EECA’s response to COVID-19. Prison health.

Evgeniy Yuldashev, peer consultant and social worker, AFEW Kyrgyzstan, about work with (ex) prisoners. 

For reference:

For three years, Evgeniy has been working as a peer consultant with people who are released from prisons and are getting ready for the release with AFEW Kyrgyzstan. His work is to provide support to (ex) prisoners, tell them how to adapt to the social environment and live a full life with HIV and any co-morbidities, such as tuberculosis or hepatitis C.

Changes due to COVID-19

Currently, Bishkek and other big cities of Kyrgyzstan live in the state of emergency. So far, there have been no cases registered in any correctional facilities. The penitentiary system implements a set of measures to avoid any outbreaks of COVID-19 in prisons. First of all, it means that all prisons are closed for visitors, including AFEW Kyrgyzstan staff members. Since 20 March 2020, our peer consultants have not been visiting any institutions.

Fortunately, some of our team members work as social workers in the correctional facilities. Besides, in each institution there are 2-3 volunteers (navigators) from among the prisoners. Thus, we are still able to remain in contact with the prisoners.

Innovations

Currently, one of our key priorities is prevention of the spread of coronavirus.

Prisoners are one of the populations most vulnerable to the new virus. The experience of other countries shows that in prisons the epidemic develops as a fire destroying everything on its way. It can be explained with the living conditions in prisons – overcrowded cells of the detention centers and cramped prison barracks do not allow for social distancing or self-isolation.

In fact, prison life has not really changed – inspections twice a day, waiting lines in the canteens and even long waiting lines in methadone dispensing sites…

From our side, we try to make our contribution to prevent any outbreaks in prisons. The first vital thing to be done is organizing awareness-raising activities. We started with our target group – prisoners who live with HIV. Through our project WhatsApp group and during our telephone calls, we regularly share information about coronavirus with the social workers which they can further share with the prisoners.

There is still a lack of studies on the virus, but the available data shows that HIV-positive people with suppressed viral load and high immunity status do not face a higher risk of infection than the general population. That is why our social workers and volunteers continue their efforts to enroll prisoners into the ART programs and ensure their adherence to treatment in close cooperation with the prison health workers.

As a peer consultant, I always stay in touch with the social workers and through them with the volunteers. We regularly organize phone calls and WhatsApp chats. As they say we are keeping our eyes on the ball. If prisoners have any questions, they can address them with our team through the social workers.

However, it will not be enough to inform people living with HIV to avoid any possible outbreaks. With support of our partners from the UNDP, we prepared a small information brochure, which will help people to learn more about COVID-19, its prevention, symptoms and treatment, and provided the published materials to the Prison Service.

Besides, we received a request for support from the prison administration to facilitate the procurement of personal protective equipment, disinfectants, etc. We submitted this request to our partners from ICAP, who will ensure the procurement of all the necessary supplies.

We are also looking for additional funding to roll out the response to the epidemic. Many prisoners complain about the lack of basic hygiene items. Today it is more important than ever to clean your hands and keep your towel clean. However, unfortunately such people do not always have access to a sufficient stock of such basic things as soap and laundry powder. We are in the process of negotiations with GIZ about the possibility to procure such materials and conduct large-scale awareness-raising activities covering not only prisoners but also prison staff as because of their work duties they are also at high risk of contracting the virus.

So we are keeping ourselves busy and make all the efforts to help our beneficiaries live through this challenging period of time.

 

AFEW International, AFEW Kyrgyzstan and IOM Tajikistan launched a project for Tajik migrants

Tajikistan is a country marked by a high level of labour migration due to a lack of work in the country. According to official figures, in 2019 more than 500.000 Tajiks left the country for working abroad. The majority works in Russia, where there is a high prevalence of HIV. The proportion of the Tajik migrants among new registered HIV cases in Tajikistan increased  from 10.1 percent in 2014 to 18.8 percent in 2018. Also, little is known about migration of key populations, such as people who use drugs and men who have sex with men (MSM), and their behavior in using health services while working abroad.

To enhance Tajik migrants’ access to HIV services, particularly key populations, IOM Tajikistan together with AFEW International and AFEW Kyrgyzstan launched the project “Improving migrants’ access to HIV services in Tajikistan” in 2019.

What are the goals of this project and how will it change migrants’ lives? Rukhshona Kurbonova, National Professional Officer, Sub-Regional Coordinator on Migration Health for Central Asian countries, talked to AFEW International.

Rukhshona, why it is important to work with migrants?

Migrant workers significantly contribute to the economy of the countries of origin and countries of destination, but are often left out when it comes to health programming. The majority of the Tajik migrants is involved in low skilled jobs, even if they have a good education. The prerequisite for good performance – even for low skilled work – is good health; therefore, both countries of origin and destination benefit from healthy migrants. However, migrants can be stressed by facing a new environment, culture, language, and they are often exposed to poor working and living conditions in the receiving country. This all can put their health at risk. This all circumstances put their health at risk and make migrants vulnerable.

