We Fight, We Hide or We Unite

We Fight, We Hide or We Unite: coping strategies amongst resilient harm reduction organisations and community networks in the context of shrinking space for civil society in Eastern Europe and Central Asia

The title of this report, ‘We Fight, We Hide or We Unite’, reflects the survival strategies we identified amongst resilient harm reduction non-governmental organisations and community networks of people who use drugs (PWUD) in Eastern Europe and Central Asia (EECA). This assessment forms a part of the regional approach of the AFEW Network within the ‘Bridging the Gaps: health and rights of key populations’ programme, financed by the Ministry of Foreign Affairs of The Netherlands. This report presents the primary findings from the assessment, ‘Shrinking Space for Civil Society Organisations in Eastern Europe and Central Asia’, conducted between June and September 2017 at the international level by AFEW International and at the regional level.

We provide a detailed description of the overall study purpose, methodology, background and context regarding the shrinking civil society space and the coping strategies of HIV and PWUD CSOs working under these circumstances. The results of this assessment will be used to develop ideas and strategies on how to cope with the local contexts of the shrinking civil society space. In this way, it will contribute to the survival of CSOs and improving the current situation. This assessment represents the first step in the development of this focus within the AFEW Network’s regional approach within the ‘Bridging the Gaps’ programme. It will be followed by an analysis of existing gaps in the support necessary for specific interventions and initiatives to support specific coping strategies; the development of pilot projects on advocacy, service delivery or capacity building; and the continuous monitoring of results.

The full version of the report is available here.

Study of Sex Workers’ Behaviour in Georgia

Author: Irma Kakhurashvili, Georgia

Gabriela, a 40-year-old sex worker from Tbilisi has not been tested for HIV since 2016. She is convinced that she does not have HIV. She also thinks that she knows everything about this virus. However, when asked if HIV is transmitted by mosquitoes, she says ‘yes’. In July, Gabriela is going to the bustling resort city of Batumi to earn some extra money.

“I do not think that I will get tested for HIV anytime soon as I have got a lot of work and do not have free time. Besides, from Batumi I plan to relocate to Turkey,” says the woman.

Gabriela did not participate in the recent research conducted in two cities of Georgia – Tbilisi and Batumi – to study risky and safe behaviours of sex workers.

No major changes

The Tanadgoma Centre for Information and Counselling on Reproductive Health is the first Georgian organization, which has been studying the HIV transmission among sex workers since 2002. The recent study held in 2017 covered 350 women: 200 from Tbilisi and 150 from Batumi. The goal of the researchers was to determine the prevalence of HIV, hepatitis C, gonorrhoea and syphilis among people involved in sex work. Besides, they were able to analyse the key risks associated with HIV and to collect valuable information for advocacy and policy development. The research study was conducted with the support of the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Curatio International Foundation and the Infectious Diseases, AIDS and Clinical Immunology Research Centre.

The study confirmed that 85% of women in Tbilisi and 97.3% in Batumi know about the existence of HIV/AIDS, but only 11.5% of respondents in Tbilisi and 23.4% in Batumi gave correct answers to questions about the HIV transmission. For example, some respondents like Gabriela did not know that HIV is not transmitted through the bites of mosquitoes. In general, the respondents from Tbilisi were less aware of HIV if compared to the ones from Batumi.

Georgian researchers say that there have not been major changes in the study outcomes since 2012. For instance, most women mention condoms as the main measure of protection against HIV.

The study results showed that the indicators of condom use during most recent sexual intercourse with a commercial partner have not changed in the recent 10 years (over 90% in both cities). However, sex workers rarely use condoms with their regular clients.

“I do not use condoms with my regular clients to show that I trust them, but I definitely use them with other clients. I have to suffer offences because of this, but I know that it is a sure way to protect your health,” says Gabriela.

Sex work in Georgia is illegal and often police will confiscate condoms if they decide that a woman could be doing sex work.

Sex-workers and drugs

The research study showed that sex workers are well aware of HIV transmission when sharing needles and syringes. Besides, the recent study showed some interesting results concerning drug use. The share of sex-workers who used non-injecting drugs in the last 12 months was 11% in Tbilisi and 20% in Batumi. The most widely used non-injecting drugs were sleeping pills and sedatives in Tbilisi and marijuana in Batumi.

