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Response stories

Protection of the client’s rights in the medical laboratory

Nadiya, who lives with HIV, came to the local laboratory to have the tests taken. At the reception, she showed her disability identity card to receive benefits.

In the nurse’s office, they started to demand additional payment from her for test tubes for CD4+ T-lymphocyte and viral load tests. Nadiya refused to pay on principle because she knew this option had to be free.

The argument started on that basis. The laboratory worker asked Nadiya very rudely to put away her “HIV” ID card. Since the laboratory was crowded that day, all the people in the line heard this quarrel and learned about the client’s HIV+ status. Because of this, Nadiya, unable to cope with her emotions, ran away in tears.

Having calmed down, the woman came to REAct specialists for help and justice. A friendly psychologist conducted consultations to stabilize Nadiya’s condition, and the documentator referred the woman to a social worker, who accompanied her to the head of the laboratory. The receptionist initially did not admit her fault, referring to the fact that the client did not understand everything. Still, some explanatory work was conducted, during which she was also informed about the possible consequences of disclosing information about the client’s positive HIV status. After the conversation, Nadiya received all the necessary tests with appropriate discounts.

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Opioid substitution therapy program in Ukraine: the cost of the conflict between law and health

Partners' publication

In 2023, the Expert Council of the Eurasian Network of People Who Use Drugs (ENPUD) began documenting strategic cases among injection drug users in Eastern Europe and Central Asia. In Ukraine, four strategic cases were reported.

Based on the collected evidence, ENPUD experts prepared an analytical document on drug policy trends in the country. We invite you to read the community’s observations below.

In Ukraine, the opioid substitution therapy (OST) program, designed to help drug addicts and reduce the number of drug users in society, faces problems associated with aggressive police actions and the criminalization of treatment methods.

According to Program participants, the police are actively conducting operations to discredit points that dispense substitution therapy and also detain those who directly receive it. Such attacks from law enforcement agencies create mistrust among patients about the future of treatment.

The story of Yurii, a social worker who became a victim of these actions, clearly demonstrates the conflict between drug policy and health care.

While working as a social worker for an NGO, Yurii encountered an undercover police officer who posed as a cancer patient for three months. The policeman convinced Yurii to give him the drug, which led to his arrest and criminal charges.

Thus, Yurii, risking an eight-year prison sentence and illustrating the risks faced by medical and social workers participating in the substitution treatment program, became a symbol of the need for change in approaches to drug policy and the protection of human rights in the country.

According to the Expert Council on Drug Policy, a program designed to reduce the harm of drug addiction and improve the quality of life of patients is under threat due to several factors.

The main reasons include the following:

  • public stereotypes and misunderstanding of replacement therapy,
  • corruption among drug control,
  • professional unethics,
  • political motives,
  • misperceptions of program participants, and
  • incompetence in carrying out operations on the part of drug control.

These conditions lead to illegal practices, threaten the rights and safety of substitution treatment participants, undermine confidence in the healthcare system, and can lead to poor public health through the withholding of effective treatments. Policies of this kind only serve to increase stigma and discrimination against drug addicts, which leads to an increased risk of transmission of HIV and other infectious diseases.

To protect the rights and interests of substitution therapy patients, the Eurasian Network of People Who Use Drugs (ENPUD) has developed a concept that includes information work with the population and law enforcement officials about the legality and effectiveness of the program, monitoring the activities of drug control officers and other law enforcement agencies, providing legal support to patients, cooperation between government agencies, public organizations, and the medical field, as well as work to change legislation to strengthen the legal protection of patients.

In conclusion, we emphasize that advanced approaches to substitution therapy and drug policy changes are desirable and necessary to protect human rights and promote public health. The synergy between the efforts of all stakeholders, including government, the medical community, and civil society, can create an environment where the rights of every person are respected, and health and well-being are a priority. Striving for such a future is a moral imperative and the key to a healthier and more just society.

Read more in the ENPUD material “Police attack opioid substitution therapy program in Ukraine: criminalization of sites and attacks on participants.”


This publication is a product developed independently by the regional community ENPUD. The opinions expressed in the publication may not align with the position of the Global Fund, the Alliance for Public Health, the regional project SoS_project, REAct, or partners in the countries. Representatives of the aforementioned organizations were not involved in the writing, approval, or review of the material presented in this publication.
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Response stories

Rights protection of the sex-worker

Iryna, a sex worker, told a REAct documentator that the police were constantly harassing her on the highway, blackmailing and threatening her. The woman had to regularly pay them money to continue working and be under protection and not get into the police office every time.

Every such meeting ends with stress for Iryna. The last time the policeman, whom she had not seen before, behaved rudely, insulted, and humiliated her. When, after regular payment, the woman tried to send him away, arguing that his behavior scares away her clients, the policeman grabbed Iryna, twisted her arms, bent over the car bonnet, and simulated sexual intercourse. At the same time, he shouted in her ear that she was “done” and what he would do to her.

Iryna is afraid to complain about them to the police as she understands that they can detain her because of taking drugs.

