Lunch at the Drug Dependency Treatment Hospital in Myitkyina. Photo by Diana Markosian/Reportage by Getty Images
“Rehab is great. It gives you a rest. It clears your mind,” says Kan Char, his voice softening to a slur. To celebrate a successful two-week stint at a drug rehabilitation center in Myitkyina, the dusty capital of Burma’s Kachin State, he has treated himself to enough heroin to last all day. Dressed in a navy polo and khaki trousers, he stands out among the raw-boned men and furtive teenagers at the needle exchange where we meet.
“I’m not an addict, though,” he says, rubbing his hands together. As proof, Kan Char (not his real name) tells me he’s always managed to juggle his drug habit with work and school. For the past two years, since graduating from university with a psychology degree, he has earned a living as a motorcycle mechanic. He resents the fact that he can’t find work in his field, but here in northern Burma—where unemployment exceeds 50 percent and addiction rates aren’t far behind in some towns and villages—finding, and keeping, a job of any kind is no easy feat.
“The problem with most people is that they have nothing to do. Everybody is bored, everybody is angry. They start using drugs, maybe opium first, then straws [heroin sold packed into drinking straws], and soon they’re hopeless cases.”
The 26-year-old has a strategy for managing his habit. Shooting up is reserved for special occasions. He shows me his arms—I can see a bruise forming where he injected a few minutes ago, but there are no scars. The rest of the time he smokes, because smoking heroin is less addictive. When his drug use starts to get out of hand, he goes (or gets sent by his grandmother) to rehab.
“It works for me. I start feeling lost, I go,” he says, his eyes beginning to droop. “But it doesn’t work for everybody. And besides, there is not enough room [in the treatment centers].”
Patients passing time between group counseling and trips to the exercise yard. Photo by Diana Markosian/Reportage by Getty Images
To say that Burma has a drug problem is like saying Iraq has a violence problem; it’s pretty much impossible to overstate how bad things are. According to the UN Office on Drugs and Crime, there are about 300,000 addicts in Burma, most of them in Kachin and Shan States in the northeast. Anecdotally, addiction rates among young men are thought to approach 50 percent in the worst affected communities. Burma is the second largest opium producer in the world, after Afghanistan, and the northern part of the country is one of the cheapest places anywhere to get properly high.
Prices are rising, thanks to global demand, but £1 (or $1.63) will still get you a hit of reasonably high-grade heroin. The abundance of good quality narcotics, combined with mass unemployment, lax (some would argue "selective") police enforcement, and long-running regional wars between rebel groups and the Burmese army, has created an epidemic of drug addiction. Rehab offers the barest glimmer of hope for addicts. But getting clean here is a difficult proposition.
At the Drug Dependency Treatment Hospital in Myitkyina, the patients are a mix of university students, farmers, and jade miners. When I visit, they’re lined up to receive their morning ration of instant coffee. Joking around in their tracksuits, they seem happy for the diversion. It doesn’t last. Soon the patients are sent back to the military-style dormitory where they spend most of the day locked away from temptation. The size of a school gym, with bare walls painted aquamarine and two rows of creaking iron bedsteads, it houses about 50 men. They drift into the room beneath a sign that reads, “Addicts are people too” in English and Burmese. One man huddles under a blanket on the floor.
“The worst cases stay for 30 days,” explains Dr. Tin Maijong Oo, the hospital superintendent. “That is as long as we can keep them.”
Photo by Tyler Stiem
Admission is voluntary. In between group counseling and visits to the exercise yard, the patients kill time by reading, sleeping, and smoking cheroot cigars. They're weaned off heroin and onto methadone or opium, depending on where they live and the availability of one substitute or the other. Once they’re released they receive a two-year course of treatment in regular doses.
“I believe it works,” the doctor says, though he concedes that about 70 percent of patients will relapse at least once.
The problem is that addicts have few options. Government run rehab centers like this one are rare, and even those who manage to get admitted and make it through treatment face hard times when they return home. Their options are limited, with stigma making an already difficult situation even more difficult. It’s easy to fall back into old habits, because the temptations are usually still there.
The man on the floor looks up at us and utters something in Burmese.
The doctor translates: “He says he isn’t always like this. He wants you to write that down.”
Reverend Lahpai Ja Naw, a pastor with the Kachin Baptist Church and co-founder of Light of the World Mission. Photo by Tyler Stiem
Conspiracy theories are popular among the Kachin and other minority groups. Many people suspect that the lack of rehab facilities, or transitional programs, or anything resembling a coherent anti-drug strategy, is deliberate—that the government wants to encourage addiction.
“It is a cold war,” says Reverend Lahpai Ja Naw, a pastor with the Kachin Baptist Church (KBC). I meet him at Light of the World Mission, a private, faith-based rehab center on the outskirts of Myitkyina. “Drug addiction is a way for the government to disenfranchise our youth. How else can you explain what is happening here?”
The Kachin have long been at odds with the Burmese authorities. As evangelical Christians in a Buddhist country that was, until recently, ruled by the most oppressive military regime this side of North Korea, they have been persecuted for years. They are barred from using their own language in schools and their political and religious freedoms are restricted. The Burmese Army routinely abuses Kachin civilians under the pretense of rooting out fighters from the Kachin Independence Army (KIA), a rebel group that's been battling the government for the past 50 years.
