MALDIVES HAS a long history of substance abuse. Its 1,192 coral islands lie at the intersection of major historical global sea routes in the Indian Ocean. Historically, traders from all over the world brought all kinds of illicit substances to its shores. Yet the archipelago has never been a producer or manufacturing point for illicit drugs. According to state official reports, it wasn’t until the early 1970s that Maldives opened for tourism, and a steady market for drugs began to develop in the Maldives. As the tourism industry began to boom in Malé, and people traveled from all over the world to enjoy its breathtakingly beautiful beaches, the demand for illicit drugs soared. Malé’s geographic location made it the ideal drop-off point for all kinds of drugs—among them cheap, low-grade heroin called “brown sugar.”

Walking down the street, it is common to come across at least one woman high on brown sugar. What gives her away are her vacant expression and comatose demeanor. Even as nearly a third of the country’s population or at least one member in a family struggles with substance abuse, women tend to face greater ostracization and social exclusion. This is not to say that women in the Maldives do not struggle with drug abuse. During a crackdown on Malé’s (in)famous drug cafés last year, police arrested 65 women and 14 children. In fact, many Maldivians would have, at some point, viewed a moralistic YouTube video of such a woman on social media. The women in these videos are meant to serve as a cautionary tale against the wayward social behaviors and tendencies that lead to a life of substance abuse, destitution, and misery. If the social stigma around seeking harm reduction for substance use wasn’t enough, such representations of women addicts end up stigmatizing them even more. The stories of women who end up abusing heroin—or brown sugar, as it is more commonly called—are diverse, yet they share a common thread of desperation, growing addiction, and a feeling of helplessness.

One such story is Zulaikha’s (names have been changed to protect anonymity). A 38-year-old Maldivian woman who, in another life, successfully pursued a career in modeling. She now lives on a scantily-populated island of a Northern atoll, but back in the day, she was known for her exceptional beauty and talents in the creative arts. A few months ago, she knew she had hit rock bottom when she walked up to someone on the street and said (in Dhivehi): “Excuse me, can I please have a tenner for food?” The person she had asked for money turned to look at her and they both recognized each other. Zulaikha had gone to high school with them. As her old classmate’s eyes followed a line of cigarette burn marks on her arms, Zulaikha’s face turned ashen. 

The stories of women who end up abusing heroin—or brown sugar, as it is more commonly called—are diverse, yet they share a common thread of desperation, growing addiction, and a feeling of helplessness.   

Back in high school, Zulaikha was someone younger students could count on to stand up to their bullies. Her classmates fondly recall her compassionate and empathetic conduct with those younger than her. She stood up for justice and the values that mattered to her the most, and was widely admired for it. But Zulaikha’s adolescent years were marked with notoriety after she began using heroin at such a young age. Soon after high school ended, she gave birth to a child and then checked into rehab.

She relapsed several times, after which she moved away from her family’s house and began living with her partner on a Northern island. The man she lived with was physically and mentally abusive. At one point, in a fit of rage, he beat her senseless with a hammer. Despite the constant threat of physical violence, Zulaikha refused to leave her partner, who is also a heroin abuser. Deprived of the care she needed from her family, she insists that she preferred living with the person she also terms her abuser.

Zulaikha’s story is like that of several women who, after becoming heavily dependent on substances, are abandoned by their families. People in the Maldives frequently associate women’s addiction with sex work. It is after the drug dependency kicks in that the actual cycle of abuse begins. After women addicts are abandoned by their families, many end up moving in with partners who also abuse drugs and them too. The plentiful supply of drugs in the region, combined with limited support to recover, means that the chances of an ex-user relapsing are high. Stories of women who managed to end their dependency on heroin and rebuild their lives are, in fact, painfully rare. They end up falling deeper and deeper into addiction, while their circumstances inhibit them from breaking patterns of drug abuse. In situations like these, family support is pivotal in enabling women to get back on their feet.

Cycles of Addiction

As a young undergraduate student in Malé in the early 2000s, Maryam had jumped at the chance to study abroad. The twenty-something was academically gifted and creative, and she believed the experience would open up several opportunities for her. It was during her time abroad with a cohort of heroin users from back home that she began using.

She recalls that her time abroad was an incredibly vulnerable period for her. Away from her family and the security of home, she began using drugs experimentally, but soon became addicted to heroin. After returning to Malé, she remained hopelessly addicted. Her dreams and ambitions were no longer possibilities for her, and she became estranged from family and friends. A few months after she was turned away from home, Maryam was using heroin at a café frequented by criminal gangs involved with the drug trade, when the police raided the place and arrested her. 