As for the injecting drugs, 1.5% of respondents in Tbilisi and 3.3% in Batumi injected drugs in the recent 12 months The respondents used ‘vint’, ‘jeff’ and amphetamines in Tbilisi and heroin in Batumi.

“Before, we did not have such data for sex-workers,” says Nino Tsereteli, researcher and head of Tanadgoma.

Women are getting out of sight

Gabriela says that she does not inject drugs but takes some pills. The woman has no problem to buy them in a pharmacy and uses substances at least once a week.

“The issue of drugs became relevant to this key population as well. We have been working with sex-workers for 20 years in five cities in Georgia and cover 3,000 people with our services annually. As for HIV/AIDS, during the period when we conducted the study only three women in Tbilisi were diagnosed with HIV. What is bad is that sometimes as soon as a woman learns that she has HIV, she is getting out of our sight and we do not know where she is and if she continues working with clients,” says Nino Tsereteli.

Gabriela promises that in September she will get tested for HIV with the help of Tanadgoma. She is not going to change her lifestyle, but she wants to know if everything is all right with her health. In Tanadgoma, she will get recommendations not only about HIV because, according to Nino Tsereteli, another problem of sex workers in Georgia is violence. Sex workers do not always know how they can organize themselves to protect their rights, health and lives. In Tanadgoma, they can get knowledge and support of professional lawyers.

AFEW on AIDS 2018: Session ‘AFEW Network’s experience in strengthening community, Monitoring and involvement in service delivery: From grassroot to policy level’

What: Session ‘AFEW Network’s experience in strengthening community, Monitoring and involvement in service delivery: From grassroot to policy level’

Where: Global Village, Eastern Europe and Central Asian Networking zone

When: July 25, 2018/16:00-17:30

Important to know: Session will be in Russian, translation to English will be provided.

This session, organized by AFEW Network, will offer an opportunity to share experience in strengthening community monitoring and involvement in service delivery: from grassroot to policy level.

During the session we will talk about creating an enabling environment by building the bridge between service beneficiaries, services, policies and successful experiences in meaningful involvement of our service beneficiaries and building strong collaborations between communities of key populations and the public system.

Through exchange and panel discussion we aim to:

  • Demonstrate the double win (for both the public system AND the communities served) when communities and service beneficiaries are involved in service delivery and policy making;
  • Share strategies and best practices from the AFEW network members that use innovative methods of information through online media that hands bigger autonomy to the service beneficiaries;
  • Share strategies and best practices to form mechanisms of community monitoring.

This session is prepared and presented in the framework of the program ‘Bridging the Gaps: health and rights for Key populations’, through the regional EECA approach by AFEW International and AFEW Network.

Agenda

3 Session of 30 min each to share and discuss experiences.

Session 1: ‘Meaningful involvement of service beneficiaries in planning, designing and monitoring of services’ experiences within the AFEW Network

  1. Creation key populations’ advisory councils in Tajikistan: Dilshod Pulatov, project manager, AFEW-Tajikistan
  2. Involving adolescents in service delivery and monitoring of services in Ukraine: Daria Kopiyevska, activist, NGO “Return to Life”, Kropyvnitsky, Ukraine
  3. Initiative groups in the provincial steering committee of Kakheti region in Georgia: Davit Kazaishvili, Public Union “Bemoni”, Georgia
  4. Supporting community steered service delivery by key populations in Kazakhstan: Roman Dudnik, Executive director AFEW Kazakhstan, Rosa Oleynikova,  Director NGO “Doverie Plus”, Sergey Schetnikov,  NGO “Answer”
  5. Discussion

 

Session 2: ‘Building equal access to prevention, treatment and care for HIV’, experiences within the AFEW Network

  1. New digital approaches to support adherence to treatment in Kazakhstan: Yagdar Turekhanov, Program technical advisor, AFEW Kazakhstan
  2. On-line consultations in Tajikistan: Zarina Davlyatova, Project specialist of AFEW-Tajikistan
  3. Interactive prevention methods for working with young drug users in Ukraine: Aleksander Mohylka, NGO “Blago”, Kharkiv, Ukraine
  4. Discussion

 