After hearing that, the documentator, Olena, suggested that she would meet a psychologist and a lawyer. The psychologist provided the woman with the necessary support, helped her to work through profound emotional experiences, and told her about tools to deal with panic attacks and stressful conditions. Later, the client agreed to several additional meetings to level her psycho-emotional state.

The lawyer, in turn, advised Iryna about her rights and their protection in case of violation. She explained the procedure for filing a complaint, the possibility of compensation for damages, and choosing the best course of action. The client was offered practical assistance when filing complaints and claims against offenders.

Together with the lawyer and REAct coordinator in the Rivne region, they visited the head of the Regional Patrol Police Department, where they reported extortion of funds. The victim’s name was not disclosed, and the conversation occurred verbally without submitting a claim, as Iryna was the only thing agreed to. In turn, the head of the Department promised to conduct an internal investigation and deal with the problem.

Currently, Iryna is no longer in contact with the police and is completely satisfied with the assistance provided to her.

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Response stories

Assistance in passing MSEC

Andriy asked the REActor to advise and help redirect him to the MSEC regarding his diagnosis. The man said that his family doctor refused to turn the patient in for the medical and social examination, explaining that “as to the diseases Andriy has, the commission will not be able to give him a disability group.”

The rejects lasted for about a year: either the doctor sent the man to collect additional medical documents from an infectious disease specialist and a physiologist, or the family doctor did not have time to prepare documents for MSEС.

After hearing the story, the REAactor visited the family doctor personally regarding the systematic delay and refusal to redirect the client to a medical and social examination regarding his diseases. In response, the family doctor once again argued about the lack of time to prepare the necessary documents because he had “a lot of sicker patients”, so he did not have time to do everything simultaneously.

After that, the documentator suggested visiting the head doctor – the institution chief – and discussing the situation together. Immediately after that, the doctor promised to issue the necessary documents in 3 days and advised “not to wash dirty linen in public places.”

As of September 15, 2023, all the necessary documents were provided, and Andrii was sent to MSEC, where the man received the 3rd group of disability for one year.

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News

Current issues of ensuring the observance of human rights in the Dnipropetrovska Oblast: a meeting with the representative of the Commissioner for Human Rights of the Verkhovna Rada of Ukraine in the Dnipropetrovska Oblast

Yesterday, November 16, a working meeting with the representative of the Commissioner for Human Rights of the Verkhovna Rada of Ukraine in the Dnipropetrovska Oblast was held in Dnipro, organized by the ICF “Alliance for Public Health”.

Within the framework of the meeting, topical issues of ensuring the observance of the rights of key groups vulnerable to HIV and tuberculosis in the Dnipropetrovska Oblast were discussed based on the results of the implementation of the system for monitoring and responding to violations of the rights of key groups vulnerable to HIV and TB – REAct.

The event was attended by general directors of medical institutions in the region that provide services to key communities, representatives of VONA and VOLNA, regional coordinators of the REAct project in the cities of Dnipro and Kryvyi Rih, specialists from the Department of Public Health of the Dnipro City Council, the Eastern Interregional Department of the National Health Service of Ukraine and others.

More than 50 participants, including chief doctors and doctors of medical institutions in Dnipro and the region, joined the event online.

During the discussion, the importance of working not only with existing cases of violation of the rights of key communities but also of taking measures to prevent them was emphasized. In particular, identifying the prerequisites and causes of rights violations is the foundation for changes in the legal environment.

The representative of the Commissioner for Human Rights of the Verkhovna Rada of Ukraine in the Dnipropetrovska Oblast expressed his support and readiness to contribute to the resolution of cases of violation of the rights of communities in the region:

“We are ready to be that coordination platform, we are ready to hear about individual cases, and we also monitor systemic problems. We have to join our efforts”

Mykhailo Yuriyovych Karpenko, representative of the Commissioner for Human Rights of the Verkhovna Rada of Ukraine in the Dnipropetrovska Oblast.

According to the results of the event, possible algorithms of interaction between interested parties were determined as part of responding to cases of violation of the rights of key groups vulnerable to HIV and TB, as well as ways to prevent and reduce the occurrence of such claims.


For reference:

According to the REAct system, since 2019, 2,370 cases of violation of the rights of representatives of key communities have been recorded in the Dnipropetrovska Oblast, which is 25% of the total number of appeals throughout Ukraine.

Read more about the operation of the REAct system in the Dnipropetrovska Oblast in the booklet (available in Ukrainian).

Categories
Response stories

Assistance in organizing a medical examination

Oksana, an HIV-positive client, turned to a REActor from CO “100% of LIFE. Ivano-Frankivsk”. The woman asked for assistance in arranging a medical examination at a gynecologist.

She told the REActor about her last attempt to get a routine check-up, during which, for her safety and the doctor’s safety, she informed the doctor that she was HIV-positive. As a result, the doctor refused further examination, justifying it with the following phrase: “There was no need to make an appointment with me; I do not consult such people.”