Additionally, since the majority of Tajik migrants are young men from rural areas, where strong social control is part of the traditional patriarchal society, getting into a big metropolis with different norms and morals can impact their sexual behaviour. A difference in social control, little knowledge about prevention of sexually transmitted infections and HIV, alcohol consumption and drug use, and casual sex all play into migrants’ vulnerability to Sexual Transmitted Infections (STIs) and HIV. Therefore, it is important to address their health needs and raise awareness. Integrating migrants into national health programmes and strategies is part of the agenda of the Universal Health Coverage approach promoted by the WHO and other UN organizations including IOM.

The project “Improving migrants’ access to HIV services in Tajikistan” aims to enhance Tajik migrants’ access to HIV services, particularly among key populations. How do you plan to reach this goal and which tools will you use?

The project is composed of two parts: The first part is working in the field with returned migrants in Kulob to raise awareness on safe migration and promoting health seeking behaviour relating STIs and HIV through peer networks. The second part is a regional working meeting with the participation of officials and HIV service NGOs from the Russian Federation, Kazakhstan, Kyrgyzstan and Tajikistan to discuss the essential HIV related package of services for migrants from Central Asia, as recommended by the World Health Organisation.

For the fieldwork in Kulob, IOM will partner with the local NGO “Nakukor”, which has strong experience in working with different groups of migrants. Jointly, they will promote the peer-to-peer approach and hire outreach workers among representatives from the key populations. In addition, within this project supported by AFEW International, IOM will provide free access to HIV tests and survey key populations among migrants to map their sexual behavior and refer them to HIV testing when needed. A legal consultant and venereologists will conduct information sessions for migrants on safe migration and prevention of STIs and HIV. Thanks to the project, two new brochures on safe migration and prevention of STIs and HIV will be developed for migrants. To ensure the sustainability of the project, IOM implements all activities jointly with relevant governments stakeholders – the Tajik Ministry of Labour, Migration and Employment, the Republican Healthy Lifestyle Promotion Center and the Republican AIDS Control Center of the Tajik Ministry of Health and Social Protection.

How long does IOM Tajikistan work with migrants?

IOM Tajikistan has been working on migrants’ health since 2005 and implemented projects on the prevention of STIs, HIV and TB among outbound and inbound migrants. The activities of the Migration Health Unit at IOM Tajikistan are covering the four main pillars needed to ensure the health of migrants holistically: monitoring migrants’ health, advocacy for policy development, provision of migrant sensitive health care services and strengthening inter-country coordination, partnership and networking. IOM Tajikistan has been implementing innovative approaches to reach migrants through peer education, engagement of the diaspora, the creation of multidisciplinary teams in the districts, the publication of communication materials in different languages such as Tajik, Russian, Uzbek, Chinese, Dari, Turkish, and others and by ensuring a multisectoral approach and cross border cooperation. To improve knowledge and skills of the stakeholdres, NGOs and health workers on promoting migrants’ health, a number of educational materials, such as manuals, video clips, and documentaries, were developed and distributed. Additionally, IOM Tajikistan is experienced in providing technical support and promotes the inclusion of migrants’ health issues and concerns into health-related policy documents, such as those developed by the HIV and TB National programmes. Last but not least, we are currently contributing to the development of the National Health Strategy for 2021-2030 and the National Strategy on migration health. IOM Tajikikstan is a member of the Technical Working Group on developing new National AIDS Control Programme and National TB Control Programme for 2021-2025.

Which barriers you might face in Tajikistan and how you are going to overcome them?

Stigma and discrimination are the main barriers faced by migrants and the general population in Tajikistan in accessing HIV services. There is also a high stigma of people who are using drugs, and sexuality is also a taboo topic in society. With our peer-to-peer-approach, we want to reach out to key populations. Through the awareness-raising campaign, working with migration officials and health workers, we want to address and reduce stigma and discrimination of people living with HIV and of key populations. For a better understanding of migrants’ access to HIV services in Tajikistan, the project also has as an operational research component to explore the barriers face by migrants when coming back home.

What do you expect from the project?

The results of the project will improve our understanding of the migrants’ needs concerning HIV services. The project will also help in developing effective communication and health promotion strategies that improve the detection of HIV among the migrant population and refer them for adequate treatment.

Helena Arntz, Junior project officer of AFEW International

Public opinions about migrants, in particular key populations among migrants, are often full of prejudice and stereotyping, which leads to discrimination in the health care system. Migrant workers are in constant movement and often a long time from home, so they can have more difficulties in getting the health care they need. They receive little information about how to be safe abroad, which poses continuous threats to their health and that of their families.

AFEW International has experience with and knowledge on migration in Central Asia and Russia. AFEW International currently also manages two projects in Russian cities Rostov-on-Don and Yekaterinburg to improve healthcare for migrants living with HIV.

In this joint project with IOM Tajikistan we not only want to address the limited information available to key populations among migrants, but also gain better insight in the behavior of this specific group. As the consequences of unsafe migration are not limited to the home country, we will address the needs of migrants at a regional event in Dushanbe. We expect that this will increase cross-border cooperation between Central Asian countries and Russia to improve the needs of key populations among migrants.

 

Response of AFEW Kyrgyzstan to COVID-19

COVID-19 rapidly spreading around the world requires urgent and decisive actions. AFEW Kyrgyzstan quickly responded to the emerging threat and prepared the support measures, which can help the key populations in this challenging time. Natalia Shumskaya, director of AFEW Kyrgyzstan, told AFEW International about them.

