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In Africa’s ‘first narco-state’, rehab can mean torture for addicts

Patients at the Quinhamel rehabilitation centre stand locked inside a dark cell - GUY PETERSON
Patients at the Quinhamel rehabilitation centre stand locked inside a dark cell - GUY PETERSON

Shortly after mass, the pastor looked on as his burly assistants stamped on the teenager, who had been accused of smoking a cigarette. “Stay calm or I’ll break your foot,” said one of the men, as the other attached a chain around the gaunt patient’s ankle and dragged him into a dark cell. Half a dozen other addicts and mentally-ill patients already inside simply stared. The guards laughed.

The rehab centre in Quinhámel, some 40 km from the capital of Guinea-Bissau, is the go-to treatment option for drug users in the nation – widely considered as Africa’s first narco-state.

Over the past decade, Guinea-Bissau has been ravaged by a crippling drug endemic that has destroyed livelihoods and killed people across the West African country. According to the National Drugs and Addiction Observatory, an NGO that advises the government, 30 to 40 per cent of young people use highly addictive hard drugs like crack cocaine, which sells for up to £4 per gram.

At the Quinhámel rehab centre, although some of its 50-odd patients receive antipsychotic medication, most of the ‘healing’ happens through prayer.

“Medicine doesn’t reach the soul,” said its founder, a Pentecostalist called Domingos Té, who claims to have used his “spiritual method” to help more than 5,300 patients, most of whom are sent there by their families.

But those accused of relapsing, trying to escape or refusing to take their pills are locked up, enchained and beaten, The Telegraph can reveal. One patient claimed that at least three people have died in the centre in recent months. “It is inhuman. No-one should be treated like this,” he said. “You must help us.”

A patient at the Quinhamel rehabilitation centre is held by his limbs by four men working at the centre - GUY PETERSON
A patient at the Quinhamel rehabilitation centre is held by his limbs by four men working at the centre - GUY PETERSON

Presented with evidence collected by The Telegraph, the United Nations Human Rights Office said it had alerted the government of Guinea-Bissau over the centre.

“We find the acts captured in the images and video deeply concerning and believe they could amount to torture. We call on the Guinea Bissau authorities to conduct an impartial, independent and effective investigation and hold those responsible for any human rights abuses to account,” said Seif Magango, a UN spokesperson.

The pastor dismissed the allegation that three people had died at his centre and insisted that only patients who pose a “risk” to others are enchained. He claimed that patients are only held in cells for one night at a time, yet some complained of having been locked inside for months.

“We have helped many young people get off drugs here in Guinea-Bissau,” he said.

‘This is a trafficking country’

In reality, there is no end in sight to the nation’s drug crisis, which is threatening to incapacitate a whole generation of young people.

Experts say crack use (the smoking of ‘rocks’ formed by mixing cocaine with water and baking soda) has reached record levels. “The drug is consumed by people of all social classes, ethnicities and religions, but with the greatest emphasis on the most disadvantaged sectors of the population, especially adolescents, youths, the unemployed and the poor,” said Abilio Aleluia Otairo Co Junior, director of the National Drugs and Addiction Observatory.

Guinea-Bissau, which is one of the poorest countries in the world, has long been used as a transit point for an illicit global supply chain stretching from coca fields in Latin America to moreish nostrils in Europe and beyond. According to the UN, the global supply of cocaine has never been higher. Multiple reports suggest high-ranking government and military officials in Guinea-Bissau are involved in its traffic.

“This is a trafficking country. The people protecting the cartels here are often paid in drugs. That’s why you find crack sold on the street,” said Francisco Sanha, who coordinates the government’s National Council for the Fight Against Drugs, Organised Crime and Risk Reduction.

For those who get hooked, the cheapest treatment option is in Quinhámel, where a typical stay ranges from 6 to 12 months at a price of at least £40 per month (and often much more) – a considerable sum in a country where the monthly minimum wage is just £80, though many earn less.

“We believe in the myth that Quinhámel works, even if we have all seen or heard what happens there,” said Sanha. “This centre doesn’t work. It makes things worse. But we have no alternative. I sent my cousin there for a week and he no longer speaks to me. He believes I sent him to his death.”

A patients at the Quinhamel rehabilitation centre stands against the inside a dark cell that has been carved up with drawings, names and words from years of other patients locked in the same room - GUY PETERSON
A patients at the Quinhamel rehabilitation centre stands against the inside a dark cell that has been carved up with drawings, names and words from years of other patients locked in the same room - GUY PETERSON
A patient at the Quinhamel rehabilitation centre stares out from behind a make shift barred door locking a number of people inside a dark cell - GUY PETERSON
A patient at the Quinhamel rehabilitation centre stares out from behind a make shift barred door locking a number of people inside a dark cell - GUY PETERSON

The only other in-patient facility in Guinea-Bissau is a private clinic in a small town called Gardete, where prices are at least five times higher but conditions are better and staff have medical training.

Mariama Baniko’s bare house in the suburbs of Bissau, the nation’s capital, is testament to the exorbitant cost of treatment. She sold her gas stove, sofa and bed to send her son to Gardete, after an initial spell at Quinhámel where she said the conditions were “indescribable”.

