Abdul Bashir survived his first opium overdose on Tuesday. He was 15 days old.
He thrashed against the soiled hospital cot and gurgled the horrible, rhythmic wheezes of the dying. Nurses pressed an oxygen mask to his tiny face, blue from asphyxiation, and tourniqueted his convulsing limbs to inject an antidote. From the corner of the drafty hospital room, Abdul Bashir’s young mother fixed her child with a drugged stare. It was she who had given him the opium that morning, to hush his crying. It’s what all women in her village always do.
These are some well-known verities: Afghanistan’s poppy fields supply nearly all of the world’s opium and approximately half the budget of the Taliban, which uses the estimated half a billion dollars per year in drug money to fund their insurgency. The opium trade in Afghanistan is worth as much as $4 billion a year—the second-largest source of revenue after Western aid.
But far less known than the Afghan economy’s addiction to opium is the addiction of its people. Its extent is opaque, its consequences lost in the penumbra of physical and cultural isolation of entire constellations of villages not marked on any map, often not reachable by car, and virtually unchanged for centuries.
A United Nations survey last summer showed that one million adult Afghans between the ages of 15 and 64 may be addicted to drugs—twice the average global rate. A U.S. State Department study of air, hair, and surface samples in the houses of Afghan opium abusers concluded that “inhalation of second-hand smoke, as well as contact with contaminated surfaces (third-hand exposure) are endangering women and children living in households where opium or other drugs are abused.”
But these studies do not account for children like Abdul Bashir, who are growing up with no access to electricity, health care, clean water, and education—but with easy and constant access to cheap opium. The drug is used as the traditional remedy for every kind of ache or illness. In dozens, perhaps hundreds of villages in northern Afghanistan, most pregnant mothers introduce their children to opium prenatally, when they dilute specks of the sweet black paste in their morning tea to ease muscle aches, stupefy hunger, and dull depression. After the children are born, mothers typically give them infinitesimal amounts of the drug to chew in their hand-sown cradles strung from thatch ceilings, in lieu of a pacifier.
Untold thousands of people are trapped in the generations-old dependence in the plains of the ancient Khorasan. No one seems to know when the addiction took root in this parched soil. Some credit the armies of Alexander the Great with introducing the drug after he conquered the majestic city-state of Balkh in 327 B.C. In many ways, the landscape of today’s Bactria remains the same as the Macedonian must have beheld: eroding walls of mud and straw; jackknifed farmers in unbleached robes tilling hand-sown fields with wooden tools; unpaved and unmarked clay roads.
Some of these roads lead to Dawlatabad, a dull and flat market town that unshutters its stores twice a week, on bazaar days. Dawlatabad is home to the only hospital that serves several hundred villages to the north of ancient Balkh—some just a couple of miles away, like Abdul Bashir’s Joi Arab, some a day’s trek by donkey or camel. A team of six doctors and ten nurses work at the grimy one-story walled compound. Dr. Mohammad Akbar, the sole pediatrician here, told me the hospital receives approximately 1,000 child patients each year. Every single one of them, he said, has some degree of opium poisoning. “Most of them have other diseases—tuberculosis, dysentery, pneumonia,” the doctor explained. “But all of the children in our area are treated with opium first. Only after that fails do their parents take them to the doctor.”
After the nurses resuscitated Abdul Bashir with a shot of naloxone, an opiate receptor blocker, the doctor took me through his ward. The cots along the green walls streaked brown with old blood, or maybe excrement, were mostly empty. In two different rooms, three mothers sat cross-legged on cots next to their children. The doctor made macabre introductions: A two-year-old child with meningitis and opium addiction. A seven-month-old baby with pneumonia and opium addiction. A month-old baby with giardiasis and opium addiction. “They are either giving opium to them when they cry, or the child is ingesting it with the mother’s milk,” the doctor said. “We will treat them here, but when they go home…”
The doctor looked at Abdul Bashir. The infant, hooked up to a drip of IV fluid, was asleep and breathing normally. “Every month we receive two or three babies like this, not breathing, overdosed,” he said. “It is very common for people in this area to give opium to children when they cry. If he had gotten here twenty minutes later, he wouldn’t have lived. Last year, we had three children who were brought here dead.”
The other day I lunched on rice and desert dove with a hunter in Oqa, a tiny cluster of low hand-slapped houses about 30 miles east of Dawlatabad—a five-hour donkey ride, since no one in Oqa has ever owned a car. Forty-knot wind blew bits of sand and dry desert scrub, and Oqa appeared to be an island floating in a moving sea of dust.
The wild meat was dark and cottony. Dessert was green tea and an opium pipe, an implement of soldered metal brought in by my host’s seven-year-old grandson. Men took turns reclining before the pipe, supplicants before a fickle deity that enslaves and grants analgesia both. Sour smoke wafted toward the door, where half a dozen children had
assembled to watch.
The men smoked and talked about life. In the last decade, it has gotten worse. Western aid has not reached the village, but the wealth that has accumulated in cities has complicated the existence of Oqa’s residents: The proliferation of cars in Mazar-e-Sharif, for example, means they can no longer take caravans with firewood their sons collect into northern Afghanistan’s largest city, because the cars startle their camels. The Taliban’s steady progress through the region means their village may once again become ensnared in fighting. The Afghan government has clamped down on the illegal trade of artifacts, which means fewer smugglers are willing to buy the small objects the men sometimes loot from the crumbling Kushan castles that rise out of their desert like ossified dragon spines.
A child by the door hawked dreadfully, a dark, sinister cough. What about doctors, I asked. Are there any doctors around, for when the children get sick? “The nearest doctor is in Dawlatabad,” the men replied. “But we rarely take the children there. Mostly, we give them opium.”
Anna Badkhen is the author of Peace Meals and Waiting for the Taliban. She is writing a book about timelessness. Her reporting from Afghanistan is made possible by a grant from the Pulitzer Center on Crisis Reporting.