Social bureau for women living with HIV

The social bureau for women living with HIV offering peer support services as well as consultations of psychologists and social workers continues its operation during the lockdown. Before the state of emergency was announced, most people living with HIV (PLWH) in the city received Antiretroviral therapy (ARVs) for up to three months. If people were not able to come and pick up their medications, the social worker brought them to their homes. However, PLWH still need ARVs, so every day a representative of our organization brings such medications to two or three addresses using an official vehicle of the AIDS centre.

Nutritional support

About one-third of PLWH in Kyrgyzstan live in poverty. People who used to earn money for their living with odd jobs are now left without any sources of income and have urgent needs in food products, hygiene items, diapers for their babies and mobile charge cards to stay connected. Every day, the psychologist from the AIDS Centre gives calls to women living with HIV and provides them with psychological support. If people need food, the psychologist gives them contact details of the Bishkek district headquarters for them to receive humanitarian aid. We have sent a request to the Red Crescent Society of Kyrgyzstan asking them to allocate food packages for 40 women living with HIV.

In community centres for women with substance abuse problems, there was also a need in masks, disinfectants and food packages, so we procured all the needed materials to comply with the infection control measures from our project budget.

Psychological support

Three psychologists of our organization continue providing psychological support over the phone and using WhatsApp. Mostly they are contacted by women with severe anxiety, panic attacks or those who faced domestic violence. Some women have relatives with mental health problems. Besides, we received phone calls from young people with drug abuse problems.

Young people help!

There is a volunteer headquarters launched in the youth centre together with the National Agency for Youth and Physical Culture. People working at the organization and other city residents make donations to a special account to procure food products for those in need. Our Champions for Life from the Dance4life programme signed up as volunteers and deliver the humanitarian aid.

For prisoners

We procured and provided to the National Law Enforcement Service two thousand masks, 850 kg of bleach, and 50 bottles of antiseptics for the prisoners.   Besides, we developed leaflets for prisoners and prisons staff. Soon brochures will be published and distributed among the prisons.

We are currently carrying out negotiations with different donors and I hope that in the nearest future we will be able to raise more funds to support the National Law Enforcement Service.   We are waiting for the response from the German Agency for International Cooperation (GIZ) concerning our project proposal on carrying out training sessions for prisoners and non-medical personnel working in prisons on COVID-19 and on procuring soap and laundry detergent for prisoners.

Due to the physical contact being impossible, our peer consultant (PLWH) provides support to the prisoners living with HIV remotely, through phone calls.

For reference

As of today, there are 144 confirmed cases of COVID-19 and one registered death in Kyrgyzstan.

Since March 25, the government declared the state of emergency. A curfew has been introduced, so people are not allowed to leave their homes after 8 p.m. In the daytime, there can be only three reasons to go outside: to a supermarket, pharmacy or to visit a doctor provided that the person has an itinerary sheet. Public transport and taxi services are closed.

AFEW International and ICAP at Columbia University to improve HIV services in prisons in Kyrgyzstan and Tajikistan

In 2020, AFEW and ICAP at Columbia University will partner to implement «Technical Assistance to Central Asian National HIV Programs to Achieve and Sustain HIV Epidemic Control under the President’s Emergency Plan for AIDS Relief (PEPFAR)» in Kyrgyzstan and Tajikistan, a project funded by PEPFAR through the US Centers for Disease Control and Prevention (CDC). In Kyrgyzstan the project will be implemented by AFEW Kyrgyzstan; in Tajikistan, by NGO SPIN Plus with technical support of AFEW Kazakhstan.

With this project, the partners will strive to reach two important goals:

1) improving the 90-90-90 targets for people who inject drugs (PWID) and people living with HIV (PLHIV) in prisons in Kyrgyzstan and Tajikistan, using new technologies and services;

2) facilitating and improving collaboration between general public health care facilities and health care services within the penitentiary system, ensuring continuity of HIV-related services to people being released from prisons.

AFEW International will be the lead agency working with its in-country AFEW partners and local partners to implement this project in Kyrgyzstan and Tajikistan,” said Daria Alekseeva, Program Director of AFEW International. “We have a proven track record and evidence that working as a regional EECA network has encouraged the exchange of context-specific approaches that help to find appropriate local solutions and models of best practice. We combine local Central Asian knowledge and expertise, exchanging this within the wider EECA region, as well as the added advantage of an international, Netherlands-based Secretariat, contributing to international expertise and innovation. AFEW International – together with AFEW Kyrgyzstan and AFEW Kazakhstan, which will provide technical support to activities in Tajikistan – will aggregate lessons learned from ICAP’s previous work in Kazakhstan and combine those lessons with the methodological approach gained through the past experience of working in prisons in Central Asia to produce practical guidelines and training modules. AFEW International will look for possibilities to pilot this model in Kyrgyzstan and Tajikistan, where political and technical conditions may allow.”