Session 3: ‘Building bridges, connecting people’, experiences within the AFEW Network

  1. Community-based participatory research: Daria Alexeeva, project manager, AFEW international       
  2. Сoordination mechanisms on HIV in Kyrgyzstan: Ulan Kadyrbekov, Director, Republican AIDS center, Kyrgyzstan
  3. Key populations platform in Ukraine: Vielta Parkhomenko, Club Eney, Kyiv, Steering Committee of the Country Key Populations Platform
  4. Discussion and closing of the session

Share Experience and Adopt New Ideas: Kyrgyzstan Heading to AIDS 2018

Author: Olga Ochneva, Kyrgyzstan

22nd AIDS Conference AIDS 2018 is an event which is particularly important for the countries of Eastern Europe and Central Asia – the region where the HIV epidemic is still growing. Representatives of governmental, non-governmental and community-based organizations from Kyrgyzstan were active in submitting applications and abstracts as well as looking for support to participate in the conference. We spoke to some of the delegates heading to AIDS 2018 and asked them how they are going to present their country at the conference. We also talked about their expectations for this major international event in the area of HIV.

Experience of preventing gender-based violence in HIV response

For three years, civil society organizations in Kyrgyzstan have been working to prevent violence against women who use drugs: 213 women attended individual sessions. They were screened for the exposure to violence, received detailed information on this issue, together with a counsellor developed safety plans, strengthened social support, and determined their goals to resolve the issues of violence and HIV.

Tatyana Musagalieva

Asteria NGO was one of the organizations implementing the Wings of Hope project to prevent gender-based violence, and Tatyana Musagalieva as a representative of this organization will present the efficiency of this rapid intervention at AIDS 2018.

“We would like to share our experience and demonstrate that this intervention is effective: it helps women to be open for medical, social services and harm reduction programs and reduces the HIV risks. I hope that the results of our work will prove the importance of preventing gender-based violence and its linkage to the risks of HIV.”

Sex-work: challenges and solutions

Ulan Tursunbayev

The needs of Kyrgyz sex-workers will be presented at AIDS 2018 by Ulukman Daryger NGO, which received support from AFEW International to carry out community-driven research.

“We are preparing a poster to present the results of our research study. We make a focus on two most pressing challenges – HIV testing and economic adaptation after sex-work,” says Ulan Tursunbayev, Director of Ulukman Daryger NGO. “After completion of the study, we have already started making first steps to resolve the issues we identified. Now we are getting prepared to submit a funding proposal within the national social contracting mechanism. There are intentions to finance a program to socialize women in difficult life circumstances from the local budget. That is why at the conference, apart from our research results, we will also present our vision of how to resolve this problem.”

Young people are going to AIDS 2018 to gain knowledge

Renata Bayazitova

The only organization in the country working with young people who use drugs will also be prominently present at the conference. Renata Bayazitova, Project Coordinator of the Ganesha NGO will deliver a poster presentation to show the results of the assessment of services for young female drug users.

“I will present the country situation in terms of the number, quality and effectiveness of the services for young female drug users offered by governmental and non-governmental organizations. This assessment was carried out by the community and showed major gender and age-related gaps. I hope that participation in the conference will help me get new information, learn practical ways to adjust services to our young people, and share the experience with other youth organizations.”

Treatment is a priority

Margarita Sabirova

Prosvet Charity Fund will represent the Kyrgyz organizations working with people living with HIV (PLWH) at AIDS 2018. The Fund provides consultations on adherence to antiretroviral therapy as well as legal and psychological counselling, navigates clients to various services, offers support in rehabilitation and reintegration in the society, and strives for better quality of the services for PLWH.

“My expectations from the conference are to get information about the new methods of HIV/AIDS treatment based on the latest achievements of modern medicine,” says Margarita Sabirova, the psychologist of the Prosvet Charity Fund. “It would be good to learn about the experience of other countries in terms of the interaction of civil society sector with governmental agencies, to see the contribution of different governments to the activities of civil society organizations and their response to HIV.”

Sixteen delegates supported by AFEWKyrgyzstan

Natalya Shumskaya

Thanks to the support of donors (Dutch Ministry of Foreign Affairs, USAID, GIZ, UN Women, WHO), AFEW-Kyrgyzstan was able to support 16 delegates providing them with an opportunity to attend the conference. Those are representatives of AIDS centres, municipal bodies, healthcare coordinators, researchers, community leaders of key populations and AFEW-Kyrgyzstan staff members.

