Increasing computer literacy

Anatoly Leshenok, Deputy Chairman of the Board of the Association People PLUS (Belarus) talks about activities of his organization and increasing computer literacy at COVID-19 time.

For reference

The activities of the People PLUS Association are aimed at supporting people living with HIV and their families in Belarus. The organisation provides clients with comprehensive informational, social, psychological, legal and otherwise necessary assistance. People PLUS is working to improve the quality of social and medical services provided to HIV-positive people, including improving access to innovative and modern medicines for treating HIV infection, tuberculosis and hepatitis C.

Difficulties related to COVID-19

Despite the significant number of COVID-19 cases in Belarus, neither quarantine measures nor a state of emergency have been introduced. In order to avoid exposing clients to the additional risks of infection with the coronavirus, we have moved the majority of our activities online.

These days, the main problem faced by people living with HIV in Belarus is the disruption in the supply of ARV treatment — containing Tenofovir / Emtricitabine / Efavirenz. People cannot get medication for a longer treatment period, as is recommended. In some regions, they have to go to medical facilities every 10 days to get treatment, in others, treatment plans for patients were changed due to these disruptions.

The lack of access to antiretroviral therapy is also faced by Belarusian citizens staying abroad under quarantine. The organisations Life4me and EWNA help them to get ARV medication in the country of residence and they receive packages with medicaments sent from Belarus as well.

Response to COVID-19

Together with our partners from GNP +, Life4me and EATG, we looked into the reasons for the disruption in ARV supplies. We discovered that in December 2019 the production of ingredients used to produce the medication was suspended in China due to Covid–19. Later, India introduced lockdown measures that similarly slowed down production.

The company selling the medication in Belarus was notified of the delivery delays, but did not take any measures to prevent a shortage. Therefore, our association informed the Ministry of Health of the Republic of Belarus about the results of our monitoring of the procurement situation. The reaction of the Ministry was the announcement on April 10 of an emergency purchase of a 3-month volume of ARVs – medicine containing tenofovir.

At the same time, we were in touch with pharmaceutical companies, exploring the possibility of an emergency supply of necessary medicines to Belarus in the context of the disruptions in logistics caused by Covid-19. Companies that did not register medications in Belarus, but did have a WHO prequalification or were registered in ICH countries, could also participate in the competition. At this time, the Mylan company, which won the competition, has already delivered medicines to Belarus. They were cleared by custom services, and permission is received from the Center for Expertise on Importation.

Innovations

The People PLUS Association, together with UNAIDS, once conducted an online survey entitled “Assessing the Needs of People Living with HIV in Belarus in the Context of Coronavirus”. During this survey, it turned out that many PLHIV were not able to fill out the questionnaires on their own and had to call in the help of peer consultants.

And, as it turned out, many of our activists do not have sufficient proficiency in the usage of computer programs and applications either.

For this reason, UNAIDS has begun supplying our organisation with IT-classes for conferences, surveys, etc. Also, we are planning to equip a computer classroom for teaching computer literacy, starting with the basics. Such training is necessary primarily for the elderly, as well as those who have been released after a long period of imprisonment.

Belarus counts around 600 people living with HIV over the age of 60. For them, the ability to use Internet resources will be of much help. They will get access to necessary information, as well as to the website www.hiv.by, our Facebook groups facebook.com/groups/peopleplus.by and instagram.com/people_plus.by, which will in turn contribute to improving commitment to continue ART. The possibility to communicate with relatives and friends living far away through social networks will help to improve the psycho-emotional state of PLHIV.

In other words, the changes brought by the coronavirus pandemic requires the adaptation of traditional working methods. To make our work in improving the commitment to ARV therapy more efficient, we want to shoot videos on various topics that will be used in the work of equal consultants with their clients. These videos will be part of the online commitment trainings that will be available, also for PLHIV in prisons.

We do our best to provide services

Ivan Anoshkin, coordinator of the street social work of NGO “Project April” (Tolyatti, Russia) talks about harm reduction activities of his organization at COVID-19 time.

For reference:

“Project April’ works in harm reduction. The main key groups are people who inject drugs and sex workers, but with changes on the drug scene and the emergence of different stimulants and salts, the organization got new client groups, particularly people practicing Chemsex. The organization employs 18 people and also has a large number of volunteers. “Project April” is recognized in Russia as a foreign agent.