After learning about this situation, the documentator contacted a friendly gynecologist and arranged the necessary examination and consultation for Oksana. In addition, she received psychological aid and further support.

According to the Law about Prevention of Discrimination, the doctor who treated Oksana in a discriminatory way because of her HIV status could be prosecuted. However, the client refused to submit a claim and from further case consideration.

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Psychologist's advice Useful materials

What to do if you witness domestic violence?

1. Assess the situation:

  • What kind of violence is taking place – physical, psychological, economic, sexual?
  • Is the victim a child or an adult?
  • What is the condition of the victim?
  • How does the offender behave?
  • Are there other people around, and are they ready to help?
  • During a violent attack, it is recommended to choose a method of physical intervention only if you are ready for it (you have the skills of hand-to-hand combat, personal protective equipment, non-lethal self-defense, etc.).
  • Take care of your safety and the safety of those around you because the offender may have a weapon and harm you.

2. Call the police.

This way, you will not endanger your safety, but you will allow the representatives of the police to take timely and adequate measures to respond to the fact of violence and stop it properly.

You can call the police by dialing 102.

3. Provide the victim with medical assistance.

When there is an immediate threat to a person’s life and health (the physical or mental condition suddenly worsens, and it is accompanied by bleeding, convulsions, fainting, suffocation, acute pain, or other symptoms that may indicate a significant threat) – call the “ambulance” team by the number 103.

4. Record what you see.

If you or someone nearby has a mobile phone, record everything happening on a video or photo. This will help the police officers to assess the situation correctly, give the correct qualifications, and be the evidence for the trial.

5. Show concern.

If the abuser has stopped the violence and left the scene, ask the victim if there is someone to help them or if they need your help to phone this person. The victim might ask you to stay with them until someone they trust arrives. If you agree, stay in a well-lit, crowded place.

Be prepared that the victim will not be eager to change their life. The person has the right to make this choice, and you can only express your concern, offer support, or refer to specialists who can help.

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Response stories

Prosecution of ex-husband

Olga lives in a small town in the Zhytomyr region. For some time, she was in a relationship with a man who started showing aggression; because of this, Olga had to leave him to save her child’s mental health and her own life.

After that, the ex-husband started pursuing the woman because she did not want to return to him. The last straw for the victim was the fact that the “ex” posted a joint photo with Olga on his Facebook page and captioned it: “I finally left the HIV carrier; she “awarded” me with AIDS.” Although the man was healthy.

The woman was desperate because she had a small daughter and was afraid of persecution because of her HIV status. Olga no longer knew how to stop this, so she turned to REAct specialists.

The client was provided with psychological support and advice on further actions to protect her rights. Olga was told about her husband’s criminal responsibility for disclosing her HIV status. As the woman had already applied to the police and received no response, REAct experts recommended using again with a claim and emphasizing the mandatory police response according to Article 10.

Thanks to the intervention of a paralegal who accompanied the second appeal to the police and Olga`s persistence, who was already aware of her rights` protection and duties of the police, the claim was accepted, and the offender was reprimanded. Today, nothing threatens the woman. She has become more self-confident because she knows she is protected.

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Response stories

Assistance in enrolling the REAct client`s son in school

Before the full-scale invasion, Marianna, a client of the OST program, lived with her son in the Kherson region. After the explosion of Kakhovskaya HPP, the family was forced to move to Odesa. The woman immediately applied for an IDP and found a part-time job fast.

Marianna’s son is eight years old. The boy has a speech delay and does not walk well. When the issue of enrolling in school arose, the woman heard only refusals in educational institutions. During a conversation with the director of one of the schools, Marianna explained that her son studied at a regular school in Kherson and covered the program perfectly. The boy has been unable to walk since birth, but all his mental abilities are at the level of an average child.

Despite all the pleas, the director did not agree to enroll the boy. Moreover, during the conversation, she emphasized that Marianna probably had been using drugs, which is why she had such a child. In addition, the director remarked that regarding the woman’s lifestyle, she would not have time to help her son at home. Moreover, the school does not want to take responsibility for the success of “such a child.” The official reason for the refusal was the client’s son’s disability and speech delay.

Marianna turned to a REAct documentator in despair. The specialist provided the woman with primary legal advice and psychological support. Later, it was decided to redirect the client to the partner NGO “PROJECTOR”, where she received secondary legal advice.

The lawyer has explained to Marianna that if the director refuses to provide a place for her child at school due to a disability, she should contact the education department, where she will be helped with the admission of the child to school. He determined the algorithm of the following actions. A few days later, the mother received a phone call from the school director with whom there was a conflict earlier. The woman apologized and invited Marianna to submit the necessary documents to start her studies. The child has been enrolled in school and studies at the same level as his peers.

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Response stories

The fight against HIV / AIDS denialists

Alina is a client living with HIV. The girl turned to the REActor from CO “100% Life” for help. She sought advice and support in deciding about her next steps in taking ARV therapy.

