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Another Sky: An Uruguayan journey 26
Montevideo, Uruguay
By Francesco Pistilli
05 Feb 2014

Women escaping domestic violence, drug addiction and crime in a shelter and rehab center in Montevideo make dust rags. Domestic violence is widespread across Latin America including in this small, mostly rural country with an average of 68 reports of gender based violence made daily in Montevideo.

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Another Sky: An Uruguayan journey 27
Montevideo, Uruguay
By Francesco Pistilli
05 Feb 2014

Stella, 32, comes from the Uruguayan countryside (Tacuarembo area). She and her autistic son were beaten and abused by her husband for 4 years. Since her husband was jailed for attempting to kill her, Stella lives with her son in a shelter for women escaping violence and addiction.

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Herbal High - UK bans Khat
Eastleigh, Nairobi
By Celeste Hibbert
04 Jul 2013

In the UK, 90,000 people in the UK from east African and Yemeni communities chew khat. But on July 3, the UK banned the stimulant. Most of the khat comes from Kenya for £50 per box and now with the new ban, many local communities are worried about their livelihood.

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No Tobacco Day In Pakistan
Karachi, Pakistan
By U.S. Editor
31 May 2013

Each year May 31 is observed as World No Tobacco Day (WNTD), with the aim to spread awareness about the pitfalls of tobacco consumption. Tobacco use is one of the biggest public health threats the world has faced to date. May 31, 2013, Photo by Yasir Kazmi, Karachi, Pakistan.

Almost 2,500 people die in Pakistan daily due to consumption of tobacco and smoking. Many people suffer from asthma and bronchitis, in addition to the more severe cases of cancer and heart attacks.

Tobacco use is rising in Pakistan, with about 30.7 percent of men estimated to be smokers, Pakistan stands at the brink of a devastating health and economic disaster. The steep rise in the use of tobacco amongst youth, especially young girls and women, is depriving the country of a healthy workforce, while increasing the burden of disease on an already overburdened health sector.

The fact that approximately 1,200 children start smoking daily represents a huge health and economic disaster.

Individuals who smoke cigarettes are 12 times more likely to die from lung cancer, two to four times more likely to develop coronary heart disease, twice as likely to have a stroke, and 10 times more likely to die from chronic obstructive lung disease.

Although many people are aware of the health issues associated with smoking, they are unable to quit due to nicotine addiction. However, willpower and personal determination to break free from the addiction play the most crucial role.

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No Tobacco Day in Pakistan (6 of 6)
Karachi, Pakistan
By Syed Yasir Iqbal Kazmi
31 May 2013

Each year May 31 is observed as World No Tobacco Day (WNTD) with the aim to spread awareness about the ills of tobacco consumption. Tobacco use is one of the biggest public health threats the world has ever faced. May 31, 2013, Photo by Yasir Kazmi, Karachi, Pakistan.

Almost 2,500 people die in Pakistan daily due to consumption of tobacco and smoking. Many people suffer from asthma and bronchitis, in addition to than cancer and heart attacks.

Tobacco use is rising in Pakistan, with about 30.7 per cent of men estimated to be smokers, Pakistan stands at the brink of a devastating health and economic disaster. The steep rise in the use of tobacco amongst the youth, especially young girls and women is depriving the country of a healthy workforce while increasing the burden of disease on an already overburdened health sector.
The fact that approximately 1,200 children start smoking daily represents a huge health and economic impact.
Individuals who smoke cigarettes are 12 times more likely to die from lung cancer, two to four times more likely to develop coronary heart disease, twice as likely to have a stroke, and 10 times more likely to die from chronic obstructive lung disease.
Although many people are aware of health issues involved in smoking, they are unable to quit due to nicotine addiction. However, willpower and personal determination to break free from the addiction play the most crucial role.

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No Tobacco Day in Pakistan (5 of 6)
Karachi, Pakistan
By Syed Yasir Iqbal Kazmi
31 May 2013

Each year May 31 is observed as World No Tobacco Day (WNTD) with the aim to spread awareness about the ills of tobacco consumption. Tobacco use is one of the biggest public health threats the world has ever faced. May 31, 2013, Photo by Yasir Kazmi, Karachi, Pakistan.

Almost 2,500 people die in Pakistan daily due to consumption of tobacco and smoking. Many people suffer from asthma and bronchitis, in addition to than cancer and heart attacks.