Difficulties caused by COVID-19

Before the spread of the COVID-19 and the lockdown related to it, we used to receive our clients at our office every weekday. Anyone could come to get a consultation, HIV test or a harm reduction kit. We have always tried to provide the conditions for talking with our clients in a warm, comfortable atmosphere. Once the self-isolation regime was first introduced in Tolyatti in March, we had to completely close our office. However, seeing that after a few weeks it became clear that this regime could be extended over and over again, we decided that as a social organization, we cannot interrupt our activities indefinitely. Since then, one of the employees is in the office every working day to insure the provision of our regular services “on the spot”. Yet evidently, it is no longer possible for us to invite our clients to chat with them over a cup of tea, for the sake of their and our safety. Therefore, we are trying to provide our services at entrance.

Our work is largely focused on outreach and street work and in the current situation, this has had to be significantly reduced as well. For example, our employee went to a gay club every week where she developed trust relations with its visitors and maintained contacts with the community. With everything closed, this channel of communication is lost and this could negatively affect our current and potential clients. Finally, another significant obstacle that limits our activities during the crisis is a fear to cause more troubles to our clients by attracting unnecessary police attention to them.

Innovations

Under these circumstances, we have partially switched our activities to online. We are holding our work meetings on Skype. The visits we would do to rehabilitation centres every 1-2 months, we have also temporarily transferred to online. We agreed with administration of these centers to pre-deliver them brochures and HIV self-tests, and to organise our seminar via Skype afterwards. This way, patients have an opportunity to get tested and to get immediate information and support, even in these dark times.

What is more, to our clients we started to send and deliver harm reduction kits, HIV self–tests, and, if necessary, packages with basic products and goods. Basically, we already know places where our clients continue to gather. So we deliver our kits and packages there directly, based on their precise needs. For our employees, volunteers and active participants who continue to work, we purchase masks, gloves and disinfectants.

In times of crisis like this, our clients have more demand for social and psychological support as well. For this purpose, we have a service taxi that allows our employees to come to clients to provide social assistance and products of first necessity. And if necessary, we also deliver ARV therapy to clients, with their written agreement.

Certainly, due to the self-isolation regime and the hostile atmosphere in general, the number of new clients decreases, but not as significantly as we had feared. When you have already been working with harm reduction for this many years, the members of community know you. And we should also not underestimate the power of the word of mouth, that stays efficient at all times. Even now, newcomers visit our office at the recommendation of our clients.

What’s next?

This crisis has shown us how important it is to keep in touch with our clients not only live, but online as well. This way we stay in permanent contact. Hence, in the future we are hoping to have a possibility to hire a person whose work will be devoted only to managing social media and maintaining contact with our client through messengers on a regular basis.

We also really hope to offer some financial compensation to our employees, who continue to “work in the field” at their own peril and risk, especially as some of them – as I do – have a fairly low CD4 level.

We are completely online

Oleksandr Mohylka, Head of the Compass Day Center of the Kharkiv Charitable Foundation “Blago”, Coordinator of the project “Bridging the Gaps: Health and Rights for Key Populations” in Kharkiv, Ukraine.

For reference:

The Compass Day Care Centre works to reduce harm from risky behaviour among teenagers. The key group is teenagers with experience of drug use. The centre’s work includes several fields, including social support for clients, individual counselling, group information sessions for teenagers at risk and mass prevention activities. The centre has developed a rehabilitation programme in the day care centre and a resource centre for specialists working with teenagers at risk.

Difficulties due to the virus

From the beginning of quarantine all our work went online, we had to completely stop face-to-face consulting clients. In theory, clients still have the opportunity to receive condoms and other necessary materials for them, or, for example, to be tested – an employee living near the center is always ready, by prior arrangement, to provide these services. However, in practice it is difficult for clients to move around the city, and it is not safe – they are at risk catching the virus or to be fined.

Innovations

We had to go online as much as possible. This also applies to our internal management and customer service. Our specialists continue to consult both clients and their parents by phone, using Skype or other client-friendly programs. We try to retain those clients who are undergoing a rehabilitation program as well. With the help of ZOOM platform we organized a focus group with the clients of the project, and held a number of webinars for more than 50 specialists from 4 settlements of Kharkiv region.

