Survive one more day

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Rajiv Shaw doesn’t cure addicts. He keeps them alive. And he’s living proof.

By Frannie Sprouls, NewsNetNebraska

Rajiv Shaw stands opposite the expatriate from America on the soccer field: fast, strong and aggressive against a hulk of a man rumored to have shared a cell with Charles Manson.

Shaw attempts to slide tackle the expatriate, who doesn’t take it well.

“Forget the football. Let’s take this outside.”

Other players separate Shaw from the Manson cellmate.

A game of football, intended to be a distraction, turns into an almost brawl between recovering addicts.

Thirty years later, Shaw sits in his office in Haus Khas, a middle-class neighborhood in New Delhi. He twirls a pen on his desktop, remembering his days of addiction and recovery. He has been heroin-free since the mid-1980s. Now, he helps addicts through the controversial program that helped him: Sharan.

The non-governmental organization Sharan works to help addicts stay alive rather than get clean. Founded in the early 1980s, Sharan provides users with a place to go for HIV testing, counseling and clean needles.

“We have seen that the only way to fight poverty, hunger, is to use drugs,” Shaw said. “To cope with the normal life … It’s very difficult when you’re not using drugs.”

One of the three drug havens that Sharan serves is across the city ­– the eighth biggest in the world – at the Yamuna Bazaar, just across a freeway from Red Fort, built in the 17th century by the Mughal Empire. Sharan workers exchange new needles and syringes for the users’ old ones. The motto behind the method is to keep the men alive for one more day.

“If you want to inject, inject. But can I give you a fresh needle every morning?” Shaw said.

The Sharan workers befriend users spending their days in a dirt park along the Yamuna River and gradually get the users to come into the adjacent center. There, they can seek one-on-one or group counseling. If they have an abscess caused by over-injecting in one area, a dog bite or some other injury, they can seek medical attention with Sharan workers. The makeshift triage outfit also tests for tuberculosis, HIV and hepatitis – all common diseases among India’s heroin users.

“It’s emotionally draining,” Shaw said. “Every day is a challenge.”

IN THE BAZAAR

Trash littered the ground as groups of addicts gathered under sparse shade in the Bazaar. They sat in packs of no more than three or four. Some rested against trees and others sat on dirty blankets. Dirt paths wove between patchy grass mounds.

Majob and Salin sat near Sharan’s blue shelter. The pair shared a blanket and a syringe. Manoj pressed his thumb over the injection site on his arm, a slight smile on his face. Salim held a bottle of the pharmaceutical Kavil in his hand, emptying the bottle’s contents into the syringe with the same needle Manoj had used, which would make Shaw cringe.

The drug, produced by both legitimate pharmaceutical companies and underground manufacturers on the outskirts of Delhi, increases the intensity and longevity of a heroin high.

Naresh Samma, an NGO worker for Sharan, shook his head and said the pair shouldn’t be sharing syringes because of the chance of transferring HIV-positive blood. He estimates 30 percent of the park-dwellers have HIV.

“They are very much aware, but they aren’t scared of dying,” Samma said, watching the men shoot up.

Crouched next to Manoj, Salim set the bottle on the ground and took the used needle off the syringe. The needle lay on the white blanket as Salim inserted a new needle. Manoj reached over to put the used needle in a plastic casing.

The needle ready for injection, Salim turned to Manoj to administer the heroin.

Deepak helps another drug user inject at the Yamuna Bazaar in New Delhi on May 15, 2012.

Deepak helps another drug user inject at the Yamuna Bazaar in New Delhi in May.

DEPENDENCY TREATMENT

The center once ran a drug treatment program because the organization believes in the continuing treatment – contacting the addicts and bringing them from the streets all the way to employment. After years of treatment and frustration, workers realized homeless users returned to the streets after treatment.

“You provide a person services after treatment and then 15 days later, you see him using drugs again,” Shaw said. “And you really can’t blame him for it, nor can you shut the doors on his face, because where else does he go?”

Heroin has a high relapse rate because as an opiate, the reception sites in the brain have a good memory that will never fade.

“You can physically detox, but that really doesn’t mean the memory of dependence is gone,” said Luke Sampson, founder of Sharan.

Sampson and Shaw know that cycle of dependency.

1970s: THE EARLY DAYS

Shaw began taking heroin when he was 20, but his drug addiction began when he was in high school. He participated in three sports: football, boxing and track. Shaw remembers being one of Delhi’s top three sprinters. He wanted to be No. 1.

A friend came up to him one day, telling Shaw he had found out that a history teacher used Dexedrine to stay awake grading tests. His friend suggested Shaw take Dexedrine, or speed, before his next 100-meter race. Shaw said, “Why not?”