Alina’s husband is an HIV/AIDS denialist. Therefore, he interfered with and talked Alina out of taking ARV therapy, claiming he did not believe in any diagnoses. He is sure the virus does not exist and all the evidence is fake. The man argued that pharmaceutical companies invented HIV to make good money, and such a diagnosis is made only based on the results of false tests. Consequently, he constantly urged his wife to refuse “the poison” – antiretroviral therapy.

The documentator met with the HIV-positive client and emphasized the importance and benefits of ARV therapy to improve and maintain her health. Additionally, a CO “100% Life” social worker was assigned to Alina to obtain social support services and resume ART therapy. She was also assisted with registering for dispensary registration at the AIDS center. After a medical examination, the girl received the necessary antiretroviral treatment and currently takes it continuously.

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Lawyer’s advice Useful materials

Social protection of representatives of key communities who received disability as a result of participation in hostilities

What kind of state help can be counted on?

After the start of Russia’s criminal aggression against our country, many citizens of Ukraine, who are the key communities’ representatives, took part personally in counteracting Russia’s military aggression as part of both joint military and voluntary formations of local territorial defense. Having stood up for the protection of our state, they, falling under enemy fire and bombardment, faced corresponding risks to their lives and received wounds and combat injuries. Unfortunately, for some of them, the loss of health from the war actions led as well to disability.

This raises the issue of what help from the state can they count on?

Here, we should define general and particular segments of issues ensuring the social security of persons who have received a disability regarding their health. The first segment is regulated by The Law of Ukraine, “On the Basics of Social Protection of Persons with Disabilities in Ukraine,” dated March 21, 1991, No. 875-XII.   According to it, a person with a disability has a persistent body function disorder, which can limit their life activities when interacting with the external environment. As a result, the state mustcreate conditions for them to exercise their rights equally with other citizens and ensure their social protection.

According to this Law, disability as a measure of health loss is determined by an expert examination in the medical and social examination institutions (MSEC) of the Ministry of Health. Social protection of persons with disabilities is a component of the state’s activities to ensure the rights and opportunities of persons with disabilities on an equal basis with other citizens. It consists of the provision of pensions, state assistance, compensatory and other payments, benefits, social services, rehabilitation implementation, guardianship (taking care), or third-party maintenance. At the same time, material, social, household, and medical support for persons with disabilities must be provided in the form of payments (pensions, benefits, one-time payments), provision of medicines, technical and other means, as well as through the provision of medical, social, labor and professional rehabilitation services, household and trade services.

The Law of Ukraine, “On the Status of War Veterans, Guarantees of Their Social Protection,” set the second segment of social protection segment in specified cases; it defines state guarantees for combatants and establishes benefits for persons with disabilities as a result of war and participation in the war actions.

Let`s look at them. These are the following actual guarantees:

  • free provision of medicines, medical products, immunobiological preparations, and medical goods by the doctors’ prescriptions;
  • non-scheduled free dental prosthesis (except prosthetics made of precious metals), free provision of other prostheses and orthopedic products;

  • free of charge, non-scheduled annual provision of sanatorium-resort treatment with compensation for the travel cost to the facility and back. At the request of persons with disabilities, instead of a ticket for sanatorium-resort treatment, they can receive monetarycompensation once every two years: persons with disabilities because of the war of the I-II groups – in the amount of the average price of the ticket, persons with disabilities because of the battle of the III group – in the amount of 75 % of the average ticket price. Money compensation is provided regardless of the presence of the medical opinion on the need for sanatorium-resort treatment or medical contraindications;

  • 100% discount on the housing payment (apartment payment) within the limits of the norms determined by the current legislation (21 square meters of the total living area for each person who permanently lives in the residential premises (house) and is entitled to a discount, and additionally 10,5 square meters per family);

  • 100% discount on bills for communal services (gas, electricity, and other services) and liquefied cylinder gas for household needs within the limits of the average consumption norms. The area of premises, which the discount is granted, calculating the heating payment, is 21 square meters. One meter of heating area for each person permanently living in the residential premises (house) is entitled to a payment discount and an additional 10.5 square meters per family.

  • 100% discount on the fuel cost, including liquid fuel, within the sale limits set for people living in houses without central heating;

  • free travel by all types of urban passenger transport, public road transport in rural areas, as well as rail and water transport, and buses of suburban and intercity routes, including intra-district, intra- and inter-regional, regardless of distance and place of residence in the presence of the set sample certificate; and in the case of the automated accounting traveling payment system introduction – in the company of an electronic ticket, which is issued free of charge. This right also applies to a person who accompanies a person with a disability of the I group;

  • non-scheduled free complete renovation of private houses and apartments and priority current renovations of residential buildings and apartments by the procedure determined by the Cabinet of Ministers of Ukraine;

  • non-scheduled service in outpatient polyclinic institutions, as well as emergency hospitalization;

  • use after retirement (regardless of retirement time) or change of workplace of polyclinics and hospitals which they were attached to by the previous workplace;

  • right to an annual medical check and dispensarization involving the necessary specialists;