“The delegates will present the experience of AFEW Network in strengthening community monitoring and community involvement in service delivery will tell about the HIV prevention, treatment, care and support in Kyrgyz prisons. There will be poster presentations dedicated to the country’s experience in economic empowerment of women vulnerable to HIV as well as HIV prevention through opioid substitution therapy. I will speak about the assessment of opportunities of female leaders of the community of people who use drugs and their impact on the access to and quality of HIV programs,” tells Natalya Shumskaya, director of AFEW‑Kyrgyzstan. “Participation in AIDS 2018 is a unique opportunity for all of us to get acquainted with the best practices in HIV diagnostics, prevention, treatment and care as well as present our own experience. Kyrgyzstan has an extensive experience as our country has implemented innovative HIV prevention approaches both in public health care and in penal institutions.”

Ukrainian Youth Will Tell Everyone about HIV

Yana Panfilova and Dany Stolbunov from the Ukrainian organization Teenergizer! will perform on 21 July in CREA Theater, Amsterdam. The performance will take place within AIDS 2018 Conference.

The documentary theatre play ‘Don’t Tell Anyone’ aims to draw attention to the issues and stigma which HIV+ teenagers in Ukraine are facing. The performance is a story about two adolescents who are looking for the answers to their questions: “What does it mean to be born with HIV in Ukraine?”, “What do children feel when they have to hide their diagnosis because of the fear to be judged and isolated?”. The documentary theater performance will make the audience feel how it is to live with HIV in Eastern Europe and Central Asia (EECA), and why it is important to let voices of young people living with HIV from EECA be heard at the global level.

Teenergizer! is an organization created by adolescents for adolescents. The organisation creates world where every teenager can realize full potential; world free of discrimination in all areas, including live with HIV; world in which the rights of all young people are fully respected. AFEW is a unique network of organisations working in EECA for 16 years to improve health of people living with HIV, people using drugs, men who have sex with men, LGBTQI, sex-workers, prisoners, and youth at risk for HIV.

Date and time: 21 July, 15:00

Location: CREA, Nieuwe Achtergracht 170, 1018 WV Amsterdam https://goo.gl/maps/ZtDnCLvbwuF2

Language: Russian (English subtitles and translation during the discussion)

Facebook event: https://www.facebook.com/events/408902859584252/

Free entrance

Dutch Organisations Ask the Prime Minister of the Netherlands to Lead the UN High-Level Meeting

Prime Minister of the Netherlands Mark Rutte

AFEW International co-signed the letter to the Prime Minister of the Netherlands Mark Rutte. This letter is a request to lead Dutch delegation at the UN High-Level Meeting on Tuberculosis that will take place in New York on 26 September 2018.

“The Netherlands is an international leader in the fight against life-threatening epidemics, such as tuberculosis. Dutch companies, universities and social organizations make the difference with their knowledge and expertise in the field of health worldwide. 2018 is the year in which the Netherlands can present itself internationally as a member of the UN Security Council and as a participant in the G20, with global health as its theme. This year, the International AIDS Conference and the International Tuberculosis Conference will also take place in Amsterdam and The Hague.

We hope that he will strengthen this position of the Netherlands internationally by leading the Dutch delegation at the High-Level Meeting on Tuberculosis at the United Nations General Assembly in New York on 26 September. Tuberculosis is the deadliest infectious disease in the world with 1.7 million deaths per year. Multidrug-resistant forms of tuberculosis are responsible for a large part of the deaths due to antibiotic resistance. The disease is curable. Dutch expertise and research on antibiotic resistance, drug development and diagnostics are of great importance to stop this disease. International agreements and commitments at the High-Level Meeting on Tuberculosis will contribute to strengthening Dutch Research and Development for new diagnostics, vaccines and medicines. In addition, the work of Dutch NGOs will contribute significantly to the worldwide achievement of the outcomes of the summit,” written in the letter.

16 Dutch organisations are letting Mark Rutte know that to stop this disease, the political action is needed worldwide. They are asking Prime Minister of the Netherlands to represent the Dutch business community, universities and civil society during the High-Level Meeting on Tuberculosis and thus strengthen the leading Dutch role in international health.

