Side event: The rights of women who use drugs

Moderator, EHRA: Dear friends, Thank you for joining, you can choose Russian or English as the language for this event, we will have simultaneous interpretation. Hello from Georgia – typically I represent an organization for women who use drugs.

I’m welcoming all our participants on our joint event with the Alliance for Public Health and the Eurasian Harm Reduction Association at the United Nations Commission on Narcotic Drugs 2021. This event is dedicated to review and analyze the critical situation of rights violation of women using drugs in Eastern Europe and Central Asia. I wanted to start with a questioner for all participants: which type of organization do you represent?  I see that we have a broad, diverse audience and we are welcoming all of you from state and nonstate organizations, and from regional and international organizations, also welcome to the experts and organizations who are providing help to survivors of violence. Welcome everybody! We will have two parts within the meeting: one, analyzing the situation with gender-based violence and the human rights violations in Eastern Europe and Central Asia, and then we will move to two, taking action and addressing these cases.

For the very beginning, we have Victoria from Alliance for Public Health, who is providing us with review of human rights violation among vulnerable groups, connected through a database in five countries of the region.

APH: I’m happy to participate in today’s event and share with you our data, collected in five countries. We have an online tool, called REAct to record human rights violations by communities – it’s community led monitoring and response. It allows to document and to respond to legal barriers, and human rights related barriers that people living with HIV and groups at risks experience when accessing health services, confronting law enforcement agencies, or just in their everyday life. In Central Asia and Eastern Europe, REAct now covers 7 countries, over 40 cities, over 80 NGOs, and over 130 reactors. Reactors that are people who are normally social workers or outreach workers, and they are documenting cases, and they are skilled to provide primary legal support to the victims. I encourage you to visit REAct website to find out more about REAct itself, and to find out evidence and data collected through the instrument in other countries. So, talking about the countries of today’s presentation: I will speak about Georgia, Moldova, Kyrgyzstan, Tajikistan and Ukraine. These countries have different periods and scales of, different number of regions, different number of NGOs and different number of reactors, but we can analyze the collected data in particular country. Speaking about women who use drugs: You can see that the percentage in the total number of clients registered in React is quite small in Georgia, it is just 6% of clients, in Moldova 15%, in Kyrgyzstan 6%, in Pakistan 5% and in Ukraine, 24%. So, working in our countries we try to involve reactors from different groups and to see the overall picture in the country. But unfortunately, women who inject drugs are still only present in very low numbers in React among our clients, and there are some reasons for that: First of all, criminalization of drug use and possession of drugs for personal use makes these people motivated to hide, and especially women who use drugs, they are very hard to reach with services, and to offer help with human rights related health. The second reason is that women who inject drugs are less likely to go to NGOs and to seek for services in NGOs. And another reason is that women who use drugs are less likely to fight for their rights, because they do not have support, and they do not have sometimes even permission from their husbands or sexual partners or families to claim their rights. So, normally they adjust somewhere in the shadow. Next, you can see numbers of types of different relations, which happened with women who inject drugs in five countries. And during the whole period, three cases of domestic violence had been recorded, but basically this is just the tip of the iceberg. We are sure that domestic violence occurs much more frequently, and much more victims of domestic violence just don’t dare to report as they are less likely to receive adequate response from police and adequate protection. Also, we have records and listings and you can find a lot of cases of domestic violence caused by family members and relatives, and very often, drug users are evicted from their homes and face stigma and discrimination. This is a great part in every contact: stigma and discrimination because of drug use is, overall, in all spheres of the life. Also, we have recorded cases where children of woman who inject drugs were subject to stigma, discrimination, and bullying at their schools by other pupils or even by teachers. Then, I am showing you’re the red numbers here – They show us cases where the perpetrator is police or law enforcement. So you can say that arbitrary detention happens quite often and also it’s important to mention that arbitrary detention often occurs at the exit of other sites in the countries where the expansion of treatment is allowed for a couple of days. We recorded cases that police was confiscating and convicting patients for drug possession, even though these patients had all documents that prove they are in treatment. Also, it’s important to mention that women who inject drugs, they’re more vulnerable during detentions by police, because normally police forces women to give evidence against her partner or other drug users, and especially a very strong argument in such conversations is that police can manipulate women, using children. So, threats of denial of parental rights or threats to go to social services is a very strong argument to press the woman. Then I am showing you these green fields on the screen – these are arbitrations caused by health care systems.  We recorded a lot of cases in May – June of 2020, when restrictions of movement were implemented in such a way that they didn’t took into account this need of everyday. Also we have recommended a lot of cases of absence of treatment in countries like Moldova or Ukraine, and a lot of cases registered, which show us cumulating treatment in medical facilities, and humiliating attitudes there keeps patients far from health care system and keeps them far from prevention and treatment. Despite the boundaries great deal of cases are solved – for example in Ukraine, 85% of cases were solved using resources of local NGO REActors.  Another big problem we faced with is that sometimes, the client doesn’t want to resolve the case: having a big set of services or legal support of paralegals, clients are afraid to claim for their rights to protect their rights and they prefer just to hide in the shadows, and not to proceed with their cases. We have to work to bring more awareness to our clients about their rights.