  • primary employment by specialization according to the preparation and conclusions of the medical and social examination;

  • preferential right to stay at work in the event of employee reduction connected to changes in the production and work organization and suitable to be employed in the event of the enterprise, institutions, and organizations liquidation;

  • temporary disability benefits payment to working persons with disabilities as a result of the war in the amount of 100 percent of the average salary, regardless of the length of work;

  • payment of benefits to working persons with disabilities of temporary incapacity to work up to 4 months in a row or up to 5 months during a calendar year, as well as state social insurance benefits for the entire period of stay in the sanatorium, taking into account a round trip, in case there are not enough annual and additional holidays;

  • use of regular yearly leave when it is convenient for them, as well as receiving additional leave with salary retention for 14 calendar days per year;

  • non-scheduled provision of housing for persons who need to improve their housing conditions, including at the expense of living space transferred by ministries, other central executive bodies, enterprises, and organizations to the disposal of local councils and state administrations;

  • obtaining a loan for the construction, reconstruction, or general renovation of residential buildings and yard buildings, connecting them to engineering networks communications, as well as loans for the construction or purchase of country houses and garden improvement with paying back within ten years starting from the fifth year after the end of the building;

  • persons with disabilities of groups I and II are granted the right to travel free of charge once a year (round trip) by rail, water, air, or intercity road transport, and people accompanying persons with disabilities of the I group (no more than one companion) are granted;
  • 50% discount on the cost of travel once a year (round trip) by the mentioned means of transport. Persons with disabilities of the III group are granted the right to travel free of charge once every two years (round trip) by rail, water, air, or intercity road transport regardless of the availability of rail connections or travel once a year (round trip) by the mentioned modes of transportation with 50 % fare discount.
  • non-scheduled free provision of a car (with medical indications for the car provision) for a period of up to ten years of operation (with a subsequent replacement for a new one), payment of compensation for fuel, repairs, maintenance of cars or transport services by the procedure determined by the Cabinet of Ministers of Ukraine.

  • non-scheduled service by institutions and establishments that provide social care services. If providing such service is impossible, social protection institutions shall reimburse the expenses related to the care of a person with a disability in the manner and the amounts determined by the current legislation.

Benefits for housing payments, utilities, and fuel should be provided to persons with war-related disabilities and the family members living with them, regardless of the type of housing or the form of its ownership.

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Response stories

Protection against discrimination in women’s consultation

Yulia turned to the women’s consultation of one of the healthcare facilities in Kyiv to get advice on pregnancy registration. She was terrified and anxious about her HIV-positive status.

During the consultation, the gynecologist who conducted the appointment, after getting to know about Yulia’s HIV-positive status, started telling her off: “What are you thinking about? You have AIDS! You will give birth to a sick child. I do not advise you to give birth at all as there will be problems later. Moreover, the child will be born with defects, which will be your fault.”

Such doctor`s behavior was not only unreasonably aggressive, but it also deprived Yulia of receiving proper medical advice and care. The frightened and frustrated girl turned to the partner charity organization hotline “Positive Women,” where she received support and advice on further actions.

Yulia has been explained that as she takes antiretroviral therapy and has high adherence to the treatment, her viral load can be zero, and it does not interfere with a healthy pregnancy and the birth of a healthy baby. Thanks to the support of the “Positive Women” organization, Yuliya was redirected to amicable and tolerant medical professionals; they provided her with necessary medical care and counseling regarding her pregnancy. Thus, she was able to receive a decent level of medical assistance despite her HIV-positive status.

The girl was also recommended to make a written claim to the head doctor of the healthcare facility regarding the discriminatory attitude of the gynecologist, but she refused.

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Invisible voices: violation of the LGBT people`s right to health in UKRAINE in the focus of Aidspan.

The following info release of the independent observer of the Global Fund work Aidspan highlights the LGBT rights violations in Eastern Europe and Asia.  The results of a unique study by the Eurasian Coalition on Health, Rights, Gender and Sexual Diversity (ECOM) reported the critical state of respect for the LGBT people`s rights in Eastern Europe and Central Asia (EECA), in particular Ukraine and Moldova.

In its regional report on violations of the LGBT people`s right to health in Eastern Europe and Central Asia region in 2022, “Invisible Voices” ECOM presents the main changes in the legislation of the EECA region on the right to health, it analyzes the number of reported cases of rights violations of the LGBT community representatives respectively, which took place in 2022 in 8 countries of the region, including Ukraine and Moldova.

ECOM experts notice several alarming trends, which are increased by the region’s instability due to Russia’s war in Ukraine and several border conflicts in Central Asia. These deteriorations can be seen when comparing the new data with previous ECOM reports (using the same methodology for recording LGBTQI human rights violations), as it showed no significant improvement in human rights violations.

Data from the REAct system from Ukraine and Moldova were used to prepare the Regional Report. It is worth saying that the most significant number of cases of violations of the right to health and other related rights of the LGBT community representatives was documented in Ukraine (217 cases). In Moldova, the number of reported cases is the lowest (10 cases). However, it can be explained by the different scale and project resources to detect cases of the rights violations of the target group in the countries, as well as other significant limitations, particularly the community representatives` eagerness to report such issues.

