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.

New UNAIDS Strategic Information Hub for Eastern Europe and Central Asia

UNAIDS Strategic Information Hub for Eastern Europe and Central Asia (UNAIDS SI Hub) has been launched on the Internet.

The purpose of this resource is to provide an online one-stop-shop for data, publications and strategic information about HIV (and related health issues) in EECA. It is publicly accessible to anyone online, but it aims to make information accessible and easy to find for specialists and policymakers working on HIV in governmental, non-governmental organizations and partners across EECA.

The address of the hub is http://eecahub.unaids.org/ and it’s managed by UNAIDS RST  in Moscow, with support from UNAIDS HQ. It currently features HIV data from the latest GAM reports, as well as published reports and presentations related to HIV in EECA. It’s possible to access the country-specific data and reports as well as reports and publications from the various menus. By selecting “data” and “factsheets”, you can generate and print Regional and Country factsheets as PDFs as well access as epidemiology slides with global and regional statistics.

The hub works in two official UN languages – English and Russian, but most of the publications will only be available in the language they are produced (and not translated into other languages by UNAIDS).

For contribution to the UNAIDS SI Hub please send your suggestions, data, publications and other materials to eecasihub@unaids.org.

HIV in prison is not a death sentence

Nowadays Kyrgyzstan is recognized as one of the most advanced countries in the world in regards to delivery of the harm reduction and HIV care and treatment programs in prisons (details here).

At the moment here, in the penitentiaries, there are 5 active programs: syringe exchange program, methadone maintenance treatment program, rehabilitation program “Atlantis”, Center for Rehabilitation and Social Adaptation “Clean zone” and “Start Plus” program.

Dina Masalimova, AFEW-Kyrgyzstan program manager, explained what kind of work is done in this field in the country, and which significant results have already been achieved.

Dina, could you please describe the programs for inmates? What do they look like?

A pilot program on needle and syringe exchange was introduced in Kyrgyzstan in 2002, in one of the prisons with a modest reach of 50 people. A year later the program was expanded to 3 prisons, and then several more. Today there are 14 syringe exchange stations (SES) in the penitentiary system. They work in all the prisons except for the facility for underage convicts. Also, syringe exchange services are provided in the 2 largest detention centers. An actual number of SES clients in 2018 amounted to over 1300 people. They received syringes either in person, or through a secondary exchange conducted by volunteers. Aside from the sterile injection equipment you can also find other protection items at the stations – alcohol wipes, condoms; and HIV blood tests are done here too. Those clients that would like to decrease or fully stop the injecting drug use are forwarded to the methadone maintenance treatment stations.

The methadone maintenance treatment program was started in the country’s prisons over 10 years ago – in 2008.  Today there are already 9 stations in the penitentiaries, and the number of clients is over 350. These programs are conducted by the State Penitentiary Service with the support of the Global Fund To Fight Aids, Tuberculosis And Malaria, as well as Center for Disease Control (CDC).

Aside from the harm reduction programs there is a program aimed at the full withdrawal from drug use in prisons. In a number of places the  “Atlantis” program based on the famous model “12 steps” is active. The program graduates can serve their remaining sentence time in the Center for Rehabilitation and Social Adaptation “Clean zone”. “Clean” means that it’s free from drugs. There is a full-scale program of rehabilitation and preparation for sober life outside of prison there.

Over the past 5 years we also were active in delivering services directly to inmates. For instance, our consultants have supported prisons’ health system by providing peer-to-peer consultations and HIV testing, as well as supported inmates before and after their release from prison. For a long time this program has been implemented with the support of USAID. Soon it will be continued thanks to the financial and technical support of ICAP (international program by Columbia University’s Mailman School of Public Health).

How are these programs created, and who delivers them?

As a rule, these programs are created based on the actual needs of the most vulnerable groups of prisoners – people living with HIV and/or using drugs. And these programs are also delivered by the representatives of these communities.

We approach the program in a flexible way and always try to improve it so that it remains relevant. For example, one of our recent additions to the program is working with the convicts that were rejected by the prison subculture. Due to the unspoken prison rules this group of prisoners has the lowest level of access to medical and social support and faces a high level of stigma and discrimination from the other convicts, and often also from the prison staff.

Could you share some results of these programs?

