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Hong Kong’s lack of rehabilitation services leave minority drug addicts with nowhere to turn

Language, religious and cultural barriers prevent many Nepalese drug addicts in the city from getting the vital help they need

PUBLISHED : Saturday, 19 November, 2016, 10:02am
UPDATED : Saturday, 19 November, 2016, 10:02am

Thapa was only 16 when he first started abusing ‘brown sugar’ - an adulterated form of heroin - in Nepal.

He came to Hong Kong in 2004 to reunite with family, but pressured by peers and feeling disenfranchised by his experience as a member of an ethnic minority in the city, Thapa turned to heroin. He was only 18.

“Before, I had no meaning to my life,” he said.

Thapa’s story is not unique in the Nepalese community. Drug abuse among ethnic minorities in the city has been on the rise since 2005.

Statistics show drug use has risen from 1.4 per cent to 3.6 per cent in the Nepalese community, compared to a rise from 0.4 per cent for other South Asians to 2.6 per cent in this year’s first quarter.

Now, those working in the rehabilitation sector say these figures are just the tip of the iceberg, with drug addiction among ethnic minorities a “hidden” issue and real figures are much higher than official statistics.

“We and the government also know there is under reporting,” Andy Ng Wang-Tsang, chief executive at the Society for Rehabilitation and Crime Services, said. The Nepalese community has the worst problem, making up 42.8 per cent of ethnic minority drug addicts, according to a Chinese University study in 2014.

Recovered Nepalese drug addicts who now work in rehabilitation have seen the issue worsen in recent years.

“They have no direction in life and don’t want to do anything,” Thapa said.

Compounding this problem is that South Asians remain reluctant to seek help because of discrimination and barriers in and outside of rehabilitation programmes.

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An Equal Opportunities Commission report released last month (Sept 21) said non-white ethnic minorities in Hong Kong encounter the most discrimination in the provision of goods, services and facilities.

Issues that South Asian drug addicts face in rehab facilities run in parallel to the issues they face in Hong Kong society: language, culture and religion.

The Nepalese are the “underprivileged of the underprivileged”, according to Angelique Tam, executive director at The Society for the Aid and Rehabilitation of Drug Abusers (Sarda).

She said the Nepalese community is inherently disadvantaged, as many lack access to higher education and skilled working opportunities and therefore have “no upward social mobility”.

Failing to integrate into mainstream society, some turn to drugs for a sense of belonging within their community.

I have seen too many friends who don’t have money and sleep on the streets. I want to help them solve the problem
Thapa

“It’s a vicious cycle,” Tam said.

Thapa’s first attempts at seeking help in Hong Kong at Shek Kwu Chau rehab centre ended only after eight days. Faced with language barriers that prevented him from communicating with staff and worries of being unable to provide for his family without a job, Thapa left early and relapsed into heroin use.

With the government’s drug programme centred around methadone clinics, there are only two rehabilitation centres in Hong Kong that target ethnic minorities: St. Stephen’s Society and Operation Dawn.

“Culture is the biggest problem,” Benjamin Cheung, supervisor at St Stephen’s Society, said.

South Asian communities in Hong Kong are tight knit and news travels fast, creating a powerful barrier for those seeking rehab.

The South Asian population is predominantly Buddhist, Hindu or Muslim; yet nearly all of the city’s rehab services are Christian-based.

This means religion is a “first-stage barrier” that ethnic minorities face when seeking treatment, according to Puja Kapai, law professor at Hong Kong University, who has published extensive research on the status of ethnic minorities in Hong Kong.

After dropping out of Sarda’s Shek Kwu Chau in 2009, Thapa tried Operation Dawn, which uses Christianity as a base for treatment. But again he left, this time only after five days.

“It’s very difficult for us because the religion cannot work,” he said, adding that many of his friends also dropped out of faith-based services.

Cheung said St. Stephen’s emphasised integration of all ethnicities in its programmes and “100 per cent no-one discriminates against the Nepalese in our centre”.

He was adamant that faith-based services were vital to help rehabilitate drug users, saying “except for turning to Jesus, I don’t see any other way”.

