the heroin highway
By John Sparrow
huge increase in Afghanistan's production of opium since the
fall of the Taliban heightens Red Cross Red Crescent fears
for an AIDS disaster in Central Asia.
A Russian border guard prepares to burn
111 kilos of heroin seized at the Tajik-Afghan border
in September 2001. Bags of heroin were abandoned by
Afghan smugglers who escaped a Russian patrol to flee
©Alexander Nemenov / AFP PHOTO
In Tashkent province, Uzbekistan, a bus travelling from Tajikistan
to Russia aroused the suspicion of customs officers and, unhappy
with the driver's answers, they searched it. Hidden inside
was a consignment of heroin with a reported street value of
US$ 9 million.
The same day in northern Tajikistan, a Land Cruiser, stopped
by police on the road from Dushanbe to Khudzhand, revealed
another 24 kilos. The week was warming up along the heroin
highway through Central Asia but it was a week much like any
The seizures are evidence of growing drug traffic from Afghanistan.
Since the fall of the Taliban, the Afghan production of opium
has increased immensely. It is believed that the 2003 opium
harvest may have reached 4,500 tonnes, up from an estimated
4,000 tonnes in 2002, and heading back to its peak production
of 5,000 tonnes in 1999.
The heroin highway — from Afghanistan, through Tajikistan,
Kyrgyzstan, Uzbekistan and Kazakhstan, to Russia and Europe
— is in full operation once more, and other routes pass
The United Nations estimates that 80 per cent of heroin consumed
in Western Europe derives from Afghanistan and Pakistan, and
some 25 per cent reaches it via this northern route through
the "stans". A great deal, however, stays in the
region feeding its own growing drug habit, a development the
Red Cross Red Crescent says is accelerating the spread of
HIV/AIDS. An epidemic is under way and most infections have
been found among injecting drug users who share needles.
HIV/AIDS in the region
The prevalence of HIV/AIDS in Central Asia is mostly educated
guesswork. Testing and surveillance are poor or absent. Even
blood for transfusion may not be screened for the virus.
Over the past few years, however, what has been measured
has shown a startling increase in infection, official rates
growing threefold and fourfold annually, and reality thought
to be much worse. Already the scale of the Central Asian epidemic
resembles that of sub-Saharan Africa in the early 1980s, and
with the latest statistics there is no doubt that far greater
efforts to combat HIV are essential if a major tragedy is
to be avoided.
Poverty exacerbates the threat. More than a decade after
independence, over 80 per cent of the population lives below
the poverty line in Tajikistan, as does half in Kyrgyzstan,
the World Bank estimates. Most of the poor live in rural areas.
Because of poverty men leave home to sell their labour in
more affluent places, primarily Russia. Away from home, behaviour
changes, sex and drugs ease despair and dislocation, and more
than money returns to their households. Because of poverty,
women and girls are forced into prostitution and increasing
numbers of people are persuaded to work in the drug business.
The Panj River follows a tongue of Afghan territory that
protrudes past the Pamir mountains into the heart of Tajikistan.
For most of their 1,400-kilometre border, it is the Panj that
separates the countries.
It is a porous frontier. Its length, a sparsely spread population
and mountains into which law enforcement cannot penetrate
give drug traffickers freedom to operate. One of the busiest
routes has run from Khorog, the capital of Gorno Badakhshan,
Tajikistan's autonomous Pamiri east, to Osh, a southern Kyrgyz
town that is a major hub for the traffickers. What has happened
in these towns, and the spread of HIV the drugs have brought
them, provide both an insight and a warning.
Khorog has probably peaked as a player on the heroin highway.
But Gorno Badakhshan's location ensures it stays in the game.
A major poppy-growing area adjoins it and the Wakhan Pass,
a narrow Afghan strip between Gorno Badakhshan and Pakistan,
is awash with drugs for Osh. Another factor counts. Gorno
Badakhshan is the poorest corner of the poorest country of
the former Soviet Union.
A crisis in the autonomous region cannot be found in official
statistics. Officially 23 people are living with HIV/ AIDS
in Gorno Badakhshan. Bodurbet Bodurbekov, director of the
region's HIV/AIDS centre, is the first to concede that this
is far from reality. Asked what that is, he says, "Ten,
20 times more." On one thing there is consensus: the
need for greater HIV/AIDS preventive action.
The Tajikistan Red Crescent is busy informing youth, who
make up 43 per cent of the population. Information campaigns
on HIV and drugs target schools, universities and marketplaces.