Tobacco use is rising in Pakistan, with about 30.7 per cent of men estimated to be smokers, Pakistan stands at the brink of a devastating health and economic disaster. The steep rise in the use of tobacco amongst the youth, especially young girls and women is depriving the country of a healthy workforce while increasing the burden of disease on an already overburdened health sector.
The fact that approximately 1,200 children start smoking daily represents a huge health and economic impact.
Individuals who smoke cigarettes are 12 times more likely to die from lung cancer, two to four times more likely to develop coronary heart disease, twice as likely to have a stroke, and 10 times more likely to die from chronic obstructive lung disease.
Although many people are aware of health issues involved in smoking, they are unable to quit due to nicotine addiction. However, willpower and personal determination to break free from the addiction play the most crucial role.

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No Tobacco Day in Pakistan (4 of 6)
Karachi, Pakistan
By Syed Yasir Iqbal Kazmi
31 May 2013

Each year May 31 is observed as World No Tobacco Day (WNTD) with the aim to spread awareness about the ills of tobacco consumption. Tobacco use is one of the biggest public health threats the world has ever faced. May 31, 2013, Photo by Yasir Kazmi, Karachi, Pakistan.

Almost 2,500 people die in Pakistan daily due to consumption of tobacco and smoking. Many people suffer from asthma and bronchitis, in addition to than cancer and heart attacks.

Tobacco use is rising in Pakistan, with about 30.7 per cent of men estimated to be smokers, Pakistan stands at the brink of a devastating health and economic disaster. The steep rise in the use of tobacco amongst the youth, especially young girls and women is depriving the country of a healthy workforce while increasing the burden of disease on an already overburdened health sector.
The fact that approximately 1,200 children start smoking daily represents a huge health and economic impact.
Individuals who smoke cigarettes are 12 times more likely to die from lung cancer, two to four times more likely to develop coronary heart disease, twice as likely to have a stroke, and 10 times more likely to die from chronic obstructive lung disease.
Although many people are aware of health issues involved in smoking, they are unable to quit due to nicotine addiction. However, willpower and personal determination to break free from the addiction play the most crucial role.

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No Tobacco Day in Pakistan (3 of 6)
Karachi, Pakistan
By Syed Yasir Iqbal Kazmi
31 May 2013

Each year May 31 is observed as World No Tobacco Day (WNTD) with the aim to spread awareness about the ills of tobacco consumption. Tobacco use is one of the biggest public health threats the world has ever faced. May 31, 2013, Photo by Yasir Kazmi, Karachi, Pakistan.

Almost 2,500 people die in Pakistan daily due to consumption of tobacco and smoking. Many people suffer from asthma and bronchitis, in addition to than cancer and heart attacks.

Tobacco use is rising in Pakistan, with about 30.7 per cent of men estimated to be smokers, Pakistan stands at the brink of a devastating health and economic disaster. The steep rise in the use of tobacco amongst the youth, especially young girls and women is depriving the country of a healthy workforce while increasing the burden of disease on an already overburdened health sector.
The fact that approximately 1,200 children start smoking daily represents a huge health and economic impact.
Individuals who smoke cigarettes are 12 times more likely to die from lung cancer, two to four times more likely to develop coronary heart disease, twice as likely to have a stroke, and 10 times more likely to die from chronic obstructive lung disease.
Although many people are aware of health issues involved in smoking, they are unable to quit due to nicotine addiction. However, willpower and personal determination to break free from the addiction play the most crucial role.

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No Tobacco Day in Pakistan (2 of 6)
Karachi, Pakistan
By Syed Yasir Iqbal Kazmi
31 May 2013

Each year May 31 is observed as World No Tobacco Day (WNTD) with the aim to spread awareness about the ills of tobacco consumption. Tobacco use is one of the biggest public health threats the world has ever faced. May 31, 2013, Photo by Yasir Kazmi, Karachi, Pakistan.

Almost 2,500 people die in Pakistan daily due to consumption of tobacco and smoking. Many people suffer from asthma and bronchitis, in addition to than cancer and heart attacks.