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But he admitted it was a serious problem for Muslim Yemeni and Pakistani clients. .

Language is the other key barrier. Not only are Nepalese patients unable to communicate to Chinese members of staff, but classes at Operation Dawn are conducted in Cantonese.

Even at Shek Kwu Chau, where ethnic minorities have their own dorm and are free to practice their own religion, clients like Thapa struggled to communicate with staff.

“They only speak Chinese or English. I don’t know how to speak Chinese,” Thapa said.

A former Nepalese drug addict who came to Hong Kong in 1996, named Robert, also spoke negatively about his experiences in rehab programmes.

Robert began taking drugs in his first year in the city. From his five years in and out of rehab, he is equally critical of these programmes.

“Most ethnic minorities cannot speak or understand [Chinese or English] so what is the use?” he said.

Female ethnic minority drug addicts in Hong Kong are further marginalised. In addition to the barriers their male counterparts face, female drug use is highly stigmatised in their cultures. There are no rehabilitation services specifically for female ethnic minorities.

“Female ethnic minorities have to rely on themselves,” Ng said, adding that they feel “much more social pressure” and are “ashamed to disclose” their drug abuse.

Faced with discrimination and seemingly insurmountable language and cultural barriers, South Asians have two options. They can visit government methadone clinics, but often drug addicts will use methadone as a cheap heroine replacement, at just HK$1 per visit.

“If they have money, they buy drugs. If they don’t, they go to methadone clinics,” Ng said.

Another option, which many ethnic minority drug addicts turn to, is to return to their home country for rehabilitation.

According to Robert, 80 per cent of Nepalese drug abusers choose to return to Nepal to receive treatment because the centres are “well managed” by former addicts, operating in familiar language and cultural settings.

He calls this a “shame and disgrace to Hong Kong’s rehabilitation centres”.

But upon return, many relapse.

“When they return to Hong Kong they face the same community so they relapse easily,” said Horace Fung Ho-Kwan, a social worker with 10 years of experience at Yau Ma Tei Methadone Clinic.

Fung believes there is a “geographical” reason for the high proportion of drug addiction in the Nepalese community, as they live in clustered areas.

Combined with a tight sense of brotherhood, “they face temptation from the community everyday”.

The lack of government services for ethnic minorities have irked patients and organisations alike. “They are also members of our society. The government should start paying attention to this group, they can’t be living in isolation,” Ng said.

Government services are also abandoning significant numbers of ethnic minority drug addicts without HKID cards, who consequently cannot be taken into residential rehab centres or access social welfare.

Social workers and rehabilitation services agree that one way to overcome the barriers to treatment is to employ ethnic individuals .

“If they come from the same cultural background it’s much easier to build up a working relationship and attract ethnic minorities,” Ng said.

Thapa, who eventually conquered his battle with drugs after a six month stay at Shek Kwu Chau in 2014, is now a peer counsellor at the same facility, reaching out to fellow Nepalese drug addicts.

“I have seen too many friends who don’t have money and sleep on the streets. I want to help them solve the problem ... and also be a role model for them to equip myself from relapsing again.”

Spotlight on minorities trouble spots

1.Three men were treated for knife wounds after a fight broke out between rival South Asian gangs at Jordan MTR station in September 2015. The brawl happened on the Tsuen Wan Line platform. Witnesses described seeing a “bloodbath” and a chunk of flesh being cut off one of the men’s arms. Two men were charged with wounding with intent following the attack.

2.Two Nepali men were jailed for eight years for killing Nepali teenager Thapa Anup during a fight between rival gangs in September 2012 in Yuen Long. Magar Sagar, 23, and Gurung Roshan, 27, each pleaded guilty to one count of manslaughter following the

19-year-old’s death and were handed prison sentences in November last year.

3.A 44-year-old Japanese woman was jailed for 25 years for drug trafficking after attempting to transport 4.8kg of crystal methamphetamine, worth HK$1.7 million, from Hong Kong to Japan in July 2003. She was jailed along with a 35-year-old Japanese man after the discovery at Hong Kong airport’s departure hall.