Author: Victoria Kalyniuk

Description of the situation

In December 2020, a young couple came to AIDS Center of the city *** for HIV testing under compulsory medical examination before the wedding. According to the results of testing, the man revealed HIV-positive status. The man informed his bride and she supported him. The detection of HIV+ status did not affect their decision to get married in any way and they continued to collect the documents necessary for marriage. In AIDS Center, the man was given a certificate and the girl wrote a receipt that she knew of the man’s HIV status and that she intended to marry him.
Then the couple went to the polyclinic to get a medical examination report. However, they received a refusal by the deputy chief medical officer of the polyclinic who, having learned of the bridegroom’s HIV status, refused to issue a document confirming a medical examination. According to him, an HIV-positive person should not enter into marriage with healthy people. The following day, the doctor called the girl’s parents and told them about the HIV+ status of the future bridegroom. The parents supported their daughter, pointing out that, if their daughter agrees then they also agree to the registration of marriage. However, the situation was not resolved, the doctor refused to issue the conclusion necessary for the official wedding.

Resolving the problem

In desperation, the couple sought legal assistance from REActor, peer counselor of NGO providing services for PLHIV. After legal advice, REActor, together with the young people, met with deputy chief medical officer and explained to him that he had no right to refuse to issue a document. The REActor backed up its words with the relevant articles of the Constitution and the Family Code of the Republic of Tajikistan. He also emphasized that a doctor has no right to disclose the HIV status of any person and to show discrimination of any kind against people living with HIV.
The meetings produced an understanding. The polyclinic issued the necessary certificate for marriage registration and the doctor apologized to the man. A few weeks later, the couple married.

Lawyer’s comment

In 2016, because of the growing number of cases of sexual transmission of HIV, measures have been taken at the legislative level under which a prenuptial medical examination is made an obligatory part of the marriage procedure in Tajikistan (art.15 of FC RT).
In accordance with the Government decision of the Republic of Tajikistan dated August 23, 2016, No. 374 “On approval of the rules for carrying out the compulsory medical examination of the individuals entering into the marriage”, paragraph 5 states that the civil registry authorities of the Ministry of Justice of the Republic of Tajikistan accept a marriage registration form only if there is a certificate giving an assurance that each person, entering into marriage, completed a medical examination.

An HIV test is also mandatory during a medical examination.

Paragraph 4 states that individuals entering into the marriage can undergo a medical examination in health facilities non-location-dependent. On the one hand, this may preserve confidentiality for HIV-positive persons but on the other hand, according to the doctors, such confidentiality endangering another person who marries him. That’s why, doctors unreasonably consider it a necessity and their duty to disclose the status to the second person of the couple and even to inform their family members about the status. Such actions of doctors do not help adherence of PLHIV to treatment in any way but rather, entail the marriage agreements dissolution and manifestations of the profound stigma by relatives.

IMPORTANT:

– The doctor has no right to not issue medical examination findings in the case of a positive HIV status in one of the couple.

– The doctor has no right to disclose the positive HIV status to anyone except the patient himself.

– The doctor is obliged to carry out high-quality pre and post-test counseling and in case of a positive result – to do everything in his power in order to the patient was dedicated to ART therapy.

– During the epidemiological examination, PLHIV sexual partners or some persons at risk may be invited to undergo voluntary HIV testing. At the same time, the identity of a contact HIV-positive person cannot be disclosed in any case.

Furthermore, because of the legislative requirements for medical examination at marriage, the number of unofficial “Nikokh” religious marriages is increasing. These marriages do not entail legal liabilities for the married but lead to the vulnerability of women and children in such marriages. In regard to civil registration, such a requirement can cause a decrease in the number of official marriages in the country. The family is the natural and fundamental nucleus of society and is entitled to protection by society and the State.

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In 2020, almost 2,000 infractions were documented by REAct system (ReAct = Rights + Evidence +ACTion) in 5 countries of Eastern Europe and Central Asia, 165 of them were documented in Tajikistan.

