The road to relapse
HA TAY - "One! two! one! two!" shout 16 young men in
blue-striped pyjamas, raising arms and knees in ragged
rows. Their voices from the courtyard below waft
upstairs into a meeting hall, where more young men in
identical pyjamas sit slumped on the floor and absorb a
scolding. "You didn't do a good job in reporting
mistakes!" a supervisor barks at them. Next time, they
are told, they must name names. Who strayed out of
the restricted area? Who failed to fold his mosquito
net?
Netted by the police, or dispatched by desperate
families, thousands of drug addicts are now behind
barbed wire in 57 compulsory detoxification camps
stretched across the country. This camp in Ba Vi
district, 67 kilometres northwest of Hanoi, is
considered one of the better ones. Its 510 inmates,
mostly former heroin junkies, listen to anti-drug
lectures, paint murals warning against Aids, and
exercise and perform manual labour such as planting
vegetables. Family visits are restricted to 10 minutes,
with no phone calls allowed.
Tough tactics. But they're not working. It's estimated
that up to nine out of 10 inmates will wind up back on
drugs, with some enduring as many as seven
incarcerations in the camps. There they experience
everything from mindless drills to physical abuse. "All I
thought about, every day, was how to avoid a beating,"
says one former inmate, Manh, 23, who was released
in April after five months in a Hanoi camp. There are
other risks, too: Until the middle of last year, inmates
were treated with a detox drug that may have poisoned
them (see story on page 60).
Vietnam, of course, isn't alone. Other parts of the
region have similar drug worries, and have responded in
similar ways. China, Malaysia, Burma and Singapore all
have compulsory detox camps with strict discipline and
terms ranging up to two years. Similarly, they report
relapse rates of at least 70%. There is little evidence
that any regime is reaching out for fresh solutions.
"Many decision makers appear to cling to the hope that
if the current approaches can only be implemented with
more resources and more commitment, these
approaches will succeed," says a report from the
United Nations Drug Control Programme.
That also describes Vietnam's approach. A new drug
law effective from June 1 will double the maximum term
to two years. As before, there is no trial nor appeal. An
official signature at the ward level suffices. (For
hard-core traffickers, trials typically end with
execution.) Camp security could get even tougher.
The gulag will expand to accommodate the longer
terms. Existing camps will be expanded and at least
four new camps will be built. That still won't be enough
to house the officially estimated 101,000 drug addicts.
No one knows the true figures, but they appear to be
rising, with cheap Golden Triangle heroin selling for
50,000 dong ($3.45) a hit and falling into ever-younger
hands. The new drug law also mandates separate,
compulsory detoxification dormitories for children aged
12-17.
Old habits
For former inmate Manh, detox achieved little. Before
entering the camp, he snorted heroin for five years. As
soon as he was released, he resumed his old habit,
undeterred by fear of being sent back. "My family sees
me differently now, they treat me like garbage," he
grouses, lounging at a streetside tea stall with other
relapsed addicts. Family problems drove him to drugs
in the first place, he admits, but the camp's doctors and
staff never asked him about his worries. "They didn't
care," says Manh.
Vietnam has scant experience with psychological
counselling. Over the last two years, the UNDCP has
made initial attempts to help camps in seven provinces
incorporate such counselling, in part by funding training
from Daytop International, a respected United
States-based drug-treatment group. So far such efforts
have barely penetrated the punitive system.
Watch a so-called "psychological counselling" session
at the Ba Vi camp, where staff received some Daytop
training. The assembled inmates chant the camp's
disciplinary rules, then recite a homily: "I'm just an
escapist, until I share with everyone my life's secret . . .
At this place, I change. I grow up." But the "sharing," is
limited to dull praise for vegetable planting, or stilted
criticism of poor hygiene. One inmate strums a guitar,
while others take turns to sing, greeted by dull applause
from the group.
When admitted to the camps, most inmates are tested
for HIV, which causes Aids. Contrary to international
practice--which calls for immediate disclosure to
maximize time for counselling and advice on how to
avoid spreading the virus--male inmates and their
families are only told on the verge of departure. "They
don't want the HIV-infected to get depressed," shrugs
Thanh, a 45-year-old Ba Vi inmate.
Ba Vi administrators and some other officials would
prefer a shift to a more sensitive approach, along with
comprehensive programmes for vocational training and
job placement, but they just haven't the resources.
While families are expected to pay 300,000 dong a
month for each inmate, poor families are exempt.
(However, extra cash may not always be the answer:
The team that compiled the UNDCP report found a
more humane approach in Thailand. Addicts were
"regarded more as patients than as criminals," and used
the expensive heroin "replacement" methadone.
Drop-out rates, though, remained high.)
Some international aid groups remain reluctant to
become involved with Vietnam's camps. "It's ethically
very difficult to work in camps," says Jamie Uhrig, a
Canadian consultant on Aids. "It's hard to benefit the
inmates without benefiting the system. The human-rights
dilemmas are so great."
Meanwhile, the families of drug addicts endure their
own torments--the lying, the stealing, the shouting, the
constant trouble with police. While outsiders may cast a
withering eye on the detox camps, many relatives see
them as temporary rafts of calm.
In Linh Nam village, on the outskirts of Hanoi,
fruit-vendor Nguyen Thi Nhung tried to chain her
younger brother's legs together, but he always managed
to saw himself free and flee in search of another snort of
heroin. So Nhung built a tiny cement hovel, barely wide
enough to sleep in and with just a few airholes for
ventilation. For four months, she kept him bolted inside
the hovel, handing him food through a notch in the wall.
When she finally let him out, his instant relapse triggered
the family's decision to send him to a camp. "When he
comes back, we'll be so nervous. We won't know what
to do," says Nhung.
Her brother, Nguyen Van Tuyen, 23, looks cheerful in
Ba Vi. Going cold turkey was painful, but now he's
stabilized. Surrounded by green hills and shimmering
fish ponds, Tuyen sleeps on a wooden bed, seven to a
room. Facilities at Ba Vi, superior to other camps,
include television, a library and sports equipment. The
food seems adequate. Inmates grow their own rice and
vegetables, raise fish and pigs and make their own tofu.
Tuyen acknowledges that the camp seems like a
holiday spot compared to his incarceration at home.
"He'll take a vacation here, get fat, then look for
another snort," laughs a fellow inmate.
Will he go back to heroin when he gets out in July? "I
don't know," Tuyen replies. Then comes a broad smile.
"It's very enjoyable to use drugs," he blurts. "I feel like
I'm flying. I fall asleep without even trying. And when I
wake up, I immediately miss it."
By Margot Cohen - The Far Eastern Economic Review - May 24, 2001.
|