Natalya Shumskaya: “Without a Professional Team We Would Not Have Succeeded”

Author: Grana Zia, AFEW-Kyrgyzstan

The executive director of AFEW-Kyrgyzstan Natalya Shumskaya is talking about the successes and challenges of the organisation in 2018 and the new demands for 2019.

– Natalia, what are the main achievements that AFEW-Kyrgyzstan can be proud of in 2018?

– I am really proud that the World Health Organisation (WHO) recognized the clinical guideline we developed for the management of pregnancy among women who use psychoactive substances as the best practice.

In the women’s colony, where we work in partnership with the Penal Medical Service and the Republican AIDS Centre, we managed to achieve the goal of 90-90-90: 90% of HIV-positive people are aware of their status, 90% of them take antiretroviral (ARV) therapy and reach supressed viral load. This is our common contribution to the fight against the HIV epidemic, and it is very encouraging to see such results.

I am also proud that we have managed to develop guidelines for the effective functioning of the coordination commissions on HIV infection and tuberculosis. Under this guideline, we trained over 100 representatives of regional public health commissions in all regions of Kyrgyzstan. We successfully lobbied for the participation of civil society organisations in these commissions.

Remembering 2018, I should also mention the delegation from Kyrgyzstan at the International AIDS Conference in Amsterdam AIDS 2018. We have been looking for funding for a long time, negotiating with various donors. Here is our result: 16 participants from Kyrgyzstan took part in more than 15 sessions; six delegates from Kyrgyzstan became conference speakers, and five delegates took part in poster presentations. At AIDS 2018, we even organized our own workshop for the countries of the Eastern European and Central Asian (EECA) region on community participation in decision making at all levels. I consider this a success, and, taking into the account the huge amount of work for this case, I call this a great achievement.

I am also proud that in 2018 we were able to agree with AFEW International and UN-Women in Kyrgyzstan on the opening of a rehabilitation centre and a social enterprise. It was a long process of negotiating, but we were able to take this step for the sake of healthy future for our country.

– What were your main challenges in 2018?

– I think that challenges are, first of all, opportunities. For example, in 2018 we planned the opening of a centre for teenagers for the prevention of usage of psychoactive substances. It was important for us that the state also contributed to the opening of this centre. We wanted to emphasize the importance of investing in youth development by the state. Children need our help. Unfortunately, negotiations with the mayor’s office were very long. It took us a very long time to receive a huge amount of necessary permits. We organized meetings, made concessions, but we were rejected. In early 2019, the opportunity arose to open such a centre in partnership with the State Agency for Youth, Physical Culture and Sports under the Government. They gave us a large and warm room in the heart of the city of Bishkek. Starting from March, our centre for teenagers begins its work.

– What are the main goals for AFEW-Kyrgyzstan in 2019?

– First of all, we plan to start our social entrepreneurship. We have already opened a training centre and beauty studio. We plan to train women in difficult life situations and to employ them later to work in the beauty studio. Now the important task is to think about marketing strategy and put everything on a self-sufficiency track. For us, this is a new experience. Now we will master fashionable beauty services, understand all the difficulties of accounting and business.

Another goal is to ensure stable development and financial support of our rehabilitation centre. It is being built now with the support of AFEW International. We want it to be a high-quality, multi-functional, modern and convenient for people who use drugs. We do not accept “semi-results”, and will definitely achieve all the goals.

Of course, 2019 will be for us a year of searching for new directions and programs, and strengthening advocacy activities, especially in the field of budget advocacy from the state. We want to strengthen relations with the donor community, non-governmental organisations and the state.

– Natalia, what do you think distinguishes AFEW-Kyrgyzstan from other non-governmental organisations in Kyrgyzstan?

– I think our strongest point is our employees. Due to the fact that our entire team is people with completely different education and experience, we can work in a very large range of services. Among us there are specialists in the field of HIV, tuberculosis, gender experts, researchers, business consultants. In 2017, for example, we began to develop the direction of helping women in difficult life situations. It was the first experience, but now this direction is very successful: 320 women from various key groups (single mothers, victims of gender-based violence, HIV-positive women) had training on the development of economic independence. Some of them started their business after that, someone has already come to our beauty studio as a master or coach. Without a professional team that is ready for new challenges, we would not have succeeded.

Natalya Shumskaya: “We Want to Improve Country Health System Coordinating Mechanisms”

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Author: Olesya Kravchuk, AFEW International

Public Foundation “AIDS Foundation East-West in the Kyrgyz Republic” makes a significant contribution to public health of the country in reducing the growth rate of socially significant infections in Kyrgyzstan. The head of AFEW-Kyrgyzstan Natalya Shumskaya is telling what we should expect from the organisation in 2017, and outlines the achievements of the previous year.

 – How was the year of 2016 for AFEW-Kyrgyzstan? What do you think were your greatest successes?