“People living with HIV in prisons are less likely to be on antiretroviral therapy (ART) when compared to general population. They are also less likely to adhere to the prescribed treatment regimen and, therefore, are often viremic,” said Anna Deryabina, ICAP Regional Director for Central Asia. “Lower ART initiation and viral load suppression rates among prisoners are due to many factors, including structural factors, such as lack of trained health care personnel in prisons and limited adherence support and treatment monitoring. Also, lack of coordination between general and prison-based health care services and fragmented service delivery systems lead to many people living with HIV being lost to follow-up and discontinuing treatment after being released from prisons. ICAP has been very effective in improving the quality of HIV services provided to people living with HIV treatment facilities outside of prisons. We really hope that AFEW’s deep knowledge and understanding of subcultures and norms inside the prisons, as well as their experience working with the prison-based health care systems will allow this project to effectively improve the quality of services and HIV outcomes for people living with HIV in prisons.”

“AFEW-Kyrgyzstan is pleased to launch this joint project with ICAP. Under the Project, our organization will be responsible for the implementation of the component to achieve the 90-90-90 goal in the penitentiary system,” said Dina Masalimova, AFEW-Kyrgyzstan Programs Manager. “We plan to work in almost all large prisons in Chui Oblast. Our activities will be aimed at expanding HIV testing coverage with the provision of quality pre- and post-test peer counseling, motivation to start therapy, and adherence development. In addition, we will focus on ensuring that people do not stop their treatment even after release.”

This project is very important to maintaining an effective response to the HIV infection in the country, as 5-10% of all PLHIV in the country are in the prison system. With the high turnover of the prison population, this number can be easily multiplied by half per year.

“We are happy to work in a team with such a highly professional organization as ICAP,” said Masalimova. “It is planned that ICAP specialists will be responsible for medical aspects of providing assistance to PLHIV, and our organization will take over the community element and peer-to-peer support.”

In Kyrgyzstan, AFEW-KG will recruit and train a team of peer navigators representing each layer of the prison sub-population (with a special focus on prison outcasts and pre-release prisoners) in order to identify those who practice risky behaviors and haven’t been tested for HIV in the past six months. AFEW-KG will work with newly identified PLHIV to motivate them to start antiretroviral therapy and take all of the necessary tests. The peer consultants will work as liaisons between patients and prison doctors to ensure that patients are prescribed ART, are adherent to treatment, and that relationships between prison doctors and patients are built on mutual trust.

In addition, AFEW-KG will provide a series of counseling sessions for at least 200 prisoners who are PWID on the benefits of starting methadone-assisted treatment (MAT) and dispelling the myths related to the therapy.

“We believe that this collaboration will yield excellent results and that by the end of 2020 we will be able to see tangible progress on each of the 90-90-90 goals in prisons,” said Masalimova.

 

Bishkek joins Zero TB Cities International Initiative

Today, December 6, Bishkek joined Zero TB Cities international initiative aiming to reduce tuberculosis disease rate in cities, an important event happened during City Health Leadership Forum in Kyiv. Vice Mayor for social issues of the city of Bishkek Tatyana Anatolievna Kuznetsova and Executive Director of Stop TB Partnership Dr. Lucica Ditiu signed this long-waited for declaration.

Vice Mayor for social issues of the city of Bishkek Tatyana Anatolievna Kuznetsova:

Early HIV detection is one of the important tasks in order to maintain and strengthen people’s health, achieving it to a large extent involves confronting stigma and discrimination.

Firstly, I would like to point out that Mayor’s Office of Bishkek acknowledges that stigma and discrimination create breeding ground for the epidemic spread. It is the social stigma and self-stigma that build barriers to HIV-testing as well as to its treatment and care.

In the beginning of this year the Mayor’s Office started active collaboration with the civil community and AFEW-Kyrgyzstan. Signing Paris Declaration and joining the initiative to facilitate activities in big cities have become the first steps of this collaboration. We commenced to design the first city program for HIV prevention that will be running for 2 years. Even though these questions largely fall into the domain of the Ministry of Health, it was important to us to make our contribution to people’s health. The document is now at Bishkek City Kenesh awaiting approval. After the paper is approved we hope to contribute about 10 million som from the municipal budget to HIV program. Expanding HIV-testing coverage is one the program priorities. According to expert estimations, about 35% of Bishkek citizen living with HIV are still unaware about their status. When we were discussing how to achieve this goal, we thought to start with ourselves. This is why the Office Administratives, including myself, and Heads of the structural departments publicly went to have their HIV-tests made during a large event as part of the World AIDS Day. This event was widely covered in social and mass media. When the authorities send such precise signals like this, citizen pay attention and stigma weakens.

Our next step together with AFEW-Kyrgyzstan is to start a large-scale training course for the employees of the local territorial departments about HIV, stigma being a keynote of the whole training course.

