Author: Victoria Kalyniuk

In Tajikistan, during 2020-2022 there were registered more than 1000 cases of human rights violations against people living with HIV and representatives of groups at risk. Nearly 60% of such appeals inform about violations by individuals in a form of domestic violence, eviction, stigma, and discrimination on a domestic level. Read detailed statistics here.

Stigma and discrimination in Tajik society are promoted and enrooted by repressive criminalizing laws in the country against people living with HIV. Ignorance and lack of information about HIV and AIDS provoke fear and hatred against HIV-positive family members.

Fatima*, 30 years old lives with HIV.
Fatima met a man and married him. He is also HIV-positive. They live together in his mother’s home with her. The client’s mother-in-law knows about the status of the client and her husband. She always insults, does not allow the client to go to the kitchen or to take the food from the fridge. She says: “You are not allowed to enter the kitchen! I will cook food for the family and you – have to do all cleaning up. I don’t want to get infected with AIDS from you.” At the time when the client wants to go to the mother-in-law’s bathroom, she does not allow, or completely cleans everything from the bathroom. And after that, if the client enters the bathroom, after she washes her entire bath with bleach and chemicals. The client says that she cannot share with her fellings with anyone. Asked for help to talk to the mother-in-law of the clients. The client’s husband agreed REActor to go and talk to his mother.

* name is changed

“At the beginning of my work as a REActor, I heard from clients a lot of stories about domestic violence and hatred due to HIV status. The client’s relatives were so scared of HIV, that they didn`t let one use the shared kitchen and bathroom! I understood, that these violations happen because people do not know how HIV can be transmitted, and how – not. All this was happening due to a lack of information. At that point I understood, that if we provide these people with accurate information on HIV transmission and prevention, maybe – they will stop discriminating their HIV-positive close ones.” – tells one of REActor.

So the strategy “to go and talk to the perpetrator” was chosen as a reaction to such cases, registered in REAct. REActors were provided with informational brochures about HIV prevention and treatment. After the client appealed, REActor was coming to the client’s family to explain that a discriminative attitude toward HIV-positive family members will not help to win a virus, otherwise – such an attitude just keeps a person far from treatment services.

Coming back to Fatima’s case, let’s analyze how this approach worked out.

Psycho-emotional support was provided, information was given on the rights of PLHIV, she was invited to the organization, and a social worker consulted her. The next day, a visit to Fatima’s home was organized to talk to her mother-in-law. Full reliable information was given in an accessible language about HIV, VL, ARV therapy and adherence, about the rights of PLHIV, and about the legislation of the Republic of Tajikistan. After that, the mother of the client’s husband was stunned and wordless. She did not believe that if taken at the time of the pill (ART), there would be no risk of HIV-positive person and there will be no risk of infection. “Having well believed you, I will no longer infringe on the rights of my daughter-in-law and son. Let’s see what happens tomorrow and in the future.” – mother-in-law said. The client and her husband were very happy. In two months we contacted them again to find out about the situation in their home. Fatima assured us that her mother-in-law changed her attitude toward her and that everything is fine in their family.

In 2020-2021, the REAct system in Kyrgyzstan registered more than 1,300 reports of violations of the rights of people living with HIV, drug users, sex workers, and members of the LGBT community. More than 50% (668 cases) of registered cases reported violations of rights and discrimination by representatives of law enforcement agencies. Of the 668 cases, 59% reported violations by people, who inject drugs and 34% by sex workers. You can get acquainted with detailed statistics on the data page or in statistical reports.

A large percentage of the same type of stories from people, who use drugs about illegal detentions, systematic police brutality could not go unanswered by the Soros-Kyrgyzstan organization, which implements the Street Lawyers project and documents cases of rights violations using the REAct tool. Today, in this article, we look at how you can respond to police violations and what advocacy actions can be taken by an organization that has evidence of such violations.

Ilim*, February 2021

The client came to the site of the methadone maintenance therapy in the morning, at the entrance he was stopped by the officers of the *** District Department of Internal Affairs. The client was not given the opportunity to get methadone, they put him in a car, and they began to demand information about another client of the site. They threatened to put him in jail for harboring, humiliated with words, insulted. They took him to the police station and continued to humiliate and threaten. They held him for three hours and then let him go without an apology. The client refuses to write a complaint due to fear of persecution. Consultations were held: “know your rights”, “behavior during detention”.

*name changed

Ahmed*, March 2021

A client of a Methadone Maintenance Therapy site on *** Street came to get methadone. Received for 7 days. Left the site. He was stopped by police officers, put in a car, taken to a remote place, threatened, beaten, forced to cooperate in order for the client to provide information about other clients of the site. They kept him in the car for more than three hours and then let him go. The client does not want to file a complaint against the police officers. A street lawyer provided advice on “citizen’s rights”.