Tobacco use is rising in Pakistan, with about 30.7 per cent of men estimated to be smokers, Pakistan stands at the brink of a devastating health and economic disaster. The steep rise in the use of tobacco amongst the youth, especially young girls and women is depriving the country of a healthy workforce while increasing the burden of disease on an already overburdened health sector.
The fact that approximately 1,200 children start smoking daily represents a huge health and economic impact.
Individuals who smoke cigarettes are 12 times more likely to die from lung cancer, two to four times more likely to develop coronary heart disease, twice as likely to have a stroke, and 10 times more likely to die from chronic obstructive lung disease.
Although many people are aware of health issues involved in smoking, they are unable to quit due to nicotine addiction. However, willpower and personal determination to break free from the addiction play the most crucial role.

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No Tobacco Day in Pakistan (1 of 6)
Karachi, Pakistan
By Syed Yasir Iqbal Kazmi
31 May 2013

Each year May 31 is observed as World No Tobacco Day (WNTD) with the aim to spread awareness about the ills of tobacco consumption. Tobacco use is one of the biggest public health threats the world has ever faced. May 31, 2013, Photo by Yasir Kazmi, Karachi, Pakistan.

Almost 2,500 people die in Pakistan daily due to consumption of tobacco and smoking. Many people suffer from asthma and bronchitis, in addition to than cancer and heart attacks.

Tobacco use is rising in Pakistan, with about 30.7 per cent of men estimated to be smokers, Pakistan stands at the brink of a devastating health and economic disaster. The steep rise in the use of tobacco amongst the youth, especially young girls and women is depriving the country of a healthy workforce while increasing the burden of disease on an already overburdened health sector.
The fact that approximately 1,200 children start smoking daily represents a huge health and economic impact.
Individuals who smoke cigarettes are 12 times more likely to die from lung cancer, two to four times more likely to develop coronary heart disease, twice as likely to have a stroke, and 10 times more likely to die from chronic obstructive lung disease.
Although many people are aware of health issues involved in smoking, they are unable to quit due to nicotine addiction. However, willpower and personal determination to break free from the addiction play the most crucial role.

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Addiction in Paris
Paris, France
By Transterra Editor
18 Apr 2013

The number of drug addicts in France is difficult to assess. The first problem to look at is defining the addiction, and which products are most common (cocaïne, weed, crack, ecstasy...). The number is believed to be between 150 000 and 300 000. In Paris, a city project named « shoot rooms » is set to open in October where associations helping drug addicts will be able to help and assist roughly 200 drug addicts. But before this opening, in December 2012, I went to meet drug addicts to better understand their day to day life. Lot of them refused to answer questions and being photographed. Only one has accepted to be followed during the day to better understand his life. I met him at CAARUD office, an association helping drug addicts in the La Chapelle area, north of Paris. The area between the La Chapelle subway and the La Chapelle gate, is one of the most important places for drugs use in Paris. Under highways, drug users smoke cocaïne and crack every day, searching for money to pay for their drug use. Philippe is one of them. He is 58 years old and drug addict for more than 20 years.
He would like to quit, but is unable to do it. For Philippe, everyday is the same thing: smoking cocaïne and searching for money to pay for it. Over the months we spent together I better understood what being a drug addict meant. At the beginning of each month, he receives money from his Togolese family. With that money, he pays for a room in a hotel where he stays during one week. His every day is the same. He wakes up, doesn’t eat breakfast. Goes to La Boutique; the center for an association helping drug addicts. He meets other drug addicts at the center and speaks with a social assistant. The association gives Philippe some new crack pipes so that disease contamination can be avoided. He then goes to meet the dealer, buying cocaïne and going back to the hotel to smoke. He sleeps a little bit, eats a burger, and later going back to smoke more.
But after one week Philippe doesn't have enough money to pay the hotel so he has to leave the room. At this time he decides to keep small amount of money he has to buy cocaïne, and everyday he goes to Sleep-in, a drug addicts’ helping association which offers addicts a bed to sleep in. Even if he doesn't like this place because of the violence between drug addicts, he has no choice because he has to sleep there. In order to smoke his cocaine he has to go under highways, or in some squats. After few days he doesn't even have enough money to buy cocaïne. So he sells his mobile phone to the dealer and tries to buy more cocaine.
Philippe is tired of this kind of life. He would like to go in rehabilitation. He has already done so once but he failed at the end and came back in Paris where his demon took him back.
This reportage wasn't easy to do because following a drug addict is quite complicated. Rendez-vous were complicated and I had to search for him during few hours. But Philippe, like lot of drug addicts in Paris, stays in the La Chapelle Area, so I always found him. But one day I didn't. So I went back the day after and many days after that. Finally, he called to tell me that he has been arrested and is now in jail. He doesn't like it but he knows that it's also a kind of rehab, and he hopes not to fail again when he is released.