The strategic analysis of cases of rights violations based on the data collected by means of REAct system allows not only to help specific people but also to formulate recommendations for the revision of legislation in countries based on real facts.

In doing so, the seriously challenge to the expansion of human rights protection in Tajikistan remains that nearly a third of the victims, after contacting human rights defenders, do not dare to defend their rights further on and refuse legal assistance due to fear of interaction with law enforcement agencies.

 

In 2020, 503 appeals from representatives of key groups about violations of their rights and discrimination were registered in Georgia.

Out of the 503 appeals, 76% were qualified by the professional lawyer coordinating the implementation of REAct at the country level as such that do show signs of human rights violations. However, 119 cases do not have such signs but record the need for legal advice to clients on everyday issues.

Cases resolution status at the end of 2020

Of all 503 appeals, in 21% of cases response and legal assistance were successfully provided by a REActor or a professional lawyer, while in 20% of cases after receiving legal assistance, the situation was resolved positively for the client.

Medical – social assistance to the victim is provided in the form of consultations, redirection, and escort to partner organizations or health facilities to receive other necessary services for prevention and treatment.

Primary legal aid by REActors is to advise on legal matters and assist in the preparation of complaints or applications. However, both the victims and REActors themselves (also being representatives of vulnerable groups) are afraid to interact with police officers yet again because of the negative experience of such interaction in the past as well as due to fear for their safety.

Legal support of the case by REActor, first of all, is in intermediation between the victim and the perpetrator. In this way, most cases are resolved where the perpetrator is a medical professional, a representative of the education sector or other services as well as neighbors and family members. REActors give an enlightening talk with the perpetrator with a view to educating about HIV and reduce stigma. If the client is ready to defend his rights or he needs the protection of a professional attorney (cases on criminalization) then such client is redirected to specialized lawyers.

The part (27%) of cases remained unanswered since the client himself refused to take further actions to protect his rights, due to the fear of interaction with law enforcement agencies and mistrust of the law enforcement system as a whole. Victims also prefer to endure systematic violations of their rights rather than disclose during the proceedings their HIV status, sexual orientation, or membership of key groups.

It is also important to note that 8% of cases were left unanswered due to a lack of resources (human, financial) in organizations for an effective response. The demand for legal services for representatives of key groups remains incompletely covered, and this gap must be taken into account when planning projects and interventions in countries for the future.

At the time of writing the report, 26% of cases are in the process of providing assistance and active work with the client. Therefore, it is not yet possible to assess what the outcome of events will be.

Examples of cases and reactions

Read the full Annual Analytica Report, 2020, Kyrgyzstan

In 2020, 165 appeals from representatives of key groups about violations of their rights and discrimination were registered in Tajikistan.

Out of the 165 appeals, 90% were qualified by the professional lawyer coordinating the implementation of REAct at the country level as such that do show signs of human rights violations. However, 17 cases do not have such signs but record the need for legal advice to clients on everyday issues.

Cases resolution status at the end of 2020

Of all 165 appeals, in 33% of cases response and legal assistance were successfully provided by a REActor or a professional lawyer, while in 7% of cases after receiving legal assistance, the situation was resolved positively for the client.

Medical – social assistance to the victim is provided in the form of consultations, redirection, and escort to partner organizations or health facilities to receive other necessary services for prevention and treatment.

Primary legal aid by REActors is to advise on legal matters and assist in the preparation of complaints or applications. However, both the victims and REActors themselves (also being representatives of vulnerable groups) are afraid to interact with police officers yet again because of the negative experience of such interaction in the past as well as due to fear for their safety.

Legal support of the case by REActor, first of all, is in intermediation between the victim and the perpetrator. In this way, most cases are resolved where the perpetrator is a medical professional, a representative of the education sector or other services as well as neighbors and family members. REActors give an enlightening talk with the perpetrator with a view to educating about HIV and reduce stigma. If the client is ready to defend his rights or he needs the protection of a professional attorney (cases on criminalization) then such client is redirected to specialized lawyers of the State free legal service.