In addition, we have activated the work with teenagers on the page of CDP “Compass” in Instagram. There are live broadcasts with project specialists, contests and quizzes. The main goal is to attract new clients to the project. We assume that after the quarantine is over, they will apply to our center for services. Also with the help of this page we remind our clients about the necessity and rules of saving their health. Specialists of the project are in constant contact with the champions who implement the Journey4Life project. Champions actively communicate with guys from training groups in chat rooms, where they answer questions, organize competitions and give them useful information.

Through social networks, messengers and telephone, we continue to connect with partners and redirect clients to get the services they need. For example, we refer clients of the rehabilitation program to a drug therapist for advice.

Visiting statistics of our Instagram page shows that teenagers like this type of such interaction, although they miss the live communication. We assume that teenagers appreciate our social networking activity and see it as our desire to stay with them and be useful to them at this difficult time.

Overall, this situation has forced us to do the same job that we did before quarantine in a different way. This is an interesting challenge that will make us stronger and more diverse in terms of providing services for teenagers. In fact, we had to enter a world of their interests and opportunities. It’s our job to make good use of it. However, there are also more complex challenges, such as testing teenagers for HIV infection and other diseases related to their behaviour. There is nothing we can do in this direction until quarantine measures are weakened.

What’s next?

Together with the “Kharkiv Regional Youth Center” Communal Institution, we plan to conduct at least 3 trainings for adolescents on topics related to the prevention of risky behavior, as well as on the use of websites, game platforms and other applications that promote healthy lifestyles and promote the comprehensive development of adolescents.

As part of the Journey4Life program, we will conduct two sessions. The first one will be connected with the photo in the installations with the main message of the journey. The second one will be about dancing – participants will have to repeat the learned parts of the dance. Both shifts will be based on the principle that the first beginners are the champions and pass the baton to the others.

In addition, we plan to contact those visitors of our Instagram page who gave wrong answers to the quiz questions (e.g. about HIV infection or about condom use) in order to analyze their knowledge, belonging to a risk group and to involve them in the project services.

Safety measures for sex workers

Enji Shagieva, Secretary of the Russian Sex Workers’ Forum, about the Forum’s activities at COVID-19 time. 

For reference:

The Russian Sex Workers’ Forum (SW Forum) is an association which includes people with experience of sex work, active sex workers, their partners, assistants and allies. The SW Forum is a platform for constructive communication between sex workers to discuss and develop common strategies to protect health and well-being of sex workers; to provide access to evidence-based HIV/STI prevention programs; to combat violence against sex workers by clients, police and third parties; to change public opinion about sex workers and sex work for the better by the state and society (destigmatization); to waive fines for sex work; to ensure sex workers’ full access to justice; and to strengthen and develop the sex worker community and mobilize sex workers and their supporters to join forces in the above directions.

Difficulties caused by the virus

Russia has always been a difficult country for SWs, transpeople and migrants, and due to the consequences of COVID-19 the situation got even worst.

As demand for sex services has fallen sharply and the risks of COVID-19 infection have increased, some sex workers have stopped working. It is no longer easy to reach this key group since sex workers are less likely to work on the street and more likely to stay in rooms that are not accessible. Many sex workers are losing contact. Some sex workers continue to provide sex services and put themselves at risk of infection. In addition, they are at increased risk of becoming victims of crime or falling prey to police raids, and thus falling prey to police brutality. Due to the epidemic, crimes against sex workers – robbery, theft, beating, fraud, threats, blackmail, extortion – have multiplied.

Due to the quarantine, some sex workers cannot return to their homes and some are left without means of subsistence and housing. It is especially difficult for migrants to return to their homes. They have to live in one small apartment for several people, which multiplies the risk of infection with coronavirus.

Organizations working with SWs have cancelled outreach visits to places where SWs still continue their activities, at their own risk. HIV testing and the distribution of condoms have been stopped. Sex workers still need condoms, as well as protective masks, antiseptics and wet wipes, and some need food and financial means.

There are also certain problems that sex workers’ clients may also be carriers of coronavirus and break quarantine, putting sex workers at risk of infection.

Due to quarantine, HIV positive sex workers have no access to ARV therapy. Due to lack of money, inability to pay rent, hormone treatment, condoms and lubricants, someone went to work online, on webcams. But it is also difficult there, because high income requires a large number of online customers. Beginners don’t have them. And because of the influx of new people, those who have long been earning on the webcam, began to earn less.

