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Drop-in Center: Playing Many Roles at the Same Time

Pavel Kutsev, leader of Drop-in Center project

Pavel Kutsev, leader of Drop-in Center project

The leader of the Ukrainian harm reduction movement Pavel Kutsev recently shared his thoughts on what it means to be a public activist and a representative of a marginalized group. Living with a drug addiction himself, Pavel runs the non-profit organization Drop-in Center promoting opiate substitution therapy in Ukraine. Here is what he wrote on his web-blog:

What does it mean to be dedicated to a public work and in the same time to be a member of a “marginal population” a group “normal people” talk so much about…

To tell the truth, it was not my idea to write on this topic, but I was asked to do so and decided to write as clear and laconic as possible…

I have been working in a non-profit organization for 7 years and have seen a lot. At the very beginning I considered a public organization to be something that works solely for a community, but later on I realized that some of these organizations just work as commercial firms. An outsider would not even notice a difference between such nonprofits and a business, the only real difference was the kind of tax forms they fill out …

I started as a regular outreach worker, staying on a street with a box of syringes and explaining to people passing by that I collect dirty used syringes and give away new ones so that drug addicts would stop spreading diseases …

Drug addicts who did not know me were afraid to approach, but people who knew me did come for the syringe exchange. So, all the used syringes I collected, to tell the truth, I found in areas I knew since I had been on drugs for the decades … It was depressing, sometimes after this outreach work I was in a mood “to say to drugs “occasionally”…

This topic “What does it mean to be an activist and at the same time a person living with drug addiction” is most interesting to those who live with the drug addiction themselves. This work looks like pure philanthropy only to an outsider. In fact the main component of this job is lobbying for our rights and interests everywhere possible … In fact this require a permanent impersonation: now I am a journalist but in a few minutes I am an activist fighting for what I believe in…

I should admit that often I have to wear the mask of a “strict boss” especially when I hear outrageous lie in the community of people living with addiction whom have authorized me to defend their interests…

It does not matter how many problems are in your life; the main is always a drug addiction. I have personally attended a few funerals of people died on the way to a methadone site. Even today I often see people who hardly can make their way to our methadone site…

So what role should I play when I see this? Say something sympathetic like “what can I do? ..I am the same patients as you guys..” No!

Just imagine what I went through pushing aside attendants, breaking into the office of a chief doctor and telling him everything that I needed to say. […] Describing the deaths of other patients right on the site because of a perforated ulcer caused by grounded medication which you need to take in a form it was produced not in a form of powder which erode entire gullet by an active substance which supposed to be neutralized by gastric juice? [Medical personnel of Ukrainian hospitals sometimes grind methadone pills into the power to make sure that the patients do not smuggle them out of the hospital in their mouths.] … and after all these you go out of the site and hear from a youngster staying in a line that because of me doctors have taken a 40 minute break and because of me patients have to wait 40 extra minutes in a freezing cold … What should I feel after this?

Or another story … How would you feel when, after making enormous efforts in arranging a small room at the hospital where ALL patients can spend some time and get some hot tea while standing in a line, after spending one's own money and time on the renovation of this room, you hear from somebody “…well, he is the director of the funding, these guys are rich … do you think he spent his own money? Oh no, he even earned on ‘improving facilities for the patients’ for which he perhaps got some funding…”

What should I feel when I hear things like this? Sometimes I want to smash them and make them understand that there was no any money in the project’s budget for the “improving facilities”, all I have done was because I am the same as you and know what you need.To tell the truth, I have gotten used to these ingratitude … let God judge them…

But I am happy with the 467 letters I have received from Ukraine and Russia, mostly from correctional facilities. I am happy with a few e-mails per week I receive from ordinary patients saying “thank you for being with us” and “God save you” …Sometimes I am hardy able to not cry while reading them. Next morning I continue doing what in my 50th year has became a sense of the life….

So staying short while explaining how it feels to play several roles, I need to say that it is not easy….

I'll give you one more very typical example so you better understand what I mean.

When I had just started taking substitution therapy I suggested we look for funding to build one more story for the building of the site. We could have located a day care center there. This building was planned as two stories and all the construction documentation was already available. I discussed the idea with the chief engineer and the chief doctor and they seemed to support it. But when I shared this plans with the other patients they started laughing saying that I am a slyboots trying to get a piece of property….

…Those who laughed still sit on a bench in a park warming themselves with vodka as they do not have a place to go..