Among the most common types of violations in Ukraine can be distinguished:

  • hate speech against LGBT people (112 cases),
  • physical violence (54 cases), and
  • power abuse, including blackmail and threats (42 cases).

In its turn, in the “power abuse” category, two main trends of rights violations can be distinguished: refusal to provide aid to victims and improper behavior of law enforcement institutions. It mainly refers to the military at checkpoints or representatives of the territorial defense.

As for the refusal to provide medical services or medical services of inadequate quality to the LGBT community representatives, 11 cases were registered in Ukraine.

Cases were repeatedly documented when victims were refused access to pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP), explaining:

  • the necessity of a joint visit to a medical institution by partners and their testing with providing the passports to obtain PrEP;
  • the possibility of receiving drugs only in the case of a confirming negative result of the HIV test in three months, which contradicts the established country PrEP protocol;
  • the possibility to obtain drugs remotely from the city where the victim came from, as well as the prescription of PrEP “for those in need, not for gays”;
  • the irrelevance of PEP for the victim, although he was informed about unprotected sexual contact with an HIV-positive man that day.

Among the primary violators of the rights of the LGBT community representatives in Ukraine, we can distinguish citizens in the streets and social networks, including landlords (104 cases of rights violations). However, rights violations by police officers (27 cases) and military personnel (23 cases) remain relevant. Moreover, representatives of the LGBT community systematically face violations of their rights by their close environment – family members, friends, colleagues, employers, and teachers (43 cases of rights violations were documented).

The registered number of rights violation cases in 2022 and the dynamics of previous years indicate that it is necessary to continue targeted efforts to identify and register cases of violations of the rights of LGBT persons. This involves scaling up existing projects, expanding the geography of data collection, and engaging partner organizations that work with different subgroups of the LGBT community. It is also critical to increase awareness and legal education among community members, assist them in filing claims and complaints, and support their efforts to identify and prevent offenses.

Find more information and recommendations in the full version of the report “Invisible Voices”  by the link.

REAct project statistics in Moldova.

For more on identified violations of the rights of key communities in the context of HIV/TB and their response, search in the analytical REAct report for 2022.

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Psychologist's advice Useful materials

Top 5 reasons of gaslighting in a relationship and what to do about it?

Gaslighting is a manipulative behavior towards others; the purpose is to make a person doubt the adequacy of their perception of reality or the objectivity of what generally surrounds them.

Any person is susceptible to gaslighting. This technique is common for brutal dictators, narcissists, and cult leaders. They do this slowly, so the victim rarely knows what is happening.

Gaslighters can exist in the workplace, in politics, as well as in close or intimate relationships.

Unlike direct bullying, gaslighting can be subtle and insidious, intentional or not. In the same way, the intentions of gaslighting can be dictated by various motives.

Today, we suggest talking precisely about them.

Motive №1: The desire to avoid responsibility

One of the most common reasons for gaslighting is the desire to avoid responsibility. It can mean a person is not responsible for specific actions, such as infidelity or inappropriate or offensive behavior.

Motive №2: The desire of control

Another common reason for gaslighting is an attempt to control. A gaslighter wants the partner to behave in a certain way, to shape their behavior according to the gaslighter`s needs. This inevitably leads to limiting the person’s own needs, autonomy, and freedom.

Motive №3: Distrust

A gaslighter often totally distrusts other people, even close ones. This anxiety makes them try hard to control others and the circumstances. Such people fear losing control over their lives and use manipulative tactics to regain control.

Motive №4: The desire to win

A person may believe their value depends on whether they are in a dominant position. Therefore, they believe any methods of maintaining the dominant role in different or particular spheres of life are fully justified.

Motive №5: Learned behavior

For children who grow up with gaslighters, such behavior becomes routine, and they may not be aware of their actions. An understanding is formed that you need to manipulate other people to get what you want.

But what to do if you face gaslighting?

Gaslighting can unbalance you and make you feel confused, out of your mind, or crazy. However, gaslighters will not admit that they are doing this to you.

Here are some strategies that can help if you are a victim of gaslighting.

  • Minimize contact with the person. Please don’t talk to them without necessity, and don’t go out for coffee.
  • Do not believe what the person says
  • If you respond or get angry, they will try to make you look bad or act like a victim to get sympathy. Therefore, it is better to give them ambiguous answers like “Really?” or “I’m not sure.”
  • Say you’re confused, then ask the person to clarify the contradiction: “You say it didn’t happen, but I have a photo. Please explain.”
  • Talk to friends or colleagues who will validate your point of view, support you, and help you develop a strategy.
  • Remind yourself of your good qualities and achievements to withstand the negative narrative.
  • Write down or keep a diary of what happened.
  • If none of the above helps, end the relationship with the gaslighter. It is often the best way to eliminate the manipulation of your psyche.
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Response stories

Rights protection in the local administration

Nastya turned to the village council to obtain a residence registration certificate. The village council secretary looked contemptuously at the girl and advised her to get the certificate in Diya because she did not have time for such matters. The girl was confused and asked for help, but the secretary simply left the office.