All the programs currently active in the country are aimed at reaching the ambitious goal 90-90-90.  Now almost all inmates in prison are being tested for HIV “at the entrance”, and a vast majority of people living with HIV are formally in treatment. Why “formally”? The viral load indicators show that quite a few of inmates don’t use it. In prisons there are a lot of myths about HIV and antiretroviral therapy, and during in-person conversations many patients admit that they simply throw medicines away. Because of that, the main goal of our project is to increase the number of convicts who live with HIV with undetectable virus load.
Over the years we achieved great results. For instance, in prison #31 the number of people who are adherent and have a suppressed virus load has grown from 15% to 68%, and in prison #16 – from 33% to 66% in the past three years. We are especially proud of two prisons – #2 and #47, where we’ve already reached the second and third “90”.

All these programs are mainly targeting male convicts. Are there any special programs for female inmates, for pregnant women?

In Kyrgyz prisons there are only 10 female inmates living with HIV. However, it is also important to consider their needs while planning measures in response to HIV-epidemic. We approach work in female prisons quite reverently and are trying to make sure our programs are gender-sensitive.  In one prison there was a women self-help group focusing on gender violence prevention. Also we partner with NGO “Asteria”, which runs a women’s center supported by AFEW-Kyrgyzstan and open for women released from prison. Many of the center’s clients are former inmates, and the help and support program includes temporary lodging, provision of food and hygiene packages, peer consulting on HIV, sexual and reproductive health and rights (SRHR) and opioid substitution treatment (OST), as well as provides access to gynecological services.

What is the prisoners’ attitude towards such programs?

Inmates perceive this program in a very positive way. Slowly but surely our team managed to win their trust and involve them into the dialogue about their health. It’s important to understand that health is far from the first priority for a person in prison. Unfortunately, current conditions of prisons make basic survival the main priority, and HIV is perceived as a far removed problem for many of them. Our peer consultants have their own experience of living with HIV in a prison, so they can show by their own example how one could solve upcoming problems.

Could you name the main current problem for prisoners with HIV in Kyrgyzstan?

One of the main problems is the lack of medical staff in the penitentiary system. In a number of large prisons in the country there are no doctors with higher medical degree. All the work on supporting prisoners’ health is put on the shoulders of a small team of paramedics. Of course, very often they have no time or knowledge needed to perform quality work on supporting inmates with HIV. We also try to help in such cases. For example, in prison #16 there was no doctor for a whole year, and our organization set up weekly visits of a doctor from the Republican AIDS center in order to support the patients.

It is often said that many prisoners don’t trust prison staff, including health workers…

Yes, it’s a separate and quite serious problem, and the consequence of it is the unwillingness of prison inmates to follow doctors’ recommendations. Our consultants serve as a certain “bridge”, which helps to build trust-based relationships between doctors and patients. For instance, with the patients’ agreement they take the results of viral load and cd-4 tests and thoroughly explain their meaning to the patients, e.g. the influence of the therapy on those indicators etc. We try to find individual approach to everyone. For many people the possibility to have a family and healthy children when they reach undetectable viral load becomes the best motivation for treatment.

It seems that peer-to-peer consulting is a really life-saving tool when it comes to fighting for the health of prisoners living with HIV, isn’t it?

Александр Certainly! We have so many stories that prove it. For instance, the story of Alexander. He learned about his positive HIV-status in 2013. His prison mates gave him a clear verdict that he would die soon. Needless to say, he was in great shock. He didn’t have any access to information, and doctors didn’t explain much. On the verge of desperation he started to use more drugs. He looked at the people with positive HIV-status around him, and they were dying one after another. He also waited for his turn.
In 2016 peer consultants from the Action against HIV project started to come to the prison. One of them – Evgeniy – really impressed him. He was living with HIV himself, but he didn’t look like he was dying at all, quite the contrary. During one conversation with a peer consultant Alexander got more information than in the previous 3 years of his life with positive HIV-status. At that moment he told himself: “Enough. I choose life”. He started treatment and quite soon reached undetectable viral load.

Mass media as partners in counteracting HIV/AIDS epidemic

Mass media play a major role in fighting for human rights, especially when it comes to population groups vulnerable to HIV. Through the wide media coverage of successful human rights defence cases implemented by community and civil society, the government can see that the community of People Living with HIV (PLHIV) and people vulnerable to HIV can and should be an equal partner and an ally in fighting HIV/AIDS epidemic.