Next year we plan to start a working group at the City’s Healthcare Department. This group will bring together vulnerable communities and the Mayor’s Office in order to mutually discuss and plan activities within HIV prevention campaign. World Aids Day 2019 slogan is Communities Make The Difference. It is the close collaboration with the civil society and communities that will help us to eliminate stigma and discrimination in Bishkek”

Dina Masalimova, AFEW-Kyrgyzstan Programs Manager: “We would like to express our gratitude to the Mayor’s Office of the city of Bishkek for cooperation and openness to the new initiatives in healthcare. Our collaboration started in the beginning of 2019 under the framework of a PITCH project “Key populations and HIV and TB prevention priorities”. A number of meetings and panel sessions were held since then where the community and city’s healthcare representatives reported to the city authorities about difficulties and problems they face. In response, the Mayor’s Office committed to facilitate UNAIDS ambitious 90-90-90 goals by joining Paris Declaration. As the first step to implement its realization the Mayor’s Office developed a municipal program for HIV prevention together with AFEW experts. We are very glad that today the City Administration expressed their desire to step in the TB problem. It is particularly important since our research shows a large spectrum of medical and social difficulties TB patients are facing in the city. We would like to believe that signing of the ZERO TB Cities Declaration and active involvement of the Mayor’s Office of Bishkek would produce positive affect in the nearest future“.

About Zero TB Cities initiative

The purpose of the initiative is to create ‘islands of elimination’ that will contribute to lowering rates of TB and further support in implementing effective strategies on the national level.

The Initiative appeals to the local authorities to support and directly and actively participate in fighting TB in cities in close collaboration with the civil sector and other interested partners in order to achieve significant reduction of TB death rate and prevalence, develop comprehensive programs at those sites in local context, mobilize complimentary financial, technical and clinical resources, exchange the resources and experts between participating cities, as well as disseminate knowledge and generate global political will.

The Kyrgyz Republic is one of the countries that demonstrates the highest rate of TB prevalence in the European region. Like any other megapolis, Bishkek has higher concentration of key population groups with high risk of HIV and TB infection. By the end of 2018, estimated rates were as follow: living with TB – 76.9, deaths – 5.1 in 100,000 people. To ensure wellbeing of the population it is very important to grant access to high quality medical and social services to these population groups as well as focus at upholding human rights.

 

The EECA City Health Leadership Forum

On the 6 December 2019, the EECA City Health Leadership Forum will be organized in Kyiv, Ukraine, showcasing the results of the Fast Track HIV/TB Cities Project (2017-2019)

The Forum will focus on discussing the regional context, sharing successful HIV and Tuberculosis city response models and facilitating movement towards ending these diseases in Eastern European and Central Asian (EECA) cities. It will include a Mayors’ high-level panel discussion, presentations of successful city responses and innovation to fast-track cities to 90-90-90, which will feature the inclusion of key populations in the cities’ responses. The Forum will gather over 150 delegates from 20 countries of the EECA region, including 11 city Mayors.

The Fast-Track HIV/TB Cities Project

Launched on World AIDS Day 2014, the Fast-Track Cities initiative has grown to include more than 300 cities and municipalities that are committed to attain the UNAIDS 90-90-90 targets: 90% of all people living with HIV will know their HIV status; 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy (ART); and 90% of all HIV-diagnosed people receiving sustained ART will achieve viral suppression.

Alliance for Public Health (Ukraine) together with AFEW International (The Netherlands), licit (Switzerland) and Stop TB Partnership under technical guidance of UNAIDS EECA office with funding of The Global Fund initiated the regional Fast-Track HIV/TB Cities Project. The project was implemented between 2017-2019 and developed efficient and sustainable city models of HIV/TB responses that would allow to reduce AIDS and TB mortalities in five project cities; Almaty (Kazakhstan), Balti (Moldova), Odesa (Ukraine), Sofia (Bulgary), and Tbilisi (Georgia).

Amsterdam was one of the first to sign the Paris Declaration in 2014 and has introduced a comprehensive health policy for key populations. AFEW International with expertise on increasing access to health services for HIV, TB and viral hepatitis for key populations, is well-connected to the Municipal Public Health Service and police in the Netherlands. This expertise was shared in two training courses and a study tour.

International best practice suggests that collaborative city level models have been most effective in reducing HIV and TB burdens. The first training series, ‘Collaboration between municipalities and civil society – models and realities’, were designed as an exchange and sharing of experience and best practices in successful models of municipality and NGO partnerships. Five integrated work meetings and counselling sessions with selected project city stakeholders from municipality, health and social sector, NGOs and key populations were conducted by licit and AFEW International and improved key populations’ service access through better collaboration between relevant city stakeholders – most importantly, between municipalities and NGOs.

The second training series on innovative municipality funding approaches planned exchanged and adapted such approaches and income generating activities. The training replicated successful practices in the project cities through learning from experiences in Amsterdam. During this training the best international practices of public-private partnerships at city level and private funding for key population programmes offered inspiration for the participants of the training.

During the study tour different partners of AFEW International shared models, experiences and activities that demonstrated successes and challenges in increasing access to health for key populations. Project partners from Almaty, Kyiv and Tbilisi were provided the opportunity to connect to civil servants and different health actors within the Netherlands and discuss initiatives to reach out to key populations to increase their quality of life. Furthermore, representatives of municipality, police and NGOs working with key populations elaborated on different forms of collaboration, to prove that the only way to eliminate HIV and TB is if municipality, police and NGOs work together.

 

 

The 3rd regional autumn school in Bishkek

On October 29, AFEW partners came together in Bishkek, the capital of Kyrgyzstan, for 3 days to take part in the annual Autumn School, which is organized within the project “Bridging the Gaps: health and rights of key populations“.