*name changed

Utkur*, October 2021

**.10.2021, the client left the OST site and was stopped by a district police officer named *** and a police officer ***. They put him in a car, hit him on the head with a plastic bottle of water and told him to either hand over other consumers or pay them 1,000 soms a month for petrol, otherwise he would be jailed. The client agreed to 1,000 soms per month and was released on the condition that the client would bring the money the next day. The next day, fearing police persecution, he left for another city, where he remains to this day.

*name changed

Vladimir*, December 2021

After the client received the methadone and was heading home, a car stopped on the road near the client, two people in civilian clothes got out of it and introduced themselves as police officers and offered the client to take off. At the client’s refusal, they rudely stuffed him into a car and took him. On the spot, a personal search was carried out without witnesses and video recording. Not finding anything illegal, they began to recruit them to work, humiliated them, insulted them with foul language, threatened that they would find something to put himin a zone for if he won’t work for them. After five hours of detention, he was released.

*name changed

As can be seen from the cases, violations by the police are systemic. That is why it was decided to respond also systematically. The lawyer of the project, who advises street lawyers (REActors), wrote an official letter of complaint to the leadership of the Ministry of Internal Affairs that the organization has evidence of regular abuses of authority by police officers in the form of illegal detentions near OST sites. The letter was accompanied by video recordings from street surveillance cameras in neighboring buildings, which recorded the regular presence of police cars near OST sites.

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Also read:

“Do police defend me?”

Access to justice through… deprivation of parental rights?

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Reminder:

The project “Street Lawyers” is implemented by the Foundation’s “Public Health” program Soros-Kyrgyzstan with the assistance of the United Nations Development Program. This initiative appeared in response to the current problems of vulnerable groups.

Street lawyers are trained employees of non-governmental organizations in Kyrgyzstan, representing and defending the interests of vulnerable groups, key in the context of deterrence HIV epidemics.

Read more about the project.

According to the legislation of Kyrgyzstan, there are seven main reasons why parental rights can be terminated in the country. If parents (one of them):

• evade the fulfillment of the duties of parents, including in the case of malicious evasion to pay alimony;
• refuse without good reason to take their child from a maternity hospital or from another medical and educational institution;
• abuse their parental rights;
• mistreat children, including physical or mental violence against them, encroach on their sexual inviolability;
• are patients with chronic alcohol addiction or drug addiction;
• have committed an intentional crime against the life or health of their children or spouse;
• allow their minor children to wander, involve them in the worst forms of child labor.

However, alas, in practice there are a number of other reasons why a parent can be considered by the authorities as a potential violator and a person who deserves such a terrible punishment – deprivation of rights in relation to their child. For example, his HIV status and stigmatization as a representative of marginalized groups.

“Bad Parent”

On **/ **, 2021, in the Chui region (Kyrgyzstan), a meeting was held with the participation of the client, mentors and the REActor. The reason was the claim of the Social Development Office represented by the Department for Support of Family and Childhood (hereinafter as the DSFC) of the Sokuluk district of the Chui region, to deprive the girl of parental rights due to their improper implementation. The client explained the possible reasons for such an appeal: she is a representative of the PLHIV community, a former pupil of an orphanage and, unfortunately, does not have her own housing. The girl categorically disagreed with such a claim and asked for help – to defend her rights and the rights of her children, since she did not have the opportunity to hire a qualified lawyer.

At the coordination meeting, it was decided to help the client and join the REActor as a representative and mentor, for control as a second representative. Trials have begun…

“Children in Danger”

The position of the FCSD of the Sokuluk district was clear from the very beginning: they insisted on depriving the client of parental rights, since she cannot provide the children with housing and food. The REActor, together with the client, opened a voluntary patent, and after talking with his organization – Ishenim-Nuru Public Foundation, he was ready to provide the family with temporary housing. All documents and petition from the organization were submitted to the court for consideration and legal assessment. However, the representatives of the DSFC of the Sokuluk region and the prosecutor of the Sokuluk region participating in the case, having learned that the organization provides assistance and temporary accommodation to a representative of the PLHIV community, were against the placement of children in this organization, arguing that the children could be in danger.

What is the way out?

After long processes, an alternative solution was found. The client’s ex-husband agreed to provide her and her children with their temporary home. On these terms, the DSFC of the Sokuluk region agreed to withdraw their claim. On December 16, 2021, a trial was held with a ruling on the termination of the civil case on the claim of the DSFC of the Sokuluk district for the deprivation of parental rights. The client returned her children and currently lives with them.