Before the enactment of the 2011 Drugs Act, people arrested for drug use were often sentenced to spend as many as 25 years in prison, regardless of the quantity or potency of drugs in possession. It would not be a stretch to estimate that over 90 percent of all criminal cases in the Maldives are drug-related. Shortly after Maryam started serving her sentence in Maafushi prison in 2004, the devastating Indian Ocean tsunami hit. The recently constructed women’s wing where Maryam was being kept suffered severe damage. She incurred several injuries while trying to flee from the tidal swell and was subsequently sent home.

After recovering from her injuries, she started using heroin again, but this time around, she was able to rely on her family. Her mother, Maryam recalls, was relentless in her efforts to get her off drugs. Maryam began to alternate between periods of staying clean and abusing heroin. Despite her protestations, her family sent her to the Himmafushi Rehabilitation Center several times to recover. During one of her drug abuse stints, she was arrested for drug possession, but managed to avoid a prison sentence because of her confession.

Before the enactment of the 2011 Drugs Act, people arrested for drug use were often sentenced to spend as many as 25 years in prison, regardless of the quantity or potency of drugs in possession. It would not be a stretch to estimate that over 90 percent of all criminal cases in the Maldives are drug-related.

Maryam’s recovery at the Himmafushi Rehabilitation Center was slow and interrupted by relapses, but the place was somewhere she could return to safely. This feeling of security and care began to help her thrive at the center. Maryam recalls her spells there as restful. Eventually, she developed a passion for helping other drug addicts overcome their patterns of abuse. She thrived in the company of other women who were also recovering addicts, and collaborated with them on several projects.

When she returned to the rehab center for a third time, she decided to put her plans into motion. In collaboration with an NGO for vulnerable women and drug addicts, Maryam worked on building a safe space for vulnerable social groups within the rehab center. She also ran several vocational programs and capacity-building workshops. Things had begun to look up for Maryam. She was doing something that she believed in and regained her youthful confidence. After settling down and getting married in 2010, Maryam gave birth to a daughter. Her life seemed perfect—till it wasn’t.

Three years after her daughter’s birth, Maryam’s marriage soured. Depressed and despondent, she returned to using heroin. It wasn’t long till she was arrested during a drug bust for a third time. This time, she was sentenced to imprisonment. “My relationship with my child suffered because of this,” she said sorrowfully. “It’s like I’m a stranger to my own child and there’s no way to gain back the time I’ve lost.”

After three years of serving time in prison, she was released on parole. This time around, Maryam’s family decided to send her to India for treatment. She got better there and returned to her family a healthier and happier person. Since her return from treatment, she admits that she still struggles to stay sober and hold on to relationships. Her time in prison had greatly impacted her mental health and made her reticent and reluctant to talk to strangers or new acquaintances. As Maryam continues to attempt to get to know and care for her daughter, she treads a delicate balance of resentment and relapse.

Facing a wicked system

Zulaikha remembers her stay at Himmafushi Rehabilitation Center differently. A regular returnee at the center, she did not have the network of family and financial support that Maryam relied on, and faced several obstacles along the way. In fact, Zulaikha insists that she did not benefit from rehab in the slightest. She would prefer to stay with a partner she admits is abusive towards her. The reason for that, she elaborates, is that there are no alternatives for women who lack an emotional and material support base in the form of family or wealth.

There are no state-run or community-run shelters for vulnerable women looking for a safe space, and neither are there any detoxification or rehabilitation facilities available to them. Most women jailed for drug-related offenses often end up there for refusing to complete their treatment at the rehabilitation facility. Zulaikha remembers the facility itself as lacking the necessary infrastructure and support for recovering addicts.

The Himmafushi Rehab Center houses recovering men and women who are supposed to always be segregated. Women are told to stay within the confines of a small compound within the larger Himmafushi Rehab Center and are not allowed any outdoors time. Over at the men’s enclosure, the rehab center organizes outdoor activities and classes, but women are barred from participating in them. Zulaikha’s misgivings about the rehab center have been repeated by several other recovering addicts as well, which suggests that the rehab center is severely lacking in essential facilities for the recovering addicts. Even though the Drugs Act of 2011 mandates separate recovery centers for men, women, and juveniles, so far there has been no work on building separate centers. Hence, everyone gets sent to the Himmafushi Rehab Center. The clinicians and staff at the center follow a Therapeutic Community Program which aims to focus on recovery through lifestyle changes, and not simply abstinence from drugs. Yet the center’s facilities are stretched painfully thin.

Prisons too are choked with people arrested for drug possession—almost 99 per cent of all criminal cases are drug-related, after all—and these are the conditions which have forced lawmakers to reform laws pertaining to drug abuse. Yet reform work is painfully slow, hence the problems accompanying drug abuse fester and worsen over time. One of the most frequently cited problems is one of alienation—from care and support networks, as well as fellow recovering addicts.

