Ukraine: Harm Reduction and Law Enforcement

Editor's Note: The latest six Rising Voices grantees are using citizen media tools to help further the advocacy goals of public health organizations, and to empower the communities they work with. The Drop-In Center [ru] based in Kiev, Ukraine, for example, has opened a LiveJournal blog to share their experiences of working at a harm reduction facility aimed at meeting the health needs of Kiev's injection drug user community. What follows is a post written by Veronica Khokhlova which features a translation of recent post by one of the Drop-In Center's staff.

According to the International HIV/AIDS Alliance, “Ukraine has an estimated [323,000-425,000] injecting drug users and one of the fastest growing HIV epidemics in Europe.” Harm reduction initiatives – whose aim, according to the OSI International Harm Reduction Development Program, is to diminish “the individual and social harms associated with drug use, especially the risk of HIV infection” through “a pragmatic and humanistic approach” – are gradually taking root in Ukraine. For example, the first methadone substitution therapy programs, still illegal in Russia, were introduced in Ukraine in 2004 (for more info, see this report – .pdf file – by the International HIV/AIDS Alliance Ukraine).

Having the government's approval for such programs is not enough for them to succeed, however. For one thing, the general public and law enforcement officials should be aware of the situation and of the efforts to change it for the better. On a newly-launched collective LJ blog depo3p, blogger mazay – who is currently receiving methadone substitution treatment and is actively involved in a Ukrainian harm reduction info project Motylyokwrites (RUS) about a recent attempt to educate a group of Kyiv police officers:

[…] I got an offer to do a lecture on harm reduction to a whole company of Patrol Police Service (PPS)!.. An offer I couldn't refuse, no way! PPS are the guys who can be compared to those who hunt small game. And in nature, it is well-known that the smaller the predator, the more ruthless it is…

[…] And so me and a friend arrived at their den, a district police department, where we met the commander on duty, who looked us over energetically and asked right away:

- Have you brought [condoms]? [a widely-used but somewhat rude slang word for condoms is used here – gondony]
– ?
– Well, [condoms] [now here is a medical, neutral term – prezervativy]. What? You aren't distributing them anymore?..

We understood what was expected of us, and quietly placed a plastic bag with booklets on the table – “Important info for police officers.”

- We'll bring condoms another time, – my companion promised somewhat guiltily. The “commander” didn't say anything and, smiling weirdly, took us to the conference hall, where well-built guys in blue police uniforms have already gathered.

I began with the history of harm reduction. Started from Holland […]. A couple of guys out of the total of 30 woke up. Gradually, I moved to the world stats. The European stats. When I reached Ukrainian stats, a few more people raised their heads. And only when I began talking about corruption, about international experience – like, in Germany drug policies are very harsh, too, but no police officer would ever decide to do an ambush next to a drugstore, filtering, catching and searching addicts as they exit the store, taking the last money from sick people…

- Ha! Sick people!.. It's all your own fault…
– Well, it depends. Let's say, when you cross the street on red and get hit by a car. You'll become disabled, but why did you run on red in the first place, right? You shouldn't cross the street on red. And then you'll go to your doctor to get your disability papers, and the doctor will tell you – it's all your own fault! Or, like, if you drink cold vodka and catch a cold, or if you walk in the rain without your hat on… You get sick, go to the doctor, and he tells you that it's all your fault.
– But how can you compare it like this?
– Why not? Silliness leads to certain consequences. With drugs, it all starts with silliness. With being too sure that you won't get hooked. The illness itself does not begin with the first injection, but gradually, from being silly systematically. You should be able to tell which person is already sick and which one has simply “forgotten to put his hat on.”

The audience treated my comparison somewhat sceptically, but they became more lively, which was a good sign, I think.

I tried to tie this in to the situation with HIV, recounting stories about injection drug users who out of fear of the police do not always come to get clean syringes, and if they do, they do it reluctantly. […] Told them about the possibilities of [substitution therapy]… Their reaction was predictable.

- Our salaries aren't like those of the German police… And why should we pity these lazy bums, who get high in your [substitution therapies] and then go pickpocketing, taking the last money from the old people…

For an hour, we tried to get the audience to talk (mainly, they were village boys who've come to Kyiv in search of work). The discussion ended in a draw.

- You do get… eh… well… condoms? And those… all kinds of vitamins?..
– Gloves! [disposable gloves]
– Right! Do bring us some gloves and condoms!
– We'll do, – we promised them listlessly.

We shook hands and parted. […] The day didn't pass in vain – we've accomplished something big! Have made yet another step towards understanding!

You can learn more about the objectives of harm reduction programs in this video produced by the Humanitarian Action Fund based in St. Petersburg, Russia and narrated by founder Sasha Tsekhanovich.

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