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Drug Addict 4
Paris, France
By Simon Letellier
17 Apr 2013

Few weeks later, I find back Philippe in a laundromat.

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Drug Addict 14
Paris
By Simon Letellier
16 Apr 2013

Philippe showing a few crack pipes and a small strip used for preparing the cocaïne.

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Drug Addict 1
Paris, France
By Simon Letellier
16 Apr 2013

Philippe is happy to show his new teeth which was paid for by his social insurance.

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

In the octagonal communal garden at the centre of Benghazi’s Al Nafsia drug addiction clinic four men sit quietly talking in the shade. The atmosphere of contemplation makes the clinic seem like an oasis of calm in a city where assassination attempts and armed raids are a monthly occurrence and the soundscape is regularly punctuated by gunshots and squealing tires.

Here Libyans with addiction problems are helped to kick their habits with the help of psychologists and tailor made drug courses. The only problem: this clinic has room for just 40 inpatients, and it is the only treatment centre of its kind in a country where drug addiction is rapidly increasing.

Doctors across Libya say they are being overwhelmed by patients with drug problems and it is proving impossible to provide appropriate treatment for everyone.

‘Every month more people come to us needing help,’ says Dr Abdullah Fannar, deputy director at Tripoli’s Gargaresh psychiatric hospital. ‘It’s part of the fallout from the revolution. The government security forces are weak and hundreds of thousands of Libyans were displaced, wounded or bereaved during the uprising. Now street drugs are proving to be an attractive solution to many of those who are struggling to deal with their new reality.’

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

Islam
Addicted to Tramadol
From Benghazi
Has spent one month in the clinic

‘I was skateboarding a lot and started taking Tramadol because it means you can skate for longer and don’t get tired.’

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

In the octagonal communal garden at the centre of Benghazi’s Al Nafsia drug addiction clinic four men sit quietly talking in the shade. The atmosphere of contemplation makes the clinic seem like an oasis of calm in a city where assassination attempts and armed raids are a monthly occurrence and the soundscape is regularly punctuated by gunshots and squealing tires.

Here Libyans with addiction problems are helped to kick their habits with the help of psychologists and tailor made drug courses. The only problem: this clinic has room for just 40 inpatients, and it is the only treatment centre of its kind in a country where drug addiction is rapidly increasing.

Doctors across Libya say they are being overwhelmed by patients with drug problems and it is proving impossible to provide appropriate treatment for everyone.

‘Every month more people come to us needing help,’ says Dr Abdullah Fannar, deputy director at Tripoli’s Gargaresh psychiatric hospital. ‘It’s part of the fallout from the revolution. The government security forces are weak and hundreds of thousands of Libyans were displaced, wounded or bereaved during the uprising. Now street drugs are proving to be an attractive solution to many of those who are struggling to deal with their new reality.’

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

In the octagonal communal garden at the centre of Benghazi’s Al Nafsia drug addiction clinic four men sit quietly talking in the shade. The atmosphere of contemplation makes the clinic seem like an oasis of calm in a city where assassination attempts and armed raids are a monthly occurrence and the soundscape is regularly punctuated by gunshots and squealing tires.

Here Libyans with addiction problems are helped to kick their habits with the help of psychologists and tailor made drug courses. The only problem: this clinic has room for just 40 inpatients, and it is the only treatment centre of its kind in a country where drug addiction is rapidly increasing.

Doctors across Libya say they are being overwhelmed by patients with drug problems and it is proving impossible to provide appropriate treatment for everyone.

‘Every month more people come to us needing help,’ says Dr Abdullah Fannar, deputy director at Tripoli’s Gargaresh psychiatric hospital. ‘It’s part of the fallout from the revolution. The government security forces are weak and hundreds of thousands of Libyans were displaced, wounded or bereaved during the uprising. Now street drugs are proving to be an attractive solution to many of those who are struggling to deal with their new reality.’