He began popping speed and his times dropped. His football skills improved.

“So that’s how my drug life started,” he said. “Then of course, I moved onto cannabis.”

Soon, Shaw depended on his friend for a cigarette each day. He was 20 and lived in Chandigarh, in the Punjab. For 15 days straight, Shaw smoked this cigarette. He loved this cigarette.

It was summer and his friend hadn’t come by in a day. Shaw felt cold. In his apartment, he wrapped a quilt around his shivering body. His stomach cramped and his eyes watered. He felt weak and couldn’t remember a time when he felt this sick.

His friend walked into the room, another cigarette in hand.

“Rajiv, what’s happened to you?”

“Sabib, this is some funny kind of fever I’ve got. I need to go and see a doctor.”

“Yeah, take this cigarette.”

The moment Shaw took a drag, he felt like Superman.

“What have you been giving me?”

“This is heroin.”

Shaw was hooked.

SMOKING

Shahnazz crouched next to the wall and reached down to his pant cuffs. He unrolled the fabric, pulling out a matchbox similar to the one next to his feet. Instead of matches, the box held an aluminum pipe and folded aluminum foil. He pulled both out of the box.

His dirty, worn hands straightened the bent pipe. He rolled the aluminum foil between his hands until it was a perfect cylinder, then he put the pipe between his teeth. A cigarette rested on the rock as he unfolded the aluminum. Shirtless, Shahnazz pulled a thin burlap-colored cloth over his head to create a tent.

On the flat aluminum sheet was a solid, dark brown mass of liquid in the top left corner. . Shahnazz smoothed the aluminum to create the best surface to chase the heroin across the rectangle, angling the edges up to avoid losing any heroin. He reached down and drew a match from the box between his toes and sandals, striking it against the side.

The flame flared as he moved it under the liquid. He held the aluminum at an angle, allowing the melted heroin to run toward the bottom. As the smoke from the brown sugar rose into the air, Shahnazz’s pipe chased the smoke. Once the sugar was at the end, he shook the match to put out the flame.

He threw the match on the ground and reached for the cigarette. Shahnazz took a drag – this would keep the smoke in his mouth. He repeated this process four or five times, a drag in between each chase. He rarely exhaled.

Before smoking, he took Nitrazepam tablets, or sleeping pills, to prolong his high. Its label read Euphorra India Pharmaceuticals. These pills were bought through the black market by peddlers, who sell the drugs to users.

Shahnazz had finished his third high of the day and it was not yet noon.

Homeless drug addicts who are a part of the heroin and pharmaceutical injecting community in the Yamuna Bazaar begin to carry Karan Yadav, a homeless drug user, who died minutes before after overdosing on heroin. A small argument broke out between the family on the roof and a group of other homeless drug addicts on the stairs (not pictured). This is the way many addicts meet their end.

Homeless drug addicts who are a part of the heroin and pharmaceutical injecting community in the Yamuna Bazaar begin to carry Karan Yadav, a homeless drug user, who died minutes before after overdosing on heroin. A small argument broke out between the family on the roof and a group of other homeless drug addicts on the stairs (not pictured). This is the way many addicts meet their end.

MOVING OUT – 1980s

While living back home during his addiction years, Shaw argued with his father one day. What it was about, he cannot remember. Perhaps it was over money.

His father told Shaw he had ruined enough.

Shaw stormed up to his room and packed his bag full of clothes. He started toward the door, his bag in his hand. His father stopped him.

“What are you carrying?”

“I’m carrying my clothes.”

“They’re not your clothes. I bought them. You leave this bag here. Then you can get out of here.”

His father’s words struck him hard. He felt small and the words remained in his mind for the next few days.

Shaw was ashamed. His friends, relatives, neighbors and communities talked about him. His parents were embarrassed of him.

He moved from his parents’ house to the streets.

ADVANTAGE

Shaw’s former addiction to drugs, and his recovery, are a big advantage in his new job. He knows how a user’s mind works because he’s been there.

The population of drug users is written off in India, Shaw said. They are highly stigmatized, very strongly discriminated. No one tries to understand the users – they are blamed for the situation they are in. Alcohol is a more acceptable poison for Indians.

“It’s not the disease … it’s the stigma that kills,” Samma said.

The tuberculosis hospital doesn’t want a drug user and the general hospital doesn’t want a tuberculosis patient.

“So in your mind you think, should I really help this man with tuberculosis, or let him die, because he’s going to die anyway?” Shaw said. “It’s part of the frustration you live with.”