This helps with forming a positive image of PLHIV and representatives of other key populations in the society, decreases stigma and discrimination, raises their self-esteem and self-significance and gives motivation for further activities and professional growth.

Thanks to the coverage of successful practices in mass media, a large number of PLHIV, people who use drugs (PWUD) and representatives of other vulnerable groups gain opportunity to get basic human rights knowledge, action plans and tools, which allow them to solve problems related to violation of human rights due to HIV in their own regions independently.

Liudmila Vins, project manager of LUNa Social Support Centre, legal adviser of Interregional Center for Human Rights in Yekaterinburg, has applied to the Emergency Support Fund for key populations in EECA for a grant. The goal of her project is to change the legal environment and public opinion towards people living with HIV and representatives of groups vulnerable to HIV through mass media.

Liudmila, what is the core of your project?

Our way of working is as follows – our lawyer together with partners, street lawyers from the regions, collects successful legal practices and strategically important cases, prepares the gathered materials for media publications, provides a legal evaluation and an algorithm for solving the problem. An info manger writes articles based on the cases for mass media and our own media resources, passes information about these cases to journalists through mailing lists, social media, and connects media and people featured in the cases in order to prepare further materials.

Could you tell us about the intermediate project results?

Yes, the project has substantially helped us to develop the informational part of our work and also gave a start to a new project of educating Russian NGOs on working with media. We found 17 cases, which resulted in 33 publications. Each case contained a story of at least one person – the leading story character, and at least 2 more people connected to the story, close relatives of the leading character. In total 51 people were featured in the stories.

Please share the most interesting and remarkable moments of the project.

The most remarkable example of support within this project is Olga’s story (the name is changed). We published it on our website.

Local journalists quickly noticed this material; they immediately reacted and published a number of articles about the fact that a woman in detention facility doesn’t receive treatment for HIV-infection. The news travelled fast: one journalist made a lot of requests to government agencies and received a positive decision from government officials. The result was that this woman received medication the same day.

You started your social support activities for vulnerable groups in 2009. How have the statistics changed since then?

At that time harm reduction programs were developing actively. However, the issue of defending the rights of PWUD was still unresolved, so starting from 2012 I began to develop street lawyers programming in Yekaterinburg. The need for this kind of support is very high now. In 2012 legal assistance was given to 100 people per year, and there was one street lawyer. Currently we work with 5 street lawyers, and we give this kind of support to people on a regular basis.

Who are the street lawyers?

These are people from the key populations community who are taught the basics of human rights defense. So, they can provide basic support with human rights defense, and then, if necessary, pass on cases to professional lawyers.

What is the attitude of the key populations’ representatives towards your activities?

We have a good connection with our target group, they are happy to receive our support. However, there are certain difficulties. For example, a person can disappear for a period of time while being under our supervision. Then (s) he appears again in a month, and we have to start from the beginning.

Why do you think it is so important to involve representative of key populations in such work?

Almost all of our staff members except for two are people from the key populations/PWUD community. I have been in remission for a long time myself. I think that a different approach is simply not effective. Nobody can truly understand PWUD as well as a person who has gone through it too, and most importantly, who was able to overcome it and solve a problematic situation successfully.

When people are doing something for the society, they often have an ideal example of such society in mind. Do you have one?

I don’t have examples of an ideal situation in any country. There are drawbacks everywhere. When it comes to talking about the approach to working with PWUD in Russia, I reply that there’s simple no such work. Those few NGOs that provide harm reduction programs, can’t reach all the PWUD to the full extent. For me the ideal situation is when the system of social support is developed in the country, there are harm reduction programs, access to quality treatment, and there is no stigma and discrimination within the society.

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.

 

Facts abour EECA region

HIV epidemic status in Eastern Europe and Central Asia (UNAIDS, 2017)

Since the start of the epidemic:
• Over 76 million HIV-infected patients registered
• 35.0 million people died of AIDS-related illnesses
• The number of people living with HIV was 36.7 million, of which 2.1 million were children under the age of 15.
• 20.9 million people (28%) living with HIV received treatment
• 76% of pregnant women living with HIV had access to treatment to prevent transmission of the virus to the fetus
• In 2017, 1.8 million new HIV infections were reported worldwide.