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

In the octagonal communal garden at the centre of Benghazi’s Al Nafsia drug addiction clinic four men sit quietly talking in the shade. The atmosphere of contemplation makes the clinic seem like an oasis of calm in a city where assassination attempts and armed raids are a monthly occurrence and the soundscape is regularly punctuated by gunshots and squealing tires.

Here Libyans with addiction problems are helped to kick their habits with the help of psychologists and tailor made drug courses. The only problem: this clinic has room for just 40 inpatients, and it is the only treatment centre of its kind in a country where drug addiction is rapidly increasing.

Doctors across Libya say they are being overwhelmed by patients with drug problems and it is proving impossible to provide appropriate treatment for everyone.

‘Every month more people come to us needing help,’ says Dr Abdullah Fannar, deputy director at Tripoli’s Gargaresh psychiatric hospital. ‘It’s part of the fallout from the revolution. The government security forces are weak and hundreds of thousands of Libyans were displaced, wounded or bereaved during the uprising. Now street drugs are proving to be an attractive solution to many of those who are struggling to deal with their new reality.’

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

Mohamed
Addicted to pharmaceuticals including Tramadol, Diazepam, and Bromisoval
From Benghazi
Has spent 1 month at the clinic
  ‘I started taking Tramadol in 2006. At first it gives you energy and stops you feeling tired. After taking for a long time you get very depressed and frustrated. You get aches all over your body, irritable and angry. Before I came to the hospital I’d been taking Tramadol regularly for five years. I couldn’t take it anymore. I want to turn around my life and feel jealous of my friends who never tried the pills.’  

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

Salah
Addicted to heroin
From Benghazi
Has spent 17 days in the clinic
  ‘I managed to quit heroin in 2008 but restarted after the revolution. I fought on the front lines and after the liberation the government gave payouts to the revolutionaries. The extra cash meant I could afford to spend more money

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

In the octagonal communal garden at the centre of Benghazi’s Al Nafsia drug addiction clinic four men sit quietly talking in the shade. The atmosphere of contemplation makes the clinic seem like an oasis of calm in a city where assassination attempts and armed raids are a monthly occurrence and the soundscape is regularly punctuated by gunshots and squealing tires.

Here Libyans with addiction problems are helped to kick their habits with the help of psychologists and tailor made drug courses. The only problem: this clinic has room for just 40 inpatients, and it is the only treatment centre of its kind in a country where drug addiction is rapidly increasing.

Doctors across Libya say they are being overwhelmed by patients with drug problems and it is proving impossible to provide appropriate treatment for everyone.

‘Every month more people come to us needing help,’ says Dr Abdullah Fannar, deputy director at Tripoli’s Gargaresh psychiatric hospital. ‘It’s part of the fallout from the revolution. The government security forces are weak and hundreds of thousands of Libyans were displaced, wounded or bereaved during the uprising. Now street drugs are proving to be an attractive solution to many of those who are struggling to deal with their new reality.’

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

Rafah
Addicted to heroin and alcohol
From Benghazi
Has spent two weeks at the clinic

‘Bokha is made out of figs. You mash them all up and the heat the mixure for 15 days in a big barrel. It froths up and eventually the end liquid comes dripping out of a tube from the top. It’s illegal but all kinds of people drink it all over Libya.’

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

Rafah
Addicted to heroin and alcohol
From Benghazi
Has spent two weeks at the clinic

‘Bokha is made out of figs. You mash them all up and the heat the mixure for 15 days in a big barrel. It froths up and eventually the end liquid comes dripping out of a tube from the top. It’s illegal but all kinds of people drink it all over Libya.’

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

Rafah
Addicted to heroin and alcohol
From Benghazi
Has spent two weeks at the clinic

‘Bokha is made out of figs. You mash them all up and the heat the mixure for 15 days in a big barrel. It froths up and eventually the end liquid comes dripping out of a tube from the top. It’s illegal but all kinds of people drink it all over Libya.’

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

Esam
Addicted to heroin
From Tripoli
Has spent 3 weeks at the clinic

‘If you needed a fix back in the old days, there was a place in Tripoli’s medina where you could put your arm through a hole in the wall with the money in the palm of your hand and you’d receive the injection.

Gaddafi is the reason for the prevalence of HIV amongst drug users. Gaddafi made selling needles to suspected addicts a crime, forcing us to share.’