The big part (38%) of cases remained unanswered since the client himself refused to take further actions to protect his rights, due to the fear of interaction with law enforcement agencies and mistrust of the law enforcement system as a whole. Victims also prefer to endure systematic violations of their rights rather than disclose during the proceedings their HIV status, sexual orientation, or membership of key groups.

It is also important to note that 2% of cases were left unanswered due to a lack of resources (human, financial) in organizations for an effective response. The demand for legal services for representatives of key groups remains incompletely covered, and this gap must be taken into account when planning projects and interventions in countries for the future.

At the time of writing the report, 6% of cases are in the process of providing assistance and active work with the client. Therefore, it is not yet possible to assess what the outcome of events will be.

Examples of cases and reactions

Read the full Annual Analytica Report, 2020, Tajikistan

In 2020, 235 appeals from representatives of key groups about violations of their rights and discrimination were registered in Georgia.

Out of the 235 appeals, 88% were qualified by the professional lawyer coordinating the implementation of REAct at the country level as such that do show signs of human rights violations. However, 34 cases do not have such signs but record the need for legal advice to clients on everyday issues.

Cases resolution status at the end of 2020

Of all 235 appeals, in 33% of cases response and legal assistance were successfully provided by a REActor or a professional lawyer, while in 31% of cases after receiving legal assistance, the situation was resolved positively for the client.

Medical – social assistance to the victim is provided in the form of consultations, redirection, and escort to partner organizations or health facilities to receive other necessary services for prevention and treatment.

Primary legal aid by REActors is to advise on legal matters and assist in the preparation of complaints or applications. However, both the victims and REActors themselves (also being representatives of vulnerable groups) are afraid to interact with police officers yet again because of the negative experience of such interaction in the past as well as due to fear for their safety.

Legal support of the case by REActor, first of all, is in intermediation between the victim and the perpetrator. In this way, most cases are resolved where the perpetrator is a medical professional, a representative of the education sector or other services as well as neighbors and family members. REActors give an enlightening talk with the perpetrator with a view to educating about HIV and reduce stigma. If the client is ready to defend his rights or he needs the protection of a professional attorney (cases on criminalization) then such client is redirected to specialized lawyers of the State free legal service.

The part (12%) of cases remained unanswered since the client himself refused to take further actions to protect his rights, due to the fear of interaction with law enforcement agencies and mistrust of the law enforcement system as a whole. Victims also prefer to endure systematic violations of their rights rather than disclose during the proceedings their HIV status, sexual orientation, or membership of key groups.

It is also important to note that 10% of cases were left unanswered due to a lack of resources (human, financial) in organizations for an effective response. The demand for legal services for representatives of key groups remains incompletely covered, and this gap must be taken into account when planning projects and interventions in countries for the future.

At the time of writing the report, 39% of cases are in the process of providing assistance and active work with the client. Therefore, it is not yet possible to assess what the outcome of events will be.

Examples of cases and reactions

Read the full Annual Analytica Report, 2020, Moldova

In 2020, 225 appeals from representatives of key groups about violations of their rights and discrimination were registered in Georgia.

Out of the 225 applications, 85% were qualified by the professional lawyer coordinating the implementation of REAct at the country level as such that do show signs of human rights violations. However, 34 cases do not have such signs but record the need for legal advice to clients on everyday issues.

Cases resolution status at the end of 2020

Of all 225 appeals, in 28% of cases response and legal assistance were successfully provided by a REACTOR or a professional lawyer, while in 24% of cases after receiving legal assistance, the situation was resolved positively for the client.

Medical – social assistance to the victim is provided in the form of consultations, redirection, and escort to partner organizations or health facilities to receive other necessary services for prevention and treatment.

Primary legal aid by REActors is to advise on legal matters and assist in the preparation of complaints or applications. However, both the victims and REActors themselves (also being representatives of vulnerable groups) are afraid to interact with police officers yet again because of the negative experience of such interaction in the past as well as due to fear for their safety.

