In Sierra Leone, a cheap, synthetic drug is ravaging youth. Trash-strewn alleys are lined with boys and young men slumped in addiction. Healthcare services are severely limited. One frustrated community has set up what it calls a treatment center, run by volunteers. But harsh measures can be used.

The project in the Bombay suburb of the capital, Freetown, started in the past year when a group of people tried to help a colleague’s younger brother off the drug called kush. After persuasion and threats failed, they locked him in his room for two months. It worked. He has returned to university and thanked them for setting him free.

“The only time I left the room was when I went to the bathroom,” Christian Johnson, 21, recalled. He said he was motivated to kick the drug by thoughts of his family, the fear of becoming a dropout and the abandonment by many of his friends.

Two boys walk in Moa Wharf, a slum where Kush users live in Freetown, Sierra Leone, Friday, April 26, 2024. (AP Photo/ Misper Apawu)

The volunteers then expanded the effort and took over an abandoned building. They seize people at families' request and sometimes chain them to prevent them from escaping — an echo of a practice the West African country's only psychiatric hospital previously used. There's little padding against the concrete floor and walls, and little to do beyond confronting their craving.

“We turn parents away for lack of space,” said Suleiman Turay, a local football coach who helped launch the center. “The people in the community cooperate and help in their own individual ways. Some bring food, some bring water, doing whatever they can to help.” A doctor in the community visits from time to time. Police said they were not aware of the project or the practice of chaining people.

So far, the Bombay Community has treated 70 to 80 people, volunteers said. One showed the chains used in extreme cases, although no one was chained at the time. The youngest held was a 13-year-old boy sent there by his father.

“I was very angry, and I wanted to have nothing to do with him,” said the father, Gibrilla Bangura, a college lecturer. “I am very grateful to these men and women for their role in helping my son.”

Kush users rest in a room where they receive care in an unconventional rehabilitation centre in the Bombay community, in Freetown, Sierra Leone, Thursday, April 25, 2024. (AP Photo/ Misper Apawu)

Sierra Leone’s President Julius Maada Bio this year declared a war on kush, calling it an epidemic and a national threat. He has launched a task force on drug and substance abuse, promising to lead a government approach focused on prevention and treatment involving law enforcement and community engagement.

“We are witnessing the destructive consequences of kush on our country’s very foundation, our young people," Bio said in April.

People rarely know what they're getting with kush, a derivative of cannabis mixed with synthetic drugs like fentanyl and tramadol and chemicals like formaldehyde. In some communities, civil society workers say, people have dug up graves to grind bones to cut with the drug, seeking chemicals used in embalming.

The U.S. Centers for Disease Control and Prevention’s director in Sierra Leone, Daphne Moffett, said one challenge in responding to the crisis is the drug's changing composition. “Before appropriate interventions can be developed, we need to know what materials are in Kush,” she said in an email.

A group of youth meet in Bombay Street in a compound where they rehabilitate Kush users in Freetown, Sierra Leone, Saturday, April 28, 2024. (AP Photo/ Misper Apawu)

An employee at Sierra Leone Youth Development and Child Link (SLYDCL) provides medical care for Kush users at Moa Wharf, a drug den in Freetown, Sierra Leone, Friday, April 26, 2024. (AP Photo/ Misper Apawu)

The drug leaves people lethargic, desperate and ill. While the government does not publish official figures on kush-related deaths or hospital admissions, Ansu Konneh, the director of mental health at the Ministry of Social Welfare, said there had been a sharp rise in people addicted to kush turning up at Sierra Leone’s only psychiatric hospital since 2022.

Konneh heads Sierra Leone’s first public drug rehabilitation enter, which opened in Freetown in February. He said kush has affected Sierra Leone like no other drug.

“It’s making young people drop out of college, and it’s having a physical effect on their health. You can see they have swollen feet, they have multiple organ failures, they’re involved in crimes,” he said. “It’s a very serious situation. It’s creating family disintegration, problems in communities, and they’re dying every day.”

Prince Bull-Luseni, the director of the West Africa Drug Policy Network, a group that aims to promote policy reforms, said Sierra Leone is the worst-hit country in the region. “Every community in Sierra Leone, not just in Freetown, has been hit by kush and it’s tearing them apart,” he told the AP, adding that with no treatment or rehabilitation for most users, "there’s no way to address it.”

A Kush user reacts after receiving treatment at Sierra Leone's Youth Development and Child Link (SLYDCL), an NGO that provides medical care and psychological needs for drug users in Sierra Leone, Friday, April 26, 2024. (AP Photo/ Misper Apawu)

The Social Linkages For Youth Development And Child Link, a nonprofit organization that seeks to fight drug use, relies on former users of the drug to help educate young people about its toll. The organization had lobbied the government for years to allocate more resources to fighting addiction.

“Overcoming the addiction wasn’t easy. It was one of the hardest steps of my life,” said Ephraim Macaulay, a peer educator who came across kush in college and soon was paying less than a dollar for a day's supply. “It’s like you trying to get out of water and there’s water all around you.”

He motivated himself by comparing himself to friends and family. They were clean. He stank. Gradually, he stopped taking the drug. Now he sometimes feels like crying when talking to peers, reminded of what his life could have been if he hadn’t kicked the addiction.

Habib Kamara, the executive director at SLYDCL, said the availability of kush has grown exponentially after suppliers began to manufacture it locally. He said law enforcement needs to do more to target manufacturers at the top of the supply chain instead of chasing buyers and low-level sellers. The government has said it wants to help, not punish, those who use the drug.

“This country has fought two pandemics,” he said, listing COVID and West Africa's devastating Ebola outbreak that began a decade ago. Kush has had a similar impact, causing young people to drop out of school, straining the healthcare system and tearing apart families.

“If we cannot have an approach that reduces usage, in the future we will not have people to replace us tomorrow in the workforce," Kamara said.

Kush users receive treatment at a medical outreach facility of Sierra Leone's Youth Development and Child Link (SLYDCL),an NGO that provides medical care and psychological needs for drug users, Friday, April 26, 2024. (AP Photo/ Misper Apawu)

A Kush user shows his injury through a window at a medical outreach center of Sierra Leone's Youth Development and Child Link (SLYDCL), an NGO that provides medical care and psychological needs for drug users, Friday, April 26, 2024 . (AP Photo/ Misper Apawu)

Some parents are exhausted. Memunatu Kamara, 49, sells smoked fish at a market in Freetown, providing the main income for her family of six. Her husband is an imam. Their son, the oldest, has dropped out of school and stolen the few valuables they owned to buy the drug.

“A very intelligent boy has become a dropout,” she said, wiping away tears. “I feel pain seeing him in this condition. I feel shame among my peers. I feel discouraged about his future. I have no idea what else to do about it.”

She has put her son on the waiting list for the Bombay Community.

A boy looks at his phone on the street of Bombay at night, Freetown, Sierra Leone, Saturday, April 28, 2024 (AP Photo/ Misper Apawu)

Young men work on a landfill in the east end of Freetown, Sierra Leone, Tuesday, April 30, 2024. (AP Photo/ Misper Apawu)

Lead photo: A young man smokes Kush at a hideout in Freetown, Sierra Leone, Monday, April 29, 2024. (AP Photo/ Misper Apawu)

Text from AP News story, A synthetic drug ravages youth in Sierra Leone. There's little help, and some people are chained, by Kemo Cham

Photos by Misper Apawu

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