“I first tried to pawn my ring to a gold dealer but he wouldn’t accept it so I had to sell it at a corner shop for a fraction of the price,” she said. When the funds ran dry, Mariama sent her son to stay with relatives across the border in Senegal. “They tell me he is not doing well.”

Unless it develops its treatment sector, Guinea-Bissau risks having “whole cohorts of people addicted over the long term,” according to Dr Magda Robalo, the country’s former health minister and world-renowned epidemiologist.

“Addiction is a major public health problem. There was a boom following covid, due to the effects of confinement, school closures, job losses and a lack of sport. Some children start smoking as young as ten. We are seeing more and more mental health issues.”

A patient at Quinhamel stands in the door way to a dark room he shares with over a dozen others. He has been chained by his ankle to a bed next to the door for three months - GUY PETERSON
A patient at Quinhamel stands in the door way to a dark room he shares with over a dozen others. He has been chained by his ankle to a bed next to the door for three months - GUY PETERSON

The only public psychiatric hospital is in Guinea-Bissau run by Jeronimo Henriqué Té, who also runs the private rehab clinic in Gardete. It was destroyed by shelling during the 1998-99 civil war and rebuilt with funds from the European Union in 2016. There are no in-patient facilities and the drugs available are mostly first generation antipsychotics like Haloperidol and Chlorpromazine developed in the 1950s.

“We get more and more drug addicts coming here and they are getting younger and younger,” said Té. “We have to run this place like a private hospital because we don’t get any money from the government. But I certainly don’t agree with putting people in chains.”

While isolated voices clamour for the government to invest in treatment facilities, others are calling for a crackdown on supply.

“We should prioritise repression. It is an area where we have developed experience and have resources. We don’t have a developed treatment and prevention sector. If we can reduce supply, we solve the problem,” said Sanha, who also denounced the treatment in Quinhámel as a “crime”.

Those caught with a small amount of crack – or Quisa as it is known locally – are typically held for 48 hours. In some irregular cases, when the police want to extort money from the families, they are held for months, according to Braima Sissé, a spokesperson for the Judicial Police.

A patient at the Quinhamel rehabilitation centre stands next to her mattress wit her belongings pilled up in a corner - GUY PETERSON
A patient at the Quinhamel rehabilitation centre stands next to her mattress wit her belongings pilled up in a corner - GUY PETERSON
A patient at the Quinhamel rehabilitation centre lays on a mattress in a dark room - GUY PETERSON
A patient at the Quinhamel rehabilitation centre lays on a mattress in a dark room - GUY PETERSON

Efforts to crack down on supply are undermined by what a recent report from the Global Initiative Against Transnational Organized Crime, a Geneva-based NGO, describes as “close involvement of Guinea-Bissau’s political-military elite in the cocaine market”.

Hours after bullets whizzed through the Governmental Palace, killing at least 11 people in an apparent attempted coup last year, President Umaro Sissoco Embaló told the press that “some individuals involved in this cowardly and barbaric act were already being investigated for drug trafficking.”

The former head of the Navy, Admiral José Américo Bubo Na Tchuto, who had previously been convicted by a US court for drug trafficking charges, was arrested. Other prominent international traffickers are thought to live freely in Bissau.

Braima Seidi Bá, a well-known criminal entrepreneur, was convicted in absentia of importing a record 1,869 kg of cocaine in September 2019. He was acquitted by the country’s Supreme Court in June 2022 – a decision decried by civil society groups.

“We spend most of our time policing the drug trade. In recent years we have got better at it, closing down a number of networks. But it is frustrating and pitiful to see people implicated in trafficking at the highest levels of the state,” said Sissé, the Judicial Police spokesperson.

Mamad Aliu Djal, director of ENDA Bissau, sits in a car after visiting a crack den that ENDA supports - GUY PETERSON
Mamad Aliu Djal, director of ENDA Bissau, sits in a car after visiting a crack den that ENDA supports - GUY PETERSON

Reconciled to the fact that the country remains a significant global hub for cocaine trafficking, some actors now focus instead on minimising the risks for drug users on the local market. ENDA Santé, a public health NGO active in a number of West African countries, runs 16 community outreach missions every month in the capital and regions of Guinea-Bissau.

They distribute medicine, condoms and safe syringes to reduce the risk of HIV and hepatitis transmission, and clean crack pipes and filters to tackle the spread of tuberculosis, Covid and herpes.

“There is not enough education on the dangers of drug use,” said Mamadú Aliu Djaló, the country director. “We inform communities on the risks, not just for their health but also from a legal perspective.”

One beneficiary, a 36-year-old construction worker called Chigozié, lives in a small room with his two children and girlfriend. He described one of the ENDA team, a volunteer nicknamed Rasta, as “like a brother” and is grateful for the regular blood tests. “If you use drugs, you must take care. Health is more important than money,” he said.

“I want to stop but there is too much stress. Life is tough here. Everyday you wake up and nothing changes. There is no work and I have sold everything I have. When you are struggling to survive, sometimes you need something to relax.”

  • Additional reporting by Ali Embalo

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