Painting Hardship and Hope: The Human Stories Within Kachin State's Drug and HIV Epidemics

As part of the USAID HIV/AIDS Flagship (UHF) project managed by UNAIDS through Community Partners International (CPI), project partner Metta Development Foundation (Metta) operates drop-in centers in Kachin and Shan States to support people who inject drugs (PWID) and people living with HIV (PLHIV).

Alongside HIV testing and counseling (HTC), Metta utilizes a harm reduction approach at its centers, focused on minimizing the risks and harm associated with drug use. Harm reduction services include the Needle and Syringe Exchange Program (NSEP) for people who inject drugs (PWIDs). The centers also offer clients opportunities to participate in additional activities such as art therapy.
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During a recent art therapy session at a Metta drop-in center in Kachin State, CPI spoke with clients about their paintings and lives. These are the human stories of hardship and hope within the drug and HIV epidemics in Kachin State.

Interview 1: “The staff said I could paint even if I cannot read or write.”

“Including this session, I have now painted twice. At first, I had no idea about painting because I couldn’t read or write. The staff said I could paint even if I cannot read or write. I painted my difficulties and feelings like they asked me to. They were glad and complimented my drawing, and I did it again today. I painted black for the time of crisis. My son lives far away, and I cannot depend on him because he’s unreliable, so I painted him in blue. White and pink are for feelings of joy.”

“Now I want to share my feelings. The first time I approached Metta, I felt apprehensive. Some people told me not to join Metta because I would be forced to stop taking opium [1]. Whatever, I discussed with Metta and joined.”

“I’m happy to be a member of Metta [2]. I can ask the staff for help if there’s a problem. I’m happy here. We come to Metta, take snacks to eat, and ask for rice. I was skinny, but now I’m getting plump. Before I met with Metta, I was not happy. That’s why I painted black. In the middle are my family and me, five altogether. The white circles mean that Metta’s staff help and support us wholeheartedly.”

“When I tried to quit opium, I heard that it’s safe to take methadone since it doesn’t cause trouble or disease [3]. The Metta staff told me to come to Metta for methadone [4]. If I had to buy methadone, I would not be able to buy rice or food. Because it is free, I can use my money to buy rice and food. I am happy because of this.”

“I want my son to quit heroin and live happily with his wife at home. This is what I have been thinking: I want to ask my son to stop taking heroin and start taking methadone so that he would stop spending money on drugs. I also have two grandchildren who are in school now. Since their father comes and goes, I feel upset. In the future, I want to be happy. I’m already over 60 years old now.”

Interview 2 (Married couple): “The message of my painting is to have sympathy for how I’m feeling.”

Wife

“Back when my husband was using drugs, we were so desperate that we sold our house to buy drugs. I was distraught and always in tears. Now, thanks to methadone [3], we can make good use of our money, and we don’t have to get heroin anymore. I wanted to express these experiences in my painting.”

“Drugs can drive us into deep trouble. That’s why I painted this image of us both sinking in a quicksand of trouble. Black and blue describe the troubles we were facing. Our neighbors took us to Metta, and they helped him take methadone [4]. We can buy rice, oil, and other necessities with our wages. From the quicksand, a white bridge stretches beyond it, meaning we walk away from our troubles. Drowning in the quicksand of drugs is expressed with black and blue, and being able to stand on our feet is expressed with yellow. We don’t need to borrow anything from anyone. We can depend on ourselves without heroin.”

“I can’t sing, but with painting, I can express what I feel if I use certain symbols. It has lifted a burden off my shoulders. I feel light right now and can share this with others.”

“I’m sure wives of other drug users will feel the same way. I also want their husbands to take methadone and spend money for their families. I hope that a methadone project will be right here as soon as possible.”
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“Currently, we live at my mother’s house. It’s my wish to save money and build our own house.”

Husband

“Before drugs, I was quite sociable and had a lot of friends. I could go where I wanted. After being a drug user, no one cares about me. People criticize everything I do because of drugs.”

“All the things I have done come back to me in my thoughts occasionally, but I have decided not to do bad things again. The message of my painting is to have sympathy for how I’m feeling.”

“Now, I make brooms from coconut raffia for Metta’s center.”

Interview 3: “I am not useless. I was used.”

​”We human beings are curious and want to try new things. This is our instinct. So we try drugs and become dependent. But should we only blame people who are using drugs? Is it only their fault? Are not those who produce and spread drugs also responsible? That’s how I feel right now. If there were no drugs, there would be no drug users. Drugs are widespread, distributed, and produced.”