Another strategy is to collect several cases which, which are about the same problem and advocate this problem solving this problem on the national or local level. And the third strategy is to use evidence and data collected through react to, to advocate for legislative changes, laws or practices on the national level. We prefer reports of data statistics, we collect every half a year in every country, and this reports are used for advocacy actions and legislative assessments. So, from my part that’s all I’m very happy to be able to share this stunning information on such a high level forum. Thanks.

Moderator, EHRA: Thank you very much to you and to the international team who are working to document these cases and to bring awareness to these cases. The next speaker will talk about what community responses are most effective in the situation of emergency.

Eurasian Women’s Network on AIDS: Thank you, my name is Svitlana Morose and I want to share my perspective as a community activist, women’s rights defender and a woman with experience of substance use and HIV. I’m also an ex hepatitis C patient and an internally displaced person. Due to neglect, women who use drugs, the current situation in countries have more negative impact on them than on the rest of the population. COVID measures also affected the economic situation of women who use drugs that places them in an even more dependent situation on man, which increase the risk of involvement in criminal activities against their will…to explain how important it is not to interrupt the provision of HIV prevention services. Violation of confidentiality of OST recipients, including an HIV status and pregnancy is one of the most serious problem caused by the introduction of COVID measures. Again, not doctors, but the community organization came to help to communicate with police officers and checkpoints in Georgia. In Moldova and Ukraine, it was possible to get medication for several days. This was done as a result of communities’ persistent demands from the outset of the pandemic, preceded by the years of advocacy for changes to the national substitution therapy protocols. But the provision of OST medication for several days for stable patients did not resolve all problems. Those lists of immigrants, who recently entered the program have been re-classified as unstable […] being infected with the Coronavirus infection, and the risk of being detained by police for violation of the self-insulation. There is no anti-discrimination legislation, no state supportive mechanism of monitoring human rights violation or gender sensitive integrated support services for women who use drugs. Moreover, the state encourages discrimination and stigmatization by means of criminalization, zero tolerance policy and repressive gender-blind policies in general. Limited support provided mostly by NGOs also face different political and legal barriers. The conflict in Ukraine has worsened, the risk of sexual, physical, economic violence faced by women also worsened. The situation has also negatively impacted humans access to essential health care, including HIV and drug dependence treatment. Quite a few drug use was aggravated by the fact that almost one in five people has to leave their place of residence, due to the military conflict. In 2018, almost half of the community-led study respondents reported not having enough financial resources, even to buy food. The unemployment rate was significantly higher […]. More than 40% of people living with HIV have stopped treatment around 2014. Many women are also torture survivors. Therefore, they need of specialized services. Besides the closure of OST programs, some women had to endure beatings and illegal detentions, due to drug use and participation in OST programs by militants. For more than 14 months, Natasha Zelenina, activist and internally displaced woman is detained in the occupied territories. On December 2019, she was sentenced to 11 years of imprisonment for drug contraband while the bupreborphine substitution maintenance therapy was legally received, as prescribed by a doctor in Ukraine. Women who use drugs and women live with HIV are especially because of repressive government approach, discrimination and criminalization. There is also an issue of shrinking space for communities in our region. So legislation is getting tough and Russian Federation put us in danger at the country level. We are deeply concerned about this situation in requested support for security, to ensure the safety of the women activist. We need technical support from international organizations! Thank you.