Legal support of the case by REActor, first of all, is in intermediation between the victim and the perpetrator. In this way, most cases are resolved where the perpetrator is a medical professional, a representative of the education sector or other services as well as neighbors and family members. REActors give an enlightening talk with the perpetrator with a view to educating about HIV and reduce stigma. If the client is ready to defend his rights or he needs the protection of a professional attorney (cases on criminalization) then such client is redirected to specialized lawyers of the State free legal service.

A fairly large part (31%) of cases remained unanswered since the client himself refused to take further actions to protect his rights, due to the fear of interaction with law enforcement agencies and mistrust of the law enforcement system as a whole. Victims also prefer to endure systematic violations of their rights rather than disclose during the proceedings their HIV status, sexual orientation, or membership of key groups.

It is also important to note that 15% of cases were left unanswered due to a lack of resources (human, financial) in organizations for an effective response. The demand for legal services for representatives of key groups remains incompletely covered, and this gap must be taken into account when planning projects and interventions in countries for the future.

At the time of writing the report, 20% of cases are in the process of providing assistance and active work with the client. Therefore, it is not yet possible to assess what the outcome of events will be.

Examples of cases and reactions

Read the full Annual Analytica Report, 2020, Georgia

During the period February-May 2020, the REAct system recorded five cases of violations of the rights of pregnant women due to their positive HIV status. Four cases out of five were recorded in the same medical institution in *** in Moldova.

Anna *
Moldova, May 2020
” **.05.2020 woman at the 36th week of pregnancy was admitted to the obstetrics department of the Center for Maternal and Child Health of *** city. She was placed in solitary confinement because of her HIV-positive status. The paid ward was denied. It was forbidden to stay in contact with other women pregnant in the department, use the same bathroom. After giving birth, Anna and the child were staying in the birth operation room for more than two days, as the isolator was occupied. The staying in a common ward was rejected. During her entire stay in the obstetrics and gynecology department, she was treated with disrespect by junior nurses due to her HIV status.

*name changed

In documented cases, discriminatory manifestations were clearly visible during treatment of women living with HIV by junior medical staff due to the background of stigma towards people living with HIV.

Marina *
Moldova, March 2020
The woman was admitted to the maternity department of the Mother and Child Center in *** a few days before the expected birth. Due to her HIV-positive status, she was forcibly placed in solitary confinement. Throughout her stay at the Center, Marina heard reprimands from junior medical staff that, as she should not have children at all, she was forbidden to use the shared toilet and shower, and was forced to wipe the tiles on the walls if she touched them. The newborn was not properly examined because they were afraid to touch him to take tests. Marina and her child were discharged without having done all the necessary examinations and tests.

*name changed

All women who sought help from the REActor were referred to a friendly physician for the necessary postpartum examinations, which were not performed qualitatively in the maternity hospital.

Also, after the registration of four such cases of discrimination and humiliating treatment of HIV-positive women in the maternity hospital in *** city, local non-governmental organizations began to regularly monitor the situation in this medical institution. A meeting was held with management to inform them of the discriminatory practices that junior medical staff and obstetricians regularly exhibit against HIV-positive women. Representatives of NGOs warned that in case of re-detection of such incidents, a collective complaint would be filed with the Ministry of Health on behalf of NGOs.

Results

The management of the medical institution took note of this information and held an explanatory talk with the participation of NGO representatives for the medical staff about the ways of HIV transmission, as well as about a non-discriminatory approach to HIV-positive patients.

Six months have passed since that conversation, and no more complaints have been received from patients at the facility, although REActors are actively monitoring the situation and interviewing HIV-positive pregnant women who are being screened at the facility.

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In 2020, 235 complaints of violations of the rights of people living with HIV, as well as representatives of at-risk groups, were registered in Moldova.

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Related topics:

Analytical Annual Report 2020, Moldova

The REACT system in the Republic of Moldova was launched in December 2019.

For the first half of 2020, 115 appeals from representatives of key groups and people living with HIV were documented.

