By ADF
Five men entered a roofless, windowless concrete structure on the island of Lamu, just off the Kenyan coast. They sat on the building’s trash-strewn floor and used razors to cut heroin with marijuana, rolling it into a thin cigarette and smoking it.
Among the men was Mohamed Tai, one of Kenya’s estimated 27,000 heroin users, who spoke openly about his addiction. Beside him, two men sat hunched over, their eyes directed at the floor, while another man calmly pulled on the thin cigarette.
“It is a very bad addiction, but it is ignored by the community, government and other organizations which think it is the will of the person to continue using,” Tai told The Associated Press. “But it is small reasons that drive you to start using. It puts you in a trance, and you don’t understand yourself. Time flies, and you are just there. You don’t think.”
Kenya was once a transit hub for heroin flowing from Afghanistan to other regions, due to its long, porous coast. According to Reuters, the number of Kenyans injecting drugs, mostly heroin, increased by more than 50% from 2011 to 2019, as Mombasa, East Africa’s largest port city, emerged as the capital of a new international drug trafficking route.
“We have what we call the southern route, and this is the longer route from heroin production fields in Afghanistan,” Boniface Wilunda, Program Management Officer at the United Nations Office on Drugs and Crime (UNODC), told the AP.
Heroin’s low cost — as little as Ksh200 ($2) per hit — has led to its increasing popularity, particularly in coastal communities, where addiction has emerged as a critical public health issue. Observers told Reuters in 2019 that young people across all social classes were using heroin.
That’s when Doctors Without Borders (MSF) began a holistic program in prisons and local communities for people who use drugs in Kiambu, about 12 miles from Nairobi. In 2024, MSF handed over its clinics to Kenya’s Department of Health and Kenya Prison Services.
The clinics provide methadone and buprenorphine, a drug for treating opium addiction, as opioid substitution therapy, a component of harm reduction. This approach aims to stem the many negative effects of drug addiction.
“The medically assisted therapy clinics [take] a one-stop medical facilities approach, with a holistic approach to treatment beyond opioid substitution,” Dr. Edi Atte, MSF country director in Kenya, said on the organization’s website.
The approach aims to prevent infections and transmission of HIV and viral hepatitis which are caused by using contaminated needles. It offers mental health and psychosocial support and helps addicts reintegrate with their families and communities.
In Lamu, where Tai lives, King Fahd Hospital has also established a methadone clinic to help addicts wean off heroin.
“It is a very big challenge to us, and we have tried several means to combat the use of drugs, so we started to have the methadone clinic,” Aziza Shee Mubarak, a clinical officer at the hospital, told the AP.
For recovering addicts like Bui Kitaa, methadone has been a lifeline.
“Addiction was very bad on me,” Kitaa told the AP. “I did not have any friends; my brothers at home and even strangers on the road could not trust me. Nobody would hire me,” Kitaa says. “But since I started using methadone four years ago, it has helped me a lot.”
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