Malsawmdawngu was just 14 when he began injecting a powerful painkiller and opiate into his veins because, he says, all his friends did. When he finally found out he was HIV-positive at 26, he almost went mad.
“I had stopped taking drugs by then, and I was thinking about my future,” says the young man who lives in Mizoram state in remote northeastern India. “I began doing drugs again, I slept in the streets, wearing just rags. I had nothing, I had to steal just for food. I thought it was better to die.”
Somehow, he found a way back. Today he sits in his living room with his wife, Irene, knife scars and tattoos all over his arms, but free from drugs and battling for a new life.
Last year he and Irene became the first people in Mizoram to go public that they were HIV-positive.
“There is still a lot of stigma but we are fighting it,” he says. “People still point at us behind our backs, and say ‘They are positive, stay away from them’.”
The forested hills and sleepy villages of Mizoram, sandwiched between Myanmar and Bangladesh, are home to a growing menace - rampant drug use, and rapidly spreading HIV and AIDS.
Official figures show the number of HIV sufferers increased five-fold in the past four years. But the 1,000 officially listed as HIV-positive are just the tip of the iceberg.
Surveys of pregnant women in Mizoram found almost 2 percent were HIV-positive. Among drugs users and sex workers, the rates are much higher, but awareness of the risks is dangerously low.
Mizoram, experts say, will soon become the seventh Indian state to admit it has a “generalised AIDS epidemic”. Two of the others are also in the neglected northeast, where unemployment is close to 60 percent.
In the nearby state of Manipur, almost two in three intravenous drug-users are thought to be HIV-positive.
“If the trend goes on like this, there is going to be a big bang very soon,” said Betty Lalthantluangi, an adviser to the Mizoram State AIDS Control Society.
“The disease is spreading from high-risk to non-high-risk people. It is spilling over to the general public, and there is no way to control it.”
Lalthantluangi said few people used condoms and efforts to encourage them to do so have drawn criticism in the overwhelmingly Christian state as promoting sex. “Sex workers are drunk most of the time, and it is very difficult to convince them to ask their clients to use condoms,” she added.
For 20 years, Mizo rebels fought Indian rule. But with peace in 1986 came a new menace. Heroin began flooding in from Myanmar and quickly caught on in the capital, Aizawl, where long years of curfew had prevented any nightlife developing.
Anti-drugs drives in Myanmar eventually forced up the street price of heroin, but many here simply switched to Spasmo Proxyvon (SP), a prescription painkiller and opiate.
The powder inside the small, blue SP capsules is not soluble. It sticks to the walls of the veins, causing massive abscesses, gangrene and even amputations. At least 142 people died of drugs use in Mizoram last year alone, and many more in Manipur.
In 1996, under pressure from the church, the Mizo government banned alcohol. But some health workers say prohibition may have backfired, fuelling the use of other drugs.
VIGILANTES BEAT DRUGS DEALERS
Last year, authorities seized almost 700,000 SP capsules being smuggled in from the neighbouring states of Assam and Tripura inside dried fish, pumpkins, ladies’ slippers, talcum powder containers and bicycle wheels. But still drug use grew.
With the state failing to stem the tide, civil society stepped into the breach in the form of the Young Mizo Association.
Founded by Welsh missionaries in 1935, the YMA boasts more than 350,000 members - a third of the population - and rivals the church as the most powerful organisation in Mizoram. Mostly involved in social work, the YMA declared a war on drugs this year and is fighting hard.
“We visit the houses of drugs dealers and request they stop selling drugs,” said J.H. Zoremthanga, vice-president of the YMA in Aizawl. “Some do not object. But if they are stubborn, we punish them hard. We beat them, but not to death.”
“Stubborn” dealers might have their homes trashed or their cars burned by the YMA’s more enthusiastic enforcers. Brewers or smugglers of illegal liquor also face the wrath of the YMA, which is using its fearsome reach to conduct a survey of alcohol and drugs users in every town and village throughout the state.
More extreme are the MTV, the Mizo Tlang Vla, who broke one drugs dealer’s legs and left him to die in the jungle in February. Dealers, they say, will be “tsunamied”, a threat eagerly echoed by the YMA.
Many Mizos support the YMA’s efforts to rid society of a dangerous menace. But the local English-language Newslink is waging a lonely campaign against the group’s “caveman” approach, which it says will only drive the problem deeper underground.
Today, Irene is pregnant with Malsawmdawngu’s baby, but will probably lose the child because of her frail health. The couple say they started taking drugs because there was little else to do in Mizoram and only stopped because they stopped enjoying it, not because anyone forced them.
“Breaking bones and killing people will not change them,” Malsawmdawngu said. “Change only comes when we realise we are facing a problem.”
Revision date: July 6, 2011
Last revised: by Andrew G. Epstein, M.D.