient capacity in April, 2009, to 20 beds.
Wadan is located less than a block from Kandahar City's National Directorate of Security headquarters. This would seem to put it in a very safe area of the city, but suicide bombers have slipped through the security cordon. Multiple car bombs in this area killed 40 Afghans in August 2009 --though none, thankfully, at Wadan.
For this visit, INL officers from U.S. Embassy Kabul and nearby Kandahar Airfield suit up for the drive, wearing body armor and tucking themselves inside special up-armored pickup trucks designed to be less conspicuous than the more commonly-used armored vehicles. Today, the General in charge of the nearby regional police training center has loaned us two pickups complete with uniformed Afghan National Police (ANP) escorts. They stand in the back of the pickup truck gesticulating wildly for oncoming traffic to yield the right of way.
One of the police vehicles makes a sudden stop -- and our truck, weighted down with armor plating, is unable to brake in time, resulting in a minor collision. The policeman who had been standing in the bed of the pickup truck directing traffic disappears below the tailgate. A moment later, he is back on his feet, smiling broadly back at us. Shortly afterwards, we arrive at Wadan.
Dr. Mujeeb Ahmed is Wadan's gracious and engaging director, willing to break away from his rounds to explain Wadan's treatment protocol to our group of visiting INL staff.
Patients are admitted to the Wadan Center for 45 days of highly structured living. “We have them get up at 4:15 a.m. for the fajr prayer,” says Dr. Mujeeb. “They end their day after the aisha prayer and go to bed by 10:30 p.m.”
In between, the men have a busy day (all Wadan's residents are men; a separate, home-based program addresses the needs of Kandahar's female opiate addicts). “The patients attend lectures throughout the day on personal hygiene, HIV, sexually-transmitted diseases, and misconceptions about relapse,” Dr. Mujeeb says. “They get medical checkups, they exercise, and they participate in group therapy sessions. They have their meals, attend prayers and have tea time.” Patients also receive vocational instruction in fields such as motorcycle repair and tailoring.
Graduates receive follow-up visits at home for up to a year. Dr. Mujeeb stresses the importance of family: “The role of the family is so important,” he says. “When the family supports the patient, we find that relapse rates are reduced.”
After discussion and a brief tour, Dr. Mujeeb offers his visitors lunch. We look to the Personal Security Detail lead, who looks at his watch and grimaces slightly. Lunch will have to wait for another visit.