Innovations

Because of the Coronavirus pandemic, there has been an increased emphasis in the community on prevention education and protection against coronavirus. Through social networks, special groups, personal profiles, chat rooms and groups of various messengers, the forum informs SWs about what measures to take to minimize the risks of infection, both during everydayl life and during the provision of sex services. We have sent out several special documents with visual content to prevent coronavirus infection. In addition, volunteers and employees of some projects cooperating with the SW Forum purchased personal protective equipment (masks and antiseptics) and distributed it to sex workers using their own funds. Information was also distributed among sex workers on how to quickly make their own protective masks and antiseptics.

We are constantly working with the media, organising interviews with sex workers about the problems associated with the pandemic, how they comply with safety measures and what safety measures clients require.

A lawyer of the SW Forum has developed a memo on receiving social benefits from the government for families with children and the unemployed. Sex workers are encouraged to apply for social benefits if they fall into the privileged category of citizens.

We keep SWs informed about the pandemic news, new risks, prevention measures and risks of administrative penalties. At the request of one SW from St. Petersburg, the info manager of the SW Forum informed the special services that a citizen who violated the quarantine applied for services. Thus, the SW Forum helps sex workers to demonstrate their active position and combat the spread of coronavirus.

Today, the SW Forum is attempting to obtain operational funding to provide financial assistance to those SW who are particularly affected by the Coronavirus, as well as food packages or temporary accommodation.

 

 

 

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

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

For reference:

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

Changes due to COVID-19

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

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

Innovations

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

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

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

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

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

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

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

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

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

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

 

At our own risk. EECA’s reponse to COVID-19.

Yuri Avdeev, Chairman of the Board of the Chelyabinsk City Public Organization “Independent Research Center “There is an opinion”, Russia

For your information:

The independent research center “There is an opinion” has been working in the field of prevention of socially dangerous diseases and research of various aspects of social life since 2000. The Center works to reduce the spread of socially dangerous diseases, such as HIV infection, tuberculosis and sexually transmitted infections; provides assistance in overcoming psychological and communication problems (difficulties in communication, self-confidence); assistance in disclosing personal qualities, self-fulfillment of personality; socio-psychological, informational assistance to people living with HIV and TB, as well as their significant environment.

At present, the “There is an opinion” centre is the largest operator of rapid HIV testing in the Urals. Every year 19,000 residents of the Chelyabinsk Region and its border areas become clients of the programme. The main target groups are men who have sex with men (MSM), transgender people (TG), people who use drugs (PWUD) and the general population.

Difficulties caused by the virus

For five years our organization has been working in the context of HIV prevention with MSM/TG. Weekly on Fridays, two teams of specialists (psychologist + nurse) worked in two nightclubs for LGBT people, carrying out rapid HIV testing, pre- and post-test counseling, distributing prevention information materials, condoms and lubricants, and accompanying identified clients to be registered with the AIDS Center. Due to the announcement of the self-isolation regime, nightclubs are closed, so we are no longer able to continue our normal work at their base. The testing room is also closed.

Unfortunately, this situation paralyzed the work of our organization and most of the activities were stopped. Many people go online, but we should understood that online counselling, for example, will not replace HIV testing and the issuance of condoms and lubricants.

Innovations

On April 7th, at our own risk, we reopened the testing room in the evening, because we received a request from clients for testing and obtaining condoms and lubricants. The cooperation with the AIDS Center helped us to do this. In addition, today we are delivering ARVT drugs for HIV+ patients in Chelyabinsk, including MSM. We have received special passes for being in the city.

We have noticed that those who receive ART at home are even happy about it, because now they do not have to take a ticket and wait in line. However, nightclub visitors are not very happy with these innovations, but the most motivated members of the community themselves come to the testing room to receive HIV prevention and testing.

In our work we try to follow all the necessary recommendations of the regional Government: the reception is held by appointment; social distance is respected; precautions are taken – specialists work with masks, gloves and glasses, the client is given a mask; surfaces are wiped with a disinfector; washing of the room takes place every 2 hours.

Of course, statistics for our activities have fallen. Whereas we used to serve up to an average of 100 MSM/TG per month, now the number has dropped by almost 5 times.

What’s next?

Today we are thinking about self-testing. We only work with blood tests, and today it is not the most convenient option. So we’re negotiating with donors to buy saliva tests.

EECA’s reponse to COVID-19

Alexander Chebin, project coordinator at the Regional Public Foundation “New Life”, Yekaterinburg, Russia.