In the 1990s, there were no custodial buildings for women arrested on drug-related charges. So, when Fatima was arrested in Malé and sent to jail, she was put in a small isolation cell with another woman who became the first Maldivian woman sentenced to imprisonment for drug possession. Both women were suffering from withdrawals and ill health, but since Fatima was the younger one, the prison authorities tasked her with caring for her fellow inmate.

Fatima’s own condition deteriorated while she tried her best to help the woman in jail with her. The woman was undergoing severe withdrawals and needed medical attention, but none was available. Instead, she died an agonizing death within 48 hours of her sentencing, while a dehydrated and listless Fatima watched her suffer helplessly. The sight is etched in her memory forever, she says. The prison authorities hushed up the matter, while Fatima says she was left alone in the cell to tend to her psychological and physical scars.

When Fatima was arrested in Malé and sent to jail, she was put in a small isolation cell with another woman who became the first Maldivian woman sentenced to imprisonment for drug possession. Both women were suffering from withdrawals and ill health, but since Fatima was the younger one, the prison authorities tasked her with caring for her fellow inmate. 

Life hadn’t always been unkind to Fatima. Her family was wealthy, and she had led a comfortable life. It was the early 1990s and she was barely out of her teens, gullible and eager to explore the world. She jumped at the chance to try heroin with her older friends, thoroughly convinced that she would never get addicted. By the time she became aware of her drug dependency, it was too late.

When her family found out about her condition, they arranged to send her abroad for two years to recover. They also made her sever ties with the friends she used heroin with. In 1994, Fatima returned to Malé and, within no time, began using heroin again. That's when everything went downhill, she recalls.

Shooting heroin was the only priority in life, she says. Her memories of youth all involve using heroin with friends at restaurants and other places. This was a time when heroin was not that common—this was not brown sugar—and most people were unaware of its effects on people. This is how they got away with using the drug in public and remained socially functional. But it wasn’t long before she was picked up by the police in a drug bust and sent to jail. That is where she met the inmate who passed away from withdrawals. 

In the aftermath of the whole episode, Fatima was “banished” to an island instead of a prison. Historically, the term “banishment” has referred to the commonly prescribed punishment of internal exile to one of the many Maldives islands. Banishment as punishment was finally repealed in 2015 after the enactment of a new Penal Code. However, for Fatima, the punishment of banishment entailed being sent to live among a close-knit community of locals on an island in the south of the Maldives. There, she suffered from loneliness and isolation. The local people shunned anyone sent there in exile, especially if it was for drug-related offenses. Fatima was neither welcomed nor acknowledged in the community and she lived as an outcast in the eyes of the island residents. “I was scorned and ridiculed,” she recalls. “Women struggling with addiction are not acceptable in this society.”

“Back in the 1990s,” she says, “the inhabited islands were destitute places.” The islanders had limited access to drinking water and electricity, and had to struggle to make ends meet. This felt like a rude jolt to Fatima, who had been accustomed to a life of luxury and gratification her entire life. She recalls those days as a never-ending spiral into tedium, with no one to keep her company, save for occasional telephone calls from her family, which she received at the singular telephone booth on the island. Thoroughly bored and miserable, she attempted to find ways to numb her pain, but could not, and that made her desire drugs even more.

After her sentence ended, she returned to her family in Malé. There, her mental health deteriorated significantly and she started using heroin again. She began feeling resentful towards her family, friends, and even her daughter. Anger and rage festered beneath her attempts to regain control of her life, and she found herself unable to share her feelings with anyone, even those closest to her. Refusing to give up or give in, Fatima reached out to rehab centers locally and abroad for help in recovering. The experience of treatment abroad was markedly different from back home. She terms the Maldivian rehabilitation program “the Garfield program, since their clients are programmed to eat, sleep and repeat.” At the rehab centers in the Maldives, she adds, recovering addicts are called to a meeting every morning, but the goals or takeaways from that meeting aren’t clear to anyone. While the men were allowed to engage in (albeit a limited number of) activities, the women addicts were left alone in their quarters. The counselors were not properly trained or certified, and most of their clients chose not to open up and be honest about their drug use with them. 

The way Fatima describes her experience makes it appear as if rehab is a place where one goes to escape a jail conviction, get away from annoying family members, or is just somewhere you can mentally check out and go through the motions day after day. Either way, there is no measurable positive outcome.

Her time in rehab centers abroad was quite different. The day was filled with a long list of activities and tasks to complete. The recovering addicts would work hard at these tasks from sunrise to late evening, which included yoga and cooking classes. Fatima says her self-esteem improved greatly during her time there. The clients at rehab (abroad) were encouraged to journal their feelings and experiences daily, she says, and this would help them arrive at new insights into the nexus between their mental health and addiction. Fatima says these activities helped her recognize the obsessive-compulsive tendencies that she has had since her childhood (even though she had never been formally diagnosed).