Nastya started to search for how to generate the certificate and overheard from the corridor how the worker was loudly discussing with other workers. The words sounded like this: “What a shame”, “dissolute”, “What a shame to walk on earth”, and “pity for her mother”. The girl burst into tears but could still get the certificate from Diya. When the secretary returned, Nastya asked her to print it out as she needed it urgently. But she received the answer: “The printer does not work! Go and pay somewhere – you have money, but if you don’t – then you know how to earn it!” The humiliated girl left the village council and decided to turn to REActors, which she heard about from a SW friend.

The client received a psychologist’s consultation aimed at solving psychological problems and internal conflict, creating favorable conditions for positive changes and further personality development. In addition, the psychologist provided recommendations for dealing with traumatic stress and helped to stabilize Nastya’s need for the time of appeal.

An amicable lawyer advised the girl to file a complaint demanding to protect her legal citizen interests, which were violated by the secretary`s actions (inactions). The girl was also explained her rights and existing methods of their protection.

The REAct project coordinator and the documentator helped her compile a complaint about the village council secretary. The girl personally submitted it to the village head and also sent a letter to the official mailbox requesting to inform her about the response. The village council secretary called the girl with an apology the next day. Nastya was later told that the secretary was reprimanded.

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Response stories

Combating discrimination at the humanitarian aid point

Sofia came to receive humanitarian aid at the Social Assistance Centre point. Many people were in the Point, and everyone was waiting their turn, so the girl suggested her mother and child wait outside.

When Sofia’s turn came, the girl received a grocery set and clothes that did not fit her. She immediately asked to replace them. The woman who had given out the aid got angry and started shouting: “I won’t change anything! Be grateful for everything being given to you for free! Look at her, how picky she is! If you want something better, go to the soldiers; they will give you what you like!”

Sofia was confused and ashamed because many people heard this; they started looking around and whispering. The girl tried to defend herself and emphasized that the woman had no right to speak like that, everyone was equal, and she also had an IDP certificate. In response, the employee of the Point grabbed the grocery set and the clothes she had given before, put them aside, and said with a smile: “Everyone has a certificate, but not everyone is dissolute! There is nothing to do here for you! The others will get more! Get out of here, boorish you, or I’ll call the police!” None of the people around came to the girl’s defense. In despair, Sofia called her friend, who had already turned for help fighting against discrimination, to REAct specialists.

Sofia received a consultation from an amicable psychologist aimed at working with her experiences, relationships, problems, and conflicts. The psychologist helped the girl learn self-regulation, find ways to solve her problems, observe and clarify her life situation, and actualize additional resources to adapt to new conditions or find the way out of difficult circumstances. The consultation also included information on stress management tools and dealing with panic attacks.

In her turn, a lawyer from the partner organization provided advice on the client’s rights, a reference to the legislation for guidance, and helped file a complaint about the social worker.

The next day, Sofia turned to the head of the social and humanitarian aid department and filed a complaint about the employee. They apologized, immediately provided the necessary aid, and promised to react to the employee’s actions. A day later, Sofia got a call saying such situations were unacceptable, so the social worker got fired.

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Response stories

Timely help is the most significant contribution to the future

Iryna, the mother of a 16-year-old boy, turned to the documentator of the REAct project. He began to use narcotic substances periodically. The mother repeatedly tried to hold conversations with her son, but it yielded no results, only negativity on his part.

On the advice of a friend, Iryna decided to contact the local family and youth center, as she was looking for a specialist who could help in this situation. However, instead of help, the employees of the Center turned to the Children’s service, which, in turn, sent a request to the city council to deprive the mother of her parental rights. They brutally humiliated the woman and condemned her upbringing, arguing that the boy should be sent to a specialized institution or a rehabilitation center “for drug addicts”.

After the stress experienced, Iryna turned to REAktor in desperation. The documentator, being aware of the procedure for the deprivation of parental rights, turned to the city council with a request to invite the mother and the REactor as her representative to the executive committee meeting. At the meeting, he explained the situation to the executive committee members and provided recommendations from the mother’s place of work and characteristics from the neighbors. The executive committee rejected the service for children and obliged them to allow the boy to have conversations with a psychologist.

On the recommendation of the documentator, the boy and his mother were referred to a friendly psychologist, who only needed a few meetings to work on the boy’s lifestyle and change it for the better. In addition, in cooperation with the head of the Department of Family Medicine, the boy was sent to a sanatorium to change the environment and communicate with his peers.

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Lawyer’s advice Useful materials

The issue of violation of the labor rights of representatives of key communities

During the analysis of cases of violations of the rights of the REAct project clients, it is noticeable that clients from such communities as PLHIV, PLTB, PWID, OST patients, and MSM repeatedly faced their rights of work or employment being violated, which prevented them from having a decent standard of living and socialization. Illegal oppression aimed at forcing people to quit their jobs hurt the social security of the community representatives and their families.