Have you already registered your abstracts for the EECA INTERACT 2019 workshop?

Attention! Selected abstracts will get free registration. Please find here more information. 

School for People Living with HIV

Today, the community of people living with HIV (PLWH) in Kazakhstan is actively developing – the voice of community can now be heard at all levels, up to the Ministry of Health and the Parliament.

An important role in achieving this progress belongs to the events for potential activists organized by the Kazakhstan Union of PLWH together with AFEW Kazakhstan. One of them is a series of workshops called “School for People Living with HIV”. Such workshops are aimed at developing the community of PLWH to scale up the advocacy to promote their rights and interests and ensure care and support for PLWH at the local and national levels. They are organized with financial support of the Global Fund to Fight AIDS, Tuberculosis and Malaria within the project “Building Foundation for Sustainable HIV Response in Kazakhstan”. Yagdar Turekhanov, Program Advisor at AFEW Kazakhstan, told about the progress achieved.

 

Yagdar, what is the School for PLWH and how was it established?

The first workshop of the School for PLWH was held in November 2018 and brought together over 50 PLWH from all over the country. They were “newbies” – most of them just recently learned about their HIV status and did not have any experience of working in HIV organizations. People were enrolled after a competitive selection by motivation letters. It was a basic workshop where the participants learned about HIV, its treatment, and the role of civil society. They also received support in accepting their HIV status, bolstered their self-esteem and confidence. Following the first workshop, 25 most active participants who demonstrated their leadership skills, were selected. The goal of those workshops was to train a young generation of activists and to mobilize the regions to make the PLWH community of Kazakhstan act in a more targeted and coordinated way.

How would you describe the profile of the school participants?

Most trainees of the school are people who earlier had an experience of participating in similar activities, mobilized their peers and established local NGOs, making a significant contribution to the promotion of PLWH rights, reduction of the ART prices, etc.

What is the situation with PLWH rights in Kazakhstan?

The situation is different, and currently it greatly depends on separate individuals – friendly specialists, doctors, police officers, and workers of penitentiary facilities – as well as on the bravery and knowledge of the activists. Where such people are not numerous, the situation with observing the PLWH rights is disastrous.

What should a person do in case if his or her rights are violated?

Be brave enough to talk about it. File the case. Make a precedent. For this purpose, the person may ask more experienced community members and friendly lawyers for help.

Since 2019, Kazakhstan started using the ‘test and treat’ strategy. What does it mean?

For Kazakhstan, this approach, first of all, means breaking the stereotypes, challenging the traditional perceptions and the wide-spread myths about ART. It means fighting the “bonuses schemes”, when people take therapy only to get some incentives, but not because they see the linkage between ART and better quality of life. It includes working with health professionals, who can formally observe the protocols, but in some indirect ways, with their intonations, phrases, or even directly make their patients understand that they do not believe in what they do. E.g., they can often say something like “According to the new rules, I have to prescribe therapy to you, but you can refuse, all the more so because you have pretty good test results and those drugs are chemical anyway” or “I realize that you want to give birth to a child, but still you have to think twice as your husband has HIV and even if he does not transmit the virus to you – what will be the future of your child?” We try to change this kind of approach.

Is there a place for innovations in the PLWH community of Kazakhstan?

The active part of PLWH community is, of course, open to innovations – they are ready to introduce new approaches as soon as they learn about them or come up with them. Most of the general population are kind, empathetic people who are totally unaware of the modern scientific achievements in terms of HIV prevention and treatment. They are afraid for themselves and for their loved ones, thinking that HIV is a death sentence. Many people still think that HIV is transmitted through household contacts (“I know that HIV is not transmitted through air or touch, but just in case I would better protect my children from contacts with HIV-infected people”). It looks like this situation can only be changed by young people who are in their nature more open to new things, more tolerant and less prejudiced. Efforts aimed at young people, primarily at the students of medical colleges and universities, with the involvement of PLWH community, can gradually change the status quo. By the way, it is already happening – slowly but surely.

Will there be any workshops in future? Who will be able to participate in them?