The great energy of the participants and amazing nature gave a chance to everyone to enjoy the event and to discuss important issues on prevention and treatment of #HIV, harm reduction, migration, and financing in the region of Eastern Europe and Central Asia. Participants in the Autumn School included representatives of AFEW partners from Kazakhstan, Kyrgyzstan, Ukraine, Russia, and the Netherlands, sub-recipients of the project “Bridging the Gaps”, as well as other partners and experts including those from Great Britain and the USA.

Active space

The Autumn School quickly became an active space for discussion: about strategy, barriers, innovations, and partnership opportunities between the participating organizations. During the first day, participants shared updates on the “Bridging the Gaps” project and activities in their countries – Georgia, Kyrgyzstan, Ukraine, and Tajikistan. The afternoon session was devoted to a World Café, in which partners exchanged ideas and developed specific actions to overcome challenges that they often encounter in their work.

The second day was devoted to the topic “Stimulant use and chemsex”. Benjamin Collins, director of International HIV Partnership (IHP), which partners with medical and community activists across Europe and the Middle East for successful responses to HIV and viral hepatitis, joined the Autumn School in Bishkek to share his experience on chemsex . The topic of (problematic) chemsex was further elaborated in the presentations of Monty Moncrieff, Chief Executive of London Friend, a London charity working to promote the health and well-being of lesbian, gay, bisexual and trans (LGBT) people, and Daria Alexeeva, program director of AFEW International. Monty spoke about the London experience in harm reduction, while Daria presented materials of Nikolay Lyuchenkov, an infectious disease doctor and expert on sexual health issues from Russia, which were focused on trends and responses to chemsex in Russia and EECA region.

 

The third and final day of the conference was devoted to workshops on migration, rehabilitation and financial sustainability. Evgeniya Alekseeva, director of Public Health and Social Development Foundation “FOCUS-MEDIA”, presented analysis of NGOs funding situation in EECA region; Elena Zhirnova, manager of the project “Our Choice: Empowering Vulnerable Women in Kyrgyzstan” (AFEW-Kyrgyzstan) told about challenges and opportunities of social entrepreneurship in the country; and Fatima Yakupbayeva, co-founder of law firm “PRECEDENT” and publisher of the book “From Grant to Business Project”, shared auditing resources for launching a business model and recommendations on how to implement business ideas.

 

The session on migration started with a presentation by Rukhshona Kurbonova, coordinator of the Migrant Health Programs at International Organization for Migration in Tajikistan. She talked about labor migration in Central Asia, while Zulaika Esentaeva (IOM Kyrgyzstan) shared their experience on service-delivery by IOM Kyrgyzstan for vulnerable migrants.

The session on rehabilitation was devoted to building information campaigns. During the session, Marina Govorukhina, specialist on strategic communications and branding, author of the books “Communications in Public Organizations”, “Strategic Communications in Public Organizations”, demonstrated specific techniques of developing informational marketing campaigns for rehabilitation centers to the participants from Georgia, Kyrgyzstan and Ukraine.

Moreover, the School included a 2-day training for AFEW communication managers, during which participants focused on learning about storytelling and SMM in the context of NGOs.

 

 

Natalya Shumskaya, director of AFEW-Kyrgyzstan

I especially noted the session on new psychoactive substances. This topic is relevant for our country, as sexual ways of HIV transmission keep growing in Kyrgyzstan, and new psychoactive substance use impacts sexual behavior. For us it is a wonderful opportunity to take on the experience of those countries that have already faced similar problems, and elaborate effective strategies for preventative measures in our country.

The third day was remarkable due to the acute topic of sustainability of civil society organizations. We all see the tendency of decreasing donor support in our countries. That means that civil society should aim to ensure financial sustainability independently, and one of the opportunities is the development of social entrepreneurship. During this meeting we shared the experience of creating our own social enterprise – a beauty salon. I would like to especially point out the session by Fatima Yakupbayeva from the “Precedent” company. She gave us specific business-ideas, which could be developed by an NGO in order to earn money independently and further direct it to realization of our statutory goals.

The importance of this event is in sharing and exchange of experience. When the financial support for our organizations is not that high, it is important to avoid duplication of activities, and, on the other hand, to consolidate our efforts in order to realize our main strategic goals. For instance, the past regional meetings allowed us to bring good practices of working with youth at risk from Ukraine to our country. We are very grateful that we didn’t have to be the pioneers in this, but rather adapt and use their experience. Also, I think that the experience of Kyrgyzstan will be useful to some of our colleagues, and they will be able to apply it in their countries.

Monty Moncrieff MBE, Chief Executive of London Friend

It’s important for people working in the region on the same issues to have the opportunity to come together and share their knowledge and experience. It helps build the data on important topics, and enables participants to share what they’re seeing locally, as well as share tips on how to address new and emerging trends. It also helps build relationships, which spark ideas for new partnerships. Even though the internet gives us great opportunities to connect and work together online it’s difficult to get that richness of connection without bringing people together in person, and doing so for a number of days provides lots of opportunities for conversations outside the formal sessions.

We can always learn from one another, and hopefully by inviting people who have been working on issues for some time in other countries we can bring the benefit of that experience. We can share leaning about what’s worked and what hasn’t for us, and hopefully that can benefit people who are only starting to see these issues emerge locally.