From the perspective of the Kachin, drugs are just one more way the authorities are trying to wipe out their culture. It’s widely believed, for example, that the price of heroin is kept artificially low, and that the drug is sold at lower prices to Kachin youth than to other kids. There have been several high-profile cases of police officers turning a blind eye to the trade and even selling drugs themselves.
“I was outside one of the KBC churches just the other day,” the reverend says, shading his eyes from the morning sun. “I was offered heroin out in the open, just like that. The dealers have no fear of being arrested.”
As far as he’s concerned, the state’s methadone-based approach to rehab is only further proof of a conspiracy: “Imagine, sending addicts home with more drugs. They don’t want to cure those boys. They just trade one addiction for another.”
22-year-old Aung Naing (not his real name) shoots up every day. Paying less than £1 (or $1.63) for a hit, he can afford to maintain his habit by doing odd jobs and scrounging pocket money from his parents. Photo by Tyler Stiem
The Burmese government denies all of this, of course, pointing out that the drug problem has to do with Kachin State’s proximity to the Golden Triangle, and that a few bad police do not a conspiracy make. The Kachin have nevertheless taken the matter into their own hands, establishing church-based education programs—you can’t attend a KBC service without hearing anti-drug messages—and building their own rehab clinics.
Reverend Lahpai Ja Naw co-founded Light of the World Mission four years ago. Tucked away on a country road a few miles beyond the bustle and temptation of Myitkyina, the rehabilitation center is a work in progress. Scaffolding covers the buildings and the smell of fresh sawed lumber fills the air. Demand has been so high that Light of the World is expanding to offer more beds and more programs for Kachin in need.
“It’s not enough, but it is something,” the reverend says.
Prayer, cleanliness, and encouragement—in the form of counseling and peer support—are the cornerstones of the program. The strongest drug the patients receive during their stay is paracetamol. In some ways it resembles a 12-step program like AA or Narcotics Anonymous. Whether it’s more effective in the long term than the state-run programs is unclear, but, flush with donations, Light of the World is definitely further reaching. After treatment, patients are transitioned out of the program with job training, long-term peer support, and other forms of assistance. The center itself employs former patients.
Today, 30 of them are gathered in a makeshift outdoor chapel next to the new treatment center. It’s the first day of a training program that turns ex-addicts into drug counselors, and they’re listening to an inspirational sermon.
“As Christians, your life is for others, not for yourself,” a guest pastor intones. “You have overcome the self-centeredness of drug addiction. Out in the world, people don’t trust you, but by the light of your faith and hard work you can regain their trust. We believe in you.”
A patient reading the Bible. Kachin State, where the epidemic is concentrated, has a large population of Christians. Most of them are Kachin, an ethnic minority that has long been at odds with the Burmese government. Photo by Tyler Stiem
The counselors-in-training rise and sing God’s praises. Afterwards I meet Labang Dau Ze, a 24-year-old former poppy farmer who's been clean for a year-and-a-half. He started using opium and heroin to deal with the physical toll of 14-hour days in the fields.
“For a long time all I did was work and do drugs. I fought with my family too much. I thank God for giving me the strength to beat this addiction. He has given me a unique outlook on the problem,” he says.
Lean and wary, Labang Dau Ze reminds me of greyhound. He worked for a Chinese businessman who he claims operated with support from the Burmese government. When I ask him if he ever saw government officials or soldiers visit the opium farm, he says he didn’t. “But everyone knows.”
The reality of the trade is complicated. Reports from Al Jazeera, the New York Times, and others suggest that everyone from government-sponsored militias to the rebel groups to high-profile businesspeople and politicians are involved to some degree. The local market is only a tiny fraction of the business.
Whether this amounts to opportunism or an actual conspiracy is another question. Labang Dau Ze thinks the latter, but I’m not so sure. Either way, his suspicion, shared by so many, speaks to the lack of trust Burma’s leaders will have to overcome if they want to unite the country.
Charts breaking down Burma’s addiction epidemic cover the walls of the treatment hospital in Myitkyina. Photo by Tyler Stiem
Back in Myitkyina, I make a point of asking a few users whether they think certain minorities are being groomed for addiction. Some are forthcoming: no. Others say yes, the government has it out for the Kachin, or the Shan, or the Chin. Their answers tend to depend on which group they belong to. But no one confirms the rumor that there are different prices for different groups. Drugs are cheaper for everyone here because they’re being sold closer to the source.
I meet one wisp of a kid whose plan to kick heroin is based entirely on this simple economic principle. His version of rehab involves moving to Yangon, about 500 miles to the south, where drugs are ten times more expensive. “I won’t be able to afford them, so I won’t do them,” he says.
When I put the conspiracy theory to Kan Char, he scoffs. “What the Kachin are forgetting,” he says, “is that the government oppresses everybody. If there’s a conspiracy, it’s against all the people of Burma. We have democracy now, but that doesn’t change anything. The government wants to stay in control no matter what.”
Tyler Stiem's work in Burma is supported in part by the Canada Council for the Arts.