And “slyboots” me is writing and sharing with you tiny pieces of my work which I will never give up…

The leader of the Ukrainian harm reduction movement Pavel Kutsev recently shared his thoughts on what does it mean to be a public activist and a representative of a marginal group which interest he defense in a same time. Living with a drug addiction himself, Pavel runs a non-profit organization Drop-in Center promoting an opiate substitution therapy in Ukraine. Here is what he wrote on his web-blog:

 What does it mean to be dedicated to a public work and in the same time to be a member of a “marginal population” a group “normal people” talk so much about…

To tell the truth, it was not my idea to write on this topic, but I was asked to do so and decided to write as clear and laconic as possible…

Have been working in a non-profit organization for 7 years I had seen a lot. At the very beginning I have considered a public organization as something which works solely for a community, but later on I realized that some of these organizations work just as commercial firms. An outsider would not even notice a difference between such nonprofits and a business, the only real difference was a kind of tax forms they fill out….

I have started as a regular outreach worker, staying on a street with a box of syringes and explaining people passing by that I collect dirty used syringes and  give away the new so that drug addicts would stop spreading out diseases…

Drug addicts who did not know me were afraid to approach me, but people who knew me did come for the syringes exchange. So, all the used syringes I have collected, to tell the truth, I found in places I knew since I had been on drugs for the decades…It was depressing, sometimes after this outreach work I was in a mood “to say drugs “occasionally”…

This topic “What does it mean to be an activist and in the same time a person living with drug addiction” is interesting first of all to people who live with the drug addiction themselves. This work looks like pure philanthropy only to an outsider. In fact the main component of this job is lobbying our rights and interests everywhere where it possible…In fact this require a permanent impersonation: now I am a journalist but in a few minutes I am an activist fighting for what I believe in…

I should admit that often I have to wear a mask of a “strict boss” especially when I hear outrageous lie in the community of people living with addiction which authorized me to defend its interests…

Does not matter how many problems are in your life the main is always a drug addiction. I personally attended a few funerals of people died on the way to a methadone site. Even today I often see people who hardly can move drudging to our methadone site…

So what role should I play when I see this? Sympathetically say something like “what can I do? ..I am the same patients as you guys..” No!

Just imagine what I went through pushing aside attendants, breaking into the office of a chief doctor and telling him everything what I needed to say? ..Telling about a death of other patients right on the site because of perforated ulcer caused by a grinded medication which you need to take in a form it was produced not in a form of powder which erode entire gullet by an active substance which supposed to be neutralized by gastric juice? [Medical personnel of Ukrainian hospitals sometimes grind methadone pills into the power to make sure that the patients do not smuggle them out of the hospital in their mouths.] …and after all these you go out of the site and hear from a youngster staying in a line  that because of me doctors have taken a 40 minute break and because of me patients have to wait 40 extra minutes in a freezing cold…  What should I feel after this?

Or another story… What would you feel when after making enormous efforts in arranging at the hospital a small room where ALL patients can spent some time and get some hot tea while staying in a line, after spending the own money and time on renovation of this room you hear  from somebody “…well, he is a direction of a fund..These guys are reach..Do you think he spent his own money? Oh no, he even earned on “improving facilities for the patients” for which he perhaps got some funding…”     

What should I feel when I hear things like this? Sometimes I want to smash them and make them to understand that there was no any money in the  project’s budget for the “improving facilities”, all I have done was because I am the same as you and know what you need….To tell the truth I got used to these ingratitude…let the God judge them…

But I am happy with 467 letters I have received from Ukraine and Russia mostly from correctional facilities. I am happy with a few e-mails per week I receive from ordinary patients saying “thank you for been with us” and “God save you” …Sometimes I am hardy able not to cry while reading them. Next morning I continue doing what in my 50th has became a sense of the life….  

So staying short while explaining how it feels to play a several roles I need to say that it is not easy…. 

I give you one more very typical example so you would better understand what I mean.

When I have just started taking the substitution therapy I suggested we look for funding to build one more storey for the building of the site. We could have located a day care center there. This building was planed as two storeys and all construction documentation has already been available. I discussed this idea with a chief engineer and a chief doctor and they seemed to support it.   But when I shared this plans with other patients they started laughing saying that I am a slyboots trying to get a piece of property….  

…Those who laughed still sit on a bench in a park warming themselves with vodka as they do not have a place to go..

And “slyboots” me is writing and sharing with you tiny pieces of my work which I will never give up…  

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