Funding of such activities is currently very doubtful – donors gradually lose their interest to Kazakhstan, while attracting government funding is so far rather challenging. However, PLWH community is looking for new opportunities. Apart from the Schools for PLWH, PLWH camping events are held on a regular basis, where people more and more often pay for their own participation. Information about such events is shared through HIV NGOs, AIDS centers, social networks and messengers. The priority is given to “novices”. More experienced PLWH community members can try on the role of trainers after passing a competitive selection.

 

 

 

 

 

EECA INTERACT 2019

We are pleased to announce that, on the 18-19th November 2019, the first EECA INTERACT Workshop 2019 will take place in Almaty, Kazakhstan.

The EECA INTERACT 2019 Workshop builds scientific research capacity while simultaneously strengthening clinical, prevention, and research networks across the Eastern Europe and Central Asia (EECA) region. EECA INTERACT 2019 is an abstract-driven workshop focusing on factors unique to the region’s HIV, TB, and hepatitis epidemics. Bringing young and bright researchers together with top scientists, clinicians, and policymakers, EECA INTERACT 2019 aims to ignite a conversation that will build a stronger scientific base to serve the region and connect to the world.

EECA is the only region in the world where the HIV epidemic continues to rise rapidly. UNAIDS estimates point to a 57% increase in annual new HIV infections between 2010 and 2015.1 The World Health Organization has warned of a sharp rise in rate of HIV and tuberculosis coinfection, which poses a real threat to progress.2 Significant barriers to prevention and treatment services remain for people living with and affected by HIV, TB, and hepatitis across the region. For example, although the HIV epidemic in EECA is concentrated predominantly among key populations, particularly among people who inject drugs, coverage of harm-reduction and other prevention programs is insufficient to reduce new infections. The region urgently needs more effective strategies of prevention, treatment, and care and support that are tailored to the particular circumstances of individual countries.

The Amsterdam Institute of Global Health and Development (AIGHD) has over a decade of experience delivering in-country workshops and conferences that bring young researchers and established international experts together to share original research and state-of-the-art reviews on a wide range of topics. AIGHD has co-hosted the INTEREST Conference (the International Workshop on HIV Treatment, Pathogenesis, and Prevention Research in Resource-limited Settings) since its inception in 2007. The conference has grown from a small workshop to a full conference of more than 500 attendees each year.

Building on these proven results, AIGHD will collaborate closely with AFEW International and the AFEW network (AFEW) for EECA INTERACT 2019. AFEW’s deep roots and experience in the region offer a way to build sustainability into the new workshop, placing priority on local contributions. The EECA INTERACT 2019 will bring scientists, clinicians, members of civil society, and government officials together to tackle topics facing individual countries while building capacity and strengthening research and clinical networks. The two-day conference will focus on topics that are specifically relevant to EECA and dive deeply into particularities of the host country Kazakhstan, showcasing its successes, remaining challenges and responses.

The workshop objectives are:

  • To provide cutting-edge knowledge in the fields of epidemiology (modelling), treatment, pathogenesis, and prevention of HIV, TB, and viral hepatitis as well as chronic conditions;
  • To exchange ideas on providing and supporting HIV testing services and clinical care provision to adults, adolescents, and children living with HIV to achieve 90-90-90 goals;
  • To foster new research interactions among leading investigators and those who represent the potential future scientific leadership for health care and research in the region;
  • To build research and clinical capacity across EECA.

We invite researchers from EECA to submit their abstracts in the workshop. Selected abstracts will get free registration. Please find here more information.
Interested parties who do not have abstracts, but also wish to attend the event, can fill in an application form that will be considered by the committee. Please find here more information.

The deadline for all applications is September 20, 2019.

EECA INTERACT 2019 is organized by AFEW International, Amsterdam Institute for Global Health & Development (AIGHD), AFEW Kazakhstan and the Kazakh Scientific Center of Dermatology and Infectious Diseases.

EECA INTERACT 2019 is sponsored by Johnson & Johnson, Gilead, Aidsfonds.

Venue of the event: Hotel Mercure Almaty City Center.

#EECAINTRACT2019

If you have any further questions, please contact Helena_Arntz@AFEW.nl.

