At a busy street corner in Pydhonie in South Mumbai, a young woman squats near two men on the garbage flowing out of a trash can. While the men carefully unfold an aluminium foil to inhale crude heated heroin, the woman—dressed in a soiled pink kurta—stares vacantly into space. The brown sugar-induced stupor makes her oblivious to everything, including the rain that has drenched her emaciated frame.
“She needs immediate help,” says Sangita Lalge, a nurse with Mukti Sadan, a non-governmental organization (NGO) that works with drug addicts. Lalge and her colleagues will soon move the woman to GT Hospital that has the only public de-addiction centre in the city for women.
In a slum near Bandra railway station, another young female addict, with a nine-month-old infant, says she wants to undergo the de-addiction programme, but social workers cannot assist her. “Except for treating these women at our day-care centre, we cannot do much because there are no facilities for women with young children,” says Prafullachandra Sali, associate director at Mukti Sadan.
GT Hospital, say health workers, is not suitable for women addicts who have children, who need caring.
Mukti Sadan’s recently opened centre for women is housed in a one-room structure that doubles as a day shelter for destitute women addicts. On most days, more than 10 women come to the centre.
Counsellors educate the addicts and also run a harm-reduction programme. This involves providing buprenorphine, a medicine to wean addicts off injecting heroin; for those who do not give up injecting drugs, the centre provides new needles and syringes in exchange for used ones. The objective of this intervention is to reduce the spread of HIV (human immuno-deficiency virus that can lead to AIDS) among drug users.
Centres such as Mukti Sadan’s new one provide women addicts with some support and services, but may not help them to make a clean break from their addiction because of limited facilities, including the lack of a residential treatment. According to United Nations Office on Drugs and Crime (UNODC) estimates, out of a total of almost 400 treatment centres in the country, only 10-12 cater specifically to women.
The need for special facilities is becoming even more critical with the growth in the number of female addicts. According to Arbind Prasad, joint secretary, ministry of social justice and empowerment, so far it was perceived that women were only victims of drug abusers and not users themselves. “But now we have data that shows drug addiction is growing among women,” he says. Prasad was unable to quantify the exact number though. In one study conducted by UNODC, fifth of male drug users said their partners were addicted too. By that yardstick, there could be more than a million female addicts in India, clearly indicating that a handful of treatment centres are woefully inadequate.
“It is beyond doubt that we need more facilities for women. And while addressing this need we have to ensure that we take care of three main concerns—availability, accessibility and acceptability,” says Ashita Mittal, senior national programme officer at UNODC. This means that not only should there be sufficient number of facilities that are user-friendly, the kind of services offered should also be acceptable to women.
“The government is aware of this issue,” adds Deepika Naruka, research analyst at UNODC. On the cards are more centres to treat women. “Within the next three months, we will finalize the details of a special project targeting women,” adds Prasad. The centres, set up under this project, will take into account the needs of women with young children. The government is working with UNODC and NGOs across the country to roll these out.
Just having more centres though may not be enough. The government and civil society have to recognize that much of the addiction problem among women is covert. “Even though we know that addiction has become a serious issue, we have only about two-to-three women seeking help in a week, as against 10-12 men who come for de-addiction every day,” says a psychiatrist with GT Hospital who does not wish to be identified.
“Women find it more difficult to come into the open about the problem for two reasons. One, because of the stigma and second, because she usually has a family to care for,” says Debashis Mukherjee, co-ordinator of regional resources and training centre, The Calcutta Samaritans, an NGO.
The Calcutta Samaritans has been offering women de-addiction and rehabilitation services for the last 15 years and claims a success rate of 70% over two years of follow-up. “There are two parts to the de-addiction programme, one is the medical management and another is rehabilitation. This entire process takes about a month and during this time we take care of the women’s children as well,” adds Mukherjee.