And without people like Shaw, drug users find themselves in a situation where they believe nothing is going to change for them. They fall into major depressions, regrets clouding their thoughts. They regret losing their families by turning to drugs. And to get rid of their thoughts, they use heroin. It becomes a struggle to stay alive each day – a hopeless situation.

Sharan doesn’t have the funds to run a rehabilitation center, Samma said. But at the Bazaar, there is a shelter for users to spend the night and a harm-reduction program is offered. By keeping them alive, the workers are able to affect, if not change, the users’ lives, Samma said.

Shaw knows this and he knows how to help them.

“I don’t need to do a study of this population to understand what they need because I knew what I needed 30 years back,” Shaw said. “Nothing, really, has changed.”

USER DEMOGRAPHICS

India’s drug users have shifted from the middle- and upper-class users to the chap on the street, Shaw said.

The drugs have also changed in the past 20 years. Drug users are now injecting pharmaceutical drugs because the cost of heroin has gone up and the quality has gone down. Availability has decreased.

Shaw remembers Delhi’s streets in the early 1980s.

“People used to queue up for heroin,” he said. “And people didn’t know what was happening. You’d think a bunch of guys were queuing up to buy sugar or rice or something like that.”

Once the price of heroin went up and quality went down, users adapted through pharmaceutical injecting. Shaw refers to today’s street users as homeless scientists.

He never would have thought of injecting pharmaceuticals, despite his educated background.

“You are talking about people with absolutely, almost zero levels of literacy,” he said. “These are the guys who created these substitutes for themselves.

“They can’t have substandard stuff. If it doesn’t give you a high, then what the hell am I doing it for, you know?”

WOUNDED

Rajendera stumbled past the grills and the cooks flipping the naan watched as Rajendera’s friend leads him toward the abscess treatment room. Blood flowed down his arm, dripping onto the ground from his pinky. He had gotten into a fight. He took another addict’s belongings, and paid for it. The fight resulted in a beer bottle smashing Rajendera’s forearm just above the wrist.

Samma said addicts will share anything but drugs. They gather together under the trees to hide from the sun. They share needles and syringes and help each other inject. They share cheap bidi cigarettes. But they know if they have money, it has to be hidden.

Once addicts are high, other users steal their money. So money is given to counselors or workers such as Samma, who act as human savings deposit boxes.

Rajendera sat down on a stool, waiting for the amateur orderly to dress his wound. A cotton swab sat on top of the wound as the worker wiped the blood from his arm and hand. Blood continued to flow once the cotton was removed.

A cloth was placed on the open wound and the worker began wrapping Rajendera’s arm. By the time the wound was dressed, tears fell slowly down his face.

Outside the room, another addict friend of Rajendera’s used a cotton swab to wipe up the blood drops, which had a 30 percent chance of being HIV positive with maybe a trace of tuberculosis or Hepatitis-C. Samma said he knows of 20 confirmed users with HIV and two with tuberculosis who live at the bazaar.

Rajendera’s friend led him away from the triage center and back to their spot in the shade.

Rajendara, a homeless drug addict, cries after having a wound cleaned and mended at the Yamuna Bazaar in New Delhi on May 17, 2012. Without money or his own drugs, Rajendara stole from another user, who then broke a bottle over his arm.

Rajendara, a homeless drug addict, cries after having a wound cleaned and mended at the Yamuna Bazaar in New Delhi May 17, 2012. Without money or his own drugs, Rajendara stole from another user, who broke a bottle over his arm.

THE LOVE MARRIAGE

During his addiction, Shaw met Kanchan. It was 1981. He met her in his office and asked her out for coffee. She didn’t like him asking and he continued to ask her for the next three days.

To get rid of him, she told him to go to her house and ask her father for permission.

“To my surprise, I saw him at the door one evening, talking to my dad,” she said. “In the next few minutes, he was inside the house, sitting in the drawing room, chatting with my family.”

That night, he left after dinner. Her family liked him. She liked him.

But no one knew of Shaw’s drug addiction.

Shaw married Kanchan in 1985. That’s when she found out he used heroin.

“I was shocked, depressed and felt cheated,” she said.

He began going to rehab in Oct. 1986 and during the next year, he tried to get clean six or seven times, she said. But he couldn’t.

“That period was the most difficult time because I was slowly losing trust in him and started to feel that we would not be able to live together, because of his dishonest lifestyle,” she said.

To Sampson, the founder of Sharan, Shaw and Kanchan’s story is unique. They had a love marriage in a culture where arranged marriages are the most common.

“The reason he came to rehab was his marriage was breaking up,” Sampson said. “So he was one of the few people who really came in on an apology basis.”