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

Mohamed
Addicted to pharmaceuticals including Tramadol, Diazepam, and Bromisoval
From Benghazi
Has spent 1 month at the clinic

'I started taking Tramadol in 2006. At first, it gives you energy and you stop feeling tired. After taking the drug for a long time you get very depressed and frustrated. You get aches all over your body. You also become irritable and angry. Before I came to the hospital, I’d been taking Tramadol regularly for five years. I couldn’t take it anymore. I wanted to turn my life around and feel jealous of my friends who never tried the pills'

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

Mohamed
Addicted to pharmaceuticals including Tramadol, Diazepam, and Bromisoval
From Benghazi
Has spent 1 month at the clinic

‘I started taking Tramadol in 2006. At first it gives you energy and stops you feeling tired. After taking for a long time you get very depressed and frustrated. You get aches all over your body, irritable and angry. Before I came to the hospital I’d been taking Tramadol regularly for five years. I couldn’t take it anymore. I want to turn around my life and feel jealous of my friends who never tried the pills.’

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

Ali
Addicted to Tramadol
From Sebha
Has spent 1 month at the clinic

‘It spreads through schools. My neighbour gave me the first pill. He said it would make me feel powerful. It spreads through groups of friends. After a long time the side effects are very bad I was suffering from aches all over my body, insomnia and uncontrollable anger.

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

In the octagonal communal garden at the centre of Benghazi’s Al Nafsia drug addiction clinic four men sit quietly talking in the shade. The atmosphere of contemplation makes the clinic seem like an oasis of calm in a city where assassination attempts and armed raids are a monthly occurrence and the soundscape is regularly punctuated by gunshots and squealing tires.

Here Libyans with addiction problems are helped to kick their habits with the help of psychologists and tailor made drug courses. The only problem: this clinic has room for just 40 inpatients, and it is the only treatment centre of its kind in a country where drug addiction is rapidly increasing.

Doctors across Libya say they are being overwhelmed by patients with drug problems and it is proving impossible to provide appropriate treatment for everyone.

‘Every month more people come to us needing help,’ says Dr Abdullah Fannar, deputy director at Tripoli’s Gargaresh psychiatric hospital. ‘It’s part of the fallout from the revolution. The government security forces are weak and hundreds of thousands of Libyans were displaced, wounded or bereaved during the uprising. Now street drugs are proving to be an attractive solution to many of those who are struggling to deal with their new reality.’

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

In the octagonal communal garden at the centre of Benghazi’s Al Nafsia drug addiction clinic four men sit quietly talking in the shade. The atmosphere of contemplation makes the clinic seem like an oasis of calm in a city where assassination attempts and armed raids are a monthly occurrence and the soundscape is regularly punctuated by gunshots and squealing tires.

Here Libyans with addiction problems are helped to kick their habits with the help of psychologists and tailor made drug courses. The only problem: this clinic has room for just 40 inpatients, and it is the only treatment centre of its kind in a country where drug addiction is rapidly increasing.

Doctors across Libya say they are being overwhelmed by patients with drug problems and it is proving impossible to provide appropriate treatment for everyone.

‘Every month more people come to us needing help,’ says Dr Abdullah Fannar, deputy director at Tripoli’s Gargaresh psychiatric hospital. ‘It’s part of the fallout from the revolution. The government security forces are weak and hundreds of thousands of Libyans were displaced, wounded or bereaved during the uprising. Now street drugs are proving to be an attractive solution to many of those who are struggling to deal with their new reality.’

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Libya’s Only Addiction Clinic Struggl...
Benghazi, Libya
By Tripcarbons
15 Apr 2013

In the octagonal communal garden at the centre of Benghazi’s Al Nafsia drug addiction clinic four men sit quietly talking in the shade. The atmosphere of contemplation makes the clinic seem like an oasis of calm in a city where assassination attempts and armed raids are a monthly occurrence and the soundscape is regularly punctuated by gunshots and squealing tires.

Here Libyans with addiction problems are helped to kick their habits with the help of psychologists and tailor made drug courses. The only problem: this clinic has room for just 40 inpatients, and it is the only treatment centre of its kind in a country where drug addiction is rapidly increasing.

Doctors across Libya say they are being overwhelmed by patients with drug problems and it is proving impossible to provide appropriate treatment for everyone.

