The blog of the Ukrainian organization, the “Drop-in Center,” which serves people living with drug addiction was one of the first projects supported by Rising Voices. The blog maintained by Pavel Kutsev has focused on issues of opiate substitution therapy and since 2008 has become one of the leading advocacy tools for patients of harm reduction programs in Ukraine. In this two-part e-mail interview, we asked the Drop-in Center leader Kutsev to talk about the accomplishments of the organization and its plans for the future.
Improving the quality of replacement therapy programs and fighting against the stigma towards people living with drug addiction – these are the primary goals of the Drop-in Center. Outlining the main priorities for his work Kutsev said:
For me, like for other people living with the drug addiction, everything that happens in my life somehow relates to this problem. So almost all my time I devote to the public health issues. […]
When you become a patient of a medical program you become a part of the community, living in an imperfect world. Like it or not, you experience all the problems yourself. You face indifference, pain, and despair. You want to change something for better and at some point you realize that nothing is possible to change if you keep silent. […]
Every morning while approaching the narcology clinic surrounded by the multistory apartments building, an Orthodox church, and a kindergarten you see how people look at you. You see eyes full of horror from the kindergarten nannies, parents, and kids, you see the hate in the eyes of elderly, and eyes filled with hypocrisy of the Orthodox priests…
That is why I write about the problems of drug addicts from the perspective of a drug addict. I write about a disease called “drug addiction” having the diagnosis of “chronic opiate addictions.” I also write about a treatment of this disease from a perspective of a patient of one of the world’s most common medical practice – replacement therapy.
I write because I believe that when you read a text based on a person’s internal emotions, you perceive many things differently and the events surrounding us. You might find that what you did not notice before is in fact the most important thing! I also always hope that once I will be heard and understood by somebody who has a power to change the situation.
Kutsev considers 2010 to be very productive and in many areas, fairly successful. He started talking about the accomplishments of his organization and fairly sad topic which eventually led to a significant improvement in the quality of the Ukrainian substitution therapy program:
Although I did not want to talk about sorrowful things I just cannot avoid it. As I said earlier, stresses are an essential part of our life.
While waiting in line at the Methadone site, I fell down with a stroke. Eventually after this there was some progress in solving the issue of continuity of the substitution therapy. After a few patients from our site died because it was not possible for them to receive the substitution therapy and treatment of other diseases the require a stay at a hospital at the same time, this problem was at the top of an agenda of public health officials. A few regional health care authorities issued a new regulation requiring the hospital to provide “the essential medication”. […]
I produced a video film “Continuity of Substitution Therapy – Continuity of a Circle” documenting the facts that Hippocratic oath has been forgotten by our home health care system.
Uniting active patients and implementing grassroots initiatives have been additional accomplishments of the Drop-in Center, and which Kutsev highlights:
We were able to unite activists among patients and establish the Patients Council. We initiated a loan society […] to buy gas for delivering Methadone to those patients who stay at the hospitals all over the city of Kiev.
Our second accomplishment was that our organization, together with the organization of the mothers of substitution therapy patients received a grant for implementation of the project “High motivation – high quality of MPSA (medical, psychological and social assistance)”. And now at two Kiev sites, the MPSA provides social workers who themselves are substitution therapy program participants. This is our great accomplishment! The patients care for other patients! Of course we face some challenges in implementing this project. Despite the fact that everybody involved in MPSA received relevant training and earns just a symbolic salary, medical personnel do not perceive them seriously. But anyway for us, it is a great achievement to receive the donors support and to work as one team with the medical staff.
Increasing awareness of Ukrainian society on harm reduction program is another accomplishment of the 2010:
For me in 2010, the biggest accomplishment was participation in TV talk-show “Razbor Poleta” on one of the main national channels “Inter”. After the show according to a feedback of partnering organization, the interest in substitution therapy increased significantly and many people changed their attitude towards Methadone considering it as medication and not any more as a “Hitler drug”…
Another important achievement was that our organization, namely our creative team, the editorial office of “Motylek” newsletter, was entrusted to lead a very important direction – a video advocacy. Our team received a three-day training where we gained necessary knowledge and skills.
One more thing we are happy with is that our creative team became larger. New fairly capable authors and like-minded people joined the team. And as this is a seventh year of the “Motylek” initiative, the appearance of fresh creative forces, new ideas, and talented authors has been a great success!
Sharing experience and establishing partnership relations with the similar organizations abroad is another success for the Drop-in Center. Kutsev said:
Among our achievements we also should mention the visit of our guests from the Tajik organization AIDS+ which was awarded with the highest “Red Ribbon” prize during Vienna HIV/AIDS Summit in 2010. The guys came from Tajikistan specifically to learn about our experience in implementing the awareness programs. They were especially impressed by our “Motylek” newsletter which is a very popular publication among Ukrainian people living with drug addiction.
Producing videos for promoting substitution therapy programs and improving the therapy quality is the top priority for Kutsev in 2011:
This year I am going to devote a significant time to video advocacy. I am positive that we need to advocate not only for increasing the scale of the effective medical programs aiming on improving of the quality of life of people living with drug addiction, HIV, and other diseases but also for improving the quality of replacement therapy programs themselves. Because one depends on the other. […]
Among my plans for 2011 is making a documentary discussing the issues of continuity of the replacement therapy not only from the perspective of availability of treatment in another medical establishment, but from other perspectives such as decreasing of criminality or ethics and humanism.
I am also planning to produce a few video interviews of the advocacy of Methadone to certain groups of patients based on the Order # 645 of the Ministry of Health of Ukraine [prescription of Methadone and its provision through pharmacies].
I am also planning to finish writing a script for a documentary talking about overdose with various drugs and rules of behavior in situations typical for communities of drug addicts in Ukraine.
Another plan is the advocacy (and not only video) targeting the increase of cooperation with law enforcements, especially with the Department to Combat Drug Trafficking of the Ministry of Internal Affairs and the State Committee for Drug Control.
In 2011, Kutsev is also going to focus his efforts on improving and expanding his blog and “Motylek” newsletter.
Active development of the blog is among our creative plans. The blog “depo3p” will become the first collective blog of the substitution therapy patients representing various regions of Ukraine. Because of this, we are going to achieve a new level of quality and make it more informative, objective ,and focused. We hope that this will raise the interest to the issues of drug addiction. Taking into account that a number of posts will be focused on HIV/AIDS epidemic, we can say that by attracting attention to drug policy we automatically attract attention to issues of HIV/AIDS.
And of course, we are planning to continue work on our “Motylek” newsletter. In 2011 we are planning to reformat it into a full-color high quality publication.
The second part of this email interview will focus Kutsev's personal experience using citizen media to raise awareness of harm reduction in Ukraine.