Pakistani drug addicts denied help after row

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An argument between a drugs charity and the authorities in Pakistan has meant thousands of drug addicts are going without crucial, often life-saving, care.

The charity says the problems started after it refused to give the government confidential personal information about all its clients, as the BBC's Aleem Maqbool reports.

Drug addict, Lahore - June 2010 Addicts are angry the authorities cut funding to the charity they relied on

We met Allah Rakha as he sat in the shade of a tree, in a small public garden in the heart of the Pakistani city of Lahore.

His silvery hair and his beard were neatly trimmed. But his clothes were dirty, his eyes half shut, and his speech slurred.

"These days, when I inject drugs, there's a queue of people behind me, waiting to use my syringe," he tells us. "We know about Aids, but when you're desperate for a hit, you'll use anything that's available."

Close by, other addicts were openly injecting. Between uses, they washed their syringe only with water from an old soft-drinks bottle.

'Life-saving'

We found similar scenes under railway bridges, and in the narrow streets of the old quarter, and in park after park.

Even in the middle of the day in Lahore, it is extraordinary how easy it is to find addicts injecting.

Start Quote

This is about them not abiding by the verification process”

End Quote Fawad Hassan Fawad Punjab health secretary

All of the drugs users we spoke to talked of how, until recently, they got visits from charity workers who would dress their wounds, or give them advice or even food.

Crucially, those workers would also hand out clean needles and take away the dirty ones to reduce the spread of disease.

Many addicts were aware that a row between the charity and the authorities was the reason behind the abrupt loss of that, often life-saving, service.

"The Punjab government did something and shut the charity down, but it is us who have felt the full wrath of that decision," says Muhammed Ali, an addict of more than 15 years.

He displays a filthy dressing on his leg that needs changing, and produces a bent and dirty syringe from his pocket that he says he got from another user.

"If I have survived this long, it is because of that charity. I curse the government."

Money blocked

The charity he talks about is Nai Zindagi (New Life). It was set up 20 years ago by former drug-users, and, more recently, won the backing of the World Bank and the UK Government's Department for International Development (DfID).

Ahmed Baksh, drugs outreach worker Ahmed Baksh says years of trust-building have been shattered

Many of the charity's management team and its outreach workers were reformed addicts from these same streets.

They were working with thousands of addicts until earlier this year when the charity was contacted by the new Punjab health secretary.

"From nowhere, he suddenly asked us for the identities and personal details of all the drug-users we work with," says Ahmed Baksh, Nai Zindagi's deputy programme manager.

He says the charity explained that it could not do that under the terms of its contract and the international code of ethics for working with high-risk populations.

"But the health secretary immediately took the drastic step of blocking the money from our donors, he cancelled the contract," says Mr Baksh.

"After so many years of hard work building a rapport with the addicts, and gaining their trust, he just killed us."

'Insult' to government

A team from the World Bank has since met the health secretary, but he did not reverse his decision.

Nai Zindagi's drop-in centres in Lahore and seven other cities remain shut; all its staff, including doctors, have been sent home.

We went to visit the health secretary, Fawad Hassan Fawad, at the Punjab secretariat.

Drug addicts, Lahore - June 2010 The drug-users say they now have no option but to risk sharing needles

He said that he had been disappointed that he had not been given the identities of the drug users as he had asked.

"If those details were considered to be safe in the hands of the charity, then it is insulting to suggest they would not also be safe with the government," he said.

He insisted, however, that this issue was not the main reason that he took his decision.

"The contract was terminated because the project was not transparent," Mr Fawad said. "This is about them not abiding by the verification process."

Donor concern

The charity's staff say that full audits were done regularly and had been checked and approved by the Punjab government.

They say that before the contract was ended, the only information the new health secretary asked for were the addicts' details.

The UK's DfID, a donor to Nai Zindagi, said in a statement that it was "very concerned that termination of this contract by the Government of Punjab will interrupt vital services that reduce the spread of HIV/Aids."

"We have no objection to the Government of Punjab wanting further verification of the existing contract, as long as this does not breach patient confidentiality or interrupt critical services," it continues.

The health secretary has, so far, been unmoved.

Imam Tahir Muhammed, former drug addict

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The blood of each one of them that dies is on the hands of the government”

End Quote Imam Tahir Muhammed Reformed addict

"If Nai Zindagi does not exist, it is not a big problem," Mr Fawad told me. "Another group will come up to provide the service."

But with the thousands of drug addicts in this city, and the potential for the spread of disease, every day without that service provision is crucial.

Tahir Muhammed, sitting in a small mosque beside Lahore Fort, says that is why he is praying that Nai Zindagi reopens soon. It is, after all, the charity that saved his life.

He used to be an addict, stealing to pay for the synthetic drugs he injected.

Now, with the help of the charity, he has overcome his addiction and is the mosque's imam. He leads prayers and warns others of the dangers of drugs and HIV.

He is furious at the government decision.

"Drug-users in Lahore knew about HIV because of what that project has done over the last 20 years," he says.

"The workers handed out clean needles, now the addicts are sharing again. The blood of each one of them that dies is on the hands of the government."

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