Inside the grounds of Fann hospital in Senegal, men and women form a substantial queue.
Those without seats loiter in hallways, and others able to bear the sweltering heat outside play checkers under a canopy of overgrown mango trees.
They are here for the Center for the Integrated Management of Addictions.
A nurse calls them one by one dispensing a small cup of blue liquid. It’s a daily routine for methadone treatment and psychological counseling at the center and one that many journey hours to receive.
Known locally as CEPIAD [Centre de prise en charge intégrée des addictions de Dakar], the drop-in clinic is the first in West Africa running a free opioid substitution service. The aim is to reduce the spread of HIV and AIDS among addicts.
“You get here, have your methadone and you are not thinking about taking drugs. You are thinking about moving your life forwards,” says Senegalese native Moustapha Mbodj, a former heroin addict for more than 30 years.
The service available to addicts is rare in this part of the world.
CEPIAD’s program is the only one of its kind in Senegal, and West Africa, offering clean needles and opioid substitutes. A 2017 report showed that out of 37 nations in Africa reporting drug use data to the United Nations, just eight offer this type of therapy to addicts.
“Most users are coming here because it’s the only center really,” says Mbodj, who is 58. He began snorting heroin after traveling to Paris in his early twenties to study for a degree in technology.
By the age of 27 he was jailed for dealing cocaine and deported home after serving a three-year sentence.
“My family put a lot of hopes on me. When I started using they were extremely disappointed. There was a lot of deception,” he recalls. On returning home to Dakar he would steal things at home to sell and buy heroin.