‘Trump's a killer, not a healer': Heroin users fall into addiction as US aid freeze hits rehab clinics

Telegraph

22-05-2025

On January 25, as the sun rose over a glistening Lake Victoria, hundreds of recovering heroin addicts dutifully arrived at a treatment clinic on the outskirts of the Ugandan capital of Kampala.
They had each come to receive a small cup of methadone, the synthetic opioid used to treat withdrawal symptoms and keep former addicts functioning and stable.
But on this day, despite some patients having visited for years, the staff at the clinic could not help. A sweeping 'stop-work' order had come from Donald Trump and Elon Musk, putting an immediate end to all United States funded assistance programmes. The recovering addicts were turned away one by one, and left to face their demons and the bone-deep ache of heroin withdrawal alone.
The clinic was the only one of its kind in Kampala, and over the next several weeks, 200 people overdosed and three people died, said Twaibu Wamala, founder and executive director of the Uganda Harm Reduction Network. Many more of the clinic's patients relapsed, returning to foetid shacks hidden in Kampala's slums and descending into the addiction they had spent months – sometimes years – trying to escape.
The funding freeze, which came without warning, had caused widespread and unnecessary suffering, said Mr Wamala. There had been an element of cruelty to it, he added. Mr Musk and other wealthy people in the US administration had let others die 'because you can'.
The Telegraph spoke to the parents of the three young addicts who died in Uganda after the 'stop-work' order was issued and their treatment was withdrawn.
'We saw it as a miracle,' said Solomon, the father of one of the addicts, of the methadone programme. He asked to speak under pseudonym to avoid repercussions in a country where drug use is still highly stigmatised.
'But when Trump came and stopped it, we started to look at Trump – and the Americans who voted for him – as bad people,' he added.
Two of his sons were addicted to heroin. By the time the clinic was shut down, they'd been clean for four years. He even moved closer to the facility so he could easily drive them to appointments and check in with the staff himself.
'I befriend my children. Besides being their parent, I am their friend,' he said.
When the treatment centre abruptly shut its doors, Solomon was away for work. He received word that Moses, his youngest son, was in withdrawal and violently ill.
Solomon rushed home, but he was too late. Moses had returned to a ghetto in desperation, starting taking drugs again, and died. He was 21-years-old.
Doctors told Solomon that his son had died after a blood clot blocked oxygen flow to his brain.
While difficult to diagnose, Moses' death could have been caused by the stress of reintroducing drugs to his weakened system, or contaminants within those drugs causing a stroke, said Shayla Schlossenberg, head of drug services at Release UK.
Another man interviewed by The Telegraph said his son was beaten to death after the clinic was closed. He assumes the boy was caught trying to steal money for drugs.
A mother said her son was found dead in a drug den in Kampala following the closure of the treatment centre. His body was taken to a public hospital before she could claim it and was buried in a mass grave.
One of the patients cut off from treatment was Ivan George Serayange, who worked as a driver for the United States Embassy until a friend introduced him to heroin in 2014. Then addiction took hold. He lost his job. He lost his home. He lost contact with his family.
'It turns all your life around,' Mr Serayange explained. 'From righteous to wrong.'
'Heroin feels like you are saving your life. You're giving yourself another six hours ahead,' he said, referring to the length of time a heroin high typically lasts. 'After the six hours, it feels like you are dying.'
Mr Serayange had been clean for a little more than a year when the methadone clinic shut down.
Staying at his mother's house, he promised himself he would never use again. Two of his children cared for him, running their fingers down his back as he trembled and sweated. He found strength by listening to Mariah Carey's 1992 hit 'Hero' on repeat.
But by day four of withdrawals, he needed something – anything – to stop the throb of cravings. He returned to the ghettos he frequented at the peak of his addiction, stealing money from his mother as he left her house. He took any drug he could get his hands on.
Mr Serayange awoke in the hospital 32 hours later with an intravenous drip in his arm. He was lucky to have survived the overdose.
There is little he can recall of the specifics of his symptoms, but he does remember a feeling of shame at having fallen into drug use again.
The doctors and nurses looked down their noses at him 'like a pathetic sight,' he said.
Then, in February, the clinic opened its doors again after almost three weeks.
The bulk of its funding came from the US Centre for Disease Control, under the President's Emergency Plan for Aids Relief (Pepfar), so it was subject to a waiver during a ninety-day review of United States foreign funding.
Mr Serayange was in disbelief when he heard the clinic had reopened.
'I thought it was just a dream,' he said. He went there immediately and slept outside in the grass until dew wet his clothes. He was determined to be the first in line for methadone.
The US funding review was extended until May 19, giving the clinic a lifeline, but so far no announcement has been made, leaving its staff and patients in limbo.
CDC budgets have already been significantly cut, and hundreds of employees fired on the orders of Elon Musk's Department of Government Efficiency.
Mr Wamala fears the centre could be forced to close again at any moment, disrupting care for vulnerable patients who badly need consistency.
'We haven't had any communication from the US administration or our support partner,' he said. 'We are waiting to see the next steps but, for now, [we are] working as always.'
A former addict himself, Mr Wamala knows just how important consistent treatment is.
'You can't be promising people services this month, and next month there are no services. This is lifetime treatment.'
'I have no hope of getting better again'
Since 2020, Mr Wamala's UHRN network has provided at least 700 people with medically assisted treatment to curb heroin addiction, and hundreds more with HIV/Aids prevention support.
While the clinic operates out of a Ugandan government hospital, Mr Wamala estimates that about 70 per cent of the funding for its harm reduction and drug treatment programmes comes from the CDC.
Against the backdrop of this widespread disruption to funding, drugs are evolving and new threats are emerging.
'We are in maybe one of the most dangerous times in terms of the current changes in the illicit drug market, where we have new synthetic opiates emerging and spreading in various parts of the world,' said Mx Schlossenberg, of Release UK.
That means it is also a particularly bad time to stop investing in methadone treatments.
'The amount of risk people will be at today navigating the illicit opiate market is so much higher than it was 10 years ago,' they added.
The Telegraph met six men on the dirt floor of a heroin den, sitting on a ripped mattress. The ground was littered with matches and scorched foil, the air thick with acrid smoke. The only light came through holes in the walls.
One of the men, Geoffrey Mutebi, says that methadone treatment had helped him achieve sobriety. But 'now I have no hope of getting better again'. He lights a pipe to smoke, its flame dancing off the hollows of his face.
Even with the clinic open, Mr Mutebi will not return to treatment because he fears it could be shut just as quickly – it is better not to waste time. Solomon's surviving son agrees.
Sometimes Solomon imagines himself in the room with the US president.
'I'd tell Trump: 'You are a killer and not a healer',' he said. 'I'd look him straight in the eyes, and tell him: 'I lost my son Moses because of you.''