Evgeniya Alekseeva, PHD in medical sciences, Director of Public Health and Social Development Foundation “FOCUS-MEDIA”

Meetings such as the Autumn School are important, because they bring together people from different countries and cities, create space for discussing acute issues and situations in our field, allow to form alliances, agree about partnerships, as well as have informal conversations and take a break from the daily routine.

At the Autumn School in Bishkek, I especially noted a very interesting session on chemsex, sessions on business projects for NGOs, and on migration. I will certainly use this knowledge further while writing proposals, developing new projects and creating new ideas.

Zarina Siyakova, program coordinator of the Tajik Network of Women Living with HIV

This meeting provided me with a great opportunity to learn more about what is happening in other countries in regards to promoting prevention and treatment of HIV. I especially noted the session on chemsex, as I hadn’t had a chance to encounter this issue before. I was particularly interested in the presentation by Monty Moncrieff, as well as the presentation of Nikolay Luchenkov from Russia on chemsex in EECA.

Also, I received answers to many questions on migration that I’m interested in, and most importantly, exchanged contacts with almost all the participants. It is well known that nowadays there is a very large stream of migrants from Tajikistan to Russia, and many of them lack information about services for migrants and d existing organizations in Russia. Now our organization will be able to refer our clients to these organizations, and we won’t lose them out of sight.

If you are interested in specific presentations of the Autumn School, please send your request to autumnschool@AFEW.nl.

Support. Do not punish!

In June 2019, dozens of cities in the EECA region hosted the campaign «Support. Do not punish». Activists took to the streets to publicly protest against repressive drug policies.

This action, which is held annually all over the world, is a great chance to once again draw attention to this unresolved problem. How it was in the EECA region in 2019 you can read here.

Plans for 2020

Are you part of a collective, network or organisation advocating for drug policies that prioritise health and human rights? Are you planning to join the 2020 Support. Don’t Punish Global Day of Action and have an outstanding plan to build momentum? If your answer is “yes” then this call for applications might be for you!

Through this call, the Support. Don’t Punish campaign aims to identify and support local partners (up to 7) with funding of between USD 2,000 – 4,000 for strategic, creative and collaborative projects building up to the 2020 Global Day of Action that advance drug policy reform, bolster harm reduction and build bridges with/within/between communities disproportionately affected by the “war on drugs” (e.g. people who use drugs, farmers of crops deemed illicit, youth, ethnic minorities, LGBTQ+, among many others).

You can apply for the grant here.

What is “Support. Do not punish”?

Support. Don’t Punish is a global grassroots-centred initiative in support of harm reduction and drug policies that prioritise public health and human rights. The campaign seeks to put harm reduction on the political agenda by strengthening the mobilisation capacity of affected communities and their allies, opening dialogue with policy makers, and raising awareness among the media and the public.

The campaign’s yearly high point is the Global Day of Action, which takes place on, or around, 26th June (the International Day Against Drug Abuse and Illicit Trafficking). Historically, this date has been used by governments to showcase their drug control “achievements” in coercive terms. The campaign’s Global Day of Action seeks to reclaim and shift that day’s narrative. And so, every year, an increasing number of  activists in dozens of cities all over the world join this unique and multifaceted show of force for reform and harm reduction.

The Support. Don’t Punish campaign aligns with the following key messages

  • The drug control system is broken and in need of reform
  • People who use drugs should no longer be criminalised
  • People involved in the drug trade at low levels, especially those involved for reasons of subsistence or coercion, should not face harsh or disproportionate punishments
  • The death penalty should never be imposed for drug offences
  • Drug policy should focus on health, well-being and harm reduction
  • Drug policy budgets need rebalancing to ensure health and harm reduction-based responses are adequately financed.

 

AFEW-Kyrgyzstan Opened a Youth Centre in Bishkek

Author: Grana Ziia, AFEW-Kyrgyzstan

On March 19, the ground floor of the Palace of Sports in Bishkek was crowded: teenagers, civil servants, representatives of the city hall and non-governmental organisations, social workers of district administrations and AFEW-Kyrgyzstan team all gathered together for the opening ceremony of a new youth centre.

In the spacious hall, decorated with felt paintings and bright red wallpapers, the Deputy Director of the State Agency for Youth Affairs, Physical Culture and Sports Mirlan Parkhanov welcomes all the guests. He says that this centre was opened last year to organise events and conferences for young people.

– Now, with the support of AFEW-Kyrgyzstan, a teenage centre is opened here. A psychologist and a social worker are now working here. They will organise free counselling for adolescents and their parents, organise useful leisure activities for young people, those who wish can join sport clubs and do other extracurricular activities, – Mr. Parkhanov is saying and inviting all guests for a tour around the centre.

The most important thing is to have trust from children

Guests are entering the interactive room. Judging by the interest with which they take pictures there, they like this room very much. Inside there is a dozen of bright fashionable beanbags, a shelf with board games and brochures about health, family planning, and drug use prevention. On the walls, there are posters with the rules of the centre and announcements of various competitions and grants for young people. There is a computer, a projector and a big screen for teenagers in the corner of the room.

Another room is a room for the staff of the centre and individual consultations of adolescents with a psychologist, social workers and other specialists. It is cosy here. There are also felt paintings and framed carpet, cookies on the table, and a few pillows on the sofa.

