Firstpost: New Delhi: Saturday, April 08, 2017.
This is not a story about Parshu. Why should it be? He’s just another needy two year old running around playfully on his unwashed feet, smiling an unformed, unworldly smile under a very drippy nose. Parshu, in a t-shirt with mucous stains and patches of frozen black dust, is one among the nearly two lakh children living on Delhi’s streets. Because poverty throws a thick blanket of resemblance over people’s fortunes, it gets harder to tear through it and contest it in instances. Parshu was born to teenaged parents two years ago, both balloon sellers and drug addicts. The mother is now 20 and the father died of a ‘solution’ overdose some months ago.
There are only five de-addiction centres in Delhi that are partly funded by the government and managed by NGOs. Parshu is the only boy who lives in the sixth and recently opened centre for women and child addicts in Parda Bagh, old Delhi. Some centres have 15 beds, and others twice the number. Last year, these establishments were complaining of a delay in funding from the government. Their grudge was that the Delhi government (the nodal agency for inspection and approvals of funds) delayed the release of their funds. Although that has been resolved, the greater issue at hand here is that drug addiction still comes under the purview of the Ministry of Social Justice and Empowerment, when it’s actually a serious health problem that germinates in poverty and grows cancerously in lonely, love-starved nerves. Doctors feel it should be addressed immediately by the Ministry of Health and Family Welfare.
In the last week of February, under the chairmanship of the chief secretary, government of NCT of Delhi, a meeting of the Intersectoral Coordination Committee was convened. The use of the word ‘intersectoral’ is the first formal proof of the state’s understanding of the kind of response needed to address the problem.
According to a recent survey conducted by the Delhi Aids Control Society, the number of street children who used any substance in the last one year was 23,240 children although the 95 per cent certainty estimate varied between 19,320 to 27,090 children based on statistical calculation. After excluding tobacco, the numbers still are 15,470 street children. The study estimates that the number of tobacco using street children was 20,000, a figure high enough to require immediate intervention. The findings have revealed that alcohol is used by an estimated 9,450 street children; inhalants are used by 7,910 street children; cannabis is used by 5,600 street children; heroin was used by 840 street children and pharmaceutical opioids and sedatives were used by 210 each; some street children also reported injecting drug use. As per the 2016 survey conducted by jointly by the Women and Child Development Department and AIIMS in 2016, there are 70,000 addicts on Delhi’s streets and their initiation into drugs happens as early as age nine.
A total of 30 beds in six hospitals have been earmarked exclusively for juveniles but there is lack of staff in these centres. A proposal has been initiated for creation of posts in these five existing de-addiction centres. In the drug de-addiction centres planned in government hospitals, there is a revised proposal for the increase in staff for round the clock inpatient care from one to three in each centre. Muskan Foundation runs a de-addiction centre in Amberhai, Dwarka. Dr Bharat Bhushan, who runs the facility, says increasing staff is important because the treatment cannot be limited to the three-week detoxification, it has to be intensive and lengthy so there is a less chance of relapse. Right now, a 60 to 90 percent relapse rate pulls the addict back into the black hole of addiction. To consolidate the approach towards de-addiction, the Delhi State Aids Control Society has made proposals like the establishment of additional oral substation therapy centres, specialised counselling centres for targeted interventions, capacity building and training support and intervention efforts in women and children addicts. For these activities, it has been proposed that a budget of Rs 10 crore per annum be kept aside.
Last year, AIIMS introduced a specialised course to generate five specialists of drug abuse each year. AIIMS runs two community clinics in Delhi, in Trilokpuri and Sunder Nagri, which engage with low-threshold patients. The reason for this, as Dr Atul Ambekar of AIIMS National Drugs Dependence Treatment Centre in Ghaziabad explains, was that addiction was seen as part of general psychiatry, when it is actually a far more specific problem.
