Harm Reduction for 3500 people in Moscow

Dear friends!!

We are happy to share with you some great news about a recent significant improvement in our work! Many of you remember that for several years we were trying to crowdfund a minivan that would help us improve our street work. We weren’t able to fundraise the whole needed sum, but your support helped us to maintain our services when we didn’t have money from any other sources to buy needles and syringes, condoms and rapid tests. But last year, together with other brave NGOs from Russia we have received a new grant from the Global Fund to Fight AIDS, tuberculosis and malaria, which is not huge, but it has allowed us to buy a new minivan! Today we are happy to share the photos of this minivan and report that it has moved our work to a new level – enabled us to stay longer hours, serve more people, bring more materials and provide better counseling. We are one very happy team!

Since 2009 Andrey Rylkov Foundation (ARF) works with drug users, and is determined to bring health and legal services to where they are – to the streets. ARF is the only organization in Moscow that provides clean needles and syringes, counseling on health and legal issues, family support to families of people who use drugs and warmth from heart to heart, trying to make our city and society healthier, happier, more just and humane.  ARF is a community-led organization and community activists, who suggest new ideas, develop and implement new projects and make sure that the drug users in Moscow and in Russia can benefit from our harm reduction work and from our human rights activism, direct our work.

On the photos, you can also see our dear friend and a person we all admire and respect so much! – Michel Kazatchkine -  the United Nations Special Envoy for HIV/AIDS in Eastern Europe and Central Asia who visited our minivan last week during his official visit to Russia, and who has been able to meet with our outreach workers and with our dear participants – people who use drugs in Moscow. We hope that this meeting has been mutually very inspiring!

 Just to give you some feeling on how the minivan has improved our work, we share some feedback from our team members:

Katia (our doctor): The first time we used our new van to do outreach was on the 5th of January this year, it was in Marjino [one of the Moscow districts where we carry out our work]. The van is bright, clean and comfortable inside – there is a place to see project participants, a table on which we could put all our medical stuff and – what is very important during the winter – it is warm inside! During the outreach, I had to examine one of the participants with septic wounds and it was very cold outside so we were really happy to be able to do the examination inside the car. Last Friday was the first time when I used the car to do the bandaging. There was a shy girl who had an open post-injection abscess on her shoulder. At the beginning, she just asked for ointment and bandages but I suggested examining the abscess. She refused because it was too cold outside. She was really surprised when we offered her to do the examination in the warm minivan. She couldn’t believe this and asked for a few times – is that for free? “It is the first time in my life when I was examined and provided primary care for free” she told while sitting in a car. I washed and bandaged the wound, gave her ointment and more bandages to take away and explained how to use it.

 Masha (an outreach worker): the minivan really makes our work easier; especially when it is winter and really cold outside. Fingers are freezing when you are trying to write anything down but now we can do it inside the warm van. And also now we can bring much more prevention materials with us and if the participant would like to receive legal or medical consultation, to be tested or to discuss any problem with social worker – now we have the opportunity to do that in a van where it is much more comfortable.

This is the second year the Andrey Rylkov Foundation organized a New Year celebration for the children of the participants of our project on HIV prevention among people who inject drugs, “Harm reduction – Moscow.” It is important for us not only to give them a gift just for the sake of appearances but to try to give them something which they probably really need: a New Year miracle, belief in good and sincere smile. This is why we raise funds for gifts, dress up like Father Frost and Snow Maiden and visit children in different parts of Moscow.

But nothing would happen without the help of “good Samaritans” – those people who support these our activities financially including through the Global Giving platform. Once again numerous friends provided us with money to buy presents, helped us get New Year costumes, took part in organization of all these activities or just supported us on a Facebook. We offer special thanks to our photographers, Alexander and Katya.  Thanks to them we now have those great photos documenting this our activity.

But how was it? What are the lesons did we learn this year? What are the impressions? As always, we decided to ask these questions those our colleagues who organized and personally participated in these activities:

Max: It is the second year I‘ve played the role of Father Frost and sometimes, in a moment of self-obsession, I feel like the key person in this whole initiative. But this is not true, and I understand this when I think about how much  preparatory work was done to organize all this. During our social street work, we asked about children who might be interested in such a New Year celebration. We made lists of contacts, communicated with parents, gathered money through the internet, argued with each other when deciding which presents we should buy and were involved in many other important related activities. All this was done by ARF staff and volunteers! And I was just a Father Frost.

But I have to say that this year, many questions rose for me after this our initiative. Last year, we visited only three families but this year there were many more. So the question is - how will me meet all of the need next time? How will we select what presents we buy and for what reasons and purposes? What is the overall goal of this our initiative? Is it just to give a present from Father Frost or to give the children something more than that? Is it just a New Year celebration or does our initiative also serve the purpose of co-dependency prevention among these children? Chocolate – is it good or bad as a present for children? These are only some of those things I was thinking about when organizing the event.