 

 

Rehabilitation in a Dutch Way: Learning to Take Responsibility for Yourself and for Others

Author: Olesya Kravchuk, AFEW International

The ferry boat brings people to the island Texel in the Netherlands several times per day. Just a few minutes’ walk from the ferry stop there are several cosy houses. Near one of the houses, there is a hedge, behind which there are three goats. They are not afraid of visitors, and immediately come up to you and check you out. Residents of the house clean its territory and cook dinner. It is the usual Dutch routine, but the atmosphere is somehow different…

For more than 40 years already de Skuul Foundation (Stichting de Skuul) has been working on the island. It is an independent institution that specialises in assisting in the rehabilitation of people who take drugs. They also help those who have alcohol and gambling addictions.

“The fact that our residents are on the island creates a special atmosphere. In this way, they stay in a neutral environment,” says Aglaia Westra who works as a therapist at the Foundation. She has been working here for six years. “There are usually 16 residents who live here, and they live in a mini-society. They form the groups of eight people, and everyone has a task for every day. Someone, for example, goes to buy food, someone cleans the territory, and someone cooks food. That is how they learn to take responsibility for themselves and for others.”

The main thing is not to lose touch with reality

The clients of the Foundation come here after the referral of their general practitioner. De Skuul is financed via the insurance companies, local government and business representatives. In order to get into the rehabilitation programme, you need to go through the detox programme already at home. The first four weeks of their stay in De Skuul, its residents stay only on the island. After four weeks you can (and even have to) go home for the weekend. Foundation employees say that it is very important not to lose touch with reality. During the rehabilitation programme, its participants work with a psychotherapist. They also have visiting teachers who teach them singing, drawing and other crafts. The programme starts every day at 9 am and lasts until five in the evening. In the evening, the Foundation’s residents live their normal lives: they jog, read and walk by at the Wadden Sea that surrounds the island.

There are also rules here: violence and cruelty, drugs and alcohol, and mobile phones are prohibited. It is necessary to respect others and to be present during all activities within the rehabilitation programme. Violation of these rules leads to the end of rehabilitation.

“We have group sessions. Usually, it starts with one person is talking, and it becomes more like a monologue,” tells Aglaya. “We believe that everyone builds their own way while experiencing their own feelings and emotions. We use the principle of self-help and trust residents in how they lead their lives and what they do in their free time. The most important thing is that we teach responsibility. It is like a kindergarten, where you can try everything and learn again.”

The period after rehabilitation is harder than the period before it

The Foundation’s clients say that they came here to get acquainted with themselves again and to get away from their addiction. They say only good things about the rehabilitation programme. The hardest part starts when you return back home.

“I came here only yesterday,” says Linda from the Netherlands (the name is changed) with the tears in her eyes. “This is not my first rehabilitation programme, and I very much hope that this programme will help me. Working with yourself during the rehabilitation period is not that hard. Then you follow the same pattern at home. Later though it comes the time when you go back to your old habits. I think it very important to combine treatment with reality, and de Skuul is doing this.”

Every year about 50 people are being treated in the Foundation. On average, de Skuul accepts one new person per week. Each resident stays in the programme on average for 3-6 months. Each resident himself decides when his rehabilitation ends. After the programme, if necessary, ex-residents can always call Foundation employees and ask for help. Every six weeks, former residents come to the Foundation if they want to share their experiences and hear the stories of others.

Treatment based on commitment and not punishment

The rehabilitation centre Kentra24 in the city of Sint-Oedenrode in the Dutch province of Brabant is located in an old monastery. On the windows here, there is old religious stained glass, and in the inner monastery courtyard you can meet your new friends. Young people between the ages of 12 and 24 years old who cannot control their stimulants or gambling addiction have their rehabilitation here. The rehabilitation programme includes preventive, outpatient, clinical and online assistance. At the same time here there can be 40 clients for whom about 80 employees provide services. Not all customers in the centre spend nights here, some only have a daily programme. Both boys and girls are undergoing rehabilitation.

“Most of our clients are in the centre voluntarily, but sometimes someone comes after a court decision,” says Judith who works in the centre. “We want the parents of young people who have treatment with us to be also involved in the rehabilitation process. But those adolescents who are already over 18 decide themselves how much they want to involve their parents.”