A theatre group tours schools with dramatized versions of
Figures acquired by the Netherlands Red Cross from senior
officials in national agencies would suggest the number of
drug users in Tajikistan is 60,000 to 80,000, and 80,000 to
100,000 in Kyrgyzstan. Osh province in Kyrgyzstan has a large
concentration of them. Heroin is easy to find in Osh, costing
one US dollar a fix. Growing crime and prostitution pay for
According to official figures there are 2,000 drug users
in Osh province but most sources say that is nonsense. Enormous
statistical differences are the norm in Central Asia. Officially,
Kyrgyzstan has 5,600 drug users. Yet based upon scientific
research in two specific regions, the State Commission on
Drug Control contends it could be 100,000. So what could that
mean for HIV?
Anywhere in Central Asia the answers can only be speculative.
Controls are not in place to measure it. The Kyrgyzstan Red
Crescent says simply that the danger is plain to see.
HIV is already a factor in the rise of tuberculosis, the
most common AIDS-related cause of death. In the Kyrgyz province
of Osh, there are now 126.4 cases per 100,000 people, and
up to 147 in one district. These are alarming figures and,
though they are pockets, compare to the worst in the world.
Could Osh be sitting on a time bomb? "Not only Osh,"
says the Kyrgyz Red Crescent's regional youth coordinator,
Nurgul Moldobaeva. "All the elements required to cause
a disaster are in place in Kyrgyzstan. But if people are informed,
if they understand, the danger can be dealt with."
So far information has not spread well, as the Red Crescent
has found touring villages with awareness programmes.
on youth in Kyrgyzstan
Supported by the Netherlands Red Cross in Bishkek and Chuy,
Issyk-Kul, Naryn and Talas provinces, and by the British Red
Cross in southern Osh, Jalal-Abad and Batken, the Kyrgyz Red
Crescent's main focus is on youth. Working to prevent the
use of drugs as well as to spread knowledge about HIV and
AIDS, it operates in schools and universities, on the streets,
and through Red Crescent youth centres throughout the country.
Plays, rock concerts, quizzes and contests, processions and
disco parties are used to reach young people in towns and
On a winter night in Bishkek, project coordinator Asel Ibraimova
and friends are hopping round the discotheques with a 20-minute
floorshow and a large supply of condoms. Television and newspapers
follow them and on the ill-lit street of the second club,
sex workers slip into the shadows.
On schedule inside the house music dies, the lights go up.
A young man called Azamat steps forward. "Have you ever
tried blowing up a condom?" he asks.
A condom-blowing contest follows. The audience howls and
screams but there is method in Azamat's madness.
"So," he says at last, "how much do you know
There's a series of questions with prizes for people who
shout correct answers. Before they leave, young volunteers
go table-to-table, distributing condoms and literature.
Outside, the sex workers have re-emerged and cars are cruising
round. "Hey," yells a man from his window, seeing
the Red Crescent emblem. "Do you people have a condom
"Sure," laughs a girl and wanders over. "I
also have a leaflet. If I were you, sir, I'd read it."
John Sparrow was on assignment for the Netherlands Red Cross
in Central Asia.
A Movement priority
The "stans" of Central Asia are seldom the centre
of international public attention. Since independence in 1991,
brought by the break-up of the Soviet Union, they have figured
but briefly in the geopolitical limelight, and then mostly
post-11 September, 2001, in relation to events in Afghanistan.
Yet the five countries on the often forgotten crossroads of
East and West face huge humanitarian challenges.
With a combined population of more than 50 million, Kazakhstan,
Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan continue
to struggle in a crisis-ridden transition to a new reality.
Poverty still plagues huge sections of the population, along
with poor access to health care and education.
Increased rates of tuberculosis and HIV/AIDS, infant and
maternal mortality, and recurrence of infectious diseases
are taking a heavy toll, while public health awareness is
low. Clean water is in short supply, sanitation is poor, worsening
Today, there is a real danger that the region will slip into
the shadows again as political imperatives focus elsewhere.
The Netherlands Red Cross, along with other Movement partners,
is determined to keep it on the map.
Central Asia's grass-roots networks of National Red Crescent
Societies respond fast when emergencies happen but they also
work hard to prevent the human suffering that they so often
have to mitigate. They are helping communities to reduce their
vulnerability to the dangers around them, spreading health
awareness, developing disaster preparedness plans, working
to stop discrimination, advocating on behalf of marginalized
people. They deserve all our support.
Jan Post, Director General, Netherlands Red Cross
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