For reference

“New Life” Foundation has been working in Yekaterinburg in the field of AIDS prevention and control, assistance to different categories of population since 2011. The key groups are (ex) prisoners, migrants, drug users, sex workers, people affected by HIV, tuberculosis, hepatitis.

Difficulties due to the virus

Currently, we have suspended our activities on fast HIV and hepatitis outreach testing, activities in rehabilitation centers, penal inspections, police departments, federal enforcement agency system and other organizations.

Since the introduction of the country’s self-isolation regime, representatives of our key groups have found themselves in new realities – for example, their level of anxiety has significantly increased, including with regard to treatment and care. Also we have received many requests for psychological support. Due to changing economic circumstances, people have developed a lot of fears – they are afraid of losing their jobs and uncertainty in the future. We have already analyzed our work during 2 weeks of self-isolation. The number of requests through the means of communication increased several times. Our employees conduct consultations, provide psychological support and accompany participants “by phone”, through various messengers. This is especially important for people released from prisons, who do not have the skills to apply to government agencies using Internet resources.

Innovations

Fortunately, in a pandemic, our work does not stop. However, due to the virus and quarantine measures, we had to go online and interact with our participants remotely, through communications channels.

Due to the new rules of patient’s admission, the management of the AIDS Centre decided to involve volunteers to help in the delivery of life-saving antiretroviral therapy. Thus, since March 30, our employees have been actively involved in this process. Our two staff members take calls and consult people on how to register delivery. With the help of the Foundation’s car with a driver health workers are delivered to clients. Also, 3 employees and 1 “New Life”s volunteer drive their cars to deliver ARV therapy.

In addition, the Foundation does not stop providing legal and social assistance to people, doing it remotely. Also, we accompany people released from prison to medical organizations, help to deliver food packages, clothes. In case of emergency, one of our employees collects the kits for participants at our drop-in centre and delivers them to their homes with all necessary security measures.

In the future, we plan to go back to the way we used to work, assess and reflect on our experience in the pandemic and perhaps make adjustments to some aspects of our work.

 

EECA’s response to COVID-19

What are the challenges faced by civil society organizations in Eastern Europe and Central Asia due to the coronavirus pandemic? How have they adapted to modern realities and how do they continue their activities under limited quarantine conditions?

AFEW International launched a series of materials “EECA’s response to COVID-19″. Heads of NGO’s, activists from the EECA Region – about interesting practices, unusual solutions and new opportunities in the COVID-19 reality.

Alexander Ostapov, President of PF “Return to Life”, Project Coordinator, Ukraine, Kirovohrad oblast.  

For reference:

Ukrainian Fund “Return to Life” has been working in harm reduction since 1999. The main key group is people who are vulnerable to HIV because of their risk behavior: people who use drugs, sex workers, people released from prison, young people.

Difficulties caused by the virus

Of course, the virus has made our work much more difficult. It especially affected the activities related to Dance4Life – our work in educational institutions, street actions, face-to-face work with partners (round tables and group work meetings). Online partner meetings have not been shown to be effective – many people work from home, which significantly reduces possibilities for communication.

In general, our key group is not lost, but some people have had to come back to their home towns. This makes communication difficult, as some people have no access to the Internet, and it is expensive and inefficient to reply via SMS.

Innovations

Our work has mostly moved to a virtual format through Telegram, Instagram, Viber and other applications. Also, we have developed the scheme of delivery to clients of preventive items (condoms, individual educational materials, pregnancy tests, gynecological kits, etc.).

How is the delivery going? Clients make orders, discuss it with a social worker, then a social worker prepares the package (we call such kits “Helper”) and in order to receive it the client either has to come to a service point (SP), which operates on Mondays, Wednesdays and Fridays from 12:00 to 14:00, or pick it up at an agreed place near the SP.

We are now also in the process of developing a new work format via schools’ websites to inform students.

Despite the restrictions, we have not stopped visiting some cities to meet with leaders from a group of teenagers. They are getting all the tools they need to continue their activist work. At the same time, of course, we observe all individual protection measures: social distance, using mask, gloves and disinfectant.

What’s next?

Further on, we plan to develop a new method of on-line consultations, continue working with “Helper” packages and attract new people to the project using the iPDI model (implementation by peers through social networks). Soon the quarantine will end, and we will personally meet those who have joined us during this time.

They say – what does not kill us makes us stronger. I hope that all of us will come out after the quarantine strong, with new experiences and new clients.