When analyzing the cases of such violations in more detail, two main types of violators can be identified – the management or administration of the institution and the employees of the institution, who put the workers from the key communities under psychological pressure and moral violence precisely because of the belonging of the latter to the respective communities. When one party of such harassment (mobbing) is the management (the employer), it can also be economic pressure and discrimination. At the same time, some of the employees from the communities feel unprotected, especially when it comes to having a positive HIV status (unreasonable requirement to provide a certificate of the HIV test results), TB treatment, or receiving OST, as well as when the employer is a private person.

So, let’s examine the issue below.

Firstly, obtaining official employment in the institution where the community representative works is strongly recommended, as it allows the person to use appropriate protection mechanisms in case of any violations. The Labor Code of Ukraine dated 10.12.71 No. 322-VIII establishes several guarantees regarding the employees’ rights, which are protected by law, namely:

Article 2-1 of the Labor Code of Ukraine, “Equality of labor rights of citizens of Ukraine,” defines that: “in Ukraine, any discrimination in the field of labor, in particular the violation of the principle of the equality of rights and opportunities, direct or indirect restriction of the rights of employees depending on … state health, disability, suspicion or presence of HIV/AIDS, … or other signs unrelated to the nature of work or the conditions of its performance”. Also, the state guarantees non-disabled citizens permanently residing in the territory of Ukraine a free choice of the type of activity and legal protection against unjustified refusal of employment and illegal dismissal. It is forbidden to request additional documents not indicated by the law (however, when hiring, the labor law does not demand other certificates about HIV presence).

According to the definition of the Labor Code of Ukraine, mobbing (harassment) is a systematic (repeated) long-term and deliberate action or inaction of the employer, individual employees, or a group of employees of the work team, which is aimed at humiliating the honor and dignity of the employee, their business reputation, including the purpose of acquiring, changing or terminating their labor rights and obligations, manifested in the form of psychological and economic pressure, in particular with the use of electronic communications, creating a tense, hostile, offensive atmosphere for the employee, including one that forces them underestimate their professional suitability. Mobbing is a separate type of offense against an employee.

At the same time, one should know that the forms of psychological and economic pressure, in particular, are defined as:

  • creating a tense, hostile, offensive atmosphere about the employee (threats, such as “if you don’t quit on your own, then we’ll fire you like a drug addict with the police”; ridicule, such as “you’re somehow not like normal people”; slander, such as “he can steal goods”; disparaging remarks, the behavior of the threatening, intimidating, humiliating nature and other ways of bringing the employee out of their psychological balance);
  • unjustified negative separation of the employee from the team or his isolation (non-invitation to meetings and meetings in which the employee, in accordance with local regulations and organizational and administrative acts, must participate, preventing him from performing his work function, preventing the employee from entering the workplace, transferring the workplace in places unsuitable for this type of work);
  • inequality of opportunities for education and career growth;
  • unequal pay for work of equal value performed by employees of the same qualifications;
  • unjustified deprivation of part of the employee’s payments (bonuses and other incentives);
  • unjustified, uneven distribution of the workload and tasks by the employer between employees with the same qualifications and labor productivity who perform work of equal value.

Individuals from communities who consider they have been mobbed (harassed) have the right to:

  • file a complaint with the State Labour Service, which implements the state policy in the field of supervision and control over compliance with the labor legislation;
  • file a lawsuit with the court regarding the recognition of the harassment facts and their elimination;
  • receive compensation for the damage caused by mobbing in the amount of expenses incurred by the person during treatment (payment for the damage caused by mobbing is possible if the fact of its commitment is confirmed on the grounds of the court decision that has come into force).

The question arises what the best way is to do it. We recommend backing up the complaint with evidence to make it more complicated for the violator to avoid the punishment. At the same time, proof that can help prove the fact of mobbing can be:

  • official documents (orders, directives);
  • complaints and statements to the State Labor Service from the person affected by the violation;
  • testimony of witnesses (colleagues, clients);
  • audio, photo, and video recording of the facts of violations that the victim may commit.

At the same time, a complaint to the State Labor Service of Ukraine can be sent in paper and electronic form (a scanned copy with a signature) to the address – dsp@dsp.gov.ua or on the page https://dsp.gov.ua/forma-dlia-podannia-elektronnykh-zverne/

It should be noted, as the practice shows, even a preventive conversation with the management of the institution where the violation had occurred concerning the possibility of filing a complaint with the State Labor Service of Ukraine, which can impose a significant fine in case of the confirmation of the violations, can have a quality effect on the mobbing of a community representative.

And what to do for those who work unofficially? It will be more challenging. Proper evidence will be required from the victim for the preliminary recognition of the actual employment relationship between them and the institution (the employee), which is not so simple and requires an established procedure. Therefore, we strongly recommend you insist on official employment whenever possible.