AFEW International is Finding New Possibilities in Russia

Anke van Dam meeting with the representatives of the Fund for Resocialization of the Republic of Tatarstan

Author: Olesya Kravchuk, AFEW International

AFEW International continues looking for possibilities of helping key populations at risk for HIV, tuberculosis and viral hepatitis and community organisations in the Russian Federation. AFEW’s executive director Anke van Dam visited a couple of NGOs and community-based organisations during her recent visit to Moscow and Kazan.

In Kazan, Anke van Dam visited Fund for Resocialization of the Republic of Tatarstan. This fund for the first time in Russia successfully tested the model of purposeful employment of those who went through all stages of rehabilitation. For more than three years, the Fund for Resocialization offers employment to people who were using drugs, who are working on modern production of ventilation systems.

“What Daniyar, the director of the Fund for Resocialisation is doing, is amazing. He gives people with a history of drug use and sometimes of imprisonment as well, a chance to earn their own living again. With the job they regain their self-esteem, which helps them to get in touch with their family and participate actively in society again,” says Anke van Dam.

The Fund for Resocialization of the Republic of Tatarstan is engaged in the resocialization of people dependent on the psychoactive substances

The Fund for Resocialization of the Republic of Tatarstan, is engaged in the development and implementation of the state regional program for the resocialization of people who use drugs.

“It is resocialization that will allow us to establish new links with the society, to consolidate, to approve and apply the knowledge and principles obtained at the stage of rehabilitation in the social environment. We all know that for people who use or used drugs it is not easy to find jobs. They often have problems with their relatives, and some of them even do not have their own housing. Many of those who had treatment, again find themselves in the surrounding that provokes drugs use soon after they left the hospital,” states on the Fund’s website.

AFEW on AIDS 2018: Workshop ‘Migration in EECA: access to health care for all?’

What: Seminar Migration in Eastern Europe and Central Asia: access to health care for all?

Where: E 105-108 @ RAI Amsterdam

When: 26 July, 2018/16:30-18:00 

Important to know: This workshop will offer translation facilities English – Russian.

This workshop, organized by AFEW Network, will offer a unique opportunity to not just talk about migration, HIV and key populations but also to hear a real-life experience about migration.

We will discuss the general situation on access to health for migrants and the political commitment within Eastern Europe and Central Asia (EECA), the essential package for migrant health for EECA and the situation of migrant’s access to TB/ HIV programs specifically in Tajikistan.

AFEW Network will highlight its research on People Who Use Drugs, including their regional mobility, and raise more clarity on the issue of the labor migration situation and access to prevention, treatment and care for Key Populations in Tajikistan, Kyrgyzstan and Russia. Also, a specific model for NGO service implementation will be presented by AFEW Tajikistan, where women in labor migration and wives of migrants are reached with various HIV, TB, HCV prevention, treatment and care interventions.

Through exchange and panel discussion we aim:

  • To inform all on the Universal Health Coverage when it comes to labor migrants in Eastern Europe and Central Asia;
  • to develop concrete actions that can be used within the existing platforms to advocate for further action and commitment at government level andto get key populations (PWUD, SW, LGBT/ MSM) and access to health modules in official migrant training protocols;
  • to study and discuss the role of NGOs and their collaboration with public (health) systems.

This session is prepared and presented in the framework of the program ‘Bridging the Gaps: health and rights for Key populations’, through the regional EECA approach by AFEW International and AFEW Network.

Agenda

  1. Introduction: Janine Wildschut, Director of Programmes AFEW International
  2. Meet a person with experience: Ms. Alimahmadova Zebo
  3. The essential package for migrant health and the political commitment: opportunities and challenges in EECA: Ms. Elena Vovc, WHO Technical Officer, HIV, STIs and Viral Hepatitis program
  4. Tajik migrants and access to HIV and TB services. IOM experience to address health needs of migrants: Ms. Rukhshona Qurbonova, IOM Tajikistan Migration Health Programme Coordinator
  5. Women and labor migration. The role of NGOs in health care, social and legal support of female migrant workers: Ms. Zarina Davlyatova, Project manager AFEW-Tajikistan
  6. Discussion:

    • What can we do to developing regional approaches on HIV prevention and health promotion among labour migrants with emphasis to the needs of specific groups as PWUDs living in EECA?
    • Options for cross border collaboration and between public and NGO bodies.• Set priorities and any immediate action.
  7. Conclusion

Building Bridges Between East and West – AFEW Releases its 2017 Annual Report

AFEW International releases its 2017 Annual Report ‘Building Bridges Between East and West.’ The report highlights AFEW Network’s key activities in the region of Eastern Europe and Central Asia.