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Remember, if you or your loved ones need help in Kyrgyzstan, a REActor is a community representative, an NGO employee who, in addition to providing services and outreach work, is a “street lawyer” and documents cases of rights violations when community members turn to him with complaints. The REActor can advise, provide psychological support and provide primary legal advice, help with the preparation of primary documentation for solving the case.

In Kyrgyzstan, REActors represent 13 NGOs located in different cities of the country, one REActor per region. REActor travel to cities and towns of the region in order to collect information and provide services to clients.

Only for the first half of 2021 year, REActors in Kyrgyzstan registered 166 appeals on cases involving one of the key group — people who inject drugs (PWID). Alas, one of the most customary reasons for such requests is… law enforcement. PWID are more likely to face violations, threats of physical violence, extortion of money, and abuse of authority rather than get their help. Next, one of the recent true stories.

Confess and you won’t get anything!

** August 2021, the client was at a bus stop in the *** district (****, *** region) and was waiting for passengers as he moonlighted as a taxi driver. Two young Kyrgyz approached and asked for a ride to the city center. When the client delivered them to final destination, they paid and told him to wait. After 10 minutes, three young guys got into the car without asking, hit the client twice in the chest and started recording everything on the phone. The people were in civilian clothes, did not introduce themselves, did not explain who they were, handcuffed the man and took him out of the car in a humiliating way, disparaging him. Afterwards, they began to inspect the car and the client’s personal belongings as well. After a while, two plastic bags and scales were taken out of the car. The client forthwith claimed that it did not belong to him, then sadly, he was battered, maltreated and his ribs were broken. After weighing the contents of the packages, according to the unknown people, there were 200 grams of marijuana and 143 grams of heroin. As it became clear later, these people were operational officers of the District Department of Internal Affairs of one of the districts of the *** region. All the incident was captured on a phone camera.

The operatives said that if the client had confessed, then half would be given to him. And while the investigation of the case is going on, he will not be in need of anything, and his family will be assisted in all their demands. He cast aside the offer. Then representatives of the internal organs turned off the phone camera, punched and smashed the man repeatedly. They insulted and rebuked him, then suddenly they began to promise to “Let him go”, and subsequently they took off the handcuffs and hitched the client in the car to the police department. They brought me through the duty department in an embrace, like a friend. In the office, they called me “AIDS-positive, drug addict, convict” in every possible way, stroke me repeatedly and violently. They said that they had been looking for him for a long time, allegedly he also robbed the apartment.

At 3 A.M., the client could not stand it and wrote a candid confession, under dictation, and only then was he given a drink of water and a smoke. He also offered five thousand dollars to “hush up” the case and at six in the morning everyone drove to his house in his car. The client was warned that if he “throws out the trick”, they will immediately put him in jail, the papers are already ready and will go in the course. Being at home, he asked to go into the bedroom alone, so as not to frighten his wife and children. Once in the room, the client closed the door, managed to take his son’s phone and jumped out the window that overlooks the neighbor. There he hid in a septic tank (a pit where all the sewerage from the house goes). They searched for him for a long time, but they didn’t find him, the neighbor also said that he didn’t see anyone and asked the operatives to leave, otherwise he would call 102. Before leaving, the police department officers told the client’s wife that if he came in the morning, then nothing would happen to him, otherwise he will be kept in prison for a long time.

** August the client called the NGO and partially explained the situation. He was given REActor’s phone number, they met at the appointed place, where the man told all the details of the above offense.

What was done by REActor:

The client was granted shelter outside the area of residence. There he completely came to his senses, similarly concurred to work on the same territory (caring for cattle, and the elderly owners of this place). The man refused to go anywhere, fearing for his son, since he is already a teenager, so REACTOR went himself to one of the directors of the state institution and told the whole situation. He contacted the prosecutor’s office, and a couple of hours later the REACTOR was invited for a conversation. The prosecutor’s office said he would look into it.

Happy end

** August 2021, the prosecutor’s office gave an verbal answer that the client would not be tocuhed by anyone. It turned out that on that unfortunate day for him, two operatives and an investigator got into the car. The investigator was fired (on a different case, but still, he no longer works), and the operatives received a warning from the management that they themselves would be imprisoned for such actions. Since September, the police stopped disturbing the client.

REActor: “In my judgement, the success of the result also lies in the fact that the work was done despite the client’s desire to solve the case and the refusal to officially file a complaint with the prosecutor’s office, since both ill-treatment and torture took place. Assistance was provided by REACTOR independently, in cooperation with the mentor and the head of the Harm Reduction Network Association. Even without the participation of the client, but a positive result was achieved, and most importantly, he was contented!”