Moderator, EHRA: Thank you. It’s, it’s hard to continue … and actually now when you saw all of us reviewing the situation. I want to ask you … Could you please us answer some question from us: What could be done in your opinion – if you would plan activities to respond the gender-based violence and violence against women using drugs, what you would do in your country? If you would be free to allocate resources to this topic, what priorities you would allocate resources? Shelter and services to eat in each credit crisis center, or shelter for survivors of violence? Safe space in a separate accommodation, ae shelter for women who use drugs?  Investigate cases of violence, and punish those responsible? Provide regularization and substance abuse treatment? Revoke parental rights, and maybe to send children to an orphanage for a while? Would you let it be as it is? Sorry for having such hard questions but that’s the realilty… Now we see the result of the questionnaire: majority of our respondents support providing either place for shelter and safe space and support for victims in the shelters for women, for specific shelters for women who use drugs with specific approaches to provide help and shelter, or, ensure justice and punishment for those who are responsible for human rights violations. 42% of you wants to provide rehabilitation and substance abuse treatment for women. Okay, now we go into the actions which we suggest and which international organizations, and National Police and activists are already working with. My colleague will talk about how they develop these activities, our regional initiative which is done actually together in cooperation with the Alliance for Public Health and EHRA women’s network of AIDS.

EHRA: I believe that we clearly stated that the situation of gender violence among girls and women at the backdrop of the COVID pandemic is just aggravating and women who use drugs are both victims of gender based violence AND are five times more often than women in general. So I believe that that is very important to keep in mind that even the harm reduction programs that could be entry points to receive services in the association of violence, or women injecting drugs: often they are inaccessible for those women because even harm reduction programs, they are not sufficiently focused to the needs of women. For example, there are no childcare services and women have nowhere to live with/leave their children, and there is nothing allocated where women can come and safely receive services. It is also important that the harm reduction programs often lack algorithms on how to respond to situations of violence. Women in the situation of violence, where they inject drugs have a very difficult time accessing services of other organizations that provide support for women in those situations. This is due to the fact that such organizations do not admit women injecting drugs, and for women undergoing OST therapy, children may be a barrier. There are hotlines, where it is possible to call, but often they don’t have information about what they need to tell to such women or how to support them if they take drugs. So, in this context, it is very important to focus on safety, it is important that they have adequate support – these services need to be adaptive and accessible, they need to reflect the needs that women currently have. Obviously, this is a range of services, because women may need security or medical care, psychosocial and legal aid services, resocialization. It is important to develop partnership among the different organizations here: public and non governmental organizations. So here it is important to work with harm reduction organizations and those that support women in situations of violence. And the last statement there is that we actually speak about three layers of this kind of issue: First, this is about prevention of violence, it is important for women to recognize when they were subjected to violence, so it’s important work with partners with families. Second layer is providing assistance to the woman, and all of these services need to be focused on the needs of the women, not legislative provisions.

Moderator, EHRA: Thank you very much. Maria, thank you for this project and thank you all the partners and experts who are doing this hard work, connecting harm reduction and providing shelter to women who use drugs. I need to read you one of the comments, sorry for this provocative question: Unfortunately in some of the countries of Western Europe and Central Asia even seeing violence from police, as well as this structural violence and violating rights, parental rights of women using drugs are rather often. I will give you a link in the chat on our applications for submitting reports to human rights, UN treaty bodies in the cases of violating parental rights and reproductive rights of women using drugs, in particular when they approaching police or approaching social services. And now, actually that’s a good link to the best practices of police-response and experience responding to violence in the Ukrainian system and Ukrainian police, and we are very happy to have Olena here with us. She is the head of the department monitoring gender equality and combating domestic violence. And she’s the coordinator of the respective human rights office in National Police of Ukraine.