The Scale of the Drug Epidemic

There are several detox and rehabilitation centers operated by the government across the Maldivian archipelago, but only two of them are currently being used to help drug addicts recover. Close to half of the country‘s population is below 25 years of age, and at least half of that population is addicted to brown sugar. Such is the notoriety of the Maldivian youth, that the term for youth, which is “zuvaanun,” has a negative connotation. It is commonly deployed to accuse someone of miscreancy or addiction. Suppose you hear of a road accident caused by a speeding motorbike, or see someone getting mugged on a street: as the average Maldivian, chances are that you will shake your head and cuss at those rapscallion zuvaanun.

Throughout the late 1980s and 1990s, society in Malé was undergoing a radical shift. The islands were opening up to the outside world and people were bringing in all kinds of new (mostly western) ideas and ways of life to the country. The population of the capital city boomed as residents of other islands flocked to Malé in search of higher education and basic services that were boosted by the then-burgeoning tourism industry. They dreamed of a life where they would get greater access to amenities and opportunities to better their lives. Despite the influx of so many people, or perhaps because of it, some communities and generations clung to their traditions and roots. Their children were expected to diligently study, find stable jobs, marry, and spend their lives working and raising a family. Yet the generations growing up in the 1980s and 1990s faced a more tumultuous time. Some call them a generation that was lost in between an unprecedented cultural shift. Combined with the skyrocketing demand and supply of drugs on the tiny islands, it was easy to fall prey to drug addiction.

Given the massive scale of the drug problem, it is shocking that there are so few resources to help tackle it. In the centers that are operational, recovering addicts share that medical treatment is lacking, counseling is substandard and ineffective, and that the whole program is woefully incompetent. In February 2021, a client seeking treatment at the Hanimaadhoo Detoxification Center passed away from severe withdrawals after not receiving medical attention. The center was subsequently shut down. Recently, on 14 November 2021, local media reported that a client who had just returned to Malé from a detoxification center was found dead in an abandoned home after succumbing to a drug overdose.

The government body tasked with the management of detoxification and drug treatment centers is the National Drug Agency (NDA) of the Maldives. Among journalists and related staff, there is much talk of inaction, incompetence, and even accusations of corruption plaguing this institution. The Sri Lankan counterpart to the Maldivian NDA, the National Dangerous Drugs Control Board, runs programs for addicts in 11 prisons, while managing four treatment centers in heavily populated areas. The Sri Lankan drug control body also engages with thirteen private treatment and rehabilitation centers where clients can seek services for payment. Some Maldivian addicts who can afford treatment abroad frequently enroll in treatment centers in Sri Lanka, India, and Malaysia. But most drug addicts are poor and cannot afford to go abroad for treatment. 

In February 2021, a client seeking treatment at the Hanimaadhoo Detoxification Center passed away from severe withdrawals after not receiving medical attention. The center was subsequently shut down.

Recently, the health minister of the Maldives was called to the parliament regarding an enquiry on the obstacles faced in finding solutions to the Maldives’ drug problem. The health minister stated that there was no quick solution to the large issue, and that the relevant authorities do not know the way forward. He mentioned the lack of research on drug abuse as one of the problems. However, he acknowledged that drugs and drug addiction are the most severe twin crises the country is facing today.

Change NDA and Hands Together are two movements launched by recovering addicts and members of their families and communities. Both movements have been calling for reforms in the NDA. Though the movements lack numbers in their demonstrations and protests, their members are vocal and persistent. Last year, they submitted a “Change NDA 2020” petition to the People’s Majlis with over 1,000 signatures, prompting a mass inspection of all rehabilitation and detoxification centers being run by the NDA. This petition also resulted in heavy scrutiny of the organization, and the operations of the NDA were shifted from the Gender Ministry to the Health Ministry, with a new chairman appointed.

Citizen engagement efforts and advocacy initiatives, along with transnational solidarity campaigns among recovering drug addicts, can help provide the impetus necessary to push the government towards action. It is not enough to rely on the goodwill of authorities who themselves admit to state collusion with drug cartels operating in the region. At present, most detoxification centers in the country are closed and there is no headway in improving the rehab infrastructure and facilities for recovering addicts. While there is talk of the government bringing on board a foreign private company to design a new, more effective rehabilitation and detoxification program, people on the ground know not to put too much faith in these talks of plans. At the end of the day, those who suffer through drug abuse and its related problems rely on the solidarity of family members, friends, and organizations to help them navigate an otherwise incredibly dehumanizing system. ∎