And, concerning feelings, I feld many different ones, including warmth, satisfaction, tiredness, tendernessand regret. And now I feel not only with my heart but also with my head that we should expand this kind of our activities. Happy New Year! And, I am eagerly awaiting the next New Year celebration!

Asya: I started notice that the older I am the less magical the New Year is. But there is a possibility to return these almost forgotten holiday feelings – you just need to take part in congratulations of those who are still waiting for a New Year miracle.

This time those children who we visited last year were not afraid of the Father Frost and Snow Maiden, but were excited to meet them again, as old friends. Some of them were happy to play and to dance with us and of course they all wanted to make a photo with us. This year we used funding raised through social networks, Global Giving and also other crowd funding platforms where the coordinator of our children’s project, Lema, put an advertisement. And although we were not sure how it would work, our concerns were groundless and we managed to get twice the amount we expected. Thank you to all those who supported us! Also, this year we had a Christmas crèche in our program prepared and performed by Kaya. She managed to make it regardless the skepticism of all other members of our team about this new activity.

Lema: It is great that each year we congratulate more and more children! This time there were 15 of them, not counting the elder ones. And they all really enjoyed the event and were happy to see Father Frost. This year I had the role of the Father Frost’s manager.  I communicated with parents, calling them in advance of the event to confirm that we are coming. Because of that I had a chance to watch from outside how the celebrations are going on. Is was really warm because of the children’s smiles and New Year songs and poetry and when you see how happy they are to get presents and how excited the parents are. I believe this year all those who were involved in the organization of this activity started to think more about the project. Now we have many questions to answer and ideas for to implement next year. And what made my day was the feeling that we grew up, made progress and moved towards working with community in terms of their empowerment. Thanks to all who participated in this project! This was a good job!

Kaya: I really enjoyed how we congratulated children this year. I participated only one day but from the experience of previous years, when I also participated in these kind of New Year events I would like to say that everything was great! Father Frost was very flamboyant and cute. Children had the opportunity to express themselves and everyone had a feeling of a celebration. Communication was very warm, alive and joyful. It is great that ARF managed to organize such a New Year for children whose parents are addicts once again. And thanks to all who contributed! I believe there is a huge demand for such kind of activities targeted on children drug dependent families and we could fill this niche.

Links:

• Read this report in Russian on our website

Initially the text beow was prepared upon a request from one UN agency (we were asked not to name it) for their report on HIV and Human Rights issues. But for some reason at the last moment they refused to include our case in their report. So we would like to publish it here as this work was also done with the use of those funds received from our supporters through the Global Giving platform. 

Russia is home to 69% of all people living with HIV in Eastern Europe and Central Asia, and its HIV epidemic is concentrated among people who inject drugs. In Moscow alone there were more than 30,000 people who use drugs registered with the drug treatment specialists in public clinics in 2013, and the total number of people who use drugs in the city is likely to be higher.

In addition to being at highest risk of HIV in Russia, people who inject drugs are among the most marginalized and stigmatized populations in the country. Criminalization of drug use, quota-based law enforcement and low availability of opioid substitution therapy are major barriers to harm reduction.

Activists in Moscow allege that people who use drugs are frequently denied their rights. An initiative by the Andrey Rylkov Foundation (ARF), a non-governmental organization working in Moscow since 2009, is providing legal support to people who use drugs and seeking justice through the legal system. In late 2013, the Foundation’s Harm Reduction – Moscow Project with support of the Canadian AIDS Legal Network launched a ‘street lawyer’ initiative, which links those who need legal aid with a social workers and a legal advisers. Services include rights counselling, mediation, filing of official requests or complaints to medical practitioners or government offices, and resolution of cases through the justice system. In addition to legal support, the project gives clients moral support and boosts confidence in their ability to access legal recourse. The Foundation also provides expert witness testimony in court and advocates for changes to Russia’s drug policy.

Before the legal support was taken to the streets, few people who use drugs attempted to defend their civil, social and economic rights within the justice system. Today people approach the street lawyers on the street, call the hotline, write and ask through friends.  In the space of a year, the project has supported 15 legal cases, including one that exhausted all domestic legal remedies and has been filed with the European Court of Human Rights.

One example of this ARF work related to a drug-using woman living with HIV who was refused dental treatment at a government-funded clinic. Marina had to visit a doctor to get a surgical dental treatment. For that reason she went to the governmental dental clinic. But when Marina informed the dentist that she was HIV positive he refused to provide her medical help. Marina went to another dentist at this clinic, who told her she will provide her with medical assistance but only after all the other patients. In Marina’s opinion, such an attitude of dentists was discriminating and illegal. That is why she approached ARF and asked us to help her to protect her rights.  Social workers helped her to prepare and submit the compliance to the head of this clinic. The compliance included a description of the situation and a request to take relevant measures to educate the staff personal on HIV\AIDS issues and also to prevent further discrimination of people living with HIV in this governmental health care facility. As a result the head of the clinic responded to Marina, apologized to her and informed that he will not allow discrimination of people leaving with HIV in his clinic anymore. Marina got a required medical assistance and cured her teeth.