“Poppy fields don’t run away. I don’t know why they aren’t destroyed yet. When it becomes heroin, it is easy to pass on and hide. We drug users are not criminals who need to be punished. We have not committed a crime. We are just damaged by heroin for someone else’s advantage.”

“I used yellow, blue, and white. White is for the graveyard. Yellow means gold and natural resources. Blue expresses mountains and hills. If you try to look farther, you will see more. If you are fixated on one thing, you will only see that thing. What I’m trying to see lies farther ahead in the future. I painted a group of drug users and a group of Metta staff.”

“Other drug users might feel intimidated and reluctant to speak up because the community ostracizes them. People around them say things like, ‘He’s useless. Being dead might be better for him.’ I am not useless. I was used.”

Interview 4: “Do not lose hope if you have what I have. There are medications. There are people there to help you.”

“This is my first time painting. I’m worried I can’t explain what I’ve painted. My painting is a combination of blue and red. My husband used drugs and died because of HIV-related causes. I was sick and could not get up. So, I went to a clinic and had a blood test. Then, I was told that I had HIV. That’s why I combine blue and red with the feeling of being a widow with five children who is taking Antiretroviral Therapy (ART) medication. I added white because there will be days of happiness when my children grow up, earn money and support my medications. The combination of green and yellow here conveys joy because my friends have not abandoned me.”
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“Do not lose hope if you have what I have. There are medications. There are people there to help you. You don’t have to feel ashamed or afraid. I aim to live long and happily with my children, taking ART medication. I hope for medication that will cure HIV/AIDS.”

Interview 5: “My painting is nothing more than expressing my true wish.”

“I was quite worried that my hands would be unable to express what I had in mind. As a Metta staff member suggested, I tried mixing yellow with blue to get green since I wa­nted to paint a mountain range at first. I tried painting after mixing the colors, but it was not what I wanted. Then, I had to process what I wanted in my mind again. The one that I just painted is about the cyclical nature of drug addiction. It’s about how we cannot escape.”

“Honestly, I want people in my situation to stop taking drugs. I want to quit, too. I have tried many times but couldn’t. I’m still trying. If you can’t completely quit, I would advise you to take methadone [3], which doesn’t consume time and money. I want methadone to be widespread in my region [4]. That’s why I painted about being unable to escape. You will see people caught up in that circle of addiction in my painting. I want people to see a way out. I want people to see the exit that I see.”

“I’m married. Because of drugs, I am now homeless, and I have to depend on others for a place to live. I feel like an outcast. I dream of living happily with my family in my own home. When I meet with people in my situation, they ask me what I am thinking. I reply that I am thinking about why we can’t escape from drugs. It’s beneficial for us that Metta is here. They give us food, and we can exchange used needles for clean needles [1]. This prevents transmission of diseases.”

“I aim to escape from drugs, and I’m still trying. As soon as I’m free from drugs, it will be as if I’ve achieved my goal. My painting is nothing more than expressing my true wish.”

[1] Metta Development Foundation utilizes a harm reduction approach at its centers. Through this approach, the Metta Development Foundation focuses on minimizing the risks and harms associated with drug use. Harm reduction services include the Needle and Syringe Exchange Program (NSEP) for people who inject drugs (PWIDs).
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[2] At drug users network group meetings facilitated by Metta Development Foundation, members learn about harm reduction to reduce transmission of HIV and blood-borne diseases. During sessions, members also share their experiences and support one another. Drug user network groups also actively coordinate public awareness campaigns to change public perception of PWIDs. The purpose is to reduce stigma or discrimination against PWIDs and to increase community acceptance of harm reduction services.

[3] Methadone is used for opioid substitution treatment (OST). It is prescribed and administered at Methadone Maintenance Treatment (MMT) clinics in Kachin State.

[4] Metta Development Foundation provides transportation support for clients in this project site to take methadone in Hopin. Due to the distance, however, some clients are waiting for the construction of an MMT clinic at a station hospital in this location. The clinic is expected to open within the next month. Metta Development Foundation will provide human resources support (two nurses) at the MMT clinic.These interviews have been translated and edited. The views and opinions expressed in these interviews are those of the interviewees and do not necessarily reflect those of PEPFAR, USAID, UNAIDS, Community Partners International, or Metta Development Foundation.

USAID funds the USAID HIV/AIDS Flagship (UHF) project under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through UNAIDS Myanmar. UNAIDS oversees the project, while Community Partners International (CPI) provides project implementation support and management to five partner organizations: Asian Harm Reduction Network (AHRN), Medical Action Myanmar (MAM), Médecins du Monde (MDM), Metta Development Foundation (Metta), and Population Services International (PSI).