You risk not only your health, but also your reputation

By law, doctors and medical staff are not allowed to disclose information related to the patient’s health without his/her consent. Alas, this rule is often violated, which causes family conflicts, nervous breakdowns, and even suicide attempts. This is especially true of diagnoses that are still condemned in some countries, including Tajikistan: HIV / AIDS, hepatitis, and psychiatric illness…

Of course, there are times when it is necessary to talk to third parties about the diagnosis, for example:

• when the patient is not able to express his will (in a state of coma), and doctors need to know if he/she suffers from diabetes and if he is taking any medications.
• in case of an unfavorable prognosis of the development of the disease. Then it is allowed to provide information about the patient’s state of health to his spouse or one of the close relatives
• with the threat of the spread of infections or mass poisoning.
• either when there is a trial (you can transfer information about the disease upon request to the relevant authorities), or the patient is a minor (information about the disease is transmitted only to his parents or guardians).

By the way, in Soviet medical institutions (usually these were oncologic dispensaries), after the examination, three extracts were drawn up: one remained in the card of the department, the second was for a medical institution, and the third was handed over in an envelope. Moreover, often not even to the patient, but to his relatives (this was done out of good intentions: relatives can more delicately inform the patient about difficult news).

In a stigmatized society, many people are still forced to hide their status. But the information scatters in seconds, as soon as it “goes outside”: the doctor told the nurse, the nurse told her friend, a friend – a relative, and the town is so small… And the disclosure of medical secrets becomes a real crime against this person.

Neighborhood close to tortures

Alfia (name has been changed) has lived in the town *** all her life, led a normal life.
The woman learned that she had HIV during her pregnancy. There was shock, doubts, a depressed state, but after weighing all the pros and cons, I decided to give birth. The baby was born healthy.

The delivery was attended by nursing staff who knew about her status, including a nurse – her neighbor.
A year later, during a quarrel, the nurse began to insult Alfia and shout to the whole yard: “Alfia has AIDS, Alfia is a prostitute, etc.” And her son threatened to write the name and status of the woman on the poster so that all other neighbors would know about it.
For Alfia, it was a strong psychological blow, it became ashamed and scared. Going outside has become like torture for her, and she thinks about moving, fearing bullying from neighbors.

Corpus delicti … not found

Alfia came to REActor. Together with the REAct lawyer, a statement was drawn up to initiate a criminal case against the nurse and submitted to the prosecutor’s office in accordance with Art. 145 of the Criminal Code of the Republic of Tajikistan (On medical secrecy). Criminal liability under this article is imprisonment for up to 2 years with the deprivation of the right to hold certain positions or engage in certain activities for the same period (maximum penalty).

However, according to a written response dated September 14, 2021, number 12 / 230-21, the prosecutor, having examined the application against the nurse, did not reveal any offense in her actions, which would fall under Article 145 of the Criminal Code of the Republic of Tajikistan. In this connection, unfortunately, it was refused to initiate a criminal case.

What does the law say?

According to Art. 23 of the Constitution of the Republic of Tajikistan (RT), the collection, storage, use and dissemination of information about a person’s personal life without his consent is prohibited, i.e. establishes the right of every citizen to privacy, personal and family secrets. Medical secrecy is a personal secret.

Medical and pharmaceutical workers are obliged to keep medical confidentiality (information about the state of health, about visiting a health care organization) and other personal information (Article 49 of the Health Code of the Republic of Tajikistan). Also, according to part 2 of article 162 of the Health Code of the Republic of Tajikistan, information received about HIV infection is confidential (medical secret) and at the request of health authorities, if this is required in the interests of protecting public health in order to prevent the spread of infectious diseases, on the basis of a court order or upon request the investigating authorities are provided with such information. It is prohibited to use this information for the purposes of criminal administrative prosecution of persons, except for the cases established by the legislation of the Republic of Tajikistan.

В случае отсутствия названных в законе условий врач не имеет права разглашать врачебную тайну. Он не может предоставить такого рода информацию даже родным и близким больного. Обязанность не разглашать сведения, составляющие врачебную тайну, распространяется, прежде всего, на медицинских работников (врачей, медицинских сестер, санитарок, сиделок, регистраторов, студентов, проходящих практику в лечебных учреждениях) и фармацевтических работников. Если диагноз пациента разгласили лица, которые узнали о нем при исполнении служебных обязанностей, они могут быть привлечены к ответственности.

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You might be interested in:

The invisible barrier: how fear makes one silently endure

Positive marriage: in Tajikistan, HIV-positive status is an obstacle to marriage registration

Breakthrough in human rights protection in Tajikistan: court fined 20,000 somoni from husband for disclosing wife’s HIV+ status