Beating Drug Addiction in Tehran
Dr Dolan’s book details the intimate lives of four Iranian women, their struggle with drugs and the daily grind they faced in their personal lives.
Surprisingly, Iran responded well to its AIDS crisis but forgot to include female drug users. While Dr Dolan delivered training to Iranian prison doctors, she met women who were addicted to drugs and were desperately in need of treatment. With her health professional colleagues in Iran, she set out to establish the first drug treatment clinic for women. She was granted access to areas and people not normally afforded to outsiders.
One of the most interesting aspect of the clinic was the safe room that allowed women to remove their hejabs, smoke cigarettes and reveal their life stories. Working at the clinic challenged assumptions Dr Dolan had of Iran and its people. She came away with insights that are rare even in the world of international development.
|ISBN 9781922332325 (PB, 142pp);
152mm x 229mm
|AUD $30||USD $24||CAD $26||NZD $33||GBP £18||EUR €20|
|ISBN 9781922332332 (eBook)||AUD $16||USD $10||CAD $12||NZD $18||GBP £8||EUR €9|
Dolan draws from her vast international experience, weaving together the history and epidemiology of drug use in Iran with a tapestry of incredible, heart-rending stories from Iranian women experiencing the darkest depths of addiction. For readers who thought that epidemiologists were just ‘bean counters’, you’re in for the shock of your lives.
– Steffanie Strathdee, PhD, Associate Dean of Global Health Sciences, Harold Simon Professor, UCSD Department of Medicine
This deftly crafted recollection recounts a decade-long quest to have methadone programs embedded in an Iranian prison. Kate’s multi-layered narrative takes us through the multitude of people, governments, policies, religions, moral imperatives and myths that swirl around any new drug and alcohol-related activity. Her mission was a matter of life and death.
– Jude Byrne, Australian Injecting and Illicit Drug Users League
An Australian professor of public health recounts the struggles of establishing and maintaining a women’s drug treatment clinic in Tehran in this debut memoir.
In the mid-1980s, Dr. Kate Dolan was co-founder of the Australian Prostitutes’ Collective and the Australian Drug Information Collective. She and her colleagues discussed ways to respond to the HIV epidemic, including a program for
handing out free, sterile needles and syringes. In researching other countries’ similar programs, the author learned that a primary reason people shared syringes was because they were in prison. So when she traveled to Iran in the early 2000s to see its response to HIV, she toured the nation’s prisons and spoke with inmates. While Iran implemented “harm reduction” strategies for those taking drugs, Dolan noticed a neglected group—women. She set about starting a clinic in south Tehran to help women who used drugs. After several years of rejected funding requests, the clinic’s doors finally opened in 2007. The building’s highlight was the “safe room,” where clients could discuss difficulties frankly and remove their hijabs. As Dolan lived in Sydney and was raising twins, she only visited the clinic periodically. In this book, she focuses on four clients and their progress over a few years. Zahra, for example, was a pregnant teen trying to quit heroin. Dolan and the staff, as with most clients, fought for Zahra to continue treatment, but numerous issues impeded their efforts, like drug-using family members acting as enablers.
Dolan’s account treats Iran and its culture respectfully, noting intriguing differences without condemning any of them. For example, she was initially concerned about a midwife on the clinic’s staff, as this job in Iran concentrates on the expectant mother’s sexual health rather than aiding delivery. The author also adds personal touches, such as photographs, mostly from her days visiting prisons. In a particularly moving turn, she tells of returning home after an overseas trip only to be shaken by the tragic, sudden death of her partner, Margaret. While it’s understandable why Dolan, an Australian resident, didn’t step inside the Iranian clinic for the first two years, the lack of stories about the staff getting the facility off the ground is disappointing. Still, the author provides intriguing specifics about treatment, which predominantly involved methadone for those with heroin addictions. There were surprising hurdles as well, from the laborious process of securing money for the clinic to something as simple as the building’s electricity continually going out. Nevertheless, the latter half of the work becomes muddled. The timeline, for example, is confusing; at one point, Dolan had a chance to visit Iran again in 2012, then later it’s 2010 and, even later, 2009. Equally perplexing is Fariba, one of the four women the author spotlights. In a handful of scenes, details of her backstory repeatedly conflict, like her age when she first got married and the supposedly drug-free husband she ended up sharing opium with. But these missteps don’t mar Dolan’s unquestionable compassion, as she devoted years to helping others.