National Police, Ukraine: We have changed the laws on domestic violence in 2017. Now Ukraine transformed the law that is now expanding the circle of people who are covered by such laws. So, in 2017 we had a pilot project. It was called Polina. And it was a network of mobile groups to respond to domestic violence cases. They worked in three pilot towns and when those mobile groups were working, there were no changes in the legislation yet, better than bad. It allowed us to see the key issues, which police saw in terms of domestic violence. So some personal problems some the subjective attitude to certain situations and seem more systematic issues, and the legal problems and legislative problems, like why certain things could not be done. So this mobile groups included police officers from different departments to investigate the terrorists, juvenile prevention officers a district police, and with these activities proved to be quite successful and effective and when new legislation was approved based on the data that we collected through the work of such mobile groups, they were able to approve certain regulations at have more practical nature, regulating the work of police and expanded the activities of mobile groups throughout the territory of Ukraine, in September 2019 We had 45 Mobile groups working in all regions of Ukraine. So today, we have those groups working at other sectors to counter domestic violence in each region, and we will increase the total number up to 50. So the main response, our grid. So how do those groups work and how does police respond to the cases of domestic violence in our cooperation, or were the other partners. So, they are the ones who make a decision on further action – maybe they would engage investigators, or if there is a criminal offense and the National Police informs the responsible coordinator, who is responsible at the level of the Ministry for coordinating any interactions in response to domestic violence. So, what are the powers of police in this area: First, that’s fact finding and responding to the cases of domestic violence. Second thing that we do, we receive and review reports of domestic violence and notifications, so people can call or come to the police office and tell about cases. The third thing is informing the victims of the rights and offer the services available for them of the possibilities that they have in the social sphere, and in the legal environment. Then, when the police officers come to the scene of domestic violence, they do risk assessment, and they can make a decision […] the offender can be requested to leave the premises or not to come closer to the victim. So one of those methods can be used or bills can be used based on risk assessment and this order can be implemented for one or 210 days and if the offender does not , there would be administrative responsibility against the offender. The next component is putting the offenders to a preventive register and the next component is our monitoring of the implementation of special measures such as restricted for order. The next  component is revoking permits for the right to bear arms and munitions as well as their seizures. We also collaborate with other actors in the sphere of countering domestic violence. So if we talk about the data on domestic violence so we can say that in 2020, the National Police registered 208,000 reports on domestic violence among them over 11,000 are physical violence, 120,500 psychological violence and […] economic violence, and there were 41,000 of the restrictive orders issues. We have criminal responsibility now – there is a new article in national legislature, and we have already 1669 criminal cases. Plus, we have a separate register for children – we have 240 children registered. So that is how the police responds to the cases of domestic violence, thank you for your attention.

Moderator: Thank you. I will give forward on this phone over to Kyrgyzstan, we have an activists who actually now united and a lot of one showing their faces and going with their voices to respond to the violence, and we want to hear from all of the her experience and experience of the group of women using drugs.

Community responses. The WINGS project: Dear colleges, my name is Alla Bessonova and I thank you for the opportunity to present my work with women who use drugs, related to. I’ve experienced drug use, and then I myself had to go through all forms of violence. Unfortunately, even today, the level of violence against women is still high. As successful practice of work to combat violence, let me introduce you the WINGS model which has been implemented within Kyrgstan since 2013: the model is a collection of key elements of interventions, that’s allowed to be approached in the context of shelters crisis centers, community-based NGOs and almost any other organization who is developing assistance to survivors. It has been proven to be effective in assisting women who use drugs as this model targets those who prefer to receive assistance by single window methods, when the entire range of social services is provided in one organization. This model focuses on ensuring health and safety, which is particularly important for low-income women and those who have children. We have now started to develop the next version of interventions to provide more effective services to prevent domestic and gender based violence to women who use NPS. The methodology allows better interaction with immediate environment, with specialists of emergency medical team, and with law enforcement agencies – the criminalization of acquisition and personal possession of drugs for personal use relates to abuse by the police, as well as it makes difficult and impossible to report on the effects of violence and coercion to collaboration as well as refusal to provide access to state guaranteed legal assistance. Women who faced violence are almost entirely unable to use their legal instruments of protection by the state. The difficult situation of women who use drugs as well reflected in result of research. COVID-19 increased the level of domestic violence for the whole country. Many centers can’t take any applicants currently as we are in the period of State Emergency. Organizations for safe housing have increased but important roles have not been adapted in Kyrgyzstan, there is no support to work of mechanism for the protection of women who are faced with intersecting forms of discrimination in accordance with their national law on protect protection against domestic violence – the state, for its part, continued to support intolerance and repressive attitudes toward people who use drugs. […] NGOs lack funding, specialized services, and specialists […] Women rarely write complaints against violence from police, and investigative bodies ultimately result of more lenient sentences for perpetrators. Activists in Kyrgyzstan are concerned of action on the part of the state… patriarchal authority. This sparked a wave of change. We hope that cooperation and assistance from international organizations and networks of women who use drugs can help us obtain all possible services and technical support. Thank you all.

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