“‘Building bridges’ stands at the core of AFEW’s work. During its more than 15 years of working in Eastern Europe and Central Asia (EECA), AFEW has aimed to connect the East and the West by introducing and sharing expertise on prevention, treatment and care for HIV, tuberculosis and viral hepatitis,” says Anke van Dam, executive director of AFEW.

AFEW Network will use AIDS 2018 with its focus on Eastern Europe and Central Asia as a springboard to address the three epidemics of HIV, viral hepatitis and TB including multi-drug resistant TB. We will renew our advocacy strategy, work with partners to ensure additional and better healthcare services for all and lead efforts to ensure that the Sustainable Development Goals and other multilateral efforts result in a better future for the people of Eastern Europe and Central Asia.

The English version of our Annual Report is available here (download PDF.) The Russian version of the Report can be read here (download PDF.)

Civic Campaign Cup for People

The Diversity House and Civic Info Centre opened in St. Petersburg during the World Cup. Source: http://cupforpeople.spb.ru/

The Diversity House and Civic Info Centre opened in St. Petersburg during the World Cup on June 16 and will be open until July 16, 2018, as a part of civic campaign Cup for People.

The project is implemented by the Fare network, an international umbrella of organisations and ethnic minority groups, LGBT+ fans working to fight discrimination and promote diversity, and the Cup for People, a network of grassroot initiatives and civic activists created before the World Cup in St. Petersburg in order to use the World Cup in the city as an opportunity to enhance communication among people from different countries, both guests and locals, on the human rights, inclusion and civil society topics.

The Diversity House and Civic Info Centre will work every day between June 16 and July 16 as an open and safe space for everybody to celebrate diversity and meet people using football to create awareness and change for inclusion, protection of human rights and development of civil society.  The Diversity Houses will feature a football exhibition, World Cup match-viewings, lectures, discussions, festivals, and meetings with local supporters and residents. See the programme here.

The Civic Info Centre will be an information point within the Diversity House, which will provide assistance to the international and Russian guests as well as journalists concerning the available civil society organizations and activities in St. Petersburg. They will also disseminate safety guidelines and help for guests, organize dialogues and network with locals. Alternative tours with the human rights and civil society focus will take place.

Guests of the World Cup in St. Petersburg are invited:

  • To visit the Diversity House and Civic Info Centre any time to ask questions about social and cultural life of St. Petersburg and Russia, to watch the Exhibition on the Inclusion in Football and translation of the football matches
  • To participate in our public events on different topics, see the program here.
  • To organize a public event on your country or your field of interest in our space.
  • To come with our excursions and walks in English by guides among the thematic experts and grassroots activists on different aspects of cultural and civil society life in St. Petersburg: on creative spaces, street art, social problems, charitable projects, etc. check here.
  • To check the Map for People, a St. Petersburg map of responsible consumption, which will show, where to eat and make shopping by supporting local and ethically, environmentally and socially responsible enterprises, click here.
  • To check the bars in St. Petersburg, which are especially safe for women, click here.
  • To support the Diversity House and all the activities of the Cup for People financially, click here.
  • To use the Fare Diversity Guide, a comprehensive online resource combining travel advice and important information including historical context, Do’s and Don’ts and what to expect in each of the 11 host cities, including specific guidance and safety advice for the LGBT community and ethnic minorities traveling to Russia. The WhatsApp hotline is being set up to help support visiting minorities in Russia with issues of discrimination to report or who require other urgent help: + 79169481108.

Time: June 16 — July 16, 12:00 — 23:00

Place: St. Petersburg, Berthold center, Grazhdanskaya str., 13-15, enter through the yard

Source: http://cupforpeople.spb.ru/