Despite some flaws, an absorbing look at treating women with drug addictions in Iran.
– Kirkus Reviews
Dr Kate Dolan
Dr Dolan's Profile on Yale Medicine
Her work at The National Drug & Alcohol Research Centre
And at Harm Reduction Australia
A broadcast interview with her on ABC's Health Report
And with Radio National's Dr Norman Swan on the Iranian Drug Treatment Project
Also check out her interview with Cassie McCullagh on ABC Radio Sydney
Feature on the book by the Institute for Global Development at UNSW
from Chapter 1. Evin Prison
In 2003, I was invited to deliver training on HIV to prison doctors in Iran. After the training, I was taken on a study tour of Iranian prisons. When I asked about women in prison, I was offered a chance to tour their wing within Evin Prison. I had accepted immediately. This was an environment that we see and hear nothing of in the West. To enter the female wing, I had to walk through several metal doors from the male wing. Inside, the walls were white with a pale blue trim. I had just visited eight prisons for men over the last ten days. But it was this visit—to a female prison in Iran—which would have a lasting effect on me. It changed my focus at work, my circle of friends and the way I viewed Iran and Islam. This prison in North West Tehran was newish, having been built in 1971. It sat at the foot of the Alborz Mountains, which are covered in snow in winter. This was the first trip of many I would make to Iran over the next decade.
The foyer of the women’s wing was clean like a hospital, sparse even. We walked down the corridor and there, on the right, was a cell. As we stood in the doorway, all the occupants turned away to hide, holding their chadors—long, flowing capes—up close under their chins. Each woman was wearing the same navy blue and white patterned chador, the prison-issue uniform. Some inmates had small children with them, and a few had babes in their arms. My visiting party comprised my interpreter, my guide, a prison guard and me.
Even with a borrowed hejab—the mandatory headscarf to cover a woman’s hair—everyone could see I was a foreigner. Strands of my blonde hair protruded from my pale hejab and my peaches and cream complexion meant I was from somewhere other than Iran. The female inmates were taken aback, suspicious even, to see me, as were their male peers when I was in their prisons. The interpreter introduced us to the women. As the interpreter spoke, they slowly turned around. Without exception they looked harmless, terrified even. These prisoners did not need to be locked up for society’s safety. They were here for punishment.
Female offenders tend to commit fraud and other non-violent crimes, but still I was intrigued to find out what crimes had resulted in their imprisonment. You realise as a prison visitor you should refrain from asking someone what the reason is for their imprisonment. I did ask the interpreter, though, about the sort of crimes, in general, they might have committed that resulted in their incarceration. He said a variety of offences, which, like in most countries; revolve around income generating scams to raise money to buy drugs. Female prisoners the world over are twice as likely as male ones to have a drug problem.
As we entered the first prison cell, I was surprised at how large, airy and light it was. Two bunk beds were pushed up against two walls that met at a corner. White cotton makeshift curtains hanged down from the top bunk, softening the metal bedframes and hiding the bottom bunk bed. The prisoners’ eyes ferreted across the room and back and forth to each member in our party. Then my guide explained the reason for my presence, on this warm sunny day in a female prison in Iran, of all places. He told them I was from Australia examining the programs Iran was implementing to prevent HIV. He informed them of my workshop for prison doctors, where we discussed treating females who had a heroin problem so they could avoid prison. I knew any mention of heroin and ways to avoid prison would be of interest to those who used drugs.
My student and I had delivered a three-day workshop to Iranian prison doctors. The workshop covered everything from sharing syringes and transmitting HIV to conjugal visits, condoms and homosexual sex. I remember thinking how would these Muslim men, as all participants were male, respond to two western women discussing homosexual sex in prison? Homosexual sex is illegal in Iran. Offenders are hanged. But the participants were all doctors, so I had hoped that they were pragmatic about the repertoire of human sexual behaviour. One key topic was strategies to prevent HIV. In practice it was rather straightforward, but in reality, many issues hindered prevention. Homophobia and a dislike of drug users discouraged prison authorities from providing condoms and other assistance. Even though methadone is a very effective treatment, authorities disliked it because it is a powerful narcotic drug with euphoric qualities. Most prison authorities preferred that inmates went cold turkey even if that approach was a resounding failure. It was unclear whether our proposed HIV prevention actions were going to be embraced or rejected outright.