Shaw couldn’t hide his addiction. Sampson said Shaw was going through five grams a day.

OCT. 22, 1985

Everything changed for Shaw in 1985.

Jimmy, the younger brother of Shaw’s friend Carl, was working in the gulf area and traveled to Delhi for a holiday. Shaw and Carl used drugs together and had known each other since childhood. They lived together for six months in a government hospital after a serious accident.

Jimmy heard Shaw was using.

On a Sunday at 6:37 a.m., Jimmy walked into Shaw’s house and told Shaw’s parents everything. He recommended a place for Shaw to go – Carl had gone through a program called Sharan. Perhaps it would work for Shaw.

“And from there, my life changed,” Shaw said. “I think, the day Jimmy walked into my house that Sunday morning and told my dad about my heroin use, he did the right thing.

“Today I can see that it was done purely out of concern and welfare of my family and me. … Had he not done this to me, – maybe I would have never made it.”

Shaw will always remember the day he moved in to Sharan: Oct. 22, 1985.

He had consistently failed in treatment. This time, he wouldn’t fail.

BEATING THE ADDICTION

Shaw used boxing to beat his addiction, at least at the beginning.

“It think probably the sixth or seventh time I saw him, he was all beaten up,” Sampson said. “He got it into his head that he wanted to get back into boxing.”

He was determined to take part in the Delhi Open Boxing Championship 30 days after he quit heroin. His opponent was the Delhi University boxing captain.

“I don’t think Rajiv managed to hit him even once. Instead, he got hammered nicely and returned to the rehab center all bashed up,” his wife said. “But we all admired and respected the guts and determination he had showed.”

Sampson laughed when he remembered Shaw’s fight against the boxing captain.

“He was so bad (when) he came back,” he said. “He gave up boxing and got into football.”

Most of Shaw’s rehab time focused on football. He played in matches, and he organized and led sideline meetings.

When he started treatment at Sharan, Shaw had hardly any weight and he used to be a 100-meter sprint champion. This made him really fast, really good and strong, Sampson said.

“He’d kick really hard, rattle the goalposts, kind of thing,” Sampson said, “but he had aggressive temperaments … I’d have to put him away. I’d say, ‘Cool down and smoke a cigarette. Chill out.’ ”

After three months of detox, Shaw was a different person – full of life and energy, honest and kind to the rehab staff, his wife said. Through football, Shaw was able to regain a healthy lifestyle, which made her feel secure in their relationship.

“I think I fell in love with Rajiv again,” she said. “It was almost like he had found something very valuable that he had lost some time back.”

Rajiv Shaw reflects on his story and how it continually teaches him how to connect to the heroin addicts of New Delhi, and keep them alive.

Rajiv Shaw reflects on his story and how it continually teaches him how to connect to the heroin addicts of New Delhi, and keep them alive.

 

RELAXED RECOVERY

Shaw has been clean for almost 30 years. He is a counselor at the NGO Sharan, which helped him recover. Some days, he goes to the Yamuna Bazaar to check in with the operation. But not often.

He takes what he’s learned in his past and from his time working with Sharan leaders before him and applies it to his work.

“This is not a job for me. This is a part of my life,” he said. “That comes from within, and it’s also there because of the past I’ve gone through, the broken phase of my life. I try to share everything that I have.”

The NGO Sharan is not just a project for him. When he’s driving home or driving somewhere and sees a drug user, his mind immediately thinks of ways to talk to the user. He knows them even if he doesn’t know them.

“You can’t forget them,” Shaw said. “They will never go away from your lives. You’ll always do what you can.”

At home, he drinks a Kingfisher beer. Sometimes whiskey.

If he’s with a close friend, he’ll smoke some cannabis every now and then, he admits.

“I like being naughty,” he said. “I wouldn’t survive otherwise. No chance.”

He doesn’t drink in isolation to unwind. When his two grown daughters are at home, Shaw drinks as he sits and watches TV with them. He joins their discussions about hopes and dreams.

If no one is watching, he turns the channel to sports – more specifically, football. He loves to watch Barcelona and his favorite player changes with how they play. Messi is all over the place, in his opinion.

“These people are like magicians,” Shaw said. “They have just changed the standard of football. It’s amazing.”

One thing Shaw has been careful about: He does not bring his work home. He brings his briefcase home, but he doesn’t open it. He doesn’t need to open it. He knows users without the papers or the computer. He know them with a drink in his hand, or a cigarette between his lips.

(Frannie Sprouls is a junior at the College of Journalism and Mass Communications who traveled with 10 classmates and three professors to India for a special report on poverty.)

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