FMT FOCUS KUALA LUMPUR: The rotund middle-aged Malay woman shuffled as fast as she could to her corner foodstall without spilling the contents of the metal tray that she carried. As she neared her stall, she threw a quick glance at the two young men sitting beneath a tree across from her.
The duo were intently scanning the still empty food court in Dataran Merdeka. Beside them was a stuffed black backpack, a small yellow plastic bin marked “Danger” and sheaves of paraphernalia.
First-time patrons to the food court would have wrestled with unease but the stall owner was unperturbed. Nur Fadlan and Mohd Azaha were familiar faces after all.
Twice a week they would settle down across a corner of the food court in wait of their clients who would stream in by the dozen to exchange used needles for a pack of four sterile ones.
The two are outreach workers under the Needle and Syringe Exchange Programme (NSEP), jointly run by the Health Ministry and the Malaysian AIDS Council (MAC), in an effort to reduce HIV infections among intravenous drug users (IDUs).
The Dataran Merdeka outreach point is just one of 260 in the country and serves up to 40 clients at each time. Today, however, the usual stream is a mere trickle and both outreach workers are concerned.
It was almost noon and the lunchtime crowd was due anytime. Once they began arriving, Fadlan and Azaha would have to disappear as was their arrangement with the stall owners.
“Only four clients have turned up so far,” Azaha said. “This spot used to be a regular among our clients but the police carried out frequent raids during Ramadan and many clients have stopped coming. So we have to go looking for them.”
Precious insight
Both Fadlan and Azaha are former IDUs themselves which not only endears them to their clients but
also allows them precious insight into how their clients operate.
“They understand what we are trying to do and they appreciate it,” Fadlan said. “But visiting the outreach points is always a risk for them as they never know if the police are waiting to pounce.”
“So if we get wind of a possible raid we have to move our outreach point elsewhere and hope that word travels fast enough to all our clients.”
Azaha suddenly raised his hand in recognition at a gaunt man approaching them. They chatted easily as Fadlan checked his card and Azaha emptied the used needles into the yellow bin.
“How many packs do you need?” Azaha asked as he dipped his hand into the backpack. The man mumbled a reply and Azaha handed him four packs.
“Most of them collect on behalf of their friends,” he explained, watching the man amble away. “We don't mind because it means that they're helping us reach out to those who aren't our clients.”
A youth came up the stairs and Fadlan called out: “Oy! Haven't seen you in a while!” The youth flashed a half-guilty smile. He had just “gotten out” (from prison), he confessed.
Fadlan shook his head and held out a new pack of needles but the youth sat close to him and murmured in his ear. Fadlan reached back into the bag and pulled out a bar of soap, a disposable razor and Panadol.
After collecting the items, the youth headed towards a closed foodstall. Outside it lay a bright red suitcase. He stuffed the items into the suitcase, zipped it up and walked away leaving it there.
“He probably lives under the bridge like the rest,” Fadlan observed. “We know what their lives are like so we also provide them basic necessities and medication. And we give them these pamphlets too.”
The pamphlets depicted diagrams indicating safe areas for injection. According to Fadlan, most IDUs have no idea how to locate the right vein for injection which has resulted in blood clots or serious infections.
And educating them on safe injection methods, he firmly said, does not constitute encouragement of drug use. As far as MAC is concerned, its focus is solely on reducing HIV infections and not drug prevention.
A safe haven
When they're not on the streets, Fadlan and Azaha are busy at the IKHLAS drop-in centre, another site for IDUs to exchange their needles. The centre is a safe space created by the Pink Triangle Foundation for drug users, sex workers and transsexuals in the Chow Kit area.
The centre runs two inter-related programmes – the NSEP and the Methadone Maintenance programme. The centre occupies an innocuous two-storey shoplot in Lorong Haji Taib. Even before its gates open at 9am, a small group has gathered to await entry into what they call their “haven”.
IKHLAS coordinator, Zulkiflee Zamri, explained that beyond the programmes the centre also catered to the group's basic needs. This included offering three daily meals (breakfast, lunch and tea), counselling, referrals to rehabilitation centres or hospitals, as well as bathing and laundry facilities.
The centre's two floors are divided into male and female areas. That morning only a couple of transvestites were hanging around the female floor and were nervous about granting interviews.
“No cannot!” one of them refused, his voiced muffled by the shawl that partially covered his face. “The last journalist also promised anonymity but showed my face on TV and my whole family saw me like this!”
The male floor was teeming with drug users who were either fast asleep or glued to the TV. Among them were Mohan, 49, and Farid, 22.
Mohan had his arm in a sling. He blamed his broken arm on a ratty pair of slippers which caused him to lose his footing while scurrying for shelter during a recent downpour.
“I started on marijuana at 18,” he shared openly. “I was 23 when I was first arrested. I discovered heroin while I was in prison. I continued injecting after I was released and was arrested a second time soon after. I've wasted most of my life behind bars. I'm tired of it.”
Turning around his life, however, was trickier than expected. Mohan initially landed a job as a security guard but was fired after he slipped back into his old drug habit. Then he secured employment as a parking attendant only to have the cycle repeat itself. Today he is a daily visitor to IKHLAS where he survives on the free food.
“I don't like the dependency but I have no choice,” he said, occasionally swiping at his nose which still runs from snorting drugs. “As it is, it was already so difficult to find work what more now when I have a broken arm? The only good thing that has come out of this is that I am more determined to quit heroin for good.”
Black sheep
Mohan is the self-professed black sheep of the family. After his father passed on, the welfare of his mother fell onto the shoulders of his siblings. Mohan visited his mother regularly but was banned from the house after he was caught stealing from her. Desperate to eke a “normal” life for himself, Mohan turned to the NSEP.
“It's a very good programme,” he said earnestly. “We always knew it was risky to share needles but it was too much of a hassle to get new ones. I've since introduced other friends to the programme as well. My aim is now to kick heroin and get onto methadone instead.”
According to him, methadone allows former heroin users to function normally in daily life without craving the next hit. Farid attested to this. He has been on methadone ever since he began volunteering at the centre.
After getting hooked on marijuana at 16, he experimented with ice and wound up in prison for six months.
“My father was polygamous and never at home,” he said. “I didn't get along with my mother so I left the house and lived on the streets in Kuala Lumpur. That's when I first encountered heroin.”
“I chased heroin for eight months until a friend offered me methadone. It made a huge difference. I was a petty criminal before because I obsessed over my next hit but with methadone, I felt like a regular person.”
Farid heard of the NSEP around the same time but was hesitant to get onto the programme because of a childhood fear of needles. So he opted for sheer willpower and methadone to help him kick the heroin habit.
Both men, however, lament the discrimination that their addiction has heaped upon them.
“When employers find out about our records, they refuse to contribute to the Employees Provident Fund or they hold back our salary,” Mohan claimed. “This happens a lot with security companies. We are open and honest about our past but our employers use it against us.”
Farid related a previous experience working as a security guard at a condominium. According to him, his employers assured him that they had no problems with his past but then held back his salary on payday.
“One night the police raided our hostel and arrested all of us. It turned out that our employers had tipped them off. After I got out of prison, I went back to claim my salary but the company said that I had forfeited it after I didn't turn up for work without prior notice. I heard that they hired a different set of security guards and repeated the same trick.”
The setbacks, however, haven't eroded Mohan's faith in the NSEP or himself. He is confident that he will lift himself out of his addiction in the near future.
“But we need help,” he admitted. “We fall easily and we need support or else we're not going to make it. You know the saying, how behind every successful man is a woman? It applies here. Behind every former addict is a friend and that friend is now the NSEP.”
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