– We tried to create the most relaxed atmosphere here so that the children can trust us. I hope it worked out! – says the psychologist of the centre Margarita.

A place for useful leisure and development

After the tour, the guests gather in the conference room again. AFEW-Kyrgyzstan manager Chinara Imankulova begins the presentation of the services of the youth centre and talks about the idea of opening the centre.

– Last year, with the support of the Central Asia Drug Action Programme (CADAP), AFEW-Kyrgyzstan conducted a study on the prevalence of psychoactive substances usage among adolescents in Kyrgyzstan. The data obtained showed that it was time to begin working on prevention. Thus, this centre appeared. We want all teenagers to come here, and not just those who use psychoactive substances or are in a difficult life situation. Here, teenagers will have a safe space to relax, to talk to their peers and get professional support, – says Chinara.

The psychologist and social worker of the centre add that this form of work with adolescents is the most effective. When children come from different groups, they communicate with each other, share interests and help each other. Therefore, no one feels deprived and lonely.

Joined efforts are needed

In her presentation, Chinara is saying that the centre will also function to increase the capacity of psychologists, social workers and pedagogues, doctors and juvenile inspectors. Guests perceive the news with enthusiasm, because, according to them, there is a need for constant professional growth.

The guests of the event are also saying that Bishkek needs such a centre for a long time. They also talk about the problems they face in their practice. After the discussion, they develop a plan of cooperation with the centre: how to guide children, how to interest them, how to organise training sessions.

Employees of professional lyceums are saying that they are ready to hold master classes for teenagers; representatives of the city hall promise to help with the transportation for outdoor events; the department of physical culture and sports is ready to engage teenagers from the centre in free sports activities. After all, only with joined efforts, we can build a healthy future.

AFEW-Kyrgyzstan Opens a Social Beauty Salon in Bishkek

Head of AFEW-Kyrgyzstan Natalya Shumskaya is cutting the red ribbon during the ceremony of opening the salon

Author: Grana Ziia, AFEW-Kyrgyzstan

March 7, Bishkek, Kyrgyzstan

The city is stuck in pre-holiday traffic jams. Flower stands with colourful tulips are opening near a big shopping mall. Today flowers are in demand among the guests of a new beauty salon called Good Luck. They are doing their best to come in time for the opening ceremony. The salon is located in the city centre, surrounded by popular coffee houses, schools and apartment buildings. There is a red ribbon at the entrance to the salon. Music is playing. The guests are holding bright flowers, balloons, and cakes in their hands. Everyone is hugging, greeting each other and congratulating the AFEW-Kyrgyzstan team. It is easy to tell what the reason for such joy is.

“Good Luck is a ‘kind’ beauty studio – a social enterprise established to support women in difficult life circumstances. We opened it with the support of the UN Women Fund for Gender Equality. We are implementing a project, where women can attend workshops to develop their personal skills and knowledge of the economy and then receive mini-grants to start their own businesses. When we saw that there were many women who needed our support, we decided that we wanted to develop this area of our activities,” tells Natalya Shumskaya, head of AFEW-Kyrgyzstan, before cutting the red ribbon.

Supporting those who need support

In several minutes, the guests come inside. In the main room, they are welcomed by the staff members – six women in snow-white uniforms. They have happy smiles on their faces and are proudly fixing their badges. In the room, there are black chairs for make-up artists and hairdressers, a long manicure table and mirrors with bright lights.

AFEW-Kyrgyzstan opened a social beauty salon with the support of the UN Women Fund for Gender Equality

The studio looks like a cosy house, where every detail is chosen with love. The pink wall in the centre of the room has been painted by the salon staff. There are bright pillows on the couch and glossy magazines on the glass table. Lots of flowers and balloons. Make-up, shampoos and hair dye tubes on the shelves. You just feel like touching, watching and trying everything here.

After the welcoming speeches, the Good Luck salon gets noisy. The clients in their chairs are turning catalogues to choose their nail polish, discussing their haircuts with hairdressers or choosing the colour of their eyebrows. Someone is already washing hair. At first sight, it looks like those are just ordinary people preening their feathers on the eve of the International Women’s Day. However, if you listen to people talking, it becomes clear that it is not so simple.

“For us it is close, so we will come and support them. It is good when all the money earned goes to help women who need help,” shares her thoughts Aida Karagulova, Director of the City AIDS Centre.

Women will be trained

Natalya Shumskaya is sure that this beauty studio will become a turning point in someone’s life

Clients were satisfied with the services they received. The guests were making photos and paying compliments to each other. With their new haircuts, make-up and nails done, they went on to finish their festive preparations.

“We have a training centre here at the salon, where we plan to train women in difficult life circumstances to become beauty salon artists so that they can find jobs,” says Indira, the salon manager, taking us on a tour to show the premises.

Natalya Shumskaya presents a flower in a big pot to the studio and it takes an honourable place at the entrance. The flower is called Women’s Bliss.

“Here it is a good place for this plant as this salon works for those who are looking for their bliss so hard! I am sure that this beauty studio will become a turning point in someone’s life, helping to find a job, start a new career and believe in the woman’s power and right to independence,” says Natalya Shumskaya before she leaves the salon.