Extreme Rehab

BY IRIN
Nov 03, 2011

Resource-strapped villages in Nepal chain up child drug addicts.

1145 Nagendra is chained to the family bed. Photo: Marcus BenignoChild drug users in one of Nepal’s largest cities, Dharan, near the border with India, lack access to proper rehabilitation and social services, and those from lower caste families are especially vulnerable.

“More than 50 percent of youth [in Dharan] are involved in drug use,” said Rajendra Bista, deputy superintendent of police in Dharan. “Most of their parents are abroad working, so the children are not given proper guidance, but they get a lot of money. Misguidance leads them to drug addiction.”

In contrast with other Nepalese cities, Dharan boasts well-maintained roads and good infrastructure, thanks to remittances sent home by Nepalis working abroad.

In the absence of decent social services, however, particularly for low-income and lower caste families, some parents have resorted to drastic measures to restrain their children. For Durga Bishwakarma, chaining her 10-year-old, drug-abusing son, Nagendra, to the family bed was her only option.

“While I was at work or asleep at night, he would run away. I would pay one of the street kids to find him and pay another child and another until I had no money left to give,” Durga told IRIN.

Durga and her family are Dalits, a marginalized caste in South Asia, and live in a single room off the squatter tenements in Dharan.

According to a 2006 survey by the Nepal Central Bureau of Statistics, 53 percent of hard drug users are aged 15-24 in Nepal. Buprenorphine, in the form of Tidigesic (an injecting painkiller illegal in Nepal) and considered a hard drug, is popular in Dharan, and available for as little as US$3. Dharan’s proximity to the Nepal-India border eases drug-trafficking.

The last published local drug statistics for Dharan are a decade old and indicated that 5,000 of the city’s 68,000 people were using drugs.

In the last six months, Nagendra has played truant and joined a band of street children who use substances like glue (Dendrite) and prescription drugs like diazepam (Valium).

Reluctant to answer questions, Nagendra said his friends coerce him into stealing and using drugs. “I don’t come home because my friends will beat me,” he said.

One day last June, Durga found Nagendra unconscious on the street: For hours, he was unresponsive until he started to vomit, she said. He had taken alcohol laced with prescription pills.

Child drug users neglected?

Durga turned to the Disabled and Helpless Rehabilitation Service Centre (DHERSEC), a local NGO working with the disabled and underprivileged, but they could not get Nagendra off drugs.

“We gave him everything: school dress, stationery and supplies. We were thinking he was going to school but he wasn’t,” said Sunil Khadkha, director of DHERSEC. “With 80 kids in one classroom, the school teachers don’t care about who comes and goes.” Government schools in Dharan are unprepared to handle vulnerable children, he added.

Kirat Yakthung Chumlung (KYC), a cultural organization run by the Limbu ethnic group, opened a drug dependence treatment and post-rehabilitation centre in Dharan in 1996; and Sanjivani Kendra, a non-profit drug rehabilitation centre, is in its third year of operation. Both centres cater primarily for adult male injecting drug users.

Dristi Nepal an NGO run by female ex-drug users in Kathmandu, established a drop-in centre in Dharan offering counselling, referral and outreach services to female drug users.

While some resources are available, there are no drug rehabilitation centres in Dharan for child drugs users.

Glue-sniffing

Underprivileged Children Association (UPCA), an NGO and local partner of Save the Children, is working with 74 street children (aged 5-18) in Dharan. Twenty-seven children have been reintegrated into their families and schools, but cases of remission occur.

Of its caseload, 95 percent are sniffing glue. In an agreement with local hardware stores and shoemakers, UPCA was successful in halting the sale of Dendrite and other harmful substances to children.

“But what we found is that kids were using adults to purchase Dendrite. The rickshaw puller would take a cut,” said Sudarshan Shrestha, advocacy director of Save the Children in Kathmandu.

“In terms of rehabilitation, a lot of our resources are used to identify street children and get them back with their family and into schools... There are lots of resources, education and counseling support. Drug rehab centres for children, no,” said Shrestha.

In collaboration with KYC and the local government, UPCA is planning to monitor street children engaged in substance abuse and better implement programmes.

With a local government budget to tap into, resources exist, but lack of coordination is an impediment, aid workers say.

"In this fiscal year, the local government allocated a budget for street children," said Bijaya Limbu, programme manager of KYC, who was directly involved in the budget meeting. "No specific programme has been outlined, but the money is there."

The day after the Bishwakarma family was interviewed for this story, Nagendra was back on the streets.

This story was first published in IRIN.