Moscow’s drug users can also receive anonymous legal advice from the Hand-Help.ru, website. This virtual legal aid service promotes the legal literacy of people who use drugs and facilitates their self-representation in court when they are prosecuted. In addition to the online consultations, the users can access a regularly updating database of juridical acts, examples of cases involving drugs, legislative comments and analysis. The website is the go-to source of information on human rights issues related to drug use, receiving 3000 hits per day. The site’s administrators answer an average of 180 questions per month. Questions that have been answered previously are archived into thematic sections, available for perusal of any site visitor. The site’s main legal consultant has filed 19 drug related rights complaints to the European Court of Human Rights since April 2012.

Dear supporters!!

we are happy to share with you several pieces that featured ARF work with drug users in Moscow. 

First of all, a very short but right on the point video by AFP where you can see our outreach work near one of the pharmacies and see some of our participants! AFP VIDEO REPORT 

And also, a full story to accompany this video: 

Activists struggle in fight with Russian AIDS epidemic

Moscow (AFP) - Waiting with his rucksack full of clean syringes by a pharmacy in the Moscow suburbs, Maxim Malyshev is fighting a lonely battle on the frontline of Russia's spiralling AIDS epidemic.

A great piece in the Guardian  tells a story of our work with drug users and also describes the catastrophic situation with the AIDS epidemic in Russia and the government neglect, both of which we try to battle! 

"The official count of Russians living with HIV has risen to 930,000 from 500,000 in 2010, and the actual number is probably much higher. (Of those registered, some 192,000 have already died.)

The lack of outreach has driven organisations such as the Rylkov Foundation to hit the streets for guerrilla harm-reduction work. Five evenings a week, part-time employees like Remnyova and Sosnina stand near pharmacies selling tropicamide over the counter, mostly in the outlying districts of the city, where the drug problem is most acute. Besides clean needles and bandages, they hand out HIV and hepatitis tests, the organisation’s newspaper and other HIV prevention literature, and naloxone, a drug that can be injected to help reverse an overdose."

And one more piece, by the BBC: Fighting HIV where no-one admits it's a problem interviews some of the Russian officials in order to understand the roots of political resistanse to effective HIV prevention work and also describes our work. For some reasons, all the journalists seem to be very impressed with our rucksacks!! :)  

We are very glad that top international media pays so much attention to our work and we hope it will help to spread international awareness of the situation with the AIDS epidemic in Russia as well as importance of harm reduction approach, based on respect and protection of health, dignity and human rights.

We would love if you could spread those reports among your friends and colleagues, and maybe they would also like to contribute to our work - as it is clear from these stories that we can hardly expect much support from own government in the nearest future! Please spread the word and help us keep up our "guerrilla harm-reduction work"! ;) 

Links:

• AFP short video
• The Guardian piece
• The BBC: Fighting HIV where no-one admits it's a problem

Dear friends! 

We would like to thank you heartly for your generous support of our work - thanks to your donations we were able to sustain our work during a difficult period of the funding gap and further through the year. We were not able to get enough money to buy a mobile van, but at least we have bought very large backpacks for 10 of our 20 outreach workers and volunteers, and it will allow us to carry more materials and brochures to provide to our participants!

we would like to share our annual report for the last year with you - please read about our challenging work on the  streets of Moscow!

http://en.rylkov-fond.org/wp-content/uploads/2015/04/ARF-Anti-Report-2014-enG.pdf

Heres some highlights in figures:

- Total number of contacts: 2,376 Incl. contacts with women: 624

- First-time contacts: 982 First-time contacts with women: 253

- Distributed syringes: 70,970 Needles: 10,243

- Condoms: 3,369

- Distributed naloxone: 2,062

At least Two Hundred Twenty Three Lives Saved with Naloxone! 

- HIV tests / of them positive: 35 / 14

- Hepatitis tests / of them positive: 20 / 15

- Advice on drug treatment: 117

– Advice on HIV and hepatitis prevention and treatment: 77

- Advice on post-injection complications: 231

- Advice on overdose prevention: 294

In the report you will read about our exciting project Street Lawyers - bringing legal aid to the streets of Moscow and about our newspaper for drug users "Shlyapa i Bayan", about our great team and community work and actions to clean the streets of Moscow from syringes. You will also learn about our new initiative of helping the families of drug users to take care of their kids - organizing events and celebrations for them. We hope you will be glad that despite financial difficulties last year, our work continues and expands, to the new people and new areas !   Thank you once again for your support and solidarity! 

• ARF harm reduction work (PDF)