‘Every month more people come to us needing help,’ says Dr Abdullah Fannar, deputy director at Tripoli’s Gargaresh psychiatric hospital. ‘It’s part of the fallout from the revolution. The government security forces are weak and hundreds of thousands of Libyans were displaced, wounded or bereaved during the uprising. Now street drugs are proving to be an attractive solution to many of those who are struggling to deal with their new reality.’

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Libya’s Only Addiction Clinic Struggles
Benghazi, Libya
By Mais Istanbuli
15 Apr 2013

There’s a light sheen of sweat across Mohamed’s face as he recounts his story. ‘I first tried Tramadol more than five years ago with my friends. We’d take the pills and go to coffee shops or play music. At first it was great. It mellows you out, gives you energy and makes you feel strong. But you end up needing more and more. After a while you start to get aches all over your body. You get crazy mood swings and feel like you can’t control your own life.’
Mohamed’s tale is one that is all too familiar to the staff at Benghazi’s Al Nafsia drug addiction clinic. We’re sitting in a shady spot in the octagonal communal garden that lies at the centre of clinic. The atmosphere of contemplation makes it seem like an oasis of calm in a city where assassination attempts and armed raids are a monthly occurrence and the sound of gunshots regularly punctuates the afternoon haze. At the Nafsia clinic Libyans with addiction problems are helped to kick their habits with the help of psychologists and tailor-made drug courses. The only problem: this clinic has room for just 40 inpatients, and it is the only treatment centre of its kind in a country where drug addiction is rapidly increasing. Doctors across Libya say they are being overwhelmed by patients with drug problems and it is proving impossible to provide appropriate treatment. ‘Every month more people come to us needing help,’ says Dr Abdullah Fannir, deputy director at Tripoli’s Gargaresh psychiatric hospital. ‘It’s part of the fallout from the revolution. Border control is weak making it easy for drug traffickers, and there’s more demand as well. Hundreds of thousands of Libyans were displaced, wounded or bereaved during the uprising. Now street drugs are proving to be an attractive solution to many of those who are struggling to deal with their new reality.’

Drugs and stability

Due to Libya’s weak institutions and the stigma attached to drug taking there are no official statistics on drug use and there have been very few studies. Last June a study published by the Liverpool School of Tropical Medicine revealed that the percentage of HIV positive injecting drug users stood at 87%, the highest recorded anywhere in the world. Responding to the report last year the Libyan government said that it would treat the HIV and drug crisis as a matter of national priority but, according to Dr Fannir, so far nothing has been done to confront the problem. ‘There is still no needle exchange program and our doctors don’t have the right experience or the right drugs. In fact not a single one of the report’s recommendations has been implemented. I believe because of this inaction the rate of HIV infection is rising among injecting drug users, even as the number of drug users increases.’ According to Fannir the worsening crisis has severe implications for the wider community. ‘It is getting to the point that it threatens national stability. Heroin addiction is causing massive damage to poor communities. People are seeing their friends and family falling into destructive lifestyles. Drug dealing is fueling militia violence. All this is undermining faith in Libya’s politicians and the effect of this should not be underestimated.’

Addiction ‘not a priority’

Despite the concerns of those working on the ground senior health officials are unphased. Dr Mustafa Gebreil is an independent member of Libya’s congress and works in the Health Ministry. He rejects the idea that battling addiction should be an immediate focus for the government.
‘The Health Ministry is concentrating on crisis fighting. There are many issues that need attention in Libya, and because of this treating drug addicts is not a priority.’ The social stigma that surrounds HIV and drug taking is a big part of the problem according to Dr Alessandra Martino, an HIV specialist who has worked in Libya since 2005. ‘HIV is very closely associated with vices like casual sex, homosexuality and drug taking: things that are unacceptable in mainstream Libyan culture. This means for Libyans HIV and drug abuse are not a very fashionable area to be campaigning about or working in.’ Dr Martino says the shame that surrounds HIV leads some suffers to do terrible things to hide their illness. ‘Recently I had to treat a two month old child with HIV. The child’s mother had been infected by her husband who was addicted to heroin and knew he was HIV positive. He concealed his illness from his wife when they got married and forced her to give birth in Tunisia to avoid the HIV test that is compulsory at Libyan maternity hospitals. If doctors had known that the mother was HIV positive the child could have been born without the disease but now its future looks very bleak’.