– 2016 was a successful and fruitful for our organization. We managed to keep our activities on HIV prevention in the prison system, including law enforcement, prevention of HIV among women who use drugs. During the last year, 1013 women received an access to health and social services. One of the achievements was that in 2016 our organization supported the Ministry of Health of the Kyrgyz Republic in the development of the clinical protocol “Pregnancy, childbirth and the postnatal period for women who use drugs.” In December of the last year this protocol was adopted. Later, we started a very difficult project with the aim to return the patients with multidrug-resistant tuberculosis (MDR-TB) to the treatment. Since August 2016, AFEW-Kyrgyzstan together with the City Centre for Tuberculosis Control in Bishkek started a project “Joint control of tuberculosis and HIV in Kyrgyz Republic.” During five months of 2016, 17 MDR-TB patients returned for the treatment; three patients co-infected with HIV were connected to antiretroviral treatment, five patients with tuberculosis and extensively drug resistant TB (XDR-TB) had the necessary tests, and their results were given to the council for inclusion in a treatment program under the new scheme. There was organized controlled treatment at home for 28 patients. The delivery of products is done 6 days a week, except Sundays. Additionally, project case managers conduct information sessions with patients with MDR-TB and their inner social circle, monitor the side effects of anti-TB drugs, and, if necessary, deliver drugs to relieve the side effects. They also maintain regular contact with doctors. In January of 2017 we increased project staff. It was done for the full coverage of all MDR-TB patients who need to receive treatment at home and assisting them to diagnosis and friendly services. Two case managers and a social worker were hired.

– How is the work of the research department of your organization that you created two years ago?

– The Department continues to work successfully. Over the past year, the researchers conducted a qualitative study among the inmates of correctional facilities that are getting ready to be released. It was called “Prisons, injecting drugs and the environment of risk of HIV infection.” This is a continuation of the positive experience of effective cooperation of AFEW-Kyrgyzstan with medical school researchers from Yale University and the State Penitentiary Service of the Kyrgyz Republic. This study aims to describe and research the quality of the program of methadone substitution treatment in the penitentiary system of Kyrgyzstan and civil society. The recommendations based on those results will be offered to the country to optimize harm reduction programs.

– One of the main directions of your work is cooperation with the police and the prison systems. Please tell us, how is this cooperation going? What is the role of AFEW in it?

– AFEW cooperates with the Ministry of Internal Affairs for 10 years already. In 2016 our organization has provided technical support to the Ministry in carrying out monitoring visits to all the regions of the country. The aim of the visits was to control how the law enforcement officers perform the instruction on HIV prevention. In addition, we organized and conducted four trainings for the staff responsible for the official trainings and for non-governmental organizations on the reform of law enforcement agencies. It is important that the civil sector supports current reforms, and it is important that law enforcement officers assist the execution of the State Programme on HIV.

AFEW is also working with the penitentiary system of the country for more than 10 years. We work together in three areas: technical assistance and coordination, increasing the capacity of staff and providing direct services to prisoners. In 2016 we worked first in six and then in four institutions to promote the goal 90-90-90. We provided services for people who inject drugs (PIDs), told them about HIV and the ways of transmission, motivated them to pass the test for HIV. We actively worked with people living with HIV at the stages of realising of the diagnosis, preparation for therapy, start of therapy, development of adherence to treatment. One of the achievements, of course, is to extend the work on the colony-settlements. Before, prisoners there fell of HIV prevention services, as there are no medical units there, and they usually have no documents for getting help from the civilian health organizations.

– In October AFEW-Kyrgyzstan helped to sign a memorandum of cooperation of four key groups. Please, tell us what these groups are and why their teamwork is so important? How is this cooperation going now?

– Unfortunately, there is mutual stigma within the key groups. Cooperation can help to overcome barriers and build partnerships. The leaders of key groups started to work closer. They discuss new joint projects, research abstracts for AIDS2018 conference in Amsterdam. Together they will carry out activities to reduce stigma and discrimination in relation to other key groups through the mini-session, for example, PIDs for LGBT and sex workers’ organizations. Since last year, we have been inviting all the participants of memorandum for the event and, of course, they also invite us for their events.

– In February, you will host a training for the members of the Country Coordinating Committee on HIV/AIDS (CCC) project BACK UP-Health. Tell us more about it. What are other areas of your work with the CCC?

– Starting from July 2016, AFEW-Kyrgyzstan will implement the project “Harmonization and consolidation of resources to fight HIV infection and tuberculosis in Kyrgyzstan.” It will be done with the financial support of GIZ, program Back Up-Health. With this project we want to improve the coordination mechanisms in the country’s health care system. We want to involve civil society in the discussion on the reform of CCC, and we also want to increase the capacity of the Committee. In February of 2017 AFEW-Kyrgyzstan plans to host a seminar for members of the CCC to prepare the Country Request for continued funding in the state funding for 2018-2020. The following groups will take part in the seminar: members of the Committee for the preparation of applications for resource mobilization and harmonization of CCC; CCC board; members of the Advisory Working Group, which were included by the Kyrgyz Ministry of Health; national experts who work on the preparation of the request for continued funding who will directly collect information and write application; international consultant; head of the expert working group on writing requests for funding, and also key partners from the public and international sectors which may influence decisions and who expressed their readiness to provide technical assistance in the preparation of high-quality country request to the state financing from Kyrgyzstan. During the workshop, participants will act as experts and will share their knowledge and experience with each another. They will also learn how to fill the forms for the requests, will learn the new priority areas of TB and HIV, which are included in national policies and programs, will discuss and analyse the share of public funding, make mapping of the services, clients and funding. Actually, the main purpose of this seminar is to assist the CCC, experts and other stakeholders in the preparation of high-quality application. We want everyone to have one vision and one structure of the request, so that the process of approval of the CCC members is efficient and fast.

– What are AFEW-Kyrgyzstan plans for the year of 2017?

– AFEW-Kyrgyzstan spent its first three years as a local non-governmental organization. The most important achievement is that we were able to successfully implement its first strategic plan and to develop partnerships with international and donor organizations. In 2017 we will review the strategic plan of the organization. Of course, the priority for the board of the organization has been and continues to be ensuring of the stability of the organization.