This paper reports on the lives of women heroin users resident in a Kenyan coastal resort town. Data on the everyday lives of 24 women were collected using ethnographic field methods. Eighteen women also completed questionnaires about their reproductive health. Using these data, we analyse the extent to which the women are victims of 'structural violence', and how their disadvantaged social status and poverty make them particularly vulnerable to poor health, injury and death. The problems these women face are similar to women heroin users in other parts of the world. These Kenyan women live in a country where the majority of people are victims of 'structural violence', but as drug users and sex workers they face particular disadvantage. The limitations of using individual case studies that detail the lives of 'victims' of structural violence are discussed. (c) 2005 Elsevier B.V. All rights reserved.