InterPress News Service (IPS); Sunday, 12 May 1996.
Satya Sekaran

Last winter, inmates at a drugs rehabilitation centre in northern Malaysia went on a rampage, setting fire to five buildings and several vehicles. More than 130 inmates fled the centre after tearing down a three-metre-high electrical fence in a riot sparked by the beating of an inmate found in the possession of tobacco.

Most of the inmates, easily spotted by their shaved heads, were later caught.

The incident was not an isolated one and has forced the authorities in Malaysia to sit up and take notice of the plight of drug users in the country.

Confinement of intravenous drug users in rehabilitation centres that resemble prison camps has been Malaysian policy since the 1980s. Most inmates are apprehended during frequent police raids on red light districts in Malaysia's major cities. Anyone caught in possession of illegal drugs or whose urine tests positive for illegal drugs is sentenced to a rehabilitation centre for at least sixteen months.

Signs are this approach is not working.

The number of HIV-positive people in Malaysia has increased dramatically in recent years. Since the first case of AIDS was detected in December, 1986, the ranks of HIV positive Malaysians has swelled to approximately 15,000, according to the ministry of Health.

Intravenous drug users may account for as many as 80 percent of cases detected so far.

However, according to Susan Chong of the Malaysia AIDS Council, the true figure may be much higher because HIV testing is only regularly carried out among drug users and sex workers rounded up in police raids. The Aids Council estimates that there may be as many as 75,000 people living with HIV in Malaysia -- not all of them drug users.

The problems in the drug rehabilitation centres are partly due to a lack of trained staff. Equally, living conditions in the centres are notoriously poor.

As many as 20 inmates may be crammed into a single tiny cell. They are regularly subjected to harsh physical training regimens. Some inmates have reported being fed rotten fish and uncooked rice. With little or no counselling offered, the relapse rate among former inmates is believed to be as high as 70 percent.

Though the system has been criticised by several groups, including human rights organisations and opposition politicians, government policy appears to be confused.

Shortly before the February riots, the Deputy Home Affairs Minister Dato Megat Junid Megat Ayob, who oversees drug policy, admitted that the government's anti-drug drive was not working. But he defended the present system, arguing that only changes in implementation were needed.

There are, however, signs that the government may be beginning to seriously appreciate the limitations of the current system.

A meeting held in April at the ministry of health brought together representatives of government ministries, local non- governmental organisations and the police to discuss HIV infection among drug users.

The group drew up a proposal calling for the use of methadone, a heroine-substitute that helps wean addicts off heroin. It also urged greater emphasis on counselling in the rehabilitation centres and more research into needle exchange programmes.

The proposals are to be presented to government ministers in July. Said Karen Radzi of Ikhlas, a drop-in centre for drug users and sex workers in the red light district of Chow Kit, Kuala Lumpur: "I am optimistic. This is a long, hard process, but the fact that the ministers are even willing to discuss these issues is a very good sign."

Organisations such as Ikhlas, which offers basic medical care and counselling, have stepped in where the government has failed. According to Julian Jeyaseelam of Pink Triangle, of which Ikhlas is a subsidiary, drug users and sex workers do not have access to the information necessary to protect themselves from HIV.

He fears that in a few years, 80 percent of Malaysia's more than 200,000 drug users could be infected with HIV.

But there is a ray of hope: a handful of doctors, at risk from police action, are offering counselling and naltrexone, similar to methadone, to drug users at hospitals and clinics.

One such doctor, who requested anonymity, said that treating drug users wi thin the community allowed the users to keep their jobs and families. When they enter rehabilitation centres, he said, "all they are left with is drugs."

These doctors are liable to prosecution by the police for not reporting known drug users. But their work is allowed by hospital authorities. They have even begun to liaise with the health ministry about AIDS and other health issues related to drug use.

Malaysia is not alone in facing the task of fashioning a coherent policy towards drug users. According to Clement Chan Kam of the World Health Organisation, the situation in Malaysia is similar to that in other south east Asian countries, where governments have been often been equally harsh and heavy-handed in their decades-old crack down on illegal drug use.

Clement Chan Kam says these systems may have to change if governments want drug users to protect themselves against HIV infection. "They are struggling to do something about it within the constraints of the existing law," he said. (END/PANOS/SS/DDS/96)

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