One of the first registered cases was about discrimination against an HIV-positive person in employment:

Arthur*
December 2019
“A 30-year-old man was hired as a loader at Bomba in November 2019. A month later, the man was dismissed from his post due to the fact that he has a positive HIV status, as well as due to the fact that he has a criminal record, which is associated with multiple discrimination. All the difficulties in the workplace arose for the beneficiary, as he was forced to disclose his HIV status to his immediate supervisor. Even from the day when he was forced to reveal his status, he could no longer work, as being obliged to submit several health certificates, although he had held this position for more than a month. In addition, the recordings of conversations with company representatives clearly indicate that the reason for the firing is HIV-positive status since the working group does not accept an HIV-positive person.”

*Name has been changed

The client was immediately referred to a project lawyer from the Positive Initiative organization. An application was drawn up to the Council for the Prevention and Elimination of Discrimination and Ensuring Equality. The Council ascertained the fact of discrimination against this person on the basis of social status (former prisoner) and HIV status (HIV-positive) and made a corresponding decision. Further, the lawyer O.A. “Positive Initiative” went to court and defended the interests of the applicant in this process.

And so, on November 23, 2020, in the building of the capital’s court in the Center sector, a decision was announced in the case of discrimination by the Bomba company. Judge Lupashku Natalya partially granted the motion filed by M.A., the discriminated and dismissed person from this company, and ruled to:

• Cancel the order to dismiss M.A. from the position of a loader;
• Reinstate him on the position
• Recover material damage (collection of unpaid wages due to forced absence from work, a fine for delay and moral damage) from the company “Bomba” in favor of the plaintiff

This is an important victory and a precedent for the Republic of Moldova, in which justice has shown that it is an ally in eliminating discrimination from our society.

“We are pleased with the results of the review of the process. We hope that this court decision will send a message to the whole society that the phenomenon of discrimination is unacceptable and will not be allowed, ”said Andrei Lungu, O.A. “Positive Initiative”.

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Read also:

Impact of the COVID-19 pandemic on human rights in Moldova. First observations

Discrimination against pregnant women living with HIV in a maternity hospital

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An analytical report for the first half of 2020 has been published.

During the first half of 2020, there were registered 17 cases, one way or another related to the COVID-19 pandemic and lockdown. Some of the cases do not qualify as violations of human rights, but they make it possible to understand what problems ordinary residents of the country face.

The registered cases indicate that vulnerable groups in the field of HIV face financial difficulties and reduced incomes and inability to pay off previously taken loans.

Dismissal of patients with COVID-19 or dismissal due to
suspicion of COVID-19 or refusal of employment due to
the fact that relatives are sick

Michael*
Moldova, May 2020
“I was denied a job because one of my relatives is sick with coronavirus. But I am not in contact with him. When I got a job, they asked me if any of my relatives were sick with coronavirus, I said yes, they were. I was offered to be checked and then come again to find a job. But I have no money. How should I be?

*names changed, titles hidden

Unreasonable fines as a tool to put pressure contentе
on sex workers.

Barriers to access to OST and ARV therapy due to quarantine restrictions, as well as restrictions on movement between settlements.

Andrey*
Moldova, June 2020
“In the COVID-19 mode, a client could not get on
the OST program, since the addiction clinic was closed. He had to wait a month to solve this problem, and all this time he was using street drugs”

*names changed, titles hidden

Refusal to provide medical care: the ambulance does not arrive, hospitals are in lockdown.

Ruslan *
Moldova, May 2020
“The client, working at home with a grinder, through negligence, seriously injured his hand. An ambulance was called. The call was denied due to the fact that the ambulance will not go to the quarantine and to a remote settlement. It was recommended to somehow by himself get to the hospital of the city ***, since all the polyclinics in the district are closed for quarantine, and doctors do not see patients. The situation was resolved 2 days after contacting the Ministry of Health by the client met a doctor, operated on, and stitched.

*names changed, titles hidden

But in general, it is important to note the effective work of NGOs, which were able to quickly arrange the delivery of drugs to patients at home. Reported cases are rare exceptions, but generally reflect difficulties in obtaining drugs.