There are four groups of clients in the centre. The first group is those who undergo a detox, and all the other groups are undergoing rehabilitation. Young clients of the centre have four phases of rehabilitation: zero phase is the most strict one, the third phase is the one during which there is more freedom. For example, during the zero phase it is impossible to leave the territory of the centre, but in the third phase this can already be earned as a reward. Moving to the next phase is possible by showing good behaviour and progress in the rehabilitation process. Usually, the clients stay in the centre for 3-4 months.

“Our treatment is based on commitment and not punishment. Each of our clients has his own goal and is working towards achieving this goal,” continues Judith. “If the goal is achieved, the client gets the reward. For instance, this can be some additional time online, or purchase of the new bike, or visit of the parents with a favourite pet, or additional phone call, and much more.”

Not to have an addiction is already a success

Each of those clients who stay in the centre overnight has their own private room, where other clients are not allowed. For communication, there is a joint living room with a kitchen, where clients prepare their own food. The rehabilitation programme also includes sports at the local gym, creative workshops, work on various projects, setting goals for the week and homework. There are rules: customers cannot freely use their phones or computers.

“I decided to come here because I realised that my life was going all wrong,” says 20-year-old Jan (the name is changed). “Because I used drugs, I started to close up and drifted away from my parents and my younger sister. It feels like I lost three years of my life. After the rehabilitation programme I plan to finish school, start working and living independently. It is my goal.”

The staff of the centre understands that after the rehabilitation programme some of their clients will still use drugs or alcohol and they are loyal to this.

“After all, the main thing is not to stop taking drugs, but to know why you are doing this,” says centre employee Steve. “If there is such understanding and after the programme a person will take drugs or alcohol sometimes, and not have an addiction – this is already a success.”

United Nations and World Leaders Condemned for Failure on Drug Policy, Health and Human Rights

Wednesday 1 May,  2019, Porto

As the 26th International Harm Reduction Conference comes to a close, hundreds of health professionals, academics, drug policy and human rights experts, frontline workers and people who use drugs released a statement calling on world leaders to urgently address the health and human rights crisis among people who use drugs.

Signatory NGOs shed light on the alarming public health emergency faced by people who use drugs. Between 2009 and 2015, the number of drug-related deaths rose by a worrying 60%. In 2015 alone, this culminated in a total of 450,000 deaths – an estimated 50 deaths every hour. The target to halve the incidence of HIV among people who inject drugs by 2015, set eight years ago, was spectacularly missed by 80%, and HIV prevalence increased by one third among people who inject drugs over the same period. Furthermore, globally, six in ten people who use drugs are living with hepatitis C, while 168,000 people who use drugs were reported to have died of an overdose in 2015 alone.

These health harms are preventable. The evidence, presented at the Conference this week, shows that harm reduction and human rights-centred drug policies can save lives, prevent the spread of HIV and hepatitis C, and promote the dignity and empowerment of people who use drugs. But this requires leadership from both governments and the UN.

Naomi Burke-Shyne, Executive Director of Harm Reduction International (HRI), said: ‘The evidence for harm reduction is indisputable. It is nothing short of disgraceful that governments continue to fail to support and invest in health services for some of the most marginalised people‘.

The joint NGO statement also expresses serious concerns over the ability of the UN Office of Drugs and Crime (UNODC) to adequately lead the UN response on this issue. By its very mandate and construction, the UNODC remains more attuned to the law enforcement response to drugs. As a result, UNODC leadership has consistently failed to unequivocally champion harm reduction, human rights and decriminalisation,and has lost further creditability with repeated silence in the face of egregious human rights violations. Today, people who use drugs continue to be victims of incarceration, compulsory detention, denial of access to healthcare, corporal punishment, institutionalised violence, stigma and discriminations, and – in the most extreme cases – extrajudicial killings.

In response to the vacuum of political leadership, NGOs conveying in Porto have called for global leadership to protect the human rights of a ‘population under attack’ and demanded that these unacceptable human rights abuses to come to an end.

Ann Fordham, Executive Director of the International Drug Policy Consortium (IDPC), stated: ‘With just over ten years left for countries to meet their global commitment to champion health, reduce inequalities, and provide access to justice for all, as enshrined in the UN’s Sustainable Development Goals, there has never been a more urgent need to strengthen political leadership at all levels. Faced with the current crisis, complacency can no longer be tolerated’. 

Source: https://idpc.net/