To get married in Libya you are required to present a certificate that shows you are free of HIV, but according to Dr Martino these are readily available on the black market and before the revolution cost just 100 dinars ($80).
Once infected HIV sufferers find it difficult to receive treatment. Many hospitals are terrified of HIV contamination and will refuse treatment to those suspected of being injecting drug users. And even when they do receive treatment it can be ineffective. Problems with drug procurement means sometimes patients can’t get hold of the medicine they need. This allows the disease to mutate, and according to Dr Martino, because of this most patients being treated for HIV in Libya have become at least partially resistant to the treatment they are receiving.

Revolution and rehabilitation

Accounts from drug users back up the reports by doctors that Libya’s drug problems are worsening. Salah is a recovering heroin addict at Benghazi’s Nafsia hospital and says heroin became increasingly easy to get hold of after the uprising.
‘It was everywhere after the revolution. I originally gave up heroin in 2008 but I started to take it again after the liberation. I fought on the front lines and like other fighters I received a significant payout after the revolution. A lot of my friends started to take it, and because I had the extra money it was difficult to stay away.’

According to Dr Alessandra Martino the influx of the drug makes sense. ‘If I was a heroin importer this is exactly the place that I’d come to. Libya has a young population and there’s nothing for young people to do. There are few jobs, few sports facilities or cinemas, officially there’s no sex before marriage and there is no alcohol. Soon they’re going to have lots of money because the oil money will be distributed. And law enforcement is weak. It’s the perfect market.’

Addiction education

The lack of knowledge about drugs in Libyan society is also a cause for concern according to Dr Fannir. ‘During the Gaddafi era the general public knew very little about the dangers of drugs, and the situation isn’t improving. The chaos of revolution meant outreach and education programs collapsed and many still haven’t returned.’
Speaking about their experiences many of the patients at the drug treatment centre lament the lack of education about drugs in Libya. ‘Back in the 90s we didn’t know what we were letting ourselves in for,’ says Esam, a HIV positive veteran of Tripoli’s heroin scene. ‘There was a place in the old quarter where you could put your arm through a hole in a wall with some cash in the palm of your hand. Someone would take your money and you’d receive an injection, but you wouldn’t see anything. People aren’t so naive now, but most still don’t fully understand the consequences of their actions.’

Free treatment for some

As we leave the Nafsia clinic the patients prepare for lunch. A hospital worker hands around containers with chicken stew and rice in the communal garden. The scene is relaxed and there’s a sense of optimism amongst the patients.
Drug users from all over the country are referred to the Al Nafsia clinic by doctors. They come from all walks of life and treatment is free but, with facilities for just a handful of inpatients and a couple of hundred outpatients the vast majority have to battle their addictions without proper support. ‘This place is good for Libya but you’ve got to remember its patients are the lucky few’ says one of the hospital’s psychologists as he shows us out. ‘We help all we can but for the rest free Libya is a very difficult place.’

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Drug Addict 15
Paris, France
By Simon Letellier
05 Mar 2013

Even if he feels tired, Philippe wants a last shoot and goes out to try and find some. Outside it’s snowing.

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Drug Addict 2
Paris, France
By Simon Letellier
05 Mar 2013

Philippe showing his last tooth. Smoking crack and cocaïne destroys the teeth. Most drug addicts suffer from damaged teeth and some have none.

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Drug Addict 4
Paris, France
By Simon Letellier
05 Mar 2013

At the end of the day, Philippe doesn’t have any more money to pay for his room in a hotel. An association for helping drug addicts helps him by paying for a room. It is freezing outside and he doesn't want to sleep in the streets.

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Drug Addict 7
Paris, France
By Simon Letellier
05 Mar 2013

At the end of the day Philippe is tired. He didn’t eat anything in the day and he is far-fetched.

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Drug Addict 3
Paris, France
By Simon Letellier
05 Mar 2013

At the end of the day, Philippe is tired. He didn’t eat anything in the day and he is exhausted.

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Drug Addict 8
Paris, France
By Simon Letellier
05 Mar 2013

Philippe tidies up the few things he brought to the room.

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Drug Addict 10
Paris, France
By Simon Letellier
04 Mar 2013

Philippe smoking cocaïne below a highway. This area is full of drug addicts. Dealers are not far from the area, but they stay hidden.