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James Debono
Two persons, one of them aged 59, are spending every night squatting in a stable deprived of any water and electricity. Another man, 40, spent a whole week sleeping under an upturned boat on the Gzira quay. They have little in common, except a common habit and problem. They are users who lack shelter at night.
Charles Miceli, who heads Caritas’s harm reduction programme insists that before addressing these people’s basic needs, all talk of rehabilitation is useless. Caritas is the only institution in the country presently catering for these people’s needs.
In Floriana, just next to the polyclinic, heroin addicts can simply drop in to a pink building which Miceli prefers to call a home, sit next to a television, smoke a fag, make themselves a cup of coffee, munch biscuits and talk. There is nothing institutional about the home – not even a name on the door reminding people that the place has anything to do with people with a drug problem.
Upstairs, the home also provides full shelter for heroin users who have given up illegal substances but who are still on methadone. They are the only people, who can spend the night in the home, on condition that they accept a drug and alcohol-free regime. Previously people on high doses of methadone were not welcomed in any drug rehabilitation programme. Now they have a chance.
Not surprisingly, they are not allowed to have contacts with the people downstairs. Downstairs one finds the people still living on the streets and who are not yet ready for a drug-free regime. Unfortunately some of these are still homeless because no centre for the homeless exists to cater for these people.
Still the Caritas home offers them some shelter in the afternoons, between 1pm and 5pm.
Frustrated of being hounded and kicked from one place to another, drug addicts are increasingly finding shelter in the Caritas home. They are particularly angry that the Pietà council has passed a bye-law to ban them from “loitering” next to the St Luke’s hospital Detox centre, the only place in Malta where they can gather their dose of methadone.
“After we were kicked away from Pietà we used to gather in a bar in Msida. But now the police have told the bar owner not to allow anyone who is on methadone in his bar. I think that this is discrimination,” says a young woman sitting next to her boyfriend.
Her boyfriend would like to give up drugs. He used to spend Lm40 a day on his habit. Now he is taking methadone. “I would even cut my palm to get rid of this habit.”
But it’s far from easy. Methadone only serves to rid him from withdrawal pains but still it does not fill “the void within”. Both him and his girlfriend feel lucky that they have now found a place to meet friends in a place where they are welcomed. They feel even luckier that they have a home and a seasonal job.
Next to them sits a frail and polite 59-year-old who has been on heroin for more than 30 years. He lives with another user in a stable. “We sleep at 6pm as soon as darkness falls because in the dark there is nothing else to do.”
Reminiscing on his life in Canada, he recalls attending courses at university and owning a restaurant. But that seems ages ago.
Proponents of tough love would argue that making life easier for users by providing for their basic needs would simply prolong their habit. Miceli says it is nonsense. “Should we therefore make it easier for them to die?”
Miceli recalls the case of a drug addict who died of an overdose while spending the night on a rooftop. “Perhaps he would still be alive had we offered him adequate shelter.”
Used to images of politicians posing for a photo with successful and spotless graduates who have completed rehabilitation programme, Maltese society seems to have turned a blind eye on the majority of users who do not succeed. “We have at least 1,500 people presently taking heroin or methadone, who cannot start a programme. Not because they do not want to but mainly because they can’t. How can we expect someone to start a programme if he cannot even wash his own clothes?”
Some heroin users also face imprisonment or have accumulated debts. “Some have loan sharks threatening them. Can we expect them to start rehab with all these problems in their lives?”
Miceli’s sentiments are echoed by the drug addicts sitting next to the TV. “You can’t expect me to stop drugs if I don’t have a roof over my head. You have to first have a home before sorting out your life,” says one of the users.
Some users, especially the elderly ones have practically given up any hope of ever succeeding. “Why don’t they just make a place were heroin is offered by prescription to people like me who have taken heroin for the past 30 years?” asks one of them.
Caritas’s harm reduction programmes do not endorse such an approach but Miceli’s collaborator Ernest Cherret recognises one can’t expect miracles from people who have induced substances for most of their lives. “At the very least we should ensure that these people do not have to sleep outside.”
Miceli recalls that once a user had asked them to spend the night on a chair, begging to be allowed to sleep inside. Yet Caritas still cannot provide this service for people who are still on illegal drugs and none of the other organisations taking care of the homeless are offering this service.
“The government should invest in a shelter where heroin users can spend the night without any questions asked. This is what happens in most civilised countries,” argues Miceli.
The motley crowd of addicts are angry at the state for ignoring their plight. “They have given land cheaply to the Americans for them to use as an embassy. Why is it so difficult to find a place for us?”
But why don’t these users simply rent a place like many others rather than expect a big daddy state to provide for them? They plead that they live on relief, which amounts to Lm120 a month. They claim that finding work verges on the impossible not only because they are sick but also because most of them have a criminal record.
Finding a place to rent under Lm80 a month is a rarity. When they actually find a place they are also expected to pay in advance for the next month, which makes it impossible for some of them to find a place. “To rent a place one has to have at least Lm160 in cash,” they claim.
Still they find ways to subsidise their expensive habit. Drugs are only a phone call away according to all those present. Some admit that they have broken the law to cope. Others claim that they used to despoil empty buildings and sell the aluminium and the things they find. But even that can get them in trouble and some have been prosecuted.
One of those present had spent eight full years, from the tender age of 16 until being released at 26 for a series of thefts. He claims that in prison it was very easy to take drugs. “As long as you have the money, drugs are not a problem.”
Now he risks going to prison again as he has committed a series of petty thefts. “The magistrate was willing to commute the sentence if I attended a programme but the attorney general has appealed against this sentence because I am a repeat offender.”
Life after prison is very hard. “Just imagine going out of prison penniless and being told that you will only receive your relief money five weeks later. What do they expect us to do: starve, beg or steal?”
Finding work is not that easy. They also complain that the Employment Training Corporation calls them to attend courses for work, which they are not allowed to do. “We all have Hepatitis. Still they call us to attend food handling courses.”
Getting a clean syringe is still a problem despite the free availability of syringes from polyclinics. “Some times I have injected a syringe which I had gathered from the floor, simply because some polyclinics are closed after 5pm and the security do not allow us in.”
Miceli would prefer a needle exchange programme through which users would get new syringes in exchange for used ones. “Ideally this service should be provided through vending machines. But in Malta this sounds shocking because we like to show a façade that everything is well even when faced by real problems.”
Another daily ordeal for users is that of collecting their daily dose of methadone from Pietà. “Why don’t they offer methadone from all health centres so that we don’t have to take daily trips to Pietà?” they ask.
Surprisingly, even those living under supervision upstairs have to collect their dose of methadone from Pietà, despite living just opposite to a polyclinic. “Everyday we are crammed into a van to collect our medicine,” claims one of the home’s permanent residents.
“We have asked the polyclinic to offer this service but nurses insists that they do not want to deal with heroin addicts,” a laconic Miceli says. It’s an uphill battle for him and his team even if his work is blessed by Malta’s most respected organisations.
jdebono@mediatoday.com.mt
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