In response to an RTI filed to Delhi’s government hospitals in May 2016 for information on drug de-addiction services offered, it was stated that specialised drug de-addiction services declined at Safdarjung Hospital and VMMC; Lady Hardinge Medical College and SSK Hospital had just one child addict admitted in IPD in 2014-2015 and none in 2015-2016. No female addicts were registered in both years. If one is to visit the centre for women and children at Parda Bagh, little girls will tell you how it’s quite routine for them to get hold of a bottle of solution (chemical drug) for Rs 60 and children in Meena Bazar, Hanuman Mandir, Jhandewalan, are easy targets for peddlers. The girls (between 7 and 15) said they started out with shikhar chewing tobacco and then ‘bhaiyas’ started selling them solution. Replying to the same RTI, Dr Ram Manohar Lohia Hospital stated that the total number of drug de-addiction patients IPD was only six in 2014 and 22 in 2015. It has been finally been proposed that the Health and Welfare Department will look into activating beds for de-addiction treatment in these hospitals.
A 30-bed facility has been proposed to come up at Tilak Vihar, where there is a minimum of one addict in each home. Other regions in need of immediate relief are New Seelampur and Seemapuri, where NGOs like Asha and Parivartan are doing their bit to educate and reform. Last year, Haji Ishraq, MLA-New Seelampur, told Firstpost that the MCD doesn’t provide the government land for building a ‘nasha mukti kendra’ and that explains why addicts pass out and fall like dead bodies even outside police stations.
Aside from the six government centres, there are also a large number of private drug de-addiction centres across the capital. Some brand themselves as neuro-psychiatric centres and others call themselves wellness retreats. For the first time, the government has acknowledged that these facilities must be monitored. A standardised procedure for drug-relief must be put in place. In fact, government doctors reveal that the 150-odd private NGOs across Delhi aren’t verified by any authority and the use of muscle and stronger substitute medicines in order to prolong addiction also happens.
School children are an impressionable lot and get lured into addiction in packs. There are 1,240 schools with 13.5 lakh students from Class 6-12. A screening of these children for traces of drug abuse has been suggested. The East and South Delhi municipal corporations have trained their staff at IHBAS for this purpose, along with this, even Mohalla Clinics situated near schools are to start screening students regularly. Along with this, the government has finally admitted the need for a survey that’ll help quantify the problem. Currently, no consolidated survey of drug abuse in school children exists.
The Delhi police, the Narcotics Bureau and the Drug Control Department are the main agencies involved in regulation and supply of reduction of drugs of abuse. The information collated from investigating agencies on drugs banned under the Narcotic Drugs and Psychotropic Substances (NDPS) Act showed that Delhi had the highest seizure of chemical based intoxicants such as mandrax, syrup and tablets. The data tabled in the Lok Sabha earlier this month indicates that anti-drug agencies caught 23,519 kg mandrax, 98,480 kg syrup and 1.77 lakh tablets in Delhi in 2016. While the Drug Control Department has cancelled 18 drug licences of pharmacies to curb illegitimate drug abuse, residents in Tilak Vihar, Seemapuri and Seelampur say it is still quite easy to get hold of Avil (anti-inflammatory for aches and allergies), Siazepam (tranquilising muscle relaxant), Nitrazepam (short-term relief from insomnia and anxiety), Alprax (a sedative, hypnotic, anxiolytic) and Phenergan (antihistamine, sedative, and anti-nausea drug) over the counter. “Badi dukaan par nahi toh choti dukaan par zarur milega, nahi toh bhaiya leke aayenge,” says Bima, a child addict outside Hanuman Mandir, Cannaught Place. (Later, Bima took Firstpost to the ‘bhaiya’ or peddler, a teenage boy, offering a red and white tube for Rs 100 outside Hanuman Mandir. Fearing he’ll be caught, he ran away and merged into the crowds near the temple gates.)
It is not merely a question of breaking the chain of supply and demand of drugs but of rescuing those 70,